Lec 4: Basal Ganglia Flashcards

1
Q

Components of Basal Ganglia

A
  1. Caudate (striatum)
  2. Putamen (striatum & lenticular nucleus)
  3. Globus Pallidus (lenticular nucleus)
  4. Subthalamic nucleus
  5. Substantial Nigra
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2
Q

Basal Ganglia Circuitry

A

-BG are collection of grey matter nuclei
-caudate and putamen are separated by penetrating fibers of the internal capsule but remain joined by cellular bridges
-within BG= complex excitatory and inhibitory connections utilizing different neurotransmitters

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3
Q

BG involvement in motor control

A

-hyperkinetic
-hypokinetic
-eye movement
-associative function (Cognitive)
-limbic (emotion and memory)

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4
Q

Functions of BG

A
  1. Initiates and integrates behavior and movement
  2. Integrates executive functions, emotion, and motor activity
  3. Removes unwanted and inappropriate movement
  4. Plans motor activity
  5. Associations with attention, time estimation
  6. Regulates motor habits (functional activities)
  7. “Rewards and Motivation”
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5
Q

BG Influences & Medial Motor Systems

A

-Cortex influences BG directly
-BG influences the cortex via the thalamus
-Influences the motor system through the spinal cord pathway
-Medial motor systems terminate on interneurons that project to both side of the spinal cord

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6
Q

Overview of Motor Pathways

A
  1. Skilled movements arise from motor cortex via corticospinal tracts and brain stem
  2. Selection/ Initiation of motor programs from basal ganglia to thalamus and basal ganglia to brain stem, respectively
  3. BG circuitry to the brain stem via:
    -reticulospinal tract (maintains tone, balance, & posture)
    -vestibulospinal tract (position of the limbs and head; supporting posture and maintaining balance)
    -rubrospinal tract: red nucleus to cerebellum
  4. Spinal cord (central pattern generation, muscle movement, sensory receptors, reflexes)
  5. Cerebellum
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7
Q

BG Common Pathways for Motor System

A

Cortical input begins in striatum (putamen)
-SN provides dopamine to promote BG -function (striatum)
Direct vs Indirect Pathways:
1. Direct: Striatum —in.—GPi—in.—Thalamus—ex.—to cortex
2. Indirect: Striatum—in. & ex.—GPe—-in.—STN—ex.—GPi—in.—to cortex

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8
Q

Changing Viewpoint of Basal Ganglia and Motor Function

A

-intimately connected with cortex through parallel loops
-loops subdivided into: Motor, Associate (cognition), and Limbic
-dysfunction with BG and it’s connectivity can lead to… movement disorders (dyskinesias): Akinesia, Bradykinesia, Hyperkinesia

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9
Q

BG outputs, inputs, neurotransmitters, and parallel loops

A

Outputs: Limbic, Thalamus, Midbrain
Inputs: Cerebral cortex, Limbic
Neurotransmitters: Dopamine, Glutamate
Parallel Loops: Cognitive (associative), Voluntary, Emotional

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10
Q

Motor Functions of BG

A

involved in both preparation and execution of movements, motor control, & learning of motor sequences and habit (implicit learning)

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11
Q

Pathologies characterized by non-motor loops

A

Emotional, cognitive, and psychiatric deficits: OCD, Tourette’s, and Attention Deficit Disorders

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12
Q

BG & Perceptual Motor Decision Making

A

Interpreting sensory information from the environment and making motor decisions:
Turning= planning of cervical and trunk rotation, changing angles of hip rotation, while anticipating environmental disruptions

e.g. PD pt: slow, small and narrow steps, en bloc

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13
Q

Non motor loops of BG
(inputs to BG)

A
  1. Prefrontal Loop: connection from prefrontal cortex for initiation and selection of motor activities
  2. Limbic Loop:
    connection from limbic system (hippocampus, amygdala, anterior cingulate) influences motor output
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14
Q

