Basal ganglia – Neuropsychiatric aspect
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A Short seminar on Basal Ganglia and its neuropsychiatric importance
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Basal ganglia – Neuropsychiatric aspect
- 1. Presented by Dr. Subrata Naskar MD Psychiatry trainee Department of Psychiatry Silchar Medical College Email: nsubrata09@gmail.com
- 3. A BRIEF HISTORY OF BASAL GANGLIA
- 4. ANATOMY : MAJOR STRUCTURES WHAT IS BASAL GANGLIA? MAJOR STRUCTURES: OTHER STRUCTURESWHICH MAY BE INCLUDED AS PART OF BASALGANGLIA : • VENTRAL STRIATUM • VENTRAL PALLIDUM
- 5. The nuclei of the basal ganglia are shown from the lateral perspective.The caudate nucleus includes the head, body and tail. The lenticular (lentiform) nucleus consists of an apposition of two nuclei – the putamen laterally (seen here) and the globus pallidus medially (not seen on this view).
- 6. • The basal ganglia of the opposite side of the brain are shown, so they are being visualized from the medial perspective.This view therefore shows the globus pallidus, which is located medially, and its two subdivisions (internal and external segments). • The putamen is located more laterally.These nuclei collectively form the lentiform nucleus.
- 7. • STRIATUM • CORPUS STRIATUM • LENTIFORM NUCLEUS
- 8. BRIEF DISCUSSION ONTHE INDIVIDUAL STRUCTURES • CAUDATE NUCLEUS : • PUTAMEN:
- 10. • GLOBUS PALLIDUS: • DIENCEPHALIC IN ORIGIN Latin • INNER COMPONENT OF LENTIFORM NUCLEUS • CONE-LIKE STRUCTUREWITHTIP DIRECTED MEDIALLY • BOUNDED MEDIALLY BY POSTERIOR LIMB OF INTERNAL CAPSULE • LATERALLY BY PUTAMEN • DIVIDED INTO EXTERNAL AND INTERNAL SEGMENTS BY MEDIAL MAMILLARY LAMINA • SUBTHALAMIC NUCLEUS: ( of Luys)
- 11. SUBSTANTIA NIGRA PARS COMPACTA : PARS RETICULATA : • VENTRAL PART • SPARSE NUMBER OF CELLS • USESTHE NEUROTRANSMITTER GABA • m-RNA FOR DOPAMINETRANSPORTER & D2 RECEPTOR • CALBINDIN –VE • SENDS PROJECTIONSTO SENSORIMOTOR REGIONS OFTHE STRIATUM • MAY BE ASSOCIATED WITH • PARKINSON’S DISEASE MESENCEPHALIC IN ORIGIN PRESENT IN MIDBRAIN CONSISTSOFTWO COMPONENTS:
- 12. DORSALTIER NEURONS (FILLED CIRCLES) – pars compacta VENTRALTIER (OPEN CIRCLES) – pars reticulata DORSOCELLULAR ZONE (STARS)
- 15. INPUTSTOTHE BASAL GANGLIA STRIATUM ISTHE MAJOR RECIPIENT OF INPUTSTOTHE BASAL GANGLIA.THREE MAJOR AFFERENT PATHWAYS ARE KNOWNTO TERMINATE INTHE STRIATUM. • CORTICOSTRIATAL • NIGROSTRIATAL • THALAMOSTRIATAL
- 18. TH -THALAMUS PT – PUTAMEN CD - CAUDATE NUCLEUS CM – CENTRAL MEDIAN NUCLEUS SNC - SUBSTANCIA NIAGRA PARS COMPACTA VS –VENTRAL STRIATUM SNR – SUBSTANCIA NIAGRA PARS RETICULATA CORTICOSTRIATAL PATHWAY THALAMOSTRIATAL PATHWAY NIGROSTRIATAL PATHWAY
