L9 Basal Ganglia

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Questions and Answers

What is the primary role of the intrinsic cholinergic interneurons in the caudate?

  • To counteract the activity of nigrostriatal pathways. (correct)
  • To amplify signals from the motor cortex.
  • To stimulate the output nuclei of the basal ganglia.
  • To mediate pain responses in motor control.

Which of the following is an output nucleus of the basal ganglia?

  • Medial/Internal Segment Globus Pallidus (correct)
  • Substantia Nigra pars Reticulata (correct)
  • Lateral/External segment of Globus Pallidus
  • Caudate Nucleus

How does the basal ganglia influence movement during spontaneous discharge?

  • It remains inactive, preventing movement by default. (correct)
  • It coordinates all muscle activities simultaneously.
  • It initiates involuntary motor activity continually.
  • It enhances voluntary movement across the cortex.

What is the role of the basal ganglia in coordinating muscle actions?

<p>To ensure different muscles and joints are used in a coordinated manner while avoiding conflicting actions. (B)</p> Signup and view all the answers

What fundamental principle describes the output of the basal ganglia in the absence of external stimulation?

<p>The output inhibits motor activity in the cortex. (A)</p> Signup and view all the answers

What is the initial characteristic of the newly disinhibited motor pattern?

<p>It is uncoordinated. (A)</p> Signup and view all the answers

Which pathway provides selective inhibition of unwanted actions?

<p>Indirect Pathway (B)</p> Signup and view all the answers

What is the role of the GABA neurotransmitter in the Indirect Pathway?

<p>To inhibit similar unwanted actions. (C)</p> Signup and view all the answers

Which of the following structures is involved in the Indirect Pathway?

<p>Medial Globus Pallidus (C)</p> Signup and view all the answers

Which component is NOT associated with the Indirect Pathway?

<p>Primary Motor Cortex (B)</p> Signup and view all the answers

What must the newly disinhibited motor pattern do to become effective?

<p>It must outcompete similar but unwanted patterns. (A)</p> Signup and view all the answers

What is the function of the Lateral Globus Pallidus in motor control?

<p>To inhibit certain motor actions. (C)</p> Signup and view all the answers

Which of the following describes the relationship between the Direct and Indirect Pathway?

<p>They work together to regulate motor activity. (A)</p> Signup and view all the answers

What effect does a high level of basal ganglia activity have on movements?

<p>It allows for multitasking. (B)</p> Signup and view all the answers

How do the output nuclei of the basal ganglia function in relation to movements?

<p>They serve as the 'brake' for self-generated movements. (C)</p> Signup and view all the answers

What is the primary neurotransmitter released from the indirect pathway of the basal ganglia?

<p>GABA (B)</p> Signup and view all the answers

What role does tonic GABAergic activity in the basal ganglia output nuclei play?

<p>It inhibits the thalamus and cortex most of the time. (D)</p> Signup and view all the answers

Which structure is part of the basal ganglia and contributes to the output nuclei?

<p>Caudate/Putamen (C)</p> Signup and view all the answers

In what way does minimal activity in the basal ganglia affect motor function?

<p>It restricts all action. (A)</p> Signup and view all the answers

What could be inferred about the relationship between the basal ganglia and multitasking?

<p>High basal ganglia activity enhances the ability to manage multiple tasks. (A)</p> Signup and view all the answers

Which pathway in the basal ganglia is primarily responsible for inhibiting motor activity?

<p>Indirect Pathway (D)</p> Signup and view all the answers

What characterizes the indirect pathway in terms of synaptic connections?

<p>It has an odd number of inhibitory synapses. (A)</p> Signup and view all the answers

What role does the basal ganglia play when a sudden unexpected stimulus occurs?

<p>It initiates the Hyperdirect Pathway to prioritize new actions. (B)</p> Signup and view all the answers

Which neurotransmitter is associated with the default state of doing nothing?

<p>GABA (A)</p> Signup and view all the answers

Which of the following neurotransmitters is primarily associated with the output nuclei?

<p>GABA (B)</p> Signup and view all the answers

What is the effect of the 'global inhibition' signal sent by the basal ganglia?

<p>It inhibits all basal ganglia-controlled movements. (B)</p> Signup and view all the answers

What role does the Subthalamic Fasciculus play in the Basal Ganglia circuit?

<p>It supports both direct and indirect pathways. (A)</p> Signup and view all the answers

The pathway responsible for sending the 'global inhibition' signal is known as what?

<p>The Hyperdirect Pathway (B)</p> Signup and view all the answers

Which part of the basal ganglia is primarily responsible for initiating motor commands?

<p>Caudate/Putamen (D)</p> Signup and view all the answers

What is the primary function of the Medial Globus Pallidus within the Basal Ganglia pathways?

<p>To inhibit outputs towards the motor cortex. (C)</p> Signup and view all the answers

In which context does the basal ganglia function when a simple action transitions to a more complex series of movements?

<p>By sending a global inhibition signal to restart motor planning. (A)</p> Signup and view all the answers

Which structure provides excitatory input to the motor cortex in the context of the basal ganglia pathways?

<p>Thalamus (B)</p> Signup and view all the answers

What combination of actions is described in the passage while undergoing a realization due to an unexpected stimulus?

<p>Walking and chewing bubble gum, then reprioritizing actions. (D)</p> Signup and view all the answers

In the context of basal ganglia output pathways, what does the term 'Thalamic Fasciculus' refer to?

<p>A direct output pathway from the basal ganglia. (D)</p> Signup and view all the answers

How does glutamate function in relation to the default state of movement?

<p>It promotes the engagement of motor patterns. (D)</p> Signup and view all the answers

What is the fundamental role of the thalamus in the context presented?

