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正常与病理状态下基底神经节的功能神经解剖学

Functional Neuroanatomy of the Normal and Pathological Basal Ganglia.

作者信息

Lanciego José L, Obeso José A

机构信息

CNS Gene Therapy Program, Center for Applied Medical Research (CIMA), University of Navarra Medical School, 31008 Pamplona, Spain

Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CiberNed-ISCIII), 28029 Madrid, Spain.

出版信息

Cold Spring Harb Perspect Med. 2024 Dec 18. doi: 10.1101/cshperspect.a041617.

Abstract

The term "basal ganglia" refers to a group of interconnected subcortical nuclei engaged in motor planning and movement initiation, executive functions, behaviors, and emotions. Dopamine released from the substantia nigra is the underlying driving force keeping the basal ganglia network under proper equilibrium and, indeed, reduction of dopamine levels triggers basal ganglia dysfunction, setting the groundwork for several movement disorders. The canonical basal ganglia model has been instrumental for most of our current understanding of the normal and pathological functioning of this subcortical network. This model explains how cortical information flows through the basal ganglia nuclei back to the cortex by going through two pathways with opposing effects that together lead to the proper execution of a given movement. The basal ganglia model has paved the way for the standard clinical management of Parkinson's disease, where pharmacological and neurosurgical treatments in place collectively afford an impressive symptomatic alleviation. Although much of the model has remained, the canonical model has been enriched with new arrivals gathered from evidence provided in the last three decades. Here, we sought to provide a comprehensive review of the basal ganglia network, with emphasis on structure, connectivity patterns, and basic operational principles, both in normal and pathological conditions.

摘要

“基底神经节”一词指的是一组相互连接的皮质下核团,它们参与运动规划、运动发起、执行功能、行为和情感。黑质释放的多巴胺是维持基底神经节网络处于适当平衡状态的潜在驱动力,实际上,多巴胺水平的降低会引发基底神经节功能障碍,为多种运动障碍奠定基础。经典的基底神经节模型对我们目前对这个皮质下网络的正常和病理功能的大部分理解起到了重要作用。该模型解释了皮质信息如何通过基底神经节核团,通过两条具有相反作用的通路回到皮质,这两条通路共同导致特定运动的正确执行。基底神经节模型为帕金森病的标准临床管理铺平了道路,目前的药物和神经外科治疗共同提供了令人印象深刻症状缓解。虽然该模型的大部分内容仍然存在,但经典模型已通过过去三十年提供的证据中收集到的新内容得到了丰富。在这里,我们试图对基底神经节网络进行全面综述,重点关注其结构、连接模式以及正常和病理条件下的基本运作原理。

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