- 19. INTERNAL PROCESSING DIRECT AND INDIRECT PATHWAYS MEDIUM SPINY NEURONESWHICH CONTAINSTHE NEUROPEPTIDE SUBSTANCE P SENDS INHIBITORY PROJECTIONSTO GPi - DIRECT PATHWAY A SUBPOPULATIONOFTHESE MEDIUM SPINY NEURONES CONTAINING ENKEPHALIN PROVIDES INHIBITORY PROJECTIONSTO GPe,WHICH SENDS INHIBITORY AFFERENTSTO GPi - INDIRECT PATHWAY GPe PROJECTSTO Pars reticulate OF SUBSTANTIA NIAGRA. GPe ALSO GIVES INHIBITORY PROJECTIONSTO SUBTHALAMIC NUCLEUS. HOWEVER, NEURONES IN SUBTHALAMIC NUCLEUS ALSO PROVIDES EXCITATORY PROJECTIONSTO Gpe & GPi
- 20. OUTPUT OFTHE BASAL GANGLIA THE Gpi ISTHE SOURCEOF MUCH OFTHE INPUT OFTHE BASAL GANGLIA. THIS SEGMENTOFTHE GLOBUS PALLIDUS PROVIDESA PROJECTIONTOTHEVENTRO- LATERAL (VL) ANDVENTRO-ANTERIOR (VA) NUCLEI OFTHETHALAMUSANDTHE CENTRAL MEDIAN NUCLEUS. THE PARS RETICULATA OF SUBSTANTIA NIAGRAALSO PROVIDES PROJECTIONSTO VL &VA. THESE PROJECTIONSOFVA &VL PROJECT TO PRE-MOTOR & PRE-FRONTALCOTICES. PROJECTIONSOFTHE PRE-MOTOR & PRE- FRONTAL CORTICES PROJECTTO PRIMARY MOTOR CORTEX, SO BASAL GANGLIA ARE ABLETO INFLUENCE INDIRECTLYTHE OUTPUT OF PRIMARY MOTOR CORTEX
- 21. FUNCTIONS OF BASAL GANGLIA
- 22. • TREMORS TYPES OFTREMORS • RESTTREMOR • POSTURALTREMOR • INTENTIONTREMOR
- 23. • CHOREA:
- 24. • DYSTONIA:
- 25. • ATHETOSIS:
- 26. • HEMIBALISMUS:
- 27. MOVEMENT DISORDERSWHERE BASAL GANGLIA IS THE PRIMARY SITE OF NEUROPATHOLOGY.
- 29. CHARACTERISTICTRIAD :- RESTINGTREMOR, RIGIDITY,BRADYKINESIA. ALSO ASSOCIATED WITH GAIT & POSTURAL DISTURBANCES
- 32. • PRIMARY INVOLUNTARY MOVEMENT ABNORMALITY • ASSOCIATEDVOLUNTARY MOVEMENT ABNORMALITIES • PSYCHIATRIC MANIFESTATIONS
- 33. WILSON’S DISEASE NEUROLOGICAL FINDINGS • TREMOR • DYSTONIA • RIGIDITY • CHOREOATHETOSIS • BRADYKINESIA • MASKED FACIES • MICROGRAPHIA PSYCHIATRIC MANIFESTATIONS • PERSONALITY CHANGES • DEPRESSION • SUICIDALITY • ANXIETY DISORDERS • PSYCHOTIC DISORDERS
- 34. PROGRESSIVE SUPRANUCLEAR PALSY NEUROLOGICAL FINDINGS • PSYCHIATRIC MANIFESTATIONS • SUBCORTICAL DEMENTIAWITH BRADYPHRENIA • MEMORY DEFICITS • PREDOMINANT FRONTAL LOBE DYSFUNCTION WITH EXECUTIVEAND ATTENTION DEFICITS. • FRONTAL BEHAVIORAL DISTURBANCESOF APATHY AND DISINHIBITION • SLEEP DISTURBANCES • DEPRESSION • EMOTIONAL LABILITY INCLUDING PATHOLOGICAL LAUGHTER AND CRYING • IRRITABILITY
- 35. •LOW D2 BLOCKADE
- 36. •MEDIUM D2 BLOCKADE HIGH D2 BLOCKADE • FLUPHENAZINE • PERPHENAZINE • THIOTHIXENE • HALOPERIDOL • DROPERIDOL • PIMOZIDE • RISPERIDONE • ARIPIPRAZOLE
- 39. NEUROLEPTIC INDUCED ACUTE DYSTONIA OCCURS IN UPTO 10% PATIENTS MORE COMMON INYOUNG MEN
- 42. SUMMARY