<p>It relays information critical for motor control. (B)</p> Signup and view all the answers

What type of feedback does the entire indirect pathway provide?

<p>Negative feedback (A)</p> Signup and view all the answers

What type of neurotransmitter is primarily released by the Indirect Pathway within the Basal Ganglia?

<p>GABA (D)</p> Signup and view all the answers

Which structure within the Basal Ganglia is responsible for providing excitatory input to the Motor Cortex?

<p>Thalamus (D)</p> Signup and view all the answers

What is a characteristic symptom of Parkinson’s Disease as described?

<p>Resting tremor (B)</p> Signup and view all the answers

Which component is associated with the Direct Path within the Basal Ganglia circuitry?

<p>Striatum (D)</p> Signup and view all the answers

Which part of the Basal Ganglia is affected by the loss of dopamine in Parkinson’s Disease?

<p>Substantia Nigra pars Compacta (C)</p> Signup and view all the answers

What effect does the Indirect Pathway have on motor cortical activity?

<p>Inhibits movement (D)</p> Signup and view all the answers

Which neurotransmitter is associated with the excitatory signals in the Basal Ganglia circuit to the Motor Cortex?

<p>Glutamate (A)</p> Signup and view all the answers

What type of facial expression is often observed in individuals with Parkinson's Disease?

<p>Masked faces (D)</p> Signup and view all the answers

What characterizes akathisia among movement disorders?

<p>Uncontrollable urges to move. (B)</p> Signup and view all the answers

Which of the following is true about dystonia?

<p>It causes sustained multi-muscle contractions that are painless. (C)</p> Signup and view all the answers

What is the main feature of bradykinesia?

<p>Diminished motion without muscle weakness. (B)</p> Signup and view all the answers

Which movement disorder is characterized by large amplitude limb flailing?

<p>Ballismus/Ballism (C)</p> Signup and view all the answers

What distinguishes tics from other movement disorders?

<p>They are repetitive but can be briefly suppressed with effort. (A)</p> Signup and view all the answers

What is the primary characteristic of paratonia?

<p>Sustained postural holding of limbs. (B)</p> Signup and view all the answers

Which of the following best describes the symptom of akinesia?

<p>Difficulty starting movements. (D)</p> Signup and view all the answers

What condition can arise from long-term use of dopamine antagonist antipsychotic drugs?

<p>Tardive Dyskinesia (A)</p> Signup and view all the answers

How is athetosis typically described?

<p>Continuous writhing movements that disrupt posture. (D)</p> Signup and view all the answers

What is the primary consequence of methanol poisoning?

<p>Blindness and putaminal hemorrhages (C)</p> Signup and view all the answers

Which gait is characterized by dragging due to hemiplegia or paresis related to upper motor neuron lesions?

<p>Spastic Gait (A)</p> Signup and view all the answers

Which behavior describes complex and prolonged purposeless actions resulting from excessive phasic dopamine?

<p>Punding (C)</p> Signup and view all the answers

Cerebral palsy primarily results from the dysregulation of which brain region?

<p>Cerebral Cortex (D)</p> Signup and view all the answers

What is the primary mechanism responsible for visual impairment following methanol exposure?

<p>Formaldehyde metabolism (A)</p> Signup and view all the answers

What is the typical effect of hypoxia during pregnancy related to cerebral palsy?

<p>Dysregulation of motor function (C)</p> Signup and view all the answers

Which symptom is characteristic of punding behavior?

<p>Compulsive organization of objects (A)</p> Signup and view all the answers

What is the primary function of the Indirect Pathway in the context of motor control?

<p>Provides selective inhibition of similar but unwanted actions (D)</p> Signup and view all the answers

Which of the following components is part of the Indirect Pathway?

<p>Subthalamic Nucleus (C)</p> Signup and view all the answers

What type of neurotransmitter is predominantly involved in the Indirect Pathway of the Basal Ganglia?

<p>GABA (A)</p> Signup and view all the answers

Which statement accurately describes the interaction of the directly and indirectly activated pathways in motor control?

<p>The Direct Pathway enhances movement while the Indirect Pathway inhibits it. (C)</p> Signup and view all the answers

What does the indirect pathway primarily utilize among its synapses?

<p>An odd number of inhibitory synapses (A)</p> Signup and view all the answers

What occurs as a result of the newly disinhibited motor pattern competing with established patterns?

<p>The disinhibited pattern remains uncoordinated and ineffective. (A)</p> Signup and view all the answers

Which neurotransmitter is implicated in the overall function of the output nuclei within the basal ganglia?

<p>GABA (D)</p> Signup and view all the answers

In the context of motor control, which area primarily provides input to the motor cortex?

<p>Thalamus (C)</p> Signup and view all the answers

What is the consequence of an increase in GABAergic activity within the Indirect Pathway?

<p>Inhibition of competing movements (D)</p> Signup and view all the answers

The 'Thalamic Fasciculus' is primarily associated with which function in the basal ganglia pathway?

<p>Executing basal ganglia output toward the thalamus (D)</p> Signup and view all the answers

What does the term 'disinhibition' refer to in the context of motor patterns?

<p>Release of previous motor suppression enabling new patterns (D)</p> Signup and view all the answers

What type of feedback is provided by the indirect pathway of the basal ganglia?

<p>Negative feedback (D)</p> Signup and view all the answers

The role of the Subthalamic Fasciculus in the basal ganglia circuitry is primarily related to which aspect?

<p>Connecting the direct and indirect pathways (A)</p> Signup and view all the answers

Which part of the basal ganglia is most directly involved in inhibitory control of the motor cortex?

