2. Understanding Deep Brain
Stimulation in Parkinsonism
Izhar Bar-Gad, Shlomo Elias, Eilon Vaadia, and Hagai Bergman
Many successful therapies develop before the underlying mechanisms are understood. Such is the case for the treatment of Parkinsonism with high-frequency "deep brain stimulation" (DBS). Because DBS had similar effects to local ablation, total inhibition
of neuronal firing seemed at first to be a likely mechanism. In this week's Journal, Bar-Gad et al. revisit this issue using microstimulation of the globus pallidus (GP) in an MPTP-injected monkey. They simultaneously stimulated and recorded from the GP, and optimized their recording to minimize stimulus artifacts. Their results suggest a complex response of units in the GP to low-frequency and high- frequency stimulation. Low-frequency stimulation often evoked triphasic responses in neurons whereas high-frequency stimulation "locked" neuronal firing to the stimulus in most neurons. Although the authors could not separate segments within the GP, their results clearly indicate that DBS disrupts activity in a manner distinct from ablation, perhaps by effectively "jamming" the abnormal activity characteristic of movement disorders such as Parkinsonism.
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