Chapter 11 Flashcards by Molly Victorine

What is the basic function of the basal ganglia?

To modulate thalamo-cortical activity

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What executive commands does the basal ganglia process?

Initiation of appropriate movement

Suppression of inappropriate movement

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What are the structures of the basal ganglia?

caudate
putamen
globus pallidus
subthalamic nucleus
substantia nigra

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Caudate:

located in the cerebrum

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Putamen

located in the cerebrum

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Globus pallidus

located in the cerebrum

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Subthalamic nucleus

located within the diencephalon

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Substantia nigra

located within the midbrain

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Lentiform nucleus

globus pallidus and putamen

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Striatum

caudate and putamen

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Ventral striatum

junction of caudate and putamen

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Nucleus accumben

part of ventral striatum

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Where is dopamine from and to?

from substantia nigra to striatum

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What is the role of dopamine?

adjusts the signals to the output nuclei; the output nuclei provide the appropriate level of inhibition to their target nuclei

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What does output of the basal ganglia motor circuit regulate?

muscle contraction, muscle force, multijoint movements, and the sequence of movements

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The basal ganglia effects movements through inhibition of:

motor thalamus
ventrolateral pednculopontine nucelus (PPN)
midbrain locomotor region (MLR)

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Basal ganglia inhibition of motor thalamus:

To provide an appropriate level of facilitation in the motor cortex (such as corticospinal tracts), and ultimately a normal level to the LMNs that innervate muscles for voluntary movements

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Basal ganglia inhibition of ventrolateral pedunculopontine nucleus (PPN)

inhibit reticulospinal neurons which, in turn, provide the normal level facilitation to LMNs that innervate contraction of postural and girdle muscles, thus controlling muscle tone

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Inhibition of midbrain locomotor region (MLR):

the midbrain locomotor region stimulates the reticulospinal neurons that activate central or stepping pattern generators (CPG or SPG), eliciting rhythmical lower limb movements similar to walking or running

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Role of putamen:

receive input from premotor and motor cortex

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Role of subthalamic nucleus and substantia nigra compacta:

process information within the basal ganglia circuit

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Role of globus pallidus internus:

send output to motor areas of the cerebral cortex (via the motor thalamus), PPN and the midbrain locomotor region

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Besides motor control, parts of the four basal ganglia-thalamic loops include:

oculomotor
executive
behavioral flexibility and control
limbic

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What do all five loops of the basal ganglia contribute to?

prediction of future events, selecting desired behaviors, preventing undesired behaviors, motor learning, shifting attention, and spatial working memory

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Motor loop of basal ganglia:

movement selection and action

Where in the cerebral cortex does the motor loop go?

motor and premotor cortex

What basal ganglia is included in the motor loop?

putamen, globus pallidus

Which thalamic nuclei are included in the motor loop?

ventral lateral

Role of oculomotor loop of basal ganglia?

decisions about eye movements and spatial attention; initiation of fast eye movements

Where in the cerebral cortex does the oculomotor loop go?

dorsolateral prefrontal cortex

What basal ganglia is included in the oculomotor loop?

head of caudate, globus pallidus

Which thalamic nuclei are included in the oculmotor loop?

ventral anterior

Role of behavioral flexibility and control loop:

recognition of social disapproval, self-regulatory control, selecting relevant knowledge from irrelevant, maintaining attention, stimulus response learning

Where in the cerebral cortex does the behavioral flexibility and control loop go?

ventrolateral prefrontal and lateral orbital cortex

What basal ganglia is included in the behavioral flexibility and control loop?

head of caudate, substantia nigra reticularis

Which thalamic nuclei are included in the behavioral flexibility and control loop?

mediodorsal

Role of limbic loop:

links limbic, cognitive and motor systems; identifies value of stimuli; involved in reward guided behaviors, monitors error in predictions, concerned with seeking pleasure

Where in the cerebral cortex does the limbic loop go?

medial orbital and medial prefrontal cortex

What basal ganglia is included in the limbic loop?

ventral striatum, ventral pallidum

Which thalamic nuclei are included in the limbic loop?

mediodorsal

Hypokinetic

too little movement

Hyperkinetic

excessive movement

What does excessive inhibition lead to?

hypokinetic disorders

What does inadequate inhibition result in?

hyperkinetic disorders

What is the most common basal ganglia disorder?

parkinson's disease

What does parkinson's disease interfere with?

both voluntary and automatic movements

What are the three subtypes of Parkinson's disease?

akinetic or rigid tremor dominant mixed

Motor symptoms of PD:

Akinesia/bradykinesia/hypokinesia Rigidity Resting tremor Postural instability

Non motor symptoms of PD

``` Depression Psychosis PD dementia Constipation Fatigue ```

What is Unified PD Rating scale (UPDRS)

Is a clinical tool used to evaluate the course of PD,

PT intervention for PD:

Physical therapy/occupational therapy (PT/OT) improves mobility and functional status in individuals with Parkinson's disease. Speech therapy is provided for voice training

PT for PD can reduce what symptoms:

``` Balance problems Gait dysfunction Muscle weakness Lack of coordination Mobility disability Rigidity ```

Parkinson-Plus Syndrome:

Is the collective name for primary neuro-degenerative diseases that cause signs similar to PD

Parkinson-Plus Syndrome include:

progressive supranuclear palsy, dementia with Lewy bodies, and multiple system atrophy

Progressive supranuclear palsy (PSP)

Is characterized by the early onset of gait instability with a tendency to fall backward, axial rigidity, freezing of gait, depression, psychosis, rage attacks, and supranuclear gaze palsy

Dementia with Lewy bodies

Causes early, generalized cognitive decline, visual hallucinations, and Parkinsonism

Multiple system atrophy:

Is a progressive degenerative disease affecting the basal ganglia, cerebellar and autonomic systems; the peripheral nervous system; and the cerebral cortex

What is multiple system atrophy characterized by:

akinesia/rigidity cerebellar signs autonomic dysfunction corticospinal tract dysfunction

Parkinsomism

Encompasses disorders with signs that mimic PD but the cause is known to be toxic, infectious, or traumatic

Signs of parkinsomism:

subacute, bilateral onset with rapid progression, early postural tremor, and involuntary movements of the face and mouth

Abnormal involuntary movements are characteristics of

Huntington’s disease Dystonia Tourette’s disorder Some types of cerebral palsy

Huntington's Disease:

Autosomal dominant hereditary disorder causes degeneration in many areas of the brain, most prominently in the striatum and cerebral cortex Signs include dementia and chorea

Dystonia:

Genetic, usually nonprogressive, movement disorders are characterized by involuntary sustained muscle contractions, causing abnormal posture, twisting, and repetitive movements

Tourette's Disorder:

Causes vocal and motor tics. Involves abrupt, repetitive, stereotyped movements onset during childhood

Choreoathetotic Cerebral Palsy

a type of cerebral palsy abnormal involuntary movements associated with lesions involving both the basal ganglia and ventrolateral thalamus

Chorea

abrupt, jerky movements

Athetosis:

slow, writhing, purposeless movements