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ABSTRACT: Abnormal movements and behavioral disorders are characteristic manifestations observed in certain neuropsychiatric diseases such as Tourette's syndrome or Huntington Disease. Together with brain imaging findings, the clinical data could suggest a relationship with basal ganglia dysfunction. In the first part of this review, we recall the anatomic relationships existing, via segregated cortico-cortical circuits, between these structures and the cortical areas having motor and cognitive or motivational-emotional attributes. This structure suggests that in pathologies like Parkinson's or Huntington disease cognitive and motivational-emotional disorders as well motor disturbances could be related to lesions or dysfunctions involving individual or combined zones of the basal ganglia. The second part of the paper focuses on a description of the various methodologies used to explore these relationships: behavioral, anatomic and brain imaging methods are used in non-human primate models in order to reproduce motor and behavioral disturbances and to determine the neuronal circuits involved. Microinjection of bicucullin into the external globus pallidus has been found to induce localized and reversible neuronal activation. Abnormal movements can be obtained from the motor territory of the external globus pallidus whereas hyperactivity with attentional deficit or stereotypies have been obtained from the associative or limbic territory of the same structure. In the striatum, the same pharmacological activation can induce either abnormal movements from motor and associative functional territories or behavioural changes with hyperactivity or, on the contrary, hypoactivity from associative functional territory with stereotyped behavior and sexual manifestations when the microinjections were done in the limbic striatum. Anatomic studies as well as brain imaging using PET confirm the involvement of segregated anatomic pathways through the basal ganglia in behavioral as well as motor disorders.
Annales Pharmaceutiques Françaises 10/2009; 67(5):320-34.
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ABSTRACT: The pathophysiology of parkinsonian tremor remains a matter of debate with two opposing hypotheses proposing a peripheral and a central origin, respectively. A central origin of tremor could arise either from a rhythmic activity of the internal segment of the globus pallidus (GPi) or from a structure such as the thalamus, outside the basal ganglia. In this study, single-unit recordings were performed in three 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated monkeys within the GPi and within three territories of the motor thalamus (delimited by their afferent inputs from the GPi, the substantia nigra and the cerebellum, respectively). For each recorded neuron, we compared the variations in firing rate and pattern in tremor and no tremor periods. Tremor either occurred spontaneously or was induced by external stimulation. When the animals entered into a tremor period we observed: (i) an increase in the mean firing rate in about half of the recorded neurons of the motor thalamus; and (ii), a change from an irregular to a rhythmic discharge within the range of tremor frequency (5-7 Hz) in about 10% of the recorded neurons of the motor thalamus (pallidal and cerebellar territories) and the GPi. Most of the thalamic neurons that exhibited a rhythmic discharge during tremor were found to be sensitive to external stimulation. Because the changes in firing rate occurred predominantly in the motor thalamus and not in the GPi, and because a fast rhythmic discharge of 10-15 Hz was frequently observed in the GPi and not in the motor thalamus, we conclude that thalamic activity is not a simple reproduction of basal ganglia output. Moreover, we suggest that thalamic processing of basal ganglia outputs could participate in the genesis of tremor, and that this thalamic processing could be influenced by sensory inputs and/or changes in attentional level elicited by external stimulation.
European Journal of Neuroscience 07/2003; 17(11):2388-400. · 3.63 Impact Factor
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ABSTRACT: Parkinson's disease is a neurodegenerative condition who is related to a large loss of nigral dopaminergic neurons leading to a depletion of dopamine in the striatum. Experimental research is required in order to increase our knowledge on the cellular mechanism and functional consequences of this degenerative process. These models allow investigations of new therapeutics in order to improve the treatment of patients or to test new drugs able to protect any remaining dopaminergic neurons. It is relatively easy to obtain animal models of this disease since the target structure and the neuronal population are clearly defined. Two neurotoxic compounds are available for inducing animal models of Parkinson's disease, 6-hydroxydopamine (6-OHDA) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). A new one, rotenone, requires further investigations. Each of the neurotoxic compounds requires a specific protocol which can be used either with rodents or non-human primates. Progressive lesioning, using MPTP on green african monkeys (Cercopithecus aethiops sabaeus) provides the most reliable model of the idiopathic disease.
Annales Pharmaceutiques Françaises 02/2002; 60(1):3-21.
