Session Time: 1:45pm-3:15pm
Location: Agora 2 West, Level 2
Objective: The review provides detailed material about the Subthalamic Nucleus of Luys, including pathophisiolgy, hystorical notes about Luys, embryology, anatomy, principal afferents and efferents pathways, as well as, clinical correlations and surgery treatments involving the STN.
Background: In 1912, Samuel Wilson crafted the term “extrapyramidal” with the purpose of characterizing a set of anatomical structures represented by the basal ganglia which are involved in motor control and when dysfunctional, result in the occurrence of movement disorders.The subthalamic nucleus (STN) represents a critical component of the basal ganglia with a pivotal function in the modulation of movement.
Method: The authors review the subthalamic nucleus (STN) since its description up to current concepts of physiology, clinical and therapeutic relevance. The role of Jules Bernard Luys in the description of the STN is emphasized, as well as the anatomy, physiology, the importance of the STN in the genesis of movement disorders, and its’ potential role as a target for neuromodulation.
Results: Luys contributions to neuroanatomy were decisive, including the identification of anatomical structures including the identification of a structure in the forebrain that is still attached to his name: subthalamic nucleus, or corpus Luysii. Beyond the classical cortico-basal ganglia-thalamo-cortical circuitry, the STN connects also to the brainstem. It can be divided into three functional subregions: limbic, motor and associative. Unilateral lesion in STN leads to contralateral hemiballismus, a classic clinical observation. Non-motor manifestations are less frequent but may include neuropsychiatric disorders such as hyperphagia, aggressiveness, anxiety, irritability, euphoria, and pleomorphic impulse control disorders.
Conclusion: The STN is a small nucleus that functions as a relay of motor and non-motor circuits important for human functionality. The relationships of NST with movement disorders, in particular hemibalism and PD are well known. The neuromodulation of STN has been widely used in the last decades, however with the refinement of the understanding of its multifaceted functions, as well as the use of new technical advances that could modulate specific subregions, the STN remains as a potential target to be further explored as a therapeutic target.
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To cite this abstract in AMA style:G. Froehner, A. Meira, F. Germiniani, M. Meneses, R. Munhoz, H. Teive. Subthalamic Nucleus of Luys: A review. What has evolved since 1865? [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/subthalamic-nucleus-of-luys-a-review-what-has-evolved-since-1865/. Accessed December 1, 2023.
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