La neuromodulación en el tratamiento de los trastornos del movimiento

Fiacro  Jiménez Ponce; José D.  Carrillo-Ruiz; Francisco Velasco Campos; Fabián Piedimonte

doi:10.47924/neurotarget2007375

Authors

Fiacro Jiménez Ponce General Hospital of Mexico. Mexico.
José D. Carrillo-Ruiz General Hospital of Mexico. Mexico.
Francisco Velasco Campos General Hospital of Mexico. Mexico.
Fabian Piedimonte Fundación Cenit para la Investigación en Neurociencias, Ciudad Autónoma de Buenos Aires, Argentina https://orcid.org/0000-0003-4661-4449

DOI:

https://doi.org/10.47924/neurotarget2007375

Keywords:

neuromodulation, movement disordersmovement disorders, Parkinson's disease, dystonia, stereotactic neurosurgery

Abstract

Neuromodulation (reversible excitation or inhibition of neural systems either electrical or chemical substances) has been narrowly used for treatment of Parkinson's Disease (EP) and smaller frequency in dystonia (D), essential tremor (TE) and Tourette's Disease (ET). Several anatomical areas are efficient targets in control of positive and negative symptoms: Ventromedial thalamic nuclei (EP and TE), medial nuclei (ET and discinesias), internal globus pallidus (EP and D), external globus pallidus (ET), subthalamic nucleus (EP and TE), pedunculus pontinus nucleus (EP), zona incerta (EP) and particularly prelemniscal radiation (EP and TE).

Connection between anatomical targets has been studied carefully but there are many questions about their functioning. However, neuromodulation of subthalamic nucleus has showed efficacy in treatment of Parkinson's disease, prelemniscal radiation and zona incerta could get better results with fewer morbidity and side effects. Now a day, the cortico- striatal-thalamo-cortical loop and his dopaminergic modulator system are most important pathophysiology of tremor, rigidity and bradykinesia in PD. By other hand, D a TD could be better improvement by neuromodulation of external globus pallidus and medial thalamus.

A new approach on specific activating system (pedunculus pontinus nucleus, prelemniscal radiation, zona incerta and medial thalamic nuclei) could be important in understanding of physiology of mo- tor control.

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