Top-down control of dyskinesias in PD using brain stimulation

摘要

An interesting proposal has been discussed in a letter by Cerasa and Quattrone on the potential mechanisms by which cortical repetitive transcranial magnetic stimulation (rTMS) may influence and possibly improve levodopa-induced dyskinesias (LID) in patients with Parkinson's disease (PD). It is well established that different dysfunctional cortical regions may contribute to the development of LIDs in PD and among these regions, both the inferior frontal cortex (IFC) and pre-supplementary motor area (pre-SMA) certainly play an important role. As described in their letter, a well-defined basal ganglia model describes how cortico-subcortical interactions may account for the motor deficits observed in patients that develop LIDs. Thus, the application of rTMS in those cortical regions influencing response inhibition may be capable of modulating the fronto-striatal pathways that are relevant for action control.