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ABSTRACT: An abnormal increase in the activity of neurons of the subthalamic nucleus is a key pathophysiological feature of Parkinson's disease. We sought to determine whether riluzole, a sodium channel inhibitor that interferes with glutamatergic neurotransmission, affects neuronal activity in this brain region. Intravenous administration of riluzole reduced the discharge rate of subthalamic neurons in rats with 6-OHDA-induced lesions of the midbrain. By contrast, no effect was observed in nonlesioned control animals. This property may contribute to the neuroprotective effects of riluzole in animal models of PD through the modulation of the glutamatergic inputs these neurons feedback to nigral dopaminergic neurons.
Movement Disorders 12/2001; 16(6):1110-4. · 4.51 Impact Factor
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E C Hirsch,
C Périer,
G Orieux,
C François, J Féger,
J Yelnik,
M Vila,
R Levy,
E S Tolosa,
C Marin,
M Trinidad Herrero,
J A Obeso,
Y Agid
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ABSTRACT: In the past, functional changes in the circuitry of the basal ganglia that occur in Parkinson's disease were primarily analyzed with electrophysiological and 2-deoxyglucose measurements. The increased activity of the subthalamic nucleus (STN) observed has been attributed to a reduction in inhibition mediated by the external segment of the globus pallidus (GPe), secondary to the loss of dopaminergic-neuron influence on D2-receptor-bearing striato-pallidal neurons. More recently, in situ hybridization studies of cytochrome oxidase subunit I have confirmed the overactivity of the STN in the parkinsonian state. In addition, this technique has provided evidence that the change in STN activity is owing not only to decreased inhibition from the GPe but to hyperactivity of excitatory inputs from the parafascicular nucleus of the thalamus and the pedunculopontine nucleus in the brainstem.
Trends in Neurosciences 11/2000; 23(10 Suppl):S78-85. · 14.23 Impact Factor
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ABSTRACT: Unilateral lesions of the dopaminergic nigral neurons in rats are currently used as a model of Parkinson's disease. However, several neurochemical studies have questioned the possible influence of the lesioned side on the contralateral non-lesioned side. To address this question, electrophysiological recordings in the ipsilateral and contralateral subthalamic nucleus was performed on anaesthetized rats, 3, 7 and 14 days after induction of a unilateral dopaminergic lesion. At these three times, the mean discharge rate of the subthalamic neurons recorded ipsilateral to the lesion was increased by 85, 176 and 127%, respectively, whereas this rate was decreased by 16, 27 and 43%, respectively, in the opposite subthalamic nucleus. This result emphasizes the importance of interhemispheric regulation of this structure, contrasting with the unilateralized current model of the functional organization of the basal ganglia.
Neuroreport 10/2000; 11(14):3275-8. · 1.66 Impact Factor
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ABSTRACT: The cellular expression of cytochrome oxidase subunit I (COI) mRNA as a metabolic marker for neuronal activity has recently been used to examine the effects of nigrostriatal denervation on the functioning of the basal ganglia. However, this technique also allows functional changes to be detected in other cerebral structures in parkinsonian syndromes. Since the zona incerta has been implicated in locomotor activity and has been the site of stereotactic surgery in Parkinson's disease, the aim of our study was to determine whether changes in neuronal activity are observed in this structure during parkinsonism. Using in situ hybridization, we analyzed the expression of COI mRNA in rats with 6-hydroxydopamine unilateral lesion of the substantia nigra and sham-operated animals. A quantitative analysis showed that COI mRNA expression was increased in the zona incerta ipsilateral to the lesion 24 h and 3 days after lesion, but by day 14 had returned almost to the level observed in controls. The hyperactivity of zona incerta neurons was confirmed by single-unit electrophysiological recordings. In contrast to the COI mRNA expression, the increase in electric neuronal activity was still observed 1 month after the lesion. This increase in zona incerta neuronal activity after nigrostriatal denervation might be related to the pathophysiology of parkinsonism, at least in the early stages, in agreement with previous reports suggesting an involvement of the zona incerta in motor functions.
