The globus pallidus externus as a functional unit Physiology and therapeutic implications.
DOI:
https://doi.org/10.47924/neurotarget201883Keywords:
Dystonia, Dyskinesias, Deep Brain stimulation, Globus Pallidus Externus, Motor Function, Parkinson´s Disease, Striatum, Tourette DiseaseAbstract
Introduction: the Globus Pallidus Externus, long considered a minor structure of the striate, has a structural and functional richness, manifested by having a large number of GABAergic neurons and other neurotransmitters and with different types of discharge, a privileged link with the pathways Indirect motor and a demonstrated structural individuality that make it necessary to review this previous concept.
Discussion: The hippocampal-limbic and motor connections make the Globus Pallidus Externus, through its main efferent connection, the Ventral Pallidum, a functionally rich structure, with essential activity in the generation of sleep, which represents the main responsible for phasic motor activity in dystonia, which has a proven relationship with Huntington’s Disease, whose dysfunction is relevant to non-dystonic cognitive and motor symptoms in it and also has, through its cortical motor connections, relevance in the occurrence of dyskinesias and also in freezing of the march, in Parkinson’s Disease.
In addition, it presents psychiatric importance as a member of the reward circuit in drug addiction and depression.
Finally, the Globus Pallidus Externus has been used successfully for decades as a target of Deep Brain Stimulation for the treatment of Refractory Tourette’s Disease.
Conclusion: The Globus Pallidus Externus presents a high neurological functionality, relevant in the motor, psychic, cognitive and sleep areas, which should continue to be studied to better understand their participation in the processes of Parkinson and Tourette diseases, dystonia, persistent insomnia, addictions, depression and others, with the objective of physiological knowledge and therapeutic applications.
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Copyright (c) 2018 Juan Carlos Andreani, Fabián Piedimonte
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