Indirect vs Direct Pathway Dysfunction

A
  1. Damage in direct pathway: more inhibition of cortex (under-stimulation) = rigidity & bradykinesia
    e.g. Parkinson’s (loss of automatic movement )
  2. Damage in indirect pathway: less inhibition of cortex (over-stimulation) = chorea and other involuntary movements
    e.g. Huntington’s
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15
Q

Basal Ganglia Pathology: Movement Speed

A

Slow —> Fast
1. Bradykinesia, hypokinesia
2. Rigidity
3. Dystonia
4. Athetosis
5. Chorea
6. Ballismus
7. Tics
8. Myoclonus
9. Tremor

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16
Q

Bradykinesia Definition

A

-Loss of function: neurotransmitter dopamine
-Loss of (-) pathways from striatum
-Loss of automatic mvmt

17
Q

Dystonia Definition

A

-Abnormal twisted positions
- Generalized, focal, unilateral
-Focus torticollis
-No exact focal lesion found

18
Q

Athetosis Definition

A

-Writhing
-twisting of the limbs, face, and trunk
-Seen in Huntington’s, perinatala anoxia, kernicterus (infant jaundice untreated)

19
Q

Chorea Definition

A

-“dance” , “break dancing”
-continuous involuntary movement
-jerk, constantly varying quality
-increases with ambulation

20
Q

Ballistic Definition

A

-flinging with large amplitude
-Hemiballismus: unilateral flinging contralateral to BG lesion
-classic cause is infarct of subthalamic nucleus

21
Q

Tics Definition

A

-Tourette’s Syndrome
-4X more in girls than boys
-increased in ADHD
-symptoms wax and wane

22
Q

Tremors Definition

A

-Both agonist and antagonist involved
-bidirection movement
-asymmetrical (e.g. pinrolling tremor with PD)
Resting tremor: common in PD, postural tremor vs intentional tremor

23
Q

Rigidity

A

-Normal stretch reflexes, shoulders and cervical spine first affected, prolonged results in contracture
-Lead pipe rigidity: continuous throughout, agonist and antagonist
-Cogwheel rigidity: ratchet like interruptions as the limb is passively moved

24
Q

Parkinson’s Disease

A

-loss of dopaminergic production in substantia nigra
-Festinating gait= shuffling and slow, difficult to initiate
-Difficulty turning corners (shortened stride length), changing directions
-Gait impediments coincide with visual, decision making and motor control deficits
-Freeze with impediments: doorways, items in their immediate path
-Tremors: resting
-Classic posture: stooped forward

25
Q

Origination of Gait

A

-Located in brainstem and descending to SC
-Descending pathways originate in Mesencephalic Locomotor Region (MLR) and lateral hypothalamus
-areas project to neurons in pons and medulla, which project themselves t/o SC to activate CPG’s for locomotion
-Reticular formation tract in pons plays an improtant role in inducing locomotion

26
Q

Current concepts of PD: Connections to midbrain and SC

A

-MLR region of brainstem is implicated in control of gait and balance in humans
-Dysfunction of cholinergic neurons of pedunculopontine nucleus (PPN), located in MLR: plays imp. role in appearance of axial symptoms in PD
-stimulating structures considered to be part of MLR alleviates locomotor symptoms of patients with PD

27
Q

Additional BG Diseases

A
  1. Brain anoxia that causes choreoathetosis (dyskinetic CP)
    -common prior to 1970 brain anoxia
  2. Genetics (Huntington’s)
  3. Stroke (Hemiballismus)
28
Q

Movement Problems in BG: Umbrella term of Dyskinesias

A
  1. Choreoathetosis CP (child)
  2. Hemiballismus (stroke)
  3. Huntington’s Disease
29
Q

Where movement occurs

A

1.Preplanning= prefrontal cortex
2. Preparation of mvmt= Premotor cortex (motor units, firing, and rate)
3. Initiation, Selection, Memory, Emotion= Basal Ganglia
4. Activation= Primary Motor Cortex