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When a voluntary movement is about
to be initiated by cortical networks, a
signal is sent from the motor cortex
through the cortico-subthalamo-pallidal
pathway to activate GPi neurons exten-
sively. Ther result is the inhibitionf of their
targets .
Another signal through cortico-
striato-pallidal pathway (direct pathway)
is sent to the GPi to inhibit a specific
population of pallidal neurons. A cen-
tral population of pallidal neurons
disinhibit their target neurons in the
thalamus . Thus only the selected
motor “software” is executed at the
selected timing, Excitatory Cortical
Inputs to Pallidal Neurons Via the Sub-
thalamic Nucleus in the Monkey ATSUSHI
NAMBU et al, J Neurophysiol, 2000.
Deep Brain Stimulation Research Review
7 web pages and 17 A4 pdfs on DBS
mechanism on www.thalamus.ro in
, deep brain stimulation
t s , gysts
iel mechanism
d
e u e r s e f

GPe fibers projecting to the STN are
activated by STN stimulation. This inhibits STN
neurons (Alexander et al. 1990; DeLong 1990). This
decreases the activity of inhibitory GPi
neurons, result in increased thalamocortical neuro-
nal activities. TRANSLATIONAL PHYSIOLOGY Single
Pulse Stimulation of the Human Subthalamic
Nucleus Facilitates the Motor Cortex at Short
Intervals Ritsuko Hanajima et al, Neurophysiol 2004.
 HFS in GPi does not necessarily lead to decreased
inhibitory pallidal output and facilitation of
thalamic targets. HFS in GPi appeared to
reduce the number of bursts and the number of
spikes per burst. It is a posib.ility that the symp-
tomatology is an abnormal pattern of activity,
rather than a reduction in thalamic activity as a
result of an increase in mean pallidal discharge
rate. It may be that the beneficial effects are a
consequence of the interruption of abnormal
patterns of activity in corticothalamic circuits.
MARJORIE E. et alJ Neurophysiol, 2003,Effects of
High-Frequency Stimulation in the Internal Globus
Pallidus on the Activity of Thalamic Neurons in the
Awake Monkey

A possibility is that the STN stimulation
activates STN projection fibers to GPe
. This pathway facilitates the GPe neurons
and caused disinhibition of the thalamocorti-
cal pathway. TRANSLATIONAL PHYSIOLOGY
Single Pulse Stimulation of the Human Subtha-
lamic Nucleus Facilitates the Motor Cortex at
Short Intervals Ritsuko Hanajima et al, Neuro-

!
physiol 2004.

Thalamus in Neurology, Neurosurger

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tegmentum
acetylcholine