Modeling and Theories of Pathophysiology and Physiology of the Basal Ganglia–Thalamic–Cortical System: Critical Analysis

Theories impact the movement disorders clinic, not only affecting the development of new therapies but determining how current therapies are used. Models are theories that are procedural rather than declarative. Theories and models are important because, as argued by Kant, one cannot know the thing-in-itself (das Ding an sich) and only a model is knowable. Further, biological variability forces higher level abstraction relevant for all variants. It is that abstraction that is raison d’être of theories and models. Theories “connect the dots” to move from correlation to causation. The necessity of theory makes theories helpful or counterproductive. Theories and models of the pathophysiology and physiology of the basal ganglia–thalamic–cortical system do not spontaneously arise but have a history and consequently are legacies. Over the last 40 years, numerous theories and models of the basal ganglia have been proposed only to be forgotten or dismissed, rarely critiqued. It is not harsh to say that current popular theories positing increased neuronal activities in the Globus Pallidus Interna (GPi), excessive beta oscillations and increased synchronization not only fail to provide an adequate explication but are inconsistent with many observations. It is likely that their shared intellectual and epistemic inheritance plays a factor in their shared failures. These issues are critically examined. How one is to derive theories and models and have hope these will be better is explored as well.