The internal globus pallidus (GPi or medial globus pallidus) is one of the two subcorticalnuclei that provides inhibitory output in the basal ganglia, the other being the substantia nigrapars reticulata. Together with the external globus pallidus (GPe), it makes up one of the two segments of the globus pallidus, a structure that can decay with certain neurodegenerative disorders and is a target for medical and neurosurgical therapies. The GPi, along with the substantia nigra pars reticulata, comprise the primary output of the basal ganglia, with its outgoing GABAergic neurons having an inhibitory function in the thalamus, the centromedian complex and the pedunculopontine complex.[1]
Anatomy
The efferent bundle is constituted first of the ansa and lenticular fasciculus, then crosses the internal capsule within and in parallel to the Edinger's comb system then arrives at the laterosuperior corner of the subthalamic nucleus and constitutes the field H2 of Forel, then H, and suddenly changes its direction to form field H1 that goes to the inferior part of the thalamus. The distribution of axonal islands is widespread in the lateral region of the thalamus. The innervation of the central region is done by collaterals.[2]
The GPi acts to tonically inhibit the ventral lateral nucleus and ventral anterior nucleus of the thalamus. As these two nuclei are needed for movement planning, this inhibition restricts movement initiation and prevents unwanted movements.
Direct pathway
The GPi receives inhibitory GABAergic signals from the striatum by way of striatopallidal fibres, when a movement requirement is signaled from the cerebral cortex. As the GPi is one of the direct output centers of the basal ganglia, this causes disinhibition of the thalamus, increasing overall ease of initiating and maintaining movement. As this pathway only contains one synapse (from the striatum to the internal globus pallidus), it is known as the direct pathway.[4]
The internal globus pallidus is the target of deep brain stimulation (DBS) for these diseases. Deep brain stimulation sends regulated electrical pulses to the target. In patients with tardive dyskinesia treated with DBS, most people reported more than a 50% improvement in symptoms.[8] Tourette syndrome patients have also benefited from this treatment, showing over 50% improvement in tic severity (compulsive disabling motor tics are symptoms of Tourette patients).[7] The GPi is also considered a "highly effective target for neuromodulation" when using deep brain stimulation on Parkinson's disease patients.[6]
There is seen to be only some involvement in Huntington's disease[9] with mostly the external globus pallidus being affected.[10]
Animals
In rodents its homologue is known as the entopeduncular nucleus.[11]
^Percheron G, François C, Talbi B, Meder JF, Fenelon G, Yelnik J (1993). "The primate motor thalamus analysed with reference to subcortical afferent territories". Stereotact Funct Neurosurg. 60 (1–3): 32–41. doi:10.1159/000100588. PMID8511432.
^Morita, Makiko; Hikida, Takatoshi (2015-11-01). "[Distinct roles of the direct and indirect pathways in the basal ganglia circuit mechanism]". Nihon Shinkei Seishin Yakurigaku Zasshi = Japanese Journal of Psychopharmacology. 35 (5–6): 107–111. ISSN1340-2544. PMID26785520.
^Parent, André; Hazrati, Lili-Naz (1995-01-01). "Functional anatomy of the basal ganglia. II. The place of subthalamic nucleus and external pallidium in basal ganglia circuitry". Brain Research Reviews. 20 (1): 128–154. doi:10.1016/0165-0173(94)00008-D. PMID7711765. S2CID20808851.
^ abAndrade, Pablo; Carrillo-Ruiz, José D.; Jiménez, Fiacro (2009-07-01). "A systematic review of the efficacy of globus pallidus stimulation in the treatment of Parkinson's disease". Journal of Clinical Neuroscience. 16 (7): 877–881. doi:10.1016/j.jocn.2008.11.006. ISSN0967-5868. PMID19398341. S2CID36080071.
^Waldvogel, Henry J.; Kim, Eric H.; Tippett, Lynette J.; Vonsattel, Jean-Paul G.; Faull, Richard LM (2014-01-01). Nguyen, Hoa Huu Phuc; Cenci, M. Angela (eds.). Behavioral Neurobiology of Huntington's Disease and Parkinson's Disease. Current Topics in Behavioral Neurosciences. Vol. 22. Springer Berlin Heidelberg. pp. 33–80. doi:10.1007/7854_2014_354. ISBN9783662463437. PMID25300927.