It's not just the basal ganglia: Cerebellum as a target for dystonia therapeutics
Ambika Tewari MSc
Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
Search for more papers by this authorRachel Fremont MD, PhD
Columbia University Medical Center, Department of Psychiatry, New York, New York, USA
Search for more papers by this authorCorresponding Author
Kamran Khodakhah PhD
Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
Correspondence to: Dr. Kamran Khodakhah, 1410 Pelham Parkway South, Kennedy Center Room 506. Bronx, NY 10461; [email protected]Search for more papers by this authorAmbika Tewari MSc
Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
Search for more papers by this authorRachel Fremont MD, PhD
Columbia University Medical Center, Department of Psychiatry, New York, New York, USA
Search for more papers by this authorCorresponding Author
Kamran Khodakhah PhD
Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
Correspondence to: Dr. Kamran Khodakhah, 1410 Pelham Parkway South, Kennedy Center Room 506. Bronx, NY 10461; [email protected]Search for more papers by this authorRelevant conflicts of interest/financial disclosures: The authors declare no competing financial interests.
Abstract
Dystonia is a common movement disorder that devastates the lives of many patients, but the etiology of this disorder remains poorly understood. Dystonia has traditionally been considered a disorder of the basal ganglia. However, growing evidence suggests that the cerebellum may be involved in certain types of dystonia, raising several questions. Can different types of dystonia be classified as either a basal ganglia disorder or a cerebellar disorder? Is dystonia a network disorder that involves the cerebellum and basal ganglia? If dystonia is a network disorder, how can we target treatments to alleviate symptoms in patients? A recent study by Chen et al, using the pharmacological mouse model of rapid-onset dystonia parkinsonism, has provided some insight into these important questions. They showed that the cerebellum can directly modulate basal ganglia activity through a short latency cerebello-thalamo-basal ganglia pathway. Further, this article and others have provided evidence that in some cases, aberrant cerebello-basal ganglia communication can be involved in dystonia. In this review we examine the evidence for the involvement of the cerebellum and cerebello-basal ganglia interactions in dystonia. We conclude that there is ample evidence to suggest that the cerebellum plays a role in some dystonias, including the early-onset primary torsion dystonia DYT1 and that further studies examining the role of this brain region and its interaction with the basal ganglia in dystonia are warranted. © 2017 International Parkinson and Movement Disorder Society
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