saraf musko 111203 dr ety basalganglia2k1

8/3/2019 Saraf Musko 111203 Dr Ety BasalGanglia2K1

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Basal

Ganglia


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Muhammad Ali in Alanta Olympic

Parkinsons Disease

Disease of mesostriatal

dopaminergic system

PD

normal


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Substantia Nigra,Pars Compacta (SNc)

DOPAminergic Neuron

Slowness of Movement- Difficulty in Initiation and Cessationof Movement

Clinical Feature (1)

Parkinsons Disease - Paralysis Agitans


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DOPAminergic Neuron

Slowness of Movement- Difficulty in Initiation and Cessationof Movement




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Resting TremorParkinsonian PostureRigidity-Cogwheel Rigidity

Parkinsons Disease

Paralysis Agitans


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Clinical Feature

Principal Pathologic Lesion:Corpus Striatum (esp. caudate nucleus)

and Cerebral Cortex

- Predominantly autosomal dominantlyinherited chronic fatal disease(Gene: chromosome 4)

- Insidious onset: Usually 40-50

- Choreic movements in onset- Frequently associated withemotional disturbances

- Ultimately, grotesque gait and severdysarthria, progressive dementiaensues.

HUNTINGTONS CHOREA


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HEMIBALLISM

- Usually results from CVA(Cerebrovascular Accident)involving subthalamic nucleus

- sudden onset-Violent, writhing, involuntarymovements of wide excursionconfined to one half of the body

- The movements are continuousand often exhausting but ceaseduring sleep

- Sometimes fatal due to exhaustion- Could be controlled byphenothiazines and stereotaxicsurgery

Clinical Feature

Lesion:Subthalamic Nucleus


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SYDENHAMS CHOREA

- Complication ofRheumatic Fever

- Fine, disorganized , andrandom movements of

extremities, face andtongue

- Accompanied byMuscular Hypotonia

- Typical exaggeration ofassociated movements

during voluntary activity- Usually recoversspontaneouslyin 1 to 4 months

Clinical Feature

Principal Pathologic Lesion:Corpus Striatum


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Traditional Concepts of Basal Ganglia

Corpus StriatumCaudate Nucleus

Lenticular Nucleus Putamen

Globus Pallidus Paleostriatum Pallidum

Corpus Amygdaloideum Archistriatum

Neostriatum Striatum

Basal Ganglia Introduction


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1. Putamen

2. Tail of caudatenucleus

3. Caudatolenticulargray bridge

4. Amygdaloid body

5. thalamus

Lateral surface

of basal ganglia


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1. head of

caudate nucelus

2. body of

caudate nucelus

3. caudatolenticular

gray bridge

4. putamen

5. tail of

caudate nucleus

6. external segment ofglobus pallidus

7. internal segment ofglobus pallidus

8. amygdaloid body

9. nucleus accumbenssepti

Medial surface of basal ganglia


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Components of Basal Ganglia

Corpus Striatum

Striatum ----- Caudate Nucleus & Putamen

Pallidum ----- Globus Pallidus (GP)

Substantia NigraPars Compacta (SNc)

Pars Reticulata (SNr)

Subthalamic Nucleus (STN)

Ventral Striatum and Ventral Pallidum

Nucleus Accumbens SeptiNon cholinergic portion of Substantia Innominata

Basal Ganglia Components


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STRIATUM

Caudate Nucleus

Head, (Corpus), Tail

caudatolenticular gray bridge

Putamen

Ventral Striatum: Nucleus Accumbens (Septi)



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Striatal Compartments

(Mosaic or Modular Organization)

1. Striosome (Patches)

- 10-20% of total striatal mass

- low acetylcholinesterase (AchE) activity

- high substance P (SP), neurotensin (NT), tyrosine hydroxylase- high expression of D1 dopamine receptor

- high opiate receptor

2. Matrix

- high acetylcholinesterase (AchE) activity

- high somatostatin (SRIF) activity

- high D2 dopamine receptor



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Spiny I

neuron

Spiny II

neuron

Aspiny I

neuron

Aspiny II

neuron

Aspiny III

neuron

Neurogliformcell


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Striosome andMatrix compartment

AchE


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Inputs to the

spiny striatal neurons

distal extrinsic

proximal - intrinsic


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PALLIDUM

Globus Pallidus (Pallidum)

Internal or Medial Segment (GPi)

internal medullary lamina

External or Lateral Segment (GPe)

Ventral Pallidum

Non-cholinergic portions

of substantia innominata



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Substantia Nigra

Pars Compacta (SNc)

Dopaminergic Cell Group (A9)

cf. Ventral Tegmental Area (VTA, A10)

Retrorubral Area (A8)

Pars Reticulata (SNr)

