The rate model regarding the development of
movement disorders of basal ganglia origin suggests that hyperkinetic and hypokinetic disorders occur as a result of changes in the firing rates in the GPi and SNr, which in turn suppress thalamocortical output.
Dopamine depletion in
Parkinson's disease increases basal ganglia output, then decreases thalamocortical output, leading to
bradykinesia. This model, however, cannot explain a lack of deterioration of parkinsonian signs following thalamic coagulation surgery. Instead of the rate model, the beta oscillation hypothesis has been proposed, explaining that synchronized oscillation in the beta frequency in the basal ganglia disturbs initiation of voluntary movement. We observed that effective high-frequency STN stimulation in parkinsonian monkeys was associated with increase in the firing rate and the pattern shift from irregular burst firing to regular high-frequency firing in the projecting sites. High-frequency neural activation by
deep brain stimulation is supposed to cancel lower frequency oscillation including beta oscillation, leading to improvement of
bradykinesia. Our observation supports the significance of the neural activity pattern, rather than the tonic activity level, in the development of
movement disorders. The rate model cannot explain the improvement of
ballismus and
chorea by
pallidotomy because
pallidotomy increases the disinhibition of the thalamocortical projection, which should increase the movements. We observed repetitive bursts or pauses of neuronal firing of the globus pallidus synchronized to ballistic movements in patients with
hemiballism or
chorea, suggesting that phasic neuronal driving in the basal ganglia is important as their pathophysiology.