Dynamic studies on the human thalamocortical relation involved in the intractactable functional disorders of the brain

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(1) In the central pain patients with mild destruction of the thalamic sensory nuclei, electrophysiological study showed that the receptive field of sensory (mainly kinesthetic) responses to peripheral natural stimulation was different from standard thalamic topography in the VIM nucleus. Multiple or convergent responses were sometimes recognized in this nucleus. Irregular burst discharges were often encountered in the thalamic sensory nuclei. In those with definite thalamic damage, irregular burst discharges were often detected around CVD lesion in the thalamic sensory nuclei. Decreased activity with abnormal burst discharges in these nuclei was associated with changes of cortical activity adjacent to the central sulcus (motor, premotor area) in this group. Regional cerebral glucose metabolism (rCMRGlu) and relative ratio of rCMRGlu to oxygen metabolism increased on these cortical areas. It was important for ameliorating the central pain to inhibit these various abnormal neuronal acti … More vities occurred in and around the CVD lesion in the thalamic sensory nuclei. Gamma knife thalamotomy resulted in encouraging outcomes.(2) In rigid type and dopa-induced dyskinesia (DID) type Parkinson's disease (PD), when DID occurred after administration of L-Dopa, the glucose metabolism decreased in the lenticular nucleus but increased in the frontal cortex. Functional mapping study using rCBF revealed that these changes occurred within the premotor or prefrontal area in the frontal lobe. Electrophysiological study showed high frequency and amplitude spontaneous neuronal acitivities occurred in the medial segment of the globus pallidus (GP). In cases with hemitremor type PD,electrophysiological study generally showed that rhythmic burst discharges, being time-locked with peripheral tremor, were recorded in the physiologically identified thalamic VIM.PET study revealed spot-shaped increased zone of rCMRGlu and similar oval-shaped increased zone of rCBF in the primary cortical sensori-motor area on the contralateral side of tremor. This increased zone of rCBF was similar with that of rCBF image during the sequential opposite finger movement. Conversely, reducing tremor by hand manipulation caused decrease of rCBF in this rostral area.(3) Measurement of neurotransmitter using microdialysis was performed in the basal ganglia and the thalamus with normal or experimental tremor monkey. Less