Experimental Neurology 04/2000; 162(1):215-24. · 4.70 Impact Factor
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ABSTRACT: L-DOPA-induced dyskinesias are one of the main problems encountered in treating patients with Parkinson's disease (PD). They are induced by the antiparkinsonian medications and primarily related to the degree of dopaminergic depletion, as shown by the fact that they tend to appear several years after the onset of the disease. Do the initial therapeutic decisions taken in treating a PD patient influence the point at which dyskinesias first occur? This question is raised in view of the apparent priming phenomenon that occurs in first exposure to L-DOPA. L-DOPA administrated to an MPTP intoxicated monkey rapidly corrects the animals' motor symptoms but generate dyskinesias. In contrast, the administration of dopaminergic agonists with a long half-life has a similar therapeutic effect but without inducing dyskinesias. However, a parkinsonian monkey that had received L-DOPA and developed dyskinesias, which were subsequently abolished when the treatment was withdrawn for several months, proceeded to develop dyskinesias when treatment with dopaminergic agonists with long half-life was introduced. The monkeys' previous exposure to L-DOPA (i.e. priming) thus increased its susceptibility to develop dyskinesias after exposure to drugs which would not otherwise have had this effect. Pulsatile activation of type D2 dopamine receptors is reported to be the principal factor in the triggering of dyskinesias and may well be involved in the priming phenomenon. While the pathophysiological basis of priming is not yet known, the phenomenon would not appear to be related to a hyperexpression of dopamine receptors (types D1 and D2) in the sensorimotor striatum. The results of recent experiments have given rise to several different hypothesis for the mechanisms involved in priming: the role of internalization of dopamine receptors after administration of dopaminergic drugs; change in the distribution of D3 dopamine receptor; changes in the expression of peptides (substance P, enkephalin) in efferent neurons of the striatum; and reorganization of connections at the level of the dopaminergic neurons and their target tissue. While many questions remain unanswered, it may well be that the initial therapeutic decisions taken when treating de novo patient are crucial in trying to delay the onset of dyskinesias.
Revue Neurologique 04/2000; 156(3):224-35. · 0.49 Impact Factor
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ABSTRACT: Using a combination of metabolic measurement and retrograde tracing, we show that the neurons in the pedunculopontine nucleus and parafascicular nucleus of the thalamus that project to the subthalamic nucleus are hyperactive after nigrostriatal dopaminergic denervation in rats. In Parkinson's disease, the loss of dopaminergic neurons induces a cascade of functional changes in the basal ganglia circuitry including a hyperactivity of the subthalamic nucleus. This hyperactivity is thought to be due to a diminution of the inhibitory pallidal influence. However, recent studies have suggested that other cerebral structures are involved in the subthalamic neuronal hyperactivity. This study was undertaken to identify these cerebral structures. Neurons projecting to the subthalamic nucleus were identified by retrograde transport of wheat germ agglutinin conjugated to horseradish peroxidase, injected into the subthalamic nucleus of rats with 6-hydroxydopamine unilateral lesion of the substantia nigra pars compacta and sham-lesioned animals. Metabolic activity was determined in the same neurons using in situ hybridization for the first subunit of cytochrome oxidase messenger RNA, a metabolic marker, and image analysis. Horseradish peroxidase-labeled neurons were found in the globus pallidus, parafascicular and pedunculopontine nucleus and sometimes in raphe nuclei and the substantia nigra pars compacta. Measurement of metabolic activity was performed for the globus pallidus, the pedunculopontine and parafascicular nuclei. The expression level of the first subunit of cytochrome oxidase messenger RNA in neurons projecting to the subthalamic nucleus was 62% higher in parafascicular neurons and 123% higher in pedunculopontine neurons in 6-hydroxydopamine-lesioned rats, compared to sham-lesioned animals. An increase was also observed in the globus pallidus, but did not reach significance. Our results suggest that hyperactivity of subthalamic neurons could be due, at least in part, to an increase of excitatory input arising from the pedunculopontine and parafascicular nuclei. These data also suggest that the latter structures may play an important role in the physiopathology of Parkinson's disease.
