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Pallidotomy for hemiballismus: Efficacy and characteristics of neuronal activity
Author(s) -
Suarez J. I.,
Metman L. Verhagen,
Reich S. G.,
Dougherty P. M.,
Hallet M.,
Lenz F. A.
Publication year - 1997
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410420519
Subject(s) - pallidotomy , globus pallidus , subthalamic nucleus , neuroscience , deep brain stimulation , basal ganglia , parkinson's disease , movement disorders , thalamus , psychology , medicine , disease , central nervous system
A patient with unremitting, medically intractable hemiballismus underwent a pallidotomy that abolished his involuntary movements. Firing rates of cells in the internal segment of the globus pallidus (GPi) recorded during this procedure were significantly lower than those observed during pallidotomy for Parkinson's disease, either “on” or “off” medication. Firing patterns in hemiballismus were characterized by low‐frequency modulation of the firing rate. These results are consistent with the hyperkinetic model, which suggests that hemiballismus results from decreased inhibition of the pallidal relay nucleus of the thalamus by the GPi. The efficacy of surgery in the case of hemiballismus demonstrates that pallidotomy can be an effective treatment for this condition and suggests that patterned neuronal activity in the GPi is important in the mechanism of hyperkinetic disorders.