<p>Medial Globus Pallidus (B)</p> Signup and view all the answers

What is the primary role of glutamate in the context of the basal ganglia signaling pathways?

<p>To provide excitatory input to the motor cortex (D)</p> Signup and view all the answers

Which structure receives input from the Lateral Globus Pallidus within the basal ganglia pathways?

<p>Motor thalamus (A)</p> Signup and view all the answers

What characterizes the axons connecting the motor cortex to the subthalamus in the Hyperdirect Pathway?

<p>They are large and myelinated. (C)</p> Signup and view all the answers

What is the primary effect of the Hyperdirect Pathway on the motor thalamus and cortex during the initiation of motor patterns?

<p>A sudden increase in inhibition. (A)</p> Signup and view all the answers

Which statement regarding the global inhibition signal in the basal ganglia is accurate?

<p>It reaches the motor thalamus and cortex before any other signals. (A)</p> Signup and view all the answers

In the context of the Hyperdirect Pathway, what role do GABA neurotransmitters primarily play?

<p>To promote inhibition within the motor control pathways. (A)</p> Signup and view all the answers

What is the functional outcome of the 'phasic' increase in inhibition initiated by the Hyperdirect Pathway?

<p>It prevents the occurrence of unintended movements. (A)</p> Signup and view all the answers

What neurotransmitter is primarily associated with the excitatory signals in the basal ganglia circuit to the motor cortex?

<p>Glutamate (B)</p> Signup and view all the answers

Which structure provides inhibitory input through GABA in the indirect pathway?

<p>Medial Globus Pallidus (D)</p> Signup and view all the answers

Which characteristic best describes the Indirect Pathway in terms of its overall function?

<p>Inhibits unwanted motor actions (B)</p> Signup and view all the answers

What is a common symptom associated with Parkinson’s Disease related to emotional expressiveness?

<p>Masked faces with a loss of emotional expressions (A)</p> Signup and view all the answers

In the context of the basal ganglia and its pathways, which component is primarily affected by the loss of dopamine in Parkinson’s Disease?

<p>Substantia nigra pars compacta (D)</p> Signup and view all the answers

Which pathway is responsible for sending a 'global inhibition' signal to other parts of the brain?

<p>Indirect Pathway (B)</p> Signup and view all the answers

What effect does increased activity in the indirect pathway have on the thalamus?

<p>Inhibits thalamic activity (B)</p> Signup and view all the answers

Which neurotransmitter is primarily released by the indirect pathway within the basal ganglia?

<p>GABA (D)</p> Signup and view all the answers

What is the mechanism of the Hyperdirect Pathway in initiating new motor patterns?

<p>It causes a phasic increase in inhibition of the motor thalamus and cortex. (B)</p> Signup and view all the answers

Which statement best describes the axons connecting the motor cortex to the subthalamus in the Hyperdirect Pathway?

<p>They are large and myelinated. (B)</p> Signup and view all the answers

What type of signal does the global inhibition from the basal ganglia reach before any other signals?

<p>A motor thalamus and cortex signal. (A)</p> Signup and view all the answers

What is the primary function of the direct pathway in the basal ganglia?

<p>Facilitate disinhibition of motor cortex (D)</p> Signup and view all the answers

In terms of neurotransmitter activity, what role does GABA play in the Hyperdirect Pathway?

<p>It increases inhibition of the motor thalamus and cortex. (B)</p> Signup and view all the answers

Which neurotransmitter is predominantly involved in facilitating action within the context of the basal ganglia?

<p>Glutamate (B)</p> Signup and view all the answers

Which aspect of the Hyperdirect Pathway sets it apart from the Direct and Indirect pathways?

<p>It produces a rapid phasic change in inhibition. (C)</p> Signup and view all the answers

In the context of basal ganglia circuitry, what is the significance of the output to the thalamus?

<p>It allows for modulation of motor patterns based on sensory input. (A)</p> Signup and view all the answers

How does the basal ganglia initiate a newly selected action from a reset initial state?

<p>Using the direct pathway for disinhibition. (C)</p> Signup and view all the answers

Which statement accurately describes the role of GABA in the context of the indirect pathway?

<p>GABA is primarily responsible for inhibiting unwanted actions. (A)</p> Signup and view all the answers

What is the distinguishing characteristic of akathisia compared to other movement disorders?

<p>Uncontrollable urges to move without restful state (D)</p> Signup and view all the answers

Which of the following describes the symptoms of dystonia?

<p>Sustained postural muscle contractions with twisting movements (B)</p> Signup and view all the answers

What type of movement disorder involves involuntary, intermittent vocalizations?

<p>Tics (B)</p> Signup and view all the answers

Which movement disorder is characterized by slow or fast discrete involuntary movements?

<p>Chorea (C)</p> Signup and view all the answers

What movement disorder is typically characterized by excessive muscle movement without intentional control?

<p>Hyperkinesia (C)</p> Signup and view all the answers

Bradykinesia is primarily defined by which of the following characteristics?

<p>Slower than normal movement with starting hesitation (A)</p> Signup and view all the answers

Which of the following describes ballismus?

<p>Excessive limb flailing with larger amplitude movements (B)</p> Signup and view all the answers

What best describes the nature of athetosis as a movement disorder?

<p>Continuous, slow writhing movements affecting posture (B)</p> Signup and view all the answers

What is the main function of the Indirect Pathway in movement coordination?

<p>Enhances motor pattern selectivity by inhibiting unwanted actions (B)</p> Signup and view all the answers

Which structure primarily interacts with the Indirect Pathway's neurotransmitter?

<p>Caudate/Putamen (A)</p> Signup and view all the answers

Which neurotransmitter primarily facilitates the functions of the Indirect Pathway?

