Deep brain stimulation (DBS) is an effective treatment for Parkinson’s disease (
1
) via modulation of motor corticostriatothalamic circuits (CSTs) (
2
,
3
). CST connections to motor, limbic, and associative cortices are also promising DBS
targets for Tourette syndrome, obsessive-compulsive disorder (
4
), and major depression (
5
,
6
,
7
,
8
). Schizophrenia (SZ) is a disorder with disruptions in limbic and associative CSTs
(
9
,
10
). One-fifth to one-half of SZ patients are treatment resistant (TR). DBS targeted
at basal ganglia structures within limbic and associative CSTs could have the potential
to alleviate TR SZ symptoms. The substantia nigra pars reticulata (SNr) functions
as a major basal ganglia output of limbic and associative CSTs via ascending projections
to the mediodorsal nucleus of the thalamus and limbic and associative cortices, ultimately
closing the loop via descending inhibitory GABAergic (gamma-aminobutyric acidergic)
projections to the ventral basal ganglia and SNr (
11
,
- Yoon J.H.
- Minzenberg M.J.
- Ursu S.
- Walter B.S.R.
- Wendelken C.
- Ragland J.D.
- Carter C.S.
Association of dorsolateral prefrontal cortex dysfunction with disrupted coordinated
brain activity in schizophrenia: Relationship with impaired cognition, behavioral
disorganization, and global function.
Am J Psychiatry. 2008; 165: 1006-1014
12
,
13
). We postulated that the SNr may serve as a common node, modulating limbic and associative
cortices through a projection to the mediodorsal nucleus of the thalamus. If so, this
would make it a potentially effective target for DBS in TR SZ.To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 24, 2021
Accepted:
March 2,
2021
Received:
February 24,
2021
Identification
Copyright
© 2021 Society of Biological Psychiatry.