Neuroscience 02/2000; 97(1):79-88. · 3.38 Impact Factor
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ABSTRACT: Cellular expression of cytochrome oxidase subunit I (COI) mRNA has recently been used as a metabolic marker for neuronal activity to study the functional changes in the subthalamic nucleus (STN) in parkinsonism. The previous experimental studies have been performed when the pathological state was stabilized at a maximal level. In order to determine the evolution of changes in neuronal activity in the STN after nigrostriatal denervation, we analysed by in situ hybridization the cellular expression of COI mRNA in the subthalamic neurons at different times, from 6 h to 14 days, after unilateral intranigral microinjection of 6-hydroxydopamine (6-OHDA) in rats. In parallel, the time-dependent changes of the unit neuronal activity of subthalamic neurons have been recorded. Levels of COI mRNA increased by 41% in subthalamic neurons from 24 h after 6-OHDA intoxication, to 14 days (+26%). Similarly, electrical activity started to increase slightly 24 h after lesion (+20%) and remained significantly higher at 14 days after the lesion (+189%). Changes in neuronal mean discharge rate were associated with changes in the pattern of spiking activity, from a regular firing pattern to an irregular one with a high bursting activity. These results show that: (i) the hyperactivity of the STN represents a very early phenomenon in the physiopathology of parkinsonian syndromes; and (ii) that changes in COI mRNA expression slightly precede changes in electrical neuronal activity.
European Journal of Neuroscience 02/2000; 12(1):337-44. · 3.63 Impact Factor
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ABSTRACT: Subthalamic neuronal activity is controlled by a dopaminergic innervation, which may act via D1 and D2 dopamine receptors. This study investigates the effect of apomorphine and the selective D1 and D2 agonists, SKF 82958 and quinpirole respectively, in normal and 6-hydroxydopamine-lesioned rats. The effect of microinjection of these drugs into the subthalamic nucleus was assessed by recording unit activity and the expression of the c-Fos-immunoreactive protein in the subthalamic nucleus. Dopaminergic agonists reduced the discharge rate and did not induce c-Fos expression in the normal rat. Apomorphine and quinpirole increased the discharge rate and induced a strong expression of c-Fos-like immunoreactive proteins, whereas SKF 82958 induced a decrease of the discharge rate and a slight expression of c-Fos in 6-hydroxydopamine-lesioned rats. The striking contrast in the changes obtained with apomorphine and quinpirole in normal and 6-hydroxydopamine-lesioned rats is discussed in relation to a hyperexpression of D2 dopaminergic receptors on the GABAergic terminals into the subthalamic nucleus. These results show that, in normal rats, dopamine agonists exert an inhibitory control on subthalamic neurons via D1 and D2 receptors. However, in 6-hydroxydopamine-lesioned rats, the hyperactivity of subthalamic neurons is also reduced by D1 receptor agonist but not by D2 dopamine agonists. This last result points out one aspect of the complex mechanisms underlying the physiopathology of Parkinson's disease.
Neuroscience 02/1999; 92(2):533-43. · 3.38 Impact Factor
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ABSTRACT: Extracellular recordings and immunohistological detection of c-Fos-like immunoreactive proteins were used to determine the synaptic effect of the parafascicular projection to the globus pallidus. Electrical stimulation of the parafascicular neurons induced a single-spike excitatory response with a stable latency of 2.3 ms, suggesting a monosynaptically driven effect. Pharmacological stimulation of the parafascicular nucleus with carbachol increased tonically the pallidal discharge rate by 142%. The discharge rate of the pallidal neurons was described by 37% in parafascicular-lesioned rats. These results demonstrate the excitatory nature and the tonic action of the parafasciculopallidal projection. Carbachol activation of parafascicular neurons also induced the synthesis of c-Fos-like immunoreactive proteins in the pallidal neurons. Control experiments in subthalamic-lesioned rats showed that the parafascicular excitation of the pallidal neurons remained, but both electrophysiological and expression of c-Fos-like immunoreactive proteins were attenuated. This suggests that the direct parafascicular excitation of the pallidal neurons is indirectly reinforced by the previously described parafascicular excitatory input to the subthalamic nucleus. Conversely, the effect of this last input to the subthalamic nucleus is dramatically enhanced in rats with pallidal lesion. Our results demonstrate the complex role of the parafascicular nucleus in activating both the globus pallidus and the subthalamic nucleus, two closely related structures. These results illustrate the integrative capacities of the globus pallidus, whose activity is modulated by multiple afferents.