<p>GABA (A)</p> Signup and view all the answers

What role does the newly disinhibited motor pattern play in movement dynamics?

<p>It competes with uncoordinated muscle actions to establish control (B)</p> Signup and view all the answers

Which component is essential in the indirect pathway to modulate motor control effectively?

<p>Medial Globus Pallidus (D)</p> Signup and view all the answers

What determines the effectiveness of the Indirect Pathway in suppressing unwanted movements?

<p>The level of GABAergic influence in the striatum (B)</p> Signup and view all the answers

In terms of motor coordination, what is the significance of the interaction between the Direct and Indirect Pathways?

<p>They work in a balanced manner to facilitate smooth motor execution (B)</p> Signup and view all the answers

What is the nature of the competition faced by newly disinhibited motor patterns?

<p>They must outcompete pre-existing uncoordinated patterns (D)</p> Signup and view all the answers

What is a potential consequence of long-term use of dopamine antagonist antipsychotic drugs?

<p>Punding (C)</p> Signup and view all the answers

Which condition is described as a non-progressive motor disorder caused by dysfunction in the cerebral cortex?

<p>Cerebral Palsy (D)</p> Signup and view all the answers

What is the characteristic symptom of Tardive Dyskinesia?

<p>Frog-like mouth movements (B)</p> Signup and view all the answers

What is the primary harmful metabolite produced from methanol?

<p>Formaldehyde (B)</p> Signup and view all the answers

Which symptom is associated with bilateral putaminal hemorrhages due to methanol poisoning?

<p>Motor symptoms (A)</p> Signup and view all the answers

Which gait is typically characterized by foot-dragging and is often associated with hemiplegia?

<p>Spastic Gait (A)</p> Signup and view all the answers

What does the presence of decreased vision within days of methanol exposure indicate?

<p>Acute toxicity (C)</p> Signup and view all the answers

What leads to excessive phasic dopamine and subsequent punding behavior?

<p>Excessive dopamine activity (D)</p> Signup and view all the answers

What role do the output nuclei of the basal ganglia play in relation to self-generated movements?

<p>They act as a 'brake' on movements. (C)</p> Signup and view all the answers

What characterizes the tonic GABAergic activity of the basal ganglia output nuclei?

<p>It consistently inhibits thalamus and cortex activity. (D)</p> Signup and view all the answers

How does minimal activity in the basal ganglia affect overall movement control?

<p>It completely prevents all forms of action. (D)</p> Signup and view all the answers

What is the main consequence of high levels of activity in the basal ganglia?

<p>It allows for multitasking without necessarily speeding up movements. (D)</p> Signup and view all the answers

Which structure predominantly contributes to the inhibition of the motor cortex through the basal ganglia?

<p>Substantia Nigra pars Reticulata (C)</p> Signup and view all the answers

Which statement best describes the relationship between the direct and indirect pathways in the basal ganglia?

<p>The direct pathway promotes movement, whereas the indirect pathway inhibits it. (D)</p> Signup and view all the answers

What can be concluded about the effects of the indirect pathway in the basal ganglia?

<p>It allows for selective inhibition of non-essential movements. (A)</p> Signup and view all the answers

What is the significance of the basal ganglia's 'global inhibition' signal?

<p>It ensures that unwanted movements are suppressed. (D)</p> Signup and view all the answers

Flashcards

Caudate Nucleus

A region within the basal ganglia that releases acetylcholine to modulate activity in the nigrostriatal pathway.

Substantia Nigra Pars Compacta (SNpc)

The part of the substantia nigra that produces dopamine and projects to the striatum. Not shown in the diagram.

Lateral/External Segment of Globus Pallidus (GPL)

The lateral segment of the globus pallidus, located in the outer portion of the structure. It plays a role in inhibiting movement.

Basal Ganglia

A group of brain structures that are essential for the coordination and control of movement.

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Scenario

A typical scenario involving the basal ganglia. The output nuclei of the basal ganglia normally "inhibit" the motor cortex and thalamus, preventing spontaneous movement.

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Basal Ganglia Output Nuclei

A brain region that acts as a "brake" on movement by inhibiting the thalamus and motor cortex, preventing spontaneous actions.

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Direct Pathway

A pathway within the basal ganglia that helps to initiate movement by disinhibiting the thalamus and motor cortex.

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Indirect Pathway

A pathway within the basal ganglia that primarily inhibits movement by activating the subthalamic nucleus and thus indirectly inhibiting the thalamus and motor cortex.

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Subthalamic Nucleus

A brain area involved in regulating movement control, particularly in the indirect pathway.

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Substantia Nigra pars Reticularis

A brain region that projects dopamine to the striatum, playing a crucial role in facilitating movement.

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Striatum (Caudate/Putamen)

A brain structure within the basal ganglia that receives input from the cortex and projects to both the direct and indirect pathways.

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GABA (Gamma-aminobutyric acid)

The primary inhibitory neurotransmitter used in the basal ganglia, responsible for inhibiting the thalamus and motor cortex.

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Multitasking

Caused by a high level of basal ganglia activity, this allows for multiple actions to occur simultaneously.

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Default Brain State

The default state of the brain, characterized by a balance of inhibiting and excitatory signals, allowing for a state of rest and readiness.

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GABA

A neurotransmitter associated with reducing neuronal activity, promoting calmness and relaxation. It plays a key role in the default brain state.

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Thalamus

A brain structure crucial for sensory information processing and relaying it to other parts of the brain, contributing to the overall activity of the brain.

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Glutamate

A neurotransmitter primarily associated with stimulating neuronal activity, promoting action and movement. It plays a key role in activating the brain for motor control.

