why would a pallidotomy or thalomotomy work for parkinsons?

[Ramoray]

I was in need of some help as this basal ganglia stuff is hugely confusing but as i thought i understood things i did not understand when i read in nolte and HY neuro that to treat parkinsons thalomotomy or pallidotomy would sometimes work. From my understanding parkinsons involoves slow movements due to lack of dopamine but taking out a portion of thalamus or glob. pallidus both would supress motor cortex and wouldnt that just contribute to the lack of movment? ANyone study this stuff recently and can help that would be great.. basal ganglis SUCKS a### thanks!

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[Idiopathic]

Dopamine inhibits the Gpi, so loss of dopaminergic input leaves the Gpi free to wreak havoc by inhibiting other relays. Stereotactic removal of Gpi is the same as turning dopamine 'on' constantly, and it can eliminate many of the symptoms.

Not surer about thalamotomy, but since all basal ganglia control is exerted at this level, it would make sense. Remember Parkinsons is relative overactivity of parts of the BG, due to loss of dopaminergic input. This can, of course, manifest itself clinically as an underactivity of motion. Too much regulation.

Opposite of this is chorea, where there is not enough regulation.

I think...

 

[omarsaleh66]

I was in need of some help as this basal ganglia stuff is hugely confusing but as i thought i understood things i did not understand when i read in nolte and HY neuro that to treat parkinsons thalomotomy or pallidotomy would sometimes work. From my understanding parkinsons involoves slow movements due to lack of dopamine but taking out a portion of thalamus or glob. pallidus both would supress motor cortex and wouldnt that just contribute to the lack of movment? ANyone study this stuff recently and can help that would be great.. basal ganglis SUCKS a### thanks!

parkinsons comes from a dopamine imbalance, remember the D1/D2 receptors on the striatum are excitatory and inhibitory, so with parkinsons, u get a mix of uncrontrollable rapid movements (resting tremors) and has slow movements (like walking real slow, etc...) So the pallidotomy or thalomotomy(I forgot which one cuz i dont have the book on me right now) stops the tremors like u said by suppressing the motor cortex.

I think:
a pallidotomy would cure the slow movements
and a thalomotmy would cure the tremors,and other hyperactive movements



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