To the Editor.—Dr. Bogen's thoughtful response to my editorial is most welcome, since it begins with a look at the patient's disability, and this is the primary point I wished to emphasize.
Although I did not go into such analytic detail, I do agree that there are electrophysiological models in several areas of the nervous system, which prove that synaptic transfer through a test system may be decreased not only by a convergent inhibitory pathway but also by a convergent turning off of a facilitatory pathway, defacilitation. To prove that a behavioral depression of function is the result of defacilitation at the cellular level requires not only electrophysiological confirmation in similar preparations, but also some control of the phenomenon we call motivation without any clear understanding of a physiological mechanism. Denny-Brown and Botterell1 emphasized the importance of motivation in the performance of monkeys subjected to motor cortex
Landau WM. Dysfunction From Defacilitation-Reply. Arch Neurol. 1975;32(6):422. doi:10.1001/archneur.1975.00490480088014
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