Neuroscience 12/1997; 81(2):387-97. · 3.38 Impact Factor
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R Levy,
L N Hazrati,
M T Herrero,
M Vila,
O K Hassani,
M Mouroux,
M Ruberg,
H Asensi,
Y Agid, J Féger,
J A Obeso,
A Parent,
E C Hirsch
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ABSTRACT: In the late 1980s, a functional and anatomical model of basal ganglia organization was proposed in order to explain the clinical syndrome of Parkinson's disease. According to this model, the pathological overactivity observed in the subthalamic nucleus and the output station of the basal ganglia plays a crucial role in the pathophysiology of the motor signs of Parkinson's disease. The hyperactivity of subthalamic neurons in Parkinsonism is viewed as a direct consequence of a pathological hypoactivity of the external segment of the pallidum. This article reviews recent data from different experimental approaches that challenge the established model of basal ganglia organization by reinterpreting the functional interaction between the external segment of the pallidum and the subthalamic nucleus in both the normal and pathological state. Indeed, recent neurobiochemical studies have rather unexpectedly shown that the GABAergic and metabolic activities of the external pallidum are not decreased in human and non-human primates with Parkinsonism. This absence of any decrease in activity might be explained by the functionally antagonistic influences of the striatal and subthalamic afferences within the external pallidum, as suggested by several anatomical studies. In addition, there are clues from electrophysiological studies to suggest that the hyperactivity found in the subthalamic neurons in Parkinsonism may not depend solely on the level of activity in the external pallidum. In such a framework, the hyperactivity of the subthalamic neurons would have to be explained, at least in part, by other sources of excitation or disinhibition. However, any explanation for the origin of the subthalamic overactivity in Parkinsonism remains speculative.
Neuroscience 02/1997; 76(2):335-43. · 3.38 Impact Factor
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Advances in neurology 02/1997; 74:31-43.
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ABSTRACT: Electrophysiological records of unit activity were used to compare the effects of excitotoxic pallidal lesions and 6-hydroxydopamine-induced damage to the midbrain dopaminergic neurons on the discharge rates and patterns of the subthalamic neurons. Removal of the pallidal input induced a slight, but statistically significant, increase (19.5%) in the discharge rate and no change in the firing pattern when compared to control animals. The rats with a dopaminergic lesion showed greater increase (105.7%) while the firing pattern activity of the subthalamic neurons became more irregular, with burst. These results indicate that the increased activity of the subthalamic neurons following a midbrain dopaminergic lesion cannot be due solely to inhibition-disinhibition involving the striato-pallido-subthalamic pathway and induced by the striatal dopaminergic depletion.
Neuroscience 06/1996; 72(1):105-15. · 3.38 Impact Factor
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ABSTRACT: The activity of subthalamic neurons was recorded extracellularly in anaesthetized rats after stimulation, inhibition or lesioning of the parafascicular nucleus. Electrical stimulation of the parafascicular nucleus evoked a complex response with two excitatory phases. The first response was correlated with a monosynaptically-driven excitation via a parafascicular input to the subthalamic nucleus. Since the second phase was observed even when the early excitation was not recorded and was eliminated by lesion of the globus pallidus, we suggest that it is not generated by a mechanism intrinsic to the subthalamic nucleus and is due to a disinhibitory effect originating from the globus pallidus. Microinjection of carbachol into the parafascicular nucleus enhanced by 119% the discharge rate of the neurons in the ipsilateral subthalamic nucleus and that of muscimol decreased the discharge rate by 91%. Opposite changes, a decrease of the discharge rate of 49% after microinjection of carbachol and an increase of 47% after muscimol, occurred in the contralateral subthalamic nucleus. In contrast to the above results, the unilateral excitotoxic lesion of the parafascicular nucleus, performed one week before recording, decreased the discharge rate by 69% of the ipsilateral subthalamic nucleus neurons and by 34% that of the contralateral neurons. We suggest that the parafascicular input to the subthalamic nucleus is an excitatory pathway which can tonically drive the neuronal activity in this structure. The opposite changes recorded in the ipsi- and contralateral subthalamic nucleus during unilateral microinjection of excitatory or inhibitory drugs in the parafascicular nucleus emphasize the importance of this thalamic structure in the bilateral regulation of basal ganglia activity via the subthalamic nucleus.
