Neuromodulation : Cortico-striato-thalamo-cortical Loop Dysfunction and Treatment

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  • Fukaya Chikashi
    Division of Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine
  • Yamamoto Takamitsu
    Division of Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine

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Other Title
  • Neuromodulation
  • —皮質-線条体-視床-皮質ループ機能障害とその治療—

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Abstract

  The cortico-striato-thalamo-cortical (CSTC) loop has been regarded as an important theoretical concept in research intended to identify ways to interrupt the causative mechanism of functional neurological disease. According to the CSTC loop concept, individual circuits associated with motor, mood and cognitive function exist in the cortex, basal ganglia and thalamus, and these circuits work with each other, keeping close and appropriate relationships. Diseases that seem to involve a dysfunction of the CSTC loop are Parkinson’s disease, dystonia, obsessive compulsive disorder and Tourette syndrome. The representative state of these diseases differs depending mainly on which circuit is impaired. The majority of targets for therapy using deep brain stimulation (DBS) were established in the CSTC loop, and because it is difficult to treat motor functions separately, an individual’s mood and cognitive function may be affected by DBS. It is known that subthalamic nucleus (STN) -DBS sometimes cause emotional changes in patients. These findings regarding the CSTC loop are understandable from observations of healthy persons, whose physical activity increases when their mood is good and whose intellectual work stagnates when their mood is depressive. The CSTC loop concept has not only become a theoretical background for the mechanism of DBS ; it has also become useful in clinical practice. It has been reported that physical exercise can contribute to the prevention of depression and dementia and to the inhibition of the progress of Parkinson’s disease. It has also been reported that positive thinking and a stable emotional state help improve the status of a movement disorder and that physical exercise improves the cognition for pain.

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