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La formation réticulée mésencéphalique : implication dans le contrôle de la locomotion et les troubles de la marche. Approche électrophysiologique chez le primate et le patient parkinsonien

Abstract : The comprehension of the physiological and pathophysiological mechanisms involved in the control of locomotion and gait troubles remains a major challenge for biomedical research in order to improve quality and expectancy of life in parkinsonian patient. On the basis of experimental data, deep brain stimulation of the mesencephalic reticular formation (MRF), including the pedunculopontine and cuneiform nuclei, was proposed in 2005 as a new target to treat freezing of gait. However, regarding the heterogeneity of the clinical results, different questions now raise concerning the lack of anatomical and functional data of the MRF especially in non-human primate. The present study falls within a translational approach using clinical and pre-clinical data. First, a non-human primate model of bipedal locomotion was developed and validated on the basis of kinematic data. Multi-sequences MRI methodology was developed, allowing a longitudinal monitoring of the primate protocol and to construct a brainstem atlas of Macaca fascicularis. Then, an electrophysiological mapping of the MRF was performed in two behaving primates during rest and locomotion periods. For the first time, neurons within the MRF were found to respond to locomotion confirming the existence of a mesencephalic locomotor region in primate. After MPTP intoxication, only changes in neuronal discharge pattern were observed and arguments in favor of a misfunctioning of some MRF neurons during gait blockage. Finally, electrophysiological recordings during locomotion and natural transition from wakefulness to sleep suggest a dual function of some MRF neurons in the control of locomotion and arousal. The development of a new coordinate system adapted to human brainstem anatomy allowed to perform an anatomo-clinical evaluation of deep brain stimulation of the pedunculopontine nucleus and to provide a probabilist target for electrode implantation in the MRF to treat freezing of gait in the parkinsonian context.
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https://tel.archives-ouvertes.fr/tel-00872694
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Submitted on : Monday, October 14, 2013 - 11:47:41 AM
Last modification on : Friday, November 6, 2020 - 4:06:30 AM
Long-term archiving on: : Friday, April 7, 2017 - 10:22:28 AM

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  • HAL Id : tel-00872694, version 1

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Laurent Goetz. La formation réticulée mésencéphalique : implication dans le contrôle de la locomotion et les troubles de la marche. Approche électrophysiologique chez le primate et le patient parkinsonien. Médecine humaine et pathologie. Université de Grenoble, 2013. Français. ⟨NNT : 2013GRENS008⟩. ⟨tel-00872694⟩

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