The pedunculopontine tegmental nucleus-A functional hypothesis from the comparative literature.
The pedunculopontine tegmental nucleus-A functional hypothesis from the comparative literature.
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DOI：
10.1002/mds.26556
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Winn P
中科院分区：
文献类型：
--
作者：
Gut NK;Winn P
我们提供了来自动物研究的数据，表明脚桥脑被盖核--通过进化而保守，被分割，并具有复杂的输入和输出模式--具有涉及形成和更新动作-结果关联、注意力和快速决策的功能。这与之前关于桥脚功能的假说相反，桥脚功能是临床对桥脚功能在运动障碍中的兴趣的基础。目前的动物文献指出，它既不是一种特定的运动结构，也不是睡眠调节的主开关。桥脑脚连接到基底节回路，但也有跨通道的初级感觉输入，以及与桥脑、小脑、脊髓运动和自主神经控制系统的下行连接。对动物的功能和解剖学研究有力地表明，除了作为基底节的输入和输出站和丘脑(以及随后的皮质)活动的关键调节器外，另一个主要功能是参与基于传入感觉数据的第一遍分析的动作的产生。这种快速决策的功能对任何脊椎动物都有很高的适应价值。我们认为，在制定治疗基底节疾病的临床策略时，有必要考虑桥脑脚的正常功能。我们相信，可以用我们的假设来解释为什么临床上使用的桥脑深部电刺激在治疗帕金森症运动症状和对认知过程的影响方面有不同的结果。©2016国际帕金森病和运动障碍协会
We present data from animal studies showing that the pedunculopontine tegmental nucleus—conserved through evolution, compartmentalized, and with a complex pattern of inputs and outputs—has functions that involve formation and updates of action–outcome associations, attention, and rapid decision making. This is in contrast to previous hypotheses about pedunculopontine function, which has served as a basis for clinical interest in the pedunculopontine in movement disorders. Current animal literature points to it being neither a specifically motor structure nor a master switch for sleep regulation. The pedunculopontine is connected to basal ganglia circuitry but also has primary sensory input across modalities and descending connections to pontomedullary, cerebellar, and spinal motor and autonomic control systems. Functional and anatomical studies in animals suggest strongly that, in addition to the pedunculopontine being an input and output station for the basal ganglia and key regulator of thalamic (and consequently cortical) activity, an additional major function is participation in the generation of actions on the basis of a first‐pass analysis of incoming sensory data. Such a function—rapid decision making—has very high adaptive value for any vertebrate. We argue that in developing clinical strategies for treating basal ganglia disorders, it is necessary to take an account of the normal functions of the pedunculopontine. We believe that it is possible to use our hypothesis to explain why pedunculopontine deep brain stimulation used clinically has had variable outcomes in the treatment of parkinsonism motor symptoms and effects on cognitive processing. © 2016 International Parkinson and Movement Disorder Society