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Motor Cortex

A brain structure involved in planning and executing movements; it receives input from the basal ganglia to regulate motor function.

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Hyperdirect Pathway

A pathway within the basal ganglia responsible for globally inhibiting ongoing motor activities, allowing for transitioning to new motor patterns.

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Reprioritizing Motor Patterns

The process of prioritizing and shifting attention from one action to another based on new information, often involving the hyperdirect pathway within the basal ganglia.

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Indirect Pathway: Movement Inhibition

The indirect pathway in the basal ganglia primarily inhibits movement by activating the subthalamic nucleus (STN). This activation leads to increased inhibition of the thalamus and motor cortex, ultimately suppressing unwanted movements.

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Direct Pathway: Movement Facilitation

The direct pathway within the basal ganglia facilitates movement by disinhibiting the thalamus and motor cortex. This results in increased activation of the motor cortex, leading to a specific motor action.

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Striatum: Gatekeeper of Movement

The striatum, composed of the caudate and putamen, receives input from the cortex and relays this information to both the direct and indirect pathways, influencing movement initiation and suppression.

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Lateral Globus Pallidus: Movement Inhibition

The lateral globus pallidus (GPL), an output structure of the basal ganglia, plays a crucial role in inhibiting movement by sending inhibitory signals to the thalamus and motor cortex, ensuring smooth and controlled movements.

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Subthalamic Nucleus: Movement Inhibition

The subthalamic nucleus (STN), located in the diencephalon, is a key player in the indirect pathway. It receives input from the globus pallidus and projects to the substantia nigra pars reticulata, contributing to movement suppression.

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Substantia Nigra Pars Reticularis: Movement Control

The substantia nigra pars reticulata (SNpr) projects to the thalamus, contributing to movement suppression by inhibiting thalamocortical neurons. This inhibition helps to refine and modulate movements.

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Basal Ganglia: Movement Control Center

The basal ganglia, a group of subcortical structures, play a crucial role in planning and coordinating movement. They receive input from the cortex and project to the thalamus, influencing motor activity.

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Direct and Indirect Pathways: Complementary Roles

The direct pathway and indirect pathway work together to create a balanced control system for movement. The direct pathway facilitates desired movement, while the indirect pathway suppresses competing or unwanted movements, resulting in precise and efficient action.

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What is the striatum?

The part of the basal ganglia that receives input from the cortex and projects to both the direct and indirect pathways.

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What are the output nuclei of the basal ganglia?

The output nuclei of the basal ganglia are the Globus Pallidus (internal) and the Substantia Nigra pars Reticularis. These nuclei are responsible for inhibiting the thalamus and motor cortex.

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What is the direct pathway's role?

The direct pathway in the basal ganglia facilitates movement by directly disinhibiting the thalamus. It involves fewer inhibitory synapses.

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What is the indirect pathway's role?

The indirect pathway in the basal ganglia inhibits movement by increasing inhibition of the thalamus. It involves more inhibitory synapses.

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What is the Subthalamic Nucleus (STN)?

The Subthalamic Nucleus (STN) is a crucial part of the indirect pathway, acting as an intermediary in reducing thalamus activity.

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What is the Medial Globus Pallidus (GPi)?

The Medial Globus Pallidus (GPi) is one of the output nuclei in the basal ganglia, which plays a critical role in inhibiting the thalamus via GABA neurotransmission.

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What is GABA's role in the basal ganglia?

GABA (Gamma-aminobutyric acid) is the primary inhibitory neurotransmitter used in the basal ganglia, responsible for inhibiting the thalamus and motor cortex.

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What are the basal ganglia?

The basal ganglia are a group of brain regions involved in controlling movement, learning, and other functions. They influence movement through the thalamus and motor cortex.

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Dopamine in the Indirect Pathway

Dopamine plays a key role in controlling movement by affecting the activity of the indirect pathway. In Parkinson's disease, the loss of dopamine neurons in the substantia nigra leads to an imbalance in the balance of activity, where the indirect pathway becomes more active. The decreased dopamine levels result in increased inhibition of movement, leading to the characteristic symptoms of the disease.

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Subthalamic Nucleus (STN)

The subthalamic nucleus (STN) plays a crucial role in the indirect pathway, amplifying its inhibitory effect on movement. It receives excitatory input from the globus pallidus external segment (GPe) and projects to the globus pallidus internal segment (GPi), further increasing the inhibition of the thalamus and motor cortex.

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Globus Pallidus Internal Segment (GPi)

The globus pallidus internal segment (GPi) is the final output structure of the indirect pathway. It receives input from the subthalamic nucleus (STN) and projects to the thalamus. The GPi is highly active in inhibiting movement in the indirect pathway. In Parkinson's disease, the decreased inhibition of the GPi leads to increased inhibition of the thalamus, contributing to the slowness of movement.

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Striatum in the Indirect Pathway

The striatum is a key structure at the beginning of both the direct and indirect pathways, acting like a 'decision maker' for movement. It receives input from the cortex and integrates information from various brain regions. The striatum also receives input from the substantia nigra pars compacta (SNpc), which sends dopamine to modulate the activity of the striatum. The activity level of the striatum determines the relative activity of the direct and indirect pathways.

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Globus Pallidus External Segment (GPe)

The globus pallidus external segment (GPe) is a crucial structure in the indirect pathway, responsible for inhibiting the subthalamic nucleus (STN). The GPe receives input from the striatum and projects to the STN, helping to modulate the activity of the indirect pathway. GPe dysfunction can lead to hyperkinetic movements, such as dystonia.

