The basal ganglia are subcortical nuclei controlling voluntary actions and have been implicated in Parkinson's disease (PD). The prevailing model of basal ganglia function states that two circuits, the direct and indirect pathways, originate from distinct populations of striatal medium spiny neurons (MSNs) and project to different output structures. These circuits are believed to have opposite effects on movement. Specifically, the activity of direct pathway MSNs is postulated to promote movement, whereas the activation of indirect pathway MSNs is hypothesized to inhibit it. Recent findings have revealed that this model might not fully account for the concurrent activation of both pathways during movement. Accordingly, we propose a model in which intrastriatal connections are critical and the two pathways are structurally and functionally intertwined. Thus, all MSNs might either facilitate or inhibit movement depending on the form of synaptic plasticity expressed at a certain moment. In PD, alterations of dopamine-dependent synaptic plasticity could alter this coordinated activity.
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We thank A. Pisani for reading the manuscript and for critical discussion. This work was supported by Progetto di Ricerca di Interesse Nazionale (PRIN) 2011 2010AHHP5H (to P.C.) and Progetto del Ministero della Salute, Giovani Ricercatori (GR-2008-1142336 to B.P.; GR-2010-2316671 to V.G.).
P.C. serves as an editorial board member of Lancet Neurology, The Journal of Neuroscience, Movement Disorders and Synapse, and receives research support from Bayer Schering, Biogen, Boehringer Ingelheim, Eisai, Merck Sharp & Dohme, Novartis, Lundbeck, Sanofi-Aventis, Sigma-Tau, UCB Pharma, Ricerca Corrente IRCCS, Ricerca Finalizzata IRCCS (European Community Grants SYNSCAFF and REPLACES), the Italian Minister of Health, and Agenzia Italiana del Farmaco.
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Calabresi, P., Picconi, B., Tozzi, A. et al. Direct and indirect pathways of basal ganglia: a critical reappraisal. Nat Neurosci 17, 1022–1030 (2014). https://doi.org/10.1038/nn.3743
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