Basal ganglia and movement disorders Flashcards
What is the major output of the basal ganglia?
GPi + SNPR to thalamus
What is the major input of the basal ganglia?
Cortex to striatum
Which nucleus of the basal ganglia releases dopamine?
Substantia nigra
On which basal ganglia nucleus does dopamine act?
Striatum
What is the main type of neuron in the striatum?
Medium spiny neurons
Which glutamate receptor is involved in long-lasting synaptic plasticity?
NMDA
Activated AMPA receptors allow the influx of which ions?
Na+
Activated NMDA receptors allow the influx of which ions?
Na+ and Ca+
Before they open, what are NMDA receptors initially blocked by?
Mg2+ ions
Do medium spiny neurons have high or low excitability?
Low
What are the 2 glutamate receptors?
AMPA
NMDA
What are the 2 GABA receptors?
GABA(A)
GABA(B)
Is AMPA ionotropic or metabotropic?
Ionotropic
Is NMDA ionotropic or metabotropic?
Ionotropic
Is GABA(A) ionotropic or metabotropic?
Ionotropic
Is GABA(B) ionotropic or metabotropic?
Metabotropic
Activated GABA(A) receptors allow the influx of which ions?
Chloride
Activated GABA(B) receptors allow the efflux of which ions?
K+
Dopamine is synthesised from what?
Tyrosine
Where in the neuron is dopamine synthesised?
Presynaptic terminals
Dopamine is taken up into the presynaptic terminals for recycling via what?
Dopamine transporter (DAT)
Dopamine is repackaged into vesicles to be recycled via what?
Vesicular monoamine transporter (VMAT)
Describe the chain of events when dopamine binds to D1 receptors and how this facilitates movement.
D1 receptors activate adenylyl cyclase, which converts ATP into cyclic AMP (cAMP)
cAMP activates protein kinase A, which increases neuron excitability and enhances signalling
Where does dopamine have an effect in the indirect pathway?
It reduces inhibition of GPe by the striatum
The main motor symptoms of Parkinson’s disease can be remembered by TRAP - what does this stand for?
Tremor
Rigidity
Akinesia
Postural instability
Which 2 types of rigidity are seen in Parkinson’s disease?
Lead-pipe rigidity
Cogwheel rigidity
What happens to a patients handwriting with Parkinson’s disease?
Micrographia
What percentage of cases of Parkinson’s disease are genetic?
10%
What are the 2 autosomal dominant genes that cause Parkinson’s disease?
Alpha-synuclein
Dardarin
What are the 4 autosomal recessive genes that cause Parkinson’s disease?
Parkin
PINK1
DJ1
ATP13A2
Dopamine travels from the substantia nigra pars compacta to the striatum via which pathway?
Nigrostriatal pathway
Why is the substantia nigra black?
Due to the accumulation of neuromelanin - a by-product of dopamine synthesis
Which protein forms aggregates in Parkinson’s disease? What does this protein aggregation lead to the formation of?
Alpha-synuclein
Aggregation of alpha-synuclein leads to the formation of Lewy Bodies
What is the main protein in Lewy Bodies?
Alpha-synuclein
In which 2 areas does Lewy body pathology usually begin in Parkinson’s disease?
Medulla and olfactory bulbs
In Parkinson’s disease, what is Braak staging?
The progression of Lewy body pathology
How can Lewy bodies affect cell membranes and how can this lead to cell death?
Lewy bodies can form pore-forming complexes in the cell membrane, leading to an influx of calcium, which in excess would cause cell death
An abnormality in which process may be responsible for the aggregation of alpha-synuclein?
Abnormal phosphorylation
What are the 3 main mechanisms of cell death in Parkinson’s disease?
Protein aggregation
Abnormal ubiquitin-proteasome system
Mitochondrial dysfunction
Huntington’s disease is caused by an abnormality in which gene / protein?
Huntingtin gene
What is the genetic mutation responsible for Huntington’s disease?
CAG repeats
Does Huntington’s disease involve inclusions or plaques?
Inclusions
In Huntington’s, there is a selective loss of medium spiny neurons in the striatum associated with which pathway?
Indirect pathway
Neurons from which structure of the basal ganglia die in Huntington’s disease?
Striatum (specifically medium spiny neurons of the indirect pathway)
What is the inheritance pattern of Huntington’s disease?
Autosomal dominant