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Balance Between Direct and Indirect Pathways

The direct pathway facilitates movement by disinhibiting the thalamus, while the indirect pathway inhibits movement by activating the subthalamic nucleus (STN) and indirectly inhibiting the thalamus. The balance between these two pathways is critical for smooth and coordinated movement. This balance is affected by the level of dopamine in the brain.

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Role of Indirect Pathway in Movement Control

The indirect pathway plays a fundamental role in regulating movement by inhibiting spontaneous or unwanted actions. This is essential for maintaining a resting state and preventing involuntary movements. It allows us to control our movements intentionally and prevents undesired or uncontrolled actions.

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Striatum

A brain structure that receives input from the cerebral cortex and sends output to the thalamus, regulating movement via the direct and indirect pathways.

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Dopamine

A neurotransmitter involved in controlling movement in the basal ganglia. It is released in both the direct and indirect pathways, affecting the balance between movement facilitation and inhibition.

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Athetosis

A hyperkinetic movement disorder characterized by slow, writhing, involuntary movements, primarily affecting the upper body.

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Globus Pallidus (Internal Segment)

One of the output nuclei of the basal ganglia, responsible for inhibiting movement by sending inhibitory signals to the thalamus.

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Substantia Nigra (Pars Compacta)

A key structure located in the midbrain that produces dopamine. Its neurons project to the striatum and play a critical role in regulating movement.

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What does the Hyperdirect Pathway do?

The Hyperdirect Pathway directly inhibits the motor thalamus and cortex using a high concentration of inhibitory neurotransmitters, causing a rapid suppression of ongoing motor activities.

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What is the function of the Hyperdirect Pathway in movement?

The Hyperdirect Pathway acts like an emergency brake, abruptly reducing motor activity to prepare for a new movement, allowing for swift transitions between motor patterns.

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How does the Hyperdirect Pathway differ from the Direct Pathway?

Unlike the Direct Pathway, which uses small, unmyelinated axons, the Hyperdirect Pathway utilizes large, myelinated axons. This allows for faster signal transmission, crucial for its immediate inhibitory effect.

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What makes the Hyperdirect Pathway unique?

The Hyperdirect Pathway is so named because it directly connects the motor cortex to the subthalamic nucleus, bypassing the intermediate structures used in the Direct and Indirect Pathways.

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How does the Hyperdirect Pathway contribute to smooth movement transitions?

The Hyperdirect Pathway's rapid inhibition helps facilitate smooth transitions between motor activities. It prevents interference from previous movements while initiating new ones.

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Internal Globus Pallidus (GPi)

The internal globus pallidus (GPi) is the final output structure of the indirect pathway. It receives input from the STN and projects to the thalamus, further inhibiting thalamocortical neurons, ultimately leading to decreased movement.

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External Globus Pallidus (GPe)

The external globus pallidus (GPe) is another structure in the indirect pathway. It receives input from the striatum and projects to the STN. The GPe regulates the activity of the STN, allowing for fine-tuning of the inhibitory signals.

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Direct vs Indirect Pathway

Both the direct pathway and the indirect pathway work together to regulate movement. The direct pathway facilitates movement, while the indirect pathway inhibits movement. Their balance is crucial for smooth and coordinated voluntary actions.

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Indirect Pathway Role

The indirect pathway plays a critical role in preventing unwanted movements and maintaining a resting state. It helps us control our actions intentionally and smoothly.

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Dopamine's Role

Dopamine is a crucial neurotransmitter involved in regulating movement by modulating the activity of both the direct and indirect pathways. An imbalance in dopamine levels can lead to disorders like Parkinson's disease, where the indirect pathway becomes overly active, causing movement problems.

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Tardive Dyskinesia

A condition characterized by involuntary, repetitive muscle movements, primarily affecting the face, mouth, and tongue. It is often caused by long-term use of dopamine antagonist antipsychotic medications and can be irreversible.

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Ballism

A neurological disorder marked by large, sudden, and violent involuntary movements of the limbs, often causing a flailing or flinging motion. It is caused by damage to the basal ganglia, specifically the subthalamic nucleus.

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Punding

Involuntary, persistent, and repetitive movements that are often complex and purposeless, such as arranging objects or manipulating things repeatedly. It can be caused by dopamine imbalances in the mesolimbic pathway.

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Scissors Gait

A type of gait characterized by the legs moving in a stiff, scissor-like motion, often caused by spasticity in the muscles of the legs and hips.

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Spastic Gait

A type of gait characterized by dragging the foot on the ground, typically due to weakness or paralysis of the leg muscles. It is often seen in people with cerebral palsy or stroke.

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Cerebral Palsy

A disorder characterized by problems with muscle movement and coordination, typically caused by damage to the brain during pregnancy or shortly after birth. It is non-progressive, meaning symptoms do not worsen over time.

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Methanol

A toxic substance found in household products such as windshield washer fluid, paint removers, and antifreeze. Ingestion can lead to serious health problems like blindness and brain damage.

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Direct Pathway: Movement Initiation

The direct pathway in the basal ganglia helps initiate movements by directly inhibiting the thalamus and motor cortex.

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Striatum: Movement Decision Maker

The striatum, composed of the caudate and putamen, receives input from the cortex and relays this information to both the direct and indirect pathways, influencing movement initiation and suppression.

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Lateral Globus Pallidus: Movement Refinement

The lateral globus pallidus (GPL), an output structure of the basal ganglia, plays a crucial role in inhibiting movement by sending inhibitory signals to the thalamus and motor cortex, ensuring smooth and controlled movements.

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Subthalamic Nucleus: Movement Amplifier

The subthalamic nucleus (STN) plays a crucial role in the indirect pathway, amplifying its inhibitory effect on movement by receiving input from the globus pallidus external segment (GPe) and projecting to the globus pallidus internal segment (GPi).

