basal ganglia caudate nucleus lentiform nucleus putamen globus palidus internal external claustram...
TRANSCRIPT
Basal Ganglia (traditional concept)Basal Ganglia (traditional concept)
Corpus striatum
lenticular nucleus
putamen
globus pallidus
caudate nucleus
Amygdaloid body
Corpus striatum
lenticular nucleus
putamen
globus pallidus
caudate nucleus
Amygdaloid body
Basal GangliaBasal Ganglia
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3
12
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Basal GangliaBasal Ganglia
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12
3
Traditional Concepts of Basal GangliaTraditional Concepts of Basal Ganglia
Corpus StriatumCorpus Striatum
Caudate NucleusCaudate Nucleus
Lenticular Nucleus PutamenLenticular Nucleus Putamen
Globus Pallidus Paleostriatum PallidumGlobus Pallidus Paleostriatum Pallidum
Corpus Amygdaloideum ArchistriatumCorpus Amygdaloideum Archistriatum
Neostriatum StriatumNeostriatum Striatum
Basal Ganglia Basal Ganglia
Introduction Introduction
Basal Ganglia Basal Ganglia
Introduction Introduction
1. Putamen1. Putamen2. Tail of caudate nucleus2. Tail of caudate nucleus3. Caudatolenticular gray 3. Caudatolenticular gray
bridgebridge4. Amygdaloid body4. Amygdaloid body5. thalamus5. thalamus
Lateral surface Lateral surface of basal gangliaof basal ganglia
Input Portion Input Portion
STRIATUM STRIATUM
(Caudate Nucleus and Putamen)(Caudate Nucleus and Putamen)
Output PortionOutput Portion
1. 1. PALLIDUM PALLIDUM (Globus Pallidus)(Globus Pallidus)
2. 2. SNr SNr (Substantia Nigra, Pars Reticulata)(Substantia Nigra, Pars Reticulata)
Basal Ganglia
Connections
Basal Ganglia
Connections
STRIATUMSTRIATUM
Afferents fromAfferents from 1. 1. Cerebral Cortex Cerebral Cortex [Corticostriatal Projection][Corticostriatal Projection] 2. 2. ThalamusThalamus (CM-PF complex) [Thalamostriatal Projection] (CM-PF complex) [Thalamostriatal Projection] 3. 3. SNcSNc (Substantia Nigra, pars compacta), (Substantia Nigra, pars compacta), Ventral Tegmental Area (VTA, AVentral Tegmental Area (VTA, A1010) )
and Aand A88(Retrorubral Area) [Nigrostriatal Projection](Retrorubral Area) [Nigrostriatal Projection]
4. Dorsal Raphe Nucleus (B4. Dorsal Raphe Nucleus (B66, B, B88) [Raphestriatal Projection]) [Raphestriatal Projection]
5. Amygdaloid Nuclear Complex [Amygdalostriatal Projection]5. Amygdaloid Nuclear Complex [Amygdalostriatal Projection]
Efferents toEfferents to 1. 1. Pallidum (GPi & GPe) Pallidum (GPi & GPe) [Striopallidal Projection][Striopallidal Projection] 2. 2. SNrSNr [Strionigral Projection] [Strionigral Projection] 3. 3. SNcSNc from striosome from striosome
Basal Ganglia
Connections
Basal Ganglia
Connections
An oblique section through the diencephalon and basal ganglia. Abbreviations: A8, 9, 10, dopaminergic cell groups; AL, ansa lenticularis; CL, centrolateral nucleus of thalamus; cm, centromedian nucleus of thalamus; EX, external pallidal segment; FS, fasciculus subthalamicus; H, H1, H2, subthalamic fields of Forel; ICV, internal cerebral veins in the transverse fissure; INT, internal pallidal segment; ITA, interthalamic adhesion; MFB, median forebrain bundle; SLIC, sublentiform internal capsule; 3, 3rd ventricle.
Connections of the striatum. The major afferent projections to the striatum are shown on the left and major efferent projections from the striatum on the righ
Major interconnections of the basal ganglia.
