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BASAL GANGLIA AND PSYCHIATRY

Dr.M.A.Shaheen Post graduate Department of psychiatry Yenepoya medical college


Dr.V.V.Mohanchandran Head of department Department of psychiatry Yenepoya medical college

Location

Major structures
The caudate nucleus Putamen Globus pallidus Subthalamic nucleus Substantia nigra

The striatum caudate nucleus and putamen The corpus striatum caudate nucleus , putamen & globus pallidus Lentiform nucleus putamen and globus pallidus

Circuits
3 major afferent systems the coricostriatal the nigrostriatal the thalamostriatal Outputs globus pallidus(internal) pars reticularis

Functions
Voluntary movement Postural control Control of muscle tone

Disorders
Of voluntary movement bradykinesia Postural abnormalities Gait abnormalities parkinsonian choreiform Tone changes Involuntary movements Phonation

Parkinsonism
The muscle rigidity, tremor at rest, and slowness in initiation and execution of movement. Reduction in dopaminergic activity in the basal ganglia motor areas, particularly the putamen due to gradually reduced innervation from SNc. Other features - autonomic dysfunction, cognitive impairment, and gait/balance difficulties

Huntington's Disease
Ahereditary disease defects in behavior, cognition, and uncontrolled rapid, jerky movements. a defect that consists of an expanded CAG repeat in a gene located on chromosome 4 the basal ganglias show a decrease in activity of the mitochondrial pathway, complex II-III. often associated with basal ganglia degeneration. This degeneration of striatal neurons projecting to GPe leads to disinhibition of the indirect pathway, increased inhibition of STN.

Tourettes syndrome
A neuropsychiatric syndrome with onset in childhood Multiple chronic tics. Obsessive-compulsive behaviors are strongly associated with tourettes disorder Abnormal activation of premotor, supplementary motor, and cingulate motor areas inhibition of the Globus Pallidus or Substantia Nigra neurons would then disinhibit thalamocortical circuits

Therapeutic Research
Gene Therapy Many disorders of the basal ganglia are due to the dysfunction of a localized area. Gene therapy is performed by replacing diseased phenotypes with new genetic material. Lesioning/ablation Lesionsing is a term that signifies the destruction of neuronal cells in a particular area. involves unilateral lesioning of the GPi. This process is called pallidotomy. Deep Brain Stimulation inserting, via stereotaxic surgery, electrodes into the sensorimotor area of the brain. These electrodes emit high-frequency stimulation to the implanted areas. internal globus pallidus and the subthalmic nucleus.

References
Comprehensive textbook of psychiatry A.Berardelli,J.C.Rothwell,P.D.Thomson,M.Hallet Pathophysiology of bradykinesia in parkinsons disease,Brain(2001). J.W.Mink ,The basal ganglia and involuntary movements,Neurological Review. P.McCaffrey ,Neuropathologies of swallowing and speech,The Neuroscience on the website. Albin R.L., Young A.B., Penney J.B., The functional anatomy of basal ganglia disorders. Trends Neurosci (1989) 12 : pp 366-375