Non-dopaminergic Portion

GABAergic Neuron



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Subthalamus

Subthalamic Nucleus (STN)

zona incertaField of Forel

H ansa lenticularis

H1 thalamic fasciculus

H2 lenticular fasciculus



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Putamen

Globus pallidus

external segment

internal segment

Subthalamic Nucleus

Substantia nigra

Internal capsule

Components of

Basal Ganglia


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Subthalamic Nucleus1. epithalamus2. dorsal thalamus3. subthalamus

3-1. subthalamic

nucleus3-2. zona incerta3-3. globus pallidus

4. hypothalamus5. putamen

arrow: internal capsule

Origin of subthalamic nucleus and putamen (Kuhlenbeck)


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Input Portion

STRIATUM

(Caudate Nucleus and Putamen)

Output Portion

1. PALLIDUM (Globus Pallidus)

2. SNr (Substantia Nigra, Pars Reticulata)

Basal Ganglia Connections


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STRIATUMAfferentsfrom1. Cerebral Cortex [Corticostriatal Projection]2. Thalamus (CM-PF complex) [Thalamostriatal Projection]3. SNc (Substantia Nigra, pars compacta),

Ventral Tegmental Area (VTA, A10)and A8(Retrorubral Area) [Nigrostriatal Projection]4. Dorsal Raphe Nucleus (B6, B8) [Raphestriatal Projection]5. Amygdaloid Nuclear Complex [Amygdalostriatal Projection]

Efferentsto

1. Pallidum (GPi & GPe) [Striopallidal Projection]2. SNr [Strionigral Projection]3. SNc from striosome



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Afferent Connections of Basal Ganglia


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Input-OutputRelationshipof Basal Ganglia

1. striopallidal fiber2. strionigral fiber3. strionigral fiber

from striosometo SNc

4. ventrostrio-ventro-pallidal fiber


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PALLIDUM (Globus Pallidus)

Afferentsfrom1. Striatum [Striatopallidal Projection]

2. STN [Subthalamopallidal Projection]

Efferentsto

1. Thalamus (VLo, VApc, CM) [Pallidothalamic Projection]

2. STN [Pallidosubthalamic Projection]

SNr (Substantia Nigra, Pars Reticulata)

Afferents from Striatum [Striatonigral Projection]

Efferents to

1. Thalamus (VLm, VAmc, MD) [Nigrothalamic Projection]

2. Brain Stem Nucleus: Tectum (Superior Colliculus) &

Pedunculopontine Nucleus (PPN)



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Efferent Connections of Basal Ganglia



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Pallidothalamic Fibers

from GPi to VLo, VApc, CMAnsa Lenticularis

from outer (lateral) portion of GPifibers sweep ventromedially and rostrally around

the posterior limb of the internal capsule

enters Forels field H

Lenticular Fasciculusfrom inner (medial) portion of GPiperforate internal capsule

enters Forels field H2

Thalamic fasciculusansa lenticularis, lenticular fasciculus

and cerebellothalamic fibers

Forels field H1


C ti f th B l G li


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habenularnucleus

tectum(superior colliculus)

PPN(pedunculopontine nucleus)

amygdaloid body

raphe

CerebralCortex

STN

Pallidum

SNr

STRIATUM

Connections of the Basal Ganglia

SNc

Thalamus


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Basal Ganglia (Main Motor Circuit) Connections

SupplementaryMotor Area

(SMA)

PrimaryMotor Area

(M I)

THALAMUS

(VLo, VApc, CM)

STRIATUM(Putamen)

PALLIDUM

(GPi)

pyramidaltract

LMN

ansalenticularis

lenticularfasciculus


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Basal Ganglia (Prefronatal Complex Loop) Connections

PrefrontalAssociation

Cortex

PrimaryMotor Area

(M I)

THALAMUS

(VLm, VAmc, MD)

STRIATUM(CaudateNucleus)

SNr

(Substantia Nigra,pars reticulata)

pyramidaltract

LMN

Basal Ganglia (Microcircuitary) Connections


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GP, SNr

StriatumMotorCortex

VA-VL

complex

- GABA

-

GABA

+glutamate ?

glutamate

+

glutamate

+

Basal Ganglia (Microcircuitary) Connections


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Basal Ganglia (Limbic Loop) Connections

Orbitofrontal CortexAnterior Cingulate GyrusHippocampal Formation

THALAMUS

(VAmc, MD)

Ventral StriatumCaudate Nucleus

Ventral Pallidum

GPi, SNr

Basal Ganglia (Oculomotor Loop) Connections


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Basal Ganglia (Oculomotor Loop) Connections

FrontalEye Field(area 8)

PrimaryMotor Area

(M I)

THALAMUS(VLm, VAmc, MD)

STRIATUM(CaudateNucleus)

SNr(Substantia Nigra,

pars reticulata)

pyramidaltract

LMN Tectum

B l G li


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Basal Ganglia(SNc and CM-PF nuclear complex) Connections