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Globus Pallidus External Segment: Movement Modulator

The globus pallidus external segment (GPe) inhibits the subthalamic nucleus (STN), helping to modulate the activity of the indirect pathway. GPe dysfunction can lead to hyperkinetic movements, such as dystonia.

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Balance of Direct and Indirect Pathways

The direct pathway facilitates movement by disinhibiting the thalamus, while the indirect pathway inhibits movement by activating the subthalamic nucleus (STN) and indirectly inhibiting the thalamus. The balance between these two pathways is critical for smooth and coordinated movement. This balance is affected by the level of dopamine in the brain.

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Indirect Pathway: Movement Control

The indirect pathway plays a fundamental role in regulating movement by inhibiting spontaneous or unwanted actions. This is essential for maintaining a resting state and preventing involuntary movements. It allows us to control our movements intentionally and prevents undesired or uncontrolled actions.

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What is the Hyperdirect Pathway?

A pathway in the basal ganglia that directly inhibits the thalamus and motor cortex, resulting in a rapid suppression of ongoing motor activity.

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What is the main function of the Hyperdirect Pathway in movement?

The Hyperdirect Pathway suppresses ongoing movements to allow for the initiation of new motor patterns, enabling fast and efficient motor adjustments.

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What is the role of the Direct Pathway?

The direct pathway facilitates movement by directly inhibiting the thalamus and motor cortex, allowing for a specific action to be initiated. It involves fewer inhibitory synapses, leading to a quicker response.

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What is the role of the Indirect Pathway?

The indirect pathway inhibits movement by activating the subthalamic nucleus (STN), which further inhibits the thalamus and motor cortex. It involves more inhibitory synapses, resulting in a more nuanced control mechanism.

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What is the role of the Subthalamic Nucleus (STN)?

The subthalamic nucleus (STN) is a part of the indirect pathway and acts as a crucial intermediary. It receives input from the globus pallidus and projects to the substantia nigra, further amplifying the inhibition of the thalamus.

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What is the role of GABA in the basal ganglia?

GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter used in the basal ganglia. It plays a crucial role in inhibiting the thalamus and motor cortex, ensuring appropriate control of movement.

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What is the role of the lateral Globus Pallidus (GPL)?

The lateral Globus Pallidus (GPL) is an output structure of the basal ganglia. It sends inhibitory signals to the thalamus and motor cortex, helping to refine and smooth movements.

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What is the role of Dopamine in the basal ganglia?

Dopamine is a key neurotransmitter that plays a vital role in regulating movement. It is released in both the direct and indirect pathways, affecting the balance between movement facilitation and inhibition.

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Subthalamic Nucleus (STN) - Movement Inhibition Amplifier

The Subthalamic Nucleus (STN), a key part of the indirect pathway, amplifies the inhibitory effect on movement by increasing inhibition of the thalamus.

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Internal Globus Pallidus (GPi) - Final Inhibitory Signal

The internal Globus Pallidus (GPi) is the final output structure of the indirect pathway, further inhibiting thalamocortical neurons, ultimately leading to decreased movement.

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Hyperdirect Pathway - Sudden Movement Suppression

The hyperdirect pathway directly inhibits the motor thalamus and cortex using a high concentration of inhibitory neurotransmitters, causing a rapid suppression of ongoing motor activities. It acts like an 'emergency brake' for movement.

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Dopamine Imbalances & Antipsychotics

Schizophrenia-like psychosis can occur due to low dopamine in the mesocortical pathway or high dopamine levels in the mesolimbic pathway. Long-term use of dopamine antagonist antipsychotic drugs can also lead to problems like tardive dyskinesia and punding.

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Chorea

A type of movement disorder characterized by slow or fast, but discrete involuntary movements.

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Study Notes

Basal Ganglia Overview

  • The basal ganglia are a group of subcortical nuclei involved in motor control, cognition, and emotion.
  • They play a role in initiating and regulating movement, but do not directly control muscles.
  • Direct and indirect pathways are key components of basal ganglia functioning, affecting movement.
  • The basal ganglia receive input from various cortical areas and send output to motor areas, involving the thalamus.

Lecture Objectives

  • Students should be able to recognize and predict symptoms of major hypokinetic/hyperkinetic movement disorders (Parkinson's, Huntington's, Cerebral Palsy, Tardive Dyskinesia).
  • Students should be able to trace the direct and indirect pathways from cerebral cortex to basal ganglia and thalamus, then back to cerebral cortex.
  • Predict movement disorders from lesions in specific regions of the basal ganglia, tracts, and cortex.
  • Identify basal ganglia structures in cross-sections.

Moving Words (Motor Deficits)

  • Akathisia: Uncontrollable urges to move
  • Athetosis: Writhing movements, slower and longer than chorea
  • Ballismus (Ballism): Large-amplitude limb flailing
  • Chorea: Discrete involuntary movements (fast or slow)
  • Hyperkinesia: Excessive and abnormal movements
  • Hypokinesia: Diminished movement (not weakness)
  • Bradykinesia: Slow movement, including "start hesitation"
  • Akinesia: Inability to initiate or complete movements
  • Tics: Repeated intermittent movements or vocalizations
  • Cramps: Involuntary painful muscle contractions
  • Dystonia: Painless, sustained, postural contractions that can lead to twisting movements (e.g., Blepharospasm)
  • Paratonia: Involuntary holding positions (e.g., "waxy flexibility")

Basal Ganglia Anatomy

  • The basal ganglia are comprised of several structures: Caudate nucleus, Putamen, Globus Pallidus, Substantia Nigra, Subthalamic Nucleus.
  • These structures are involved in regulating and initiating voluntary movement

Inhibitory Interneurons and Logic

  • Neurons have a spontaneous firing rate.
  • Excitation (e.g., glutamate) increases the firing rate.
  • Inhibition (e.g., GABA) decreases the firing rate.
  • Inhibition of an inhibitory neuron causes "disinhibition."
  • Pathways with an odd number of inhibitory synapses are inhibitory, and those with an even number are excitatory.