Input-OutputInput-OutputRelationshipRelationshipof Basal Gangliaof Basal Ganglia
1. striopallidal fiber1. striopallidal fiber2. strionigral fiber2. strionigral fiber3. strionigral fiber3. strionigral fiber from striosomefrom striosome to SNcto SNc4. ventrostrio-4. ventrostrio- ventro-pallidal fiberventro-pallidal fiber
PALLIDUM (Globus Pallidus)PALLIDUM (Globus Pallidus)Afferents fromAfferents from
1. 1. Striatum Striatum [Striatopallidal Projection][Striatopallidal Projection]
2. 2. STN <GPi & GPe> STN <GPi & GPe> [Subthalamopallidal Projection][Subthalamopallidal Projection]
Efferents toEfferents to
1. 1. Thalamus (VLo, VApc, CM) <GPi> Thalamus (VLo, VApc, CM) <GPi> [Pallidothalamic Projection][Pallidothalamic Projection]2. 2. STN <GPe>STN <GPe> [Pallidosubthalamic Projection] [Pallidosubthalamic Projection]
SNr (Substantia Nigra, Pars Reticulata)SNr (Substantia Nigra, Pars Reticulata)Afferents from Afferents from Striatum Striatum [Striatonigral Projection][Striatonigral Projection]
Efferents toEfferents to
1. 1. Thalamus (VLm, VAmc, MD) Thalamus (VLm, VAmc, MD) [Nigrothalamic Projection] [Nigrothalamic Projection]
2. Brain Stem Nucleus: Tectum (Superior Colliculus) &2. Brain Stem Nucleus: Tectum (Superior Colliculus) &
Pedunculopontine Nucleus (PPN)Pedunculopontine Nucleus (PPN)
Basal Ganglia Connections
Basal Ganglia Connections
Pallidothalamic FibersPallidothalamic Fibers from GPi to VLo, VApc, CMfrom GPi to VLo, VApc, CM
Ansa LenticularisAnsa Lenticularis from outer (lateral) portion of GPifrom outer (lateral) portion of GPi fibers sweep ventromedially and rostrally around fibers sweep ventromedially and rostrally around the posterior limb of the internal capsulethe posterior limb of the internal capsule enters enters Forel’s field HForel’s field H
Lenticular FasciculusLenticular Fasciculus from inner (medial) portion of GPifrom inner (medial) portion of GPi perforate internal capsuleperforate internal capsule enters enters Forel’s field HForel’s field H22
Thalamic fasciculusThalamic fasciculus ansa lenticularis, lenticular fasciculusansa lenticularis, lenticular fasciculus and cerebellothalamic fibersand cerebellothalamic fibers Forel’s field HForel’s field H11
Basal Ganglia
Connections
Basal Ganglia
Connections
Basal Ganglia Basal Ganglia Functional Consideration Functional Consideration Basal Ganglia Basal Ganglia Functional Consideration Functional Consideration
Functional ConsiderationFunctional Consideration
1. 1. Selection Selection of “Preprogramed (learned) motor plans”of “Preprogramed (learned) motor plans”
Basal Gangla Circuit ---- Basal Gangla Circuit ---- Selection MechanismSelection Mechanism
Selection Inability -------- Selection Inability -------- Akinesia and HypokinesiaAkinesia and Hypokinesia
Faulty Selection ----------- Faulty Selection ----------- HyperkinesiaHyperkinesia
2. 2. Generation (learning) Generation (learning) of motor programsof motor programs
Programming of several Programming of several motor fragments motor fragments intointo
complex motor routinescomplex motor routines
Cerebral Palsy Cerebral Palsy ------------- Disordered motor program ------------- Disordered motor program
SYDENHAM’S CHOREASYDENHAM’S CHOREASYDENHAM’S CHOREASYDENHAM’S CHOREA
- Complication of- Complication of Rheumatic FeverRheumatic Fever- Fine, disorganized , and - Fine, disorganized , and random movements ofrandom movements of extremities, face andextremities, face and tonguetongue- Accompanied by - Accompanied by Muscular HypotoniaMuscular Hypotonia- Typical exaggeration of- Typical exaggeration of associated movements associated movements during voluntary activityduring voluntary activity- Usually recovers- Usually recovers spontaneously spontaneously in 1 to 4 monthsin 1 to 4 months
Clinical FeatureClinical Feature
Principal Pathologic Lesion: Principal Pathologic Lesion: Corpus StriatumCorpus Striatum
Clinical FeatureClinical Feature
Principal Pathologic Lesion:Principal Pathologic Lesion: Corpus Striatum (esp. caudate nucleus)Corpus Striatum (esp. caudate nucleus) and Cerebral Cortexand Cerebral Cortex
- Predominantly - Predominantly autosomal dominantlyautosomal dominantly inherited chronic fatal diseaseinherited chronic fatal disease (Gene: chromosome 4)(Gene: chromosome 4)- Insidious onset: Usually 40-50- Insidious onset: Usually 40-50- Choreic movements in onset- Choreic movements in onset- Frequently associated with- Frequently associated with emotional disturbancesemotional disturbances- Ultimately, grotesque gait and sever- Ultimately, grotesque gait and sever dysarthria, progressive dementiadysarthria, progressive dementia ensues.ensues.
HUNTINGTON’S CHOREAHUNTINGTON’S CHOREA
HEMIBALLISMHEMIBALLISMHEMIBALLISMHEMIBALLISM
- Usually results from CVA- Usually results from CVA (Cerebrovascular Accident)(Cerebrovascular Accident) involving subthalamic nucleusinvolving subthalamic nucleus- sudden onset- sudden onset- Violent, writhing, involuntary- Violent, writhing, involuntary movements of wide excursionmovements of wide excursion confined to one half of the bodyconfined to one half of the body- The movements are continuous- The movements are continuous and often exhausting but ceaseand often exhausting but cease during sleepduring sleep- Sometimes fatal due to exhaustion- Sometimes fatal due to exhaustion- Could be controlled by- Could be controlled by phenothiazines and stereotaxicphenothiazines and stereotaxic surgery surgery
Clinical FeatureClinical Feature
Lesion: Lesion: Subthalamic NucleusSubthalamic Nucleus
Muhammad Ali in Alanta OlympicMuhammad Ali in Alanta Olympic
Parkinson’s DiseaseParkinson’s Disease
Disease of mesostriatal Disease of mesostriatal dopaminergic systemdopaminergic system
PDPD
normalnormal
Substantia Nigra, Substantia Nigra, Pars Compacta (SNc)Pars Compacta (SNc)
DOPAminergic NeuronDOPAminergic Neuron
Slowness of MovementSlowness of Movement- Difficulty in Initiation and Cessation - Difficulty in Initiation and Cessation of Movementof Movement
Clinical Feature (1)Clinical Feature (1)
Parkinson’s Disease - Paralysis AgitansParkinson’s Disease - Paralysis Agitans
Clinical Feature (2)Clinical Feature (2)
Resting TremorResting TremorParkinsonian PostureParkinsonian PostureRigidity-Cogwheel RigidityRigidity-Cogwheel Rigidity
Parkinson’s Disease Parkinson’s Disease
Paralysis AgitansParalysis Agitans