Deep brain nuclei

Structurally the brain can be divided into the central core, the deep brain nuclei and the cerebral cortex (see Figure 11.1). 

Around the central core of the brain are a number of structures that collectively make up the deep brain nuclei, which are organized into the limbic system, and the basal nuclei. These systems are closely connected to the thalamus, the hypothalamus and the sensory and motor areas of the cerebral cortex. The limbic system is concerned with emotions, behaviour and memory and the basal nuclei are concerned with control of movement, although there is overlap between the two. Malfunction of these areas is implicated in disorders such as Parkinson s disease and schizophrenia. 

Metals are of fundamental importance to biological tissues (11-14) and maintenance of iron homeostasis is a basic biological requirement (15-18). By use of Peris stain for non-heme iron and other histochemical techniques pathologists have long been able to demonstrate a consistent pattern of iron deposition (19-23) in the normal human brain. This iron concentration is most prominent in specific deep brain nuclei of the basal ganglia and associated structures. These nuclei include the globus pallidus, the putamen, the caudate nucleus, the red nucleus, the substantia nigra and the dentate nucleus of the cerebellum. The iron concentration is low at birth and increases with age until a... 

Other symptomatic therapeutic interventions are surgical procedures and deep brain simulation with three targets ventral intermediate nucleus of thalamus, the internal segment of the globus pallidus and the subthalamic nucleus. 

Ashkan K, Wallace B, Bell BA, Benabid AL. Deep brain stimulation of the subthalamic nucleus in Parkinson s disease 1993-2003 where are we 10 years on Br J Neurosurg. 2004 18 19-34. 

Butson C.R., Cooper S.E., McIntyre C.C. Deep brain stimulation of the subthalamic nucleus Patient specific analysis of the volume of tissue activated. 10th Annual Conference of the International FES Society, July 2005, Montreal, Canada. 

Plaha P., Gill S.S. Bilateral deep brain stimulation of the pedoculopontine nucleus for Parkinson s disease. Neuroreport, 2005, 16,1883-1887. 

Shi L.H., Luo F., Woodward D.J., Chang J.Y. Basal ganglia neural response during behaviorally effective deep brain stimulation of the subthalamic nucleus in rats... 

Aquizerate, B., Cuny, E., Martin-Guehl, C., Guehl, D., Amieva, H., Benazzouz, A., et al. (2004). Deep brain stimulation of the ventral caudate nucleus in the treatment of obsessive-compulsive disorder and major depression. Journal of Neurosurgery, 101, 682-686. 

The pedunculopomtine nucleus (PPN) is reciprocally connected to the BG. It input is from the globus pallidus interna, substantia nigra pars reticulata, and STN. Its output is glutamatergic to STN, GPOi, and SNC. It has been reported that in PD about 50% of its intrinsic cholinergic neurons are lost. Combined deep brain... 

Hilker R, Voges J, Tliiel A, Ghaemi M, Herholz K, Stru m V, Heiss WD (2002) Deep brain sdmuladon of die subdialamic nucleus versus levodopa challenge in Pai kinson s disease Measming die on- and off-condidons widi FDG-PET. J Neural Transm 109 1257—1264. 

Kumar R, Lozano AM, Kim Y), Hutchison WD, Sime E, Halket E, Lang AE. Double-blind evaluation of subthalamic nucleus deep brain stimulation in advanced Parkinson s disease. Neurology 1998, 51, 850-855. 

Benabid, A.L. et al.. Deep brain stimulation of the corpus luysi (subthalamic nucleus) and other targets in Parkinson s disease. Extension to new indications such as dystonia and epilepsy. J. Neurol, 2001,248 (Suppl 3) 11137-11147. 

Our group has worked on two deep brain stimulation procedures according to the type of epileptic seizures (1) stimulation of the centromedian nucleus (CM) of the thalamus in the control of intractable generalized seizures and atypical absences of the Lennox-Gastaut syndrome (LGS) [Velasco et al., 1987,... 

Deep brain stimulation—Recently, in 1998, an implantable stimulation device (Activa by Medtronic) was approved by the FDA that can dramatically reduce uncontrollable tremor in patients with Parkinson s disease or essential tremor (Roller et al., 1997). With this device, an electrode array is placed stereotactically into the ventral intermediate nucleus of thalamic region of... 

The Deep-Brain Stimulation for Parkinson s Disease Study Group, Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus paUidus in Parkinson s disease, NEJM, 2001, 345 956-963. 

Nervous system Fentanyl-induced brady-kinesia occurred in a 58-year-old man with advanced Parkinson s disease who was given fentanyl to a total of 300 micrograms over 36 hours for anesthesia and analgesia in conjunction with battery replacement for deep brain stimulation of the subthalamic nucleus the severe akinetic rigid syndrome abated when fentanyl was withdrawn [87 ]. 

Guo T, Parrent AG, Peters TM. Surgical targeting accuracy analysis of six methods for subthalamic nucleus deep brain stimulation. Comput Assist Surg 2007 12(6) 325-34. 

The stereotaxic method is used for the insertion of electrodes into the deep structures of the brain. Atlases of the brains of different animals have been published describing the position of each point of the brain as determined by three orthogonal coordinates By means of a stereotaxic instrument the electrode is inserted into the brain nucleus being tested in accordance with the prescribed coordinates... 

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