Your Brain is a Tortellini

  • The embryonic telencephalon develops as an asymmetrically thick tube.
  • The pallium forms the thin outer layer, and the subpallium forms the thicker basal layer.
  • The pallium becomes the cortex, claustrum, and hippocampus
  • The subpallium is the basal ganglia

Basal Ganglia - Anatomy and Classification

  • Detailed diagram of basal ganglia structures labels structures and locations.
  • Classification of nuclei: Input nuclei (striatum), Intrinsic Nuclei (substantia nigra pars compacta and externa segment of globus pallidus and medial segment of globus pallidus), and Output nuclei (substantia nigra pars reticulata and internal segment of globus pallidus)

Inputs to Basal Ganglia

  • Major input to the striatum (caudate and putamen) is excitatory from layer 5 of the cerebral cortex.
  • Different cortical areas send input to the basal ganglia

Basal Ganglia - Output

  • Output nuclei (e.g., medial globus pallidus, substantia nigra pars reticulata) send GABAergic inhibitory signals to motor thalamus.
  • Thalamus projects to Motor Cortex

A typical basal ganglia scenario

  • Without outside stimulation, the basal ganglia's output nuclei inhibit the motor cortex and thalamus (default state).
  • Basal Ganglia activation enables the coordination of actions using different muscles and joints, preventing simultaneous actions using the same muscles.
  • Minimally active basal ganglia prevent all action, while high basal ganglia activity allows for multitasking.

Pathways

  • Direct Pathway, Indirect Pathway, Hyperdirect Pathways
  • The hyperdirect pathway is a rapid pathway that allows for rapid inhibition across the basal ganglia. This pathway is critical when a new task is to be performed.
  • The indirect pathway is used for inhibiting competing actions, allowing for better performance of the main task.
  • The direct pathway is the fastest pathway and is responsible for initiation of action selections.

Problems in Pathways

  • Hemiballismus/Ballism (unilateral basal ganglia lesion on one side of the body) -Caused by subthalamic lesions
  • Huntington's Chorea (autosomal dominant disease, degeneration of caudate nucleus neurons, less inhibition of the external globus pallidus)

Huntington's Disease

  • Gross morphology: Small brain with caudate and putamen atrophy.
  • Atrophy of frontal lobe.
  • Intranuclear protein inclusions (containing huntingtin) in striatum and cortex
  • Symptoms: Uncontrolled movements (chorea), slurred speech, difficulty with coordination, cognitive decline, emotional changes

Dopamine (Substantia Nigra)

  • Dopamine is like "motor oil" for the corticospinal tract.
  • Counteracting the tonic inhibitory output of the medial globus pallidus and sub nigra reticulata
  • Dopamine receptors modulate the balance of direct and indirect pathways (D1 receptors excite, D2 receptors inhibit).

Parkinson's Disease

  • ~1.5-2% prevalence in individuals over 65.
  • Loss of pars compacta dopaminergic neurons, resulting in disinhibition of the indirect pathway and under-facilitation of the direct pathway.
  • Genetic mutations (e.g., PARK18) and environmental factors are implicated.
  • Presence of Lewy bodies: Aggregates of alpha-synuclein protein.
  • Often is associated with other synucleinopathies (e.g., Lewy Body Dementia).
  • Symptoms include resting tremor, slow movement, rigidity, impaired balance, and masked facial expressions.
  • DaTscan can be used to detect the nigrostriatal dopamine degenerations.

Differential Diagnosis of Parkinsonism

Possible causes of Parkinson's-like symptoms, including genetic and environmental factors, drug-induced parkinsonism, vascular parkinsonism, and brain trauma, as well as diseases like Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA), and Corticobasal Ganglionic Degeneration (CBD).

Warning Signs of Parkinson's Plus Conditions

  • Characteristics of Parkinson's-plus conditions differentiate them from typical Parkinson's disease (e.g., early autonomic dysfunction, rapid progression, etc.)

Side Effects of Dopamine Replacement Drugs

  • Excessive dopamine can cause psychosis (hallucinations, delusions).
  • Insufficient dopamine can lead to negative symptoms (e.g., alogia, avolition, flat affect)
  • Blocking dopamine in the nigrostriatal pathway can worsen parkinsonian symptoms.
  • Tardive dyskinesia, punding, dopamine dysregulation syndrome (DDS).

Methanol Poisoning

  • Methanol, often found in windshield washer fluid, is metabolized to formaldehyde.
  • Exposure can cause decreased vision, blindness and bilateral putaminal hemorrhages.
  • Methanol poisoning may present with neurological symptoms and eventually lead to fatality.

Cerebral Palsy

  • Non-progressive motor disorder from dysregulation of cerebral cortex.
  • Often caused by exposure to hypoxia or toxins during pregnancy.
  • Several types exist, including spastic, dyskinetic, ataxic, and mixed.
  • Symptoms vary in severity and type. Can affect gait, coordination, tone, strength and motor skills and other abilities but is not progressive.

Practice Questions 1 & 2

  • Details for the practice questions (patient symptoms seen with a particular MRI image, the type of slice, the red structure represented, and affected pathways in the second question are included).

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