Neuroscience 08/1995; 67(2):399-407. · 3.38 Impact Factor
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ABSTRACT: The parafascicular thalamic nucleus projects to the subthalamic nucleus and the striatum. Double-retrograde fluorescent tracing was used to determine whether these projections arise from the same neurons via axon collaterals. True Blue was injected into the subthalamic nucleus and Nuclear Yellow was injected into the striatum of each rat and the parafascicular thalamic nucleus was examined under the fluorescence light-microscope. Individual parafascicular neurons were not double-labelled with the tracers. The True Blue- and Nuclear Yellow-labelled neurons wee located in different parts of the parafascicular nucleus ipsilateral to the injections. In the rostral part of the parafascicular nucleus, True Blue-labelled neurons were located ventral to the fasciculus retroflexus, and in the caudal part of the nucleus. True Blue-labelled neurons were located close to the medial and lateral borders of fasciculus retroflexus. Nuclear Yellow-labelled neurons were found mainly to encircle the fasciculus retroflexus in the rostral part of the parafascicular nucleus and in the dorsolateral sector of the caudal part of the parafascicular nucleus. Double-labelled neurons were, however, found in the cortex. The proportion of neurons projecting to both the subthalamic nucleus and the striatum accounted for 38% of the total number of cortiscosubthalamic neurons in the prefrontal cortex, 15.5% in the cingulate cortex and 9% in the sensorimotor cortex. The present finding of an individualization between the parafascicular efferents to the subthalamic nucleus and the striatum emphasize the importance of this projection and provides further evidence of the associative functions attributable to the subthalamic nucleus.
Neuroscience 06/1994; 60(1):125-32. · 3.38 Impact Factor
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ABSTRACT: The parafascicular nucleus projection to the subthalamic neurones has an excitatory synaptic effect. We have examined the possible glutamatergic mediation of this pathway. The initial excitatory response elicited by electrical stimulation of the parafascicular neurones was inhibited by a microinjection of excitatory amino acid receptor antagonists into the subthalamic nucleus. The antagonists were the broad spectrum kynurenic acid, the NMDA selective antagonist d-AP-5 and the AMPA antagonist CNQX. Their effects were dose-dependent and reversible. The results suggest that the excitatory effect of the parafascicular neurones is mediated by AMPA and NMDA receptors.
Neuroreport 07/1993; 4(6):613-5. · 1.66 Impact Factor
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ABSTRACT: The synaptic effect of the projection from an intralaminar thalamic structure, the parafascicular nucleus, to the subthalamic nucleus was investigated through extracellular recordings of subthalamic unit activities. Electrical stimulation of the parafascicular nucleus caused a complex response with two successive excitatory phases. The first excitation was assumed to be monosynaptically driven since it was not affected by pallidal lesion or transsection of the internal capsule. Pharmacological activation of the parafascicular neurons through microinjections of carbachol elicited a prolonged increase in the subthalamic discharge rate. These results suggest that the intralaminar parafascicular nucleus contributes to the activation of subthalamic neurons.
Comptes Rendus de l Académie des Sciences - Series III - Sciences de la Vie 02/1991; 313(10):447-52.
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ABSTRACT: The possible role of opioid receptor heterogeneity in the biphasic changes in locomotion (activation and inhibition) induced by non-selective opiates such as morphine, has been investigated by measuring the behaviour of rats exposed to different environments after injection into the ventral tegmental area, of selective mu (DAGO) or delta (DTLET, DSTBULET, BUBU) opioid agonists and of kelatorphan, a complete inhibitor of enkephalin metabolism. delta agonists or kelatorphan-induced hyperactivity in a familiar (actimeter), unfamiliar (four-hole box) and a fear inducing (open-field) environment. These effects were suppressed by naloxone and delta selective antagonists (ICI 174, 864 2 mg/kg SC, naltrindole 7 nmol in the ventral tegmental area). Moreover, the delta agonists and endogenous enkephalins protected by kelatorphan did not affect the emotional state of rats measured in an elevated plus maze. Infused into the ventral tegmental area, DAGO also enhanced locomotion in the actimeter but in contrast to delta agonists and kelatorphan, the mu agonist decreased activity in the open-field and the four-hole box. The hypoactivity observed in these tests could be related to an enhanced emotionality produced by mu receptor stimulation, as shown by the significant decrease in the number of visits and time spent in open arms of the elevated plus maze. Naloxone (0.3 mg/kg SC) but not delta selective antagonists, blocked the various responses induced by DAGO.
Psychopharmacology 02/1991; 103(4):493-502. · 4.08 Impact Factor
