Figure 6. Circuit therapy: focus on choke points.
(a) The thalamus is a choke point for epileptic seizures in post-stroke epilepsy99. Note that the choke point (flash: thalamus) is remote from the initial dysfunction (red flash), which is a stroke in the cerebral cortex. (b) The subthalamus (STN) is an efficient choke point for pathological circuit oscillations in Parkinson’s disease. Note that the choke point (black flash: STN) is remote from the initial dysfunction (yellow flash), which results from degeneration of dopaminergic cells (Dopamine) projecting from the substantia nigra compacta (SNC) to striatum. (c) Contralateral hippocampus is a choke point for controlling ipsilateral hippocampal epileptic activity100. (d) STN and SNR are choke points for spike-and-wave discharges associated with absence epilepsy and generated in somatosensory cortex 108. Black oscillations: pathological oscillations; Red flash: initial injury or insult; Orange flash: choke point for pathological network oscillation. Other abbreviations: GPe: External globus pallidus; SNR: substantia nigra pars reticulata. Purple cells/projections: excitatory glutamatergic; Red cells/projections: inhibitory GABAergic.