Pallidum

Striatum

THALAMUS

(CM-PF)

Pallidum

Striatum

SNc

B l G li (B i St Eff t ) Ph l


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Basal Ganglia (Brain Stem Efferents) Phylogeny

GPi

SNr

Tectum(superiorcolliculus)

SpLnDCP

DIP (thalamus)Neostriatum

Intermediale(motor cortex)

aves (birds)

GPi

SNrTectum(superiorcolliculus)

nPC

VA-VL complex(thalamus)

motorcortex

mammals

B l G li (STN) C i


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Basal Ganglia (STN) Connections

SNrGPi

STN

GPe

subthalamic

fasciculus

OutputPortionofBasalGanglia

Cerebral Coretx

Thalamus (CM-PF)

PPN

Subthalamic

Nucleus

B l G li (V t l St i t d V t l P llid ) C ti


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Basal Ganglia (Ventral Striatum and Ventral Pallidum) Connections

VentralPallidum

VentralStriatum

Hippocampal

Formation

BasolateralAmygdala

Temporal &Frontal Cortex

SNc, VTA &Dorsal Raphe

Thalamus(MD)

BasolateralAmygdala

PPN & VTA

Thalamus(MD)

Basal Ganglia (Brain Stem Efferents) Connections


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Basal Ganglia (Brain Stem Efferents) Connections

PPN(midbrain

locomotorregion)

Tectum(superiorcolliculus)

GPi, SNr

Striatum(caudate nucleus)

LowerMotor

Neuron

viareticularformation

tectospinaltract

Basal Ganglia

Brain Stem & Spinal Cord

Basal Ganglia and Pyramidal Tract


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SMA

(supplementary motor area)

Basal Ganglia and Pyramidal Tract

upper motor neuron

UMN

lower motor neuron

LMN

pyramidaltract

BASALGANGLIA

CIRCUIT

Basal Forebrain Area Components


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BASAL FORBRAIN AREA (Heimer)

Ventral Striatum, Part ofVentral PallidumBasal Nucleus of Meynert (Ch4)Extended Amygdala

cf. Cholinergic Cell Groups (Mesulam)

(Magnocellular Basomedial Telencephalic Complex)

1. Ch1 (Medial Septal Nucleus)

2. Ch2 (Nucleus of Diagonal Band of Broca)

3. Ch3 (Nucleus of Diagonal Band of Broca)4. Ch4(Basal Nucleus of Meynert)

5. Ch5 (Pedunculopontine Tegmental Nucleus)

Basal Ganglia Functional Consideration


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Basal Ganglia Functional Consideration

Functional Consideration

1. Selection of Preprogramed (learned) motor plans

Basal Gangla Circuit ----Selection Mechanism

Selection Inability -------- Akinesia and Hypokinesia

Faulty Selection ----------- Hyperkinesia

2. Generation (learning) of motor programs

Programming of several motor fragments into

complex motor routinesCerebral Palsy------------- Disordered motor program

SYDENHAMS CHOREA


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SYDENHAM S CHOREA

- Complication ofRheumatic Fever

- Fine, disorganized , andrandom movements of

extremities, face andtongue- Accompanied byMuscular Hypotonia

- Typical exaggeration ofassociated movementsduring voluntary activity

- Usually recoversspontaneouslyin 1 to 4 months

Clinical Feature

Principal Pathologic Lesion:Corpus Striatum


45/49

Clinical Feature

Principal Pathologic Lesion:Corpus Striatum (esp. caudate nucleus)

and Cerebral Cortex

- Predominantly autosomal dominantlyinherited chronic fatal disease(Gene: chromosome 4)

- Insidious onset: Usually 40-50- Choreic movements in onset

- Frequently associated withemotional disturbances

- Ultimately, grotesque gait and severdysarthria, progressive dementiaensues.

HUNTINGTONS CHOREA

HEMIBALLISM


46/49

HEMIBALLISM

- Usually results from CVA(Cerebrovascular Accident)involving subthalamic nucleus

- sudden onset

-Violent, writhing, involuntarymovements of wide excursionconfined to one half of the body

- The movements are continuousand often exhausting but ceaseduring sleep

- Sometimes fatal due to exhaustion- Could be controlled byphenothiazines and stereotaxicsurgery

Clinical Feature

Lesion:Subthalamic Nucleus


47/49

Muhammad Ali in Alanta Olympic

Parkinsons Disease

Disease of mesostriatal

dopaminergic system

PD

normal


48/49


DOPAminergic Neuron

Slowness of Movement

- Difficulty in Initiation and Cessationof Movement




49/49


Resting Tremor

Parkinsonian PostureRigidity-Cogwheel Rigidity

Parkinsons Disease

Paralysis Agitans

saraf musko 111203 dr ety basalganglia2k1

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