Romanelli Pantaleo, Esposito Vincenzo, Schaal David W, Heit Gary
Department of Neurosurgery, IRCCS NEUROMED, Pozzilli (IS), Italy.
Brain Res Brain Res Rev. 2005 Feb;48(1):112-28. doi: 10.1016/j.brainresrev.2004.09.008.
Growing experimental and clinical evidence supports the notion that the cortico-basal ganglia-thalamo-cortical loops proceed along parallel circuits linking cortical and subcortical regions subserving the processing of sensorimotor, associative and affective tasks. In particular, there is evidence that a strict topographic segregation is maintained during the processing of sensorimotor information flowing from cortical motor areas to the sensorimotor areas of the basal ganglia. The output from the basal ganglia to the motor thalamus, which projects back to neocortical motor areas, is also organized into topographically segregated channels. This high degree of topographic segregation is demonstrated by the presence of a well-defined somatotopic organization in the sensorimotor areas of the basal ganglia. The presence of body maps in the basal ganglia has become clinically relevant with the increasing use of surgical procedures, such as lesioning or deep brain stimulation, which are selectively aimed at restricted subcortical targets in the sensorimotor loop such as the subthalamic nucleus (STN) or the globus pallidus pars interna (GPi). The ability to ameliorate the motor control dysfunction without producing side effects related to interference with non-motor circuits subserving associative or affective processing requires the ability to target subcortical areas particularly involved in sensorimotor processing (currently achieved only by careful intraoperative microelectrode mapping). The goal of this article is to review current knowledge about the somatotopic segregation of basal ganglia sensorimotor areas and outline in detail what is known about their body maps.
越来越多的实验和临床证据支持这样一种观点,即皮质-基底神经节-丘脑-皮质环路沿着平行回路进行,这些回路连接着皮质和皮质下区域,负责感觉运动、联想和情感任务的处理。特别是,有证据表明,在从皮质运动区流向基底神经节感觉运动区的感觉运动信息处理过程中,保持着严格的拓扑分离。基底神经节向运动丘脑的输出,再投射回新皮质运动区,也被组织成拓扑分离的通道。基底神经节感觉运动区存在明确的躯体定位组织,证明了这种高度的拓扑分离。随着诸如毁损或深部脑刺激等外科手术的使用增加,基底神经节中身体图谱的存在在临床上变得相关,这些手术选择性地针对感觉运动环路中受限的皮质下靶点,如丘脑底核(STN)或苍白球内侧部(GPi)。在不产生与干扰参与联想或情感处理的非运动回路相关的副作用的情况下改善运动控制功能障碍的能力,需要能够靶向特别参与感觉运动处理的皮质下区域(目前仅通过术中仔细的微电极图谱绘制来实现)。本文的目的是回顾关于基底神经节感觉运动区躯体定位分离的当前知识,并详细概述关于它们的身体图谱的已知情况。