Lanciego Jose L, Rodríguez-Oroz Maria C, Blesa Francisco J, Alvarez-Erviti Lydia, Guridi Jorge, Barroso-Chinea Pedro, Smith Yoland, Obeso Jose A
Neurosciences Division, CIMA, Pamplona, University of Navarra, Spain.
Mov Disord. 2008 Apr 15;23(5):708-15. doi: 10.1002/mds.21906.
The caudal intralaminar nuclei are a major source of glutamatergic afferents to the basal ganglia. Experiments in the 6-hydroxydopamine rat model have shown that the parafascicular nucleus is overactive and its lesion alleviates basal ganglia neurochemical abnormalities associated with dopamine depletion. Accordingly, removal of this excitatory innervation of the basal ganglia could have a beneficial value in the parkinsonian state. To test this hypothesis, unilateral kainate-induced chemical ablation of the centromedian thalamic nucleus (CM) has been performed in MPTP-treated monkeys. Successful lesions restricted to the CM boundaries (n = 2) without spreading over other neighboring thalamic nuclei showed an initial, short-lasting, and mild change in the parkinsonian motor scale but no effect against levodopa-induced dyskinesias. The lack of significant and persistent motor improvement leads us to conclude that unilateral selective lesion of the CM alone cannot be considered as a suitable surgical approach for the treatment of PD or levodopa-induced dyskinesias. The role of the caudal intralaminar nuclei in the pathophysiology of movement disorders of basal ganglia origin remains to be clarified.
尾侧丘脑板内核是基底神经节谷氨酸能传入神经的主要来源。在6-羟基多巴胺大鼠模型中进行的实验表明，束旁核过度活跃，其损伤可减轻与多巴胺耗竭相关的基底神经节神经化学异常。因此，去除基底神经节的这种兴奋性神经支配可能对帕金森病状态具有有益价值。为了验证这一假设，在MPTP处理的猴子中进行了单侧海人酸诱导的中央中核（CM）化学毁损。成功的毁损局限于CM边界（n = 2），未扩散至其他相邻丘脑核，在帕金森运动量表上显示出最初的、短暂的、轻微的变化，但对左旋多巴诱导的异动症无效。缺乏显著且持续的运动改善使我们得出结论，仅单侧选择性毁损CM不能被视为治疗帕金森病或左旋多巴诱导的异动症的合适手术方法。尾侧丘脑板内核在基底神经节起源的运动障碍病理生理学中的作用仍有待阐明。
