Basal Ganglia

Question 1

Areas effected by Parkinson’s

Answer 1

Caudate nucleus
Putamen
Thalamus
Globus pallidus, internal capsule
Globus pallidus, external capsule
Subthalamic nucleus
Substantia nigra

Question 2

Basal Ganglia neurotransmitters

Answer 2

GABA (inhibitory)
Glutamate (excitatory)
Acetylcholine (excitatory)
Dopamine (excitatory or inhibitory)
Neuropeptides (modulatory)
dynorphin, substance P, enkephalins

Question 3

Diseases of the basal ganglia

Answer 3

Huntington’s disease
hemiballismus
tardive dyskinesia
Parkinson’s disease

Question 4

Usually caused by a stroke affecting a small area just below the basal ganglia called the subthalamic nucleus

Answer 4

Hemiballismus

Question 5

serious side effect oflong-term use of drugs called neuroleptics (anti-psychotics), anti-emetics or other drugs

Answer 5

Tardive dyskinesia

Question 6

Loss of dopaminergic neurons in the substantia nigra (SN)
50-70% loss prior to symptoms
Presence of Lewy bodies
Non-dopaminergic symptoms

Answer 6

Parkinson’s Disease

Question 7

Major breakthroughs in PD

Answer 7

Dopamine replacement therapy (I-DOPA)

MPTP

Question 8

What are the two main hypotheses of cell death in PD?

Answer 8

oxidative stress (free radicals)
proteasome dysfunction (accumulation of misfolded proteins)

Question 9

high-energy oxygen atoms with at least one unpaired electron (unstable & highly reactive)
Damage to lipids, proteins, DNA
Disruption of electron transport leads to accumulation of electrons

Answer 9

oxidative stress

Question 10

Mutations cause hereditary parkinsonism (13 identified)
Alpha-synuclein: structure protein
Ubiquitin Ligase: involved with protein death
Alpha-synuclein does not get destroyed and deposits in cell causing the cell death

Answer 10

proteasome dysfunction

Question 11

First line of therapy
Effective for 3-7 years
Disease continues to progress
Drug-induced dyskinesias
On-off periods
No effect on non-DA symptoms

Answer 11

DA replacement I-DOPA

Question 12

Fewer dyskinetic side effects so therapy may be continued for longer (up to 10 years)
Sudden compulsive behaviors that the patient has never had before.
compulsive gambling
compulsive sexual changes such as use of pornography
compulsive eating, shopping or cleaning
In most cases the compulsive behavior stopped when drug was discontinued

Answer 12

DA agonists

Question 13

Targets include Globus Pallidus interna (GPi), subthalamic nucleus (STN), pedunculopontine nucleus (PPN)
Reduces dosage of drug needed
Symptomatic
Side effects resulting from electrode placement

Answer 13

Deep-brain stimulation (DBS)