Basal ganglia and movement disorders Flashcards

1
Q

What is the major output of the basal ganglia?

A

GPi + SNPR to thalamus

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2
Q

What is the major input of the basal ganglia?

A

Cortex to striatum

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3
Q

Which nucleus of the basal ganglia releases dopamine?

A

Substantia nigra

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4
Q

On which basal ganglia nucleus does dopamine act?

A

Striatum

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5
Q

What is the main type of neuron in the striatum?

A

Medium spiny neurons

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6
Q

Which glutamate receptor is involved in long-lasting synaptic plasticity?

A

NMDA

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7
Q

Activated AMPA receptors allow the influx of which ions?

A

Na+

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8
Q

Activated NMDA receptors allow the influx of which ions?

A

Na+ and Ca+

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9
Q

Before they open, what are NMDA receptors initially blocked by?

A

Mg2+ ions

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10
Q

Do medium spiny neurons have high or low excitability?

A

Low

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11
Q

What are the 2 glutamate receptors?

A

AMPA
NMDA

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12
Q

What are the 2 GABA receptors?

A

GABA(A)
GABA(B)

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13
Q

Is AMPA ionotropic or metabotropic?

A

Ionotropic

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14
Q

Is NMDA ionotropic or metabotropic?

A

Ionotropic

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15
Q

Is GABA(A) ionotropic or metabotropic?

A

Ionotropic

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16
Q

Is GABA(B) ionotropic or metabotropic?

A

Metabotropic

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17
Q

Activated GABA(A) receptors allow the influx of which ions?

A

Chloride

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18
Q

Activated GABA(B) receptors allow the efflux of which ions?

A

K+

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19
Q

Dopamine is synthesised from what?

20
Q

Where in the neuron is dopamine synthesised?

A

Presynaptic terminals

21
Q

Dopamine is taken up into the presynaptic terminals for recycling via what?

A

Dopamine transporter (DAT)

22
Q

Dopamine is repackaged into vesicles to be recycled via what?

A

Vesicular monoamine transporter (VMAT)

23
Q

Describe the chain of events when dopamine binds to D1 receptors and how this facilitates movement.

A

D1 receptors activate adenylyl cyclase, which converts ATP into cyclic AMP (cAMP)

cAMP activates protein kinase A, which increases neuron excitability and enhances signalling

24
Q

Where does dopamine have an effect in the indirect pathway?

A

It reduces inhibition of GPe by the striatum

25
Q

The main motor symptoms of Parkinson’s disease can be remembered by TRAP - what does this stand for?

A

Tremor
Rigidity
Akinesia
Postural instability

26
Q

Which 2 types of rigidity are seen in Parkinson’s disease?

A

Lead-pipe rigidity
Cogwheel rigidity

27
Q

What happens to a patients handwriting with Parkinson’s disease?

A

Micrographia

28
Q

What percentage of cases of Parkinson’s disease are genetic?

29
Q

What are the 2 autosomal dominant genes that cause Parkinson’s disease?

A

Alpha-synuclein

Dardarin

30
Q

What are the 4 autosomal recessive genes that cause Parkinson’s disease?

A

Parkin
PINK1
DJ1
ATP13A2

31
Q

Dopamine travels from the substantia nigra pars compacta to the striatum via which pathway?

A

Nigrostriatal pathway

32
Q

Why is the substantia nigra black?

A

Due to the accumulation of neuromelanin - a by-product of dopamine synthesis

33
Q

Which protein forms aggregates in Parkinson’s disease? What does this protein aggregation lead to the formation of?

A

Alpha-synuclein

Aggregation of alpha-synuclein leads to the formation of Lewy Bodies

34
Q

What is the main protein in Lewy Bodies?

A

Alpha-synuclein

35
Q

In which 2 areas does Lewy body pathology usually begin in Parkinson’s disease?

A

Medulla and olfactory bulbs

36
Q

In Parkinson’s disease, what is Braak staging?

A

The progression of Lewy body pathology

37
Q

How can Lewy bodies affect cell membranes and how can this lead to cell death?

A

Lewy bodies can form pore-forming complexes in the cell membrane, leading to an influx of calcium, which in excess would cause cell death

38
Q

An abnormality in which process may be responsible for the aggregation of alpha-synuclein?

A

Abnormal phosphorylation

39
Q

What are the 3 main mechanisms of cell death in Parkinson’s disease?

A

Protein aggregation

Abnormal ubiquitin-proteasome system

Mitochondrial dysfunction

40
Q

Huntington’s disease is caused by an abnormality in which gene / protein?

A

Huntingtin gene

41
Q

What is the genetic mutation responsible for Huntington’s disease?

A

CAG repeats

42
Q

Does Huntington’s disease involve inclusions or plaques?

A

Inclusions

43
Q

In Huntington’s, there is a selective loss of medium spiny neurons in the striatum associated with which pathway?

A

Indirect pathway

44
Q

Neurons from which structure of the basal ganglia die in Huntington’s disease?

A

Striatum (specifically medium spiny neurons of the indirect pathway)

45
Q

What is the inheritance pattern of Huntington’s disease?

A

Autosomal dominant