NEUROLOGY

Dr.G.Bhanu Prakash

2.Forebrain : subcortical
Telencephalon
1
 Overview

 Components, location and function of the

basal forebrain
 Components, location and function of the
basal ganglia
 Components, location and function of the
limbic system
 Basal Forebrain Structures
Group of ill-defined structures
deep to ???

APS:
•Identifiable by perforations of
branches of ???
•Bordered by ???

Basal forebrain structures: AC

•???: Olfactory tubercle
•???
•In / near ventral striatum
•Rostral to AC
•Anterolateralto hypothalamus
•e.g., Basal nucleus of Meynert,
nucleus accumbens, septal
nuclei Haines 15-6

Basal (inferior) view 3

 Basal Forebrain Structures
Group of ill-defined structures
deep to anterior perforating
substance (APS)
APS:
•Identifiable by perforations of
branches of ACA & MCA
•Bordered by LOS, MOS of OT

Basal forebrain structures: AC

•APS gray: Olfactory tubercle
•Subcortical nuclei deep to APS
•In / near ventral striatum
•Rostral to AC
•Anterolateralto hypothalamus
•e.g., Basal nucleus of Meynert,
nucleus accumbens, septal
nuclei Haines 15-6

Basal (inferior) view 4

Basal Forebrain at ???
Level of
section
Coronal section at optic chiasm
 ??? (Ventral Striatum) AC

 Most ventral Rostral to AC:

portion of the
striatum,
where caudate
and putamen
are continuous
(no longer
separated by
Haines 15-16
anterior branch
of int. capsule
 ???
Haines 15-6

coronal section
5
Basal Forebrain at optic
chiasm Level of
section
Coronal section at optic chiasm
 Nucleus Acumbens (Ventral Striatum) AC

 Most ventral Rostral to AC:

portion of the
striatum,
where caudate
and putamen
are continuous
(no longer
separated by
Haines 15-16
anterior branch
of int. capsule
 Septal nuclei
Haines 15-6

coronal section
6
Basal Forebrain at
Level of
???? section
Coronal section at level of ???
 Located within APS AC
 ???
 AKA
substantia
innominata
 ???
Med septal
 Medial Septal N.
Nucleus
 ???
Basal
nucleus
of
N. diagonal Meynert
band.
Haines 15-16

coronal section 7
Basal Forebrain at
Level of
AnteriorCommissure section
Coronal section at level of anterior
commissure and column of fornix AC
 Located within APS
 Basal Nucleus
of Meynert
 AKA
substantia
Med septal
innominata N.
 Nucleus of
Diagnal Band
 Medial Septal Basal
nucleus
Nucleus of
Meynert
 Anterior to N. diagonal
band.
column of Haines 15-16

fornix
coronal section 8
 Basal Forebrain Structure
provide ??? inputs to cortex
BF structures neocortex
•Size:
• < 1% cortical
mass

•Function:
• ???
(emotions)
•???
(rational
thought)
•??? regulate
its
excitability
allocortex
Martin 3-17

Alzheimer’s Disease: degeneration of BF cholinergic inputs to cortex

10
 Basal Forebrain Structure provide
Cholinergic inputs to cortex
BF structures neocortex
•Size:
• < 1% cortical
mass

•Function:
• Limbic
(emotions)
•HCF
(rational
thought)
•Diffuse
cortical
projections
regulate its
allocortex
excitability Martin 3-17

Alzheimer’s Disease: degeneration of BF cholinergic inputs to cortex

11
 Basal Ganglia
Not a ganglia (Nuclei –
central) Insula

Dorsal component
 ?? + ???
Putamen
Ventral component Globus Pallidus external
 ??? Globus Pallidus internal
 parts of adjacent ???
 ???
Claustrum
Interconnected
structures
 ???
 ???
 Basal Ganglia
Not a ganglia (Nuclei –
central) Insula

Dorsal component
 Caudet + lentiform
nuclei Putamen

Ventral component Globus Pallidus external

 Nucleus Accumbens Globus Pallidus internal

 parts of adjacent
olfactory tuberal
 Substantiainnominata Claustrum

Interconnected
structures
 Subthalamic nucleus
 Substantianigra
Basal Ganglia:Basal Motor Nuclei
Functional components (basal-motor nuclei) include caudate, putamen, globuspalli
subthalamus, substantianigra.

(Telencephalic BG: caudate, putamen,GP)

(Diencephalic: subthalamus)
(Midbrain: substantianigra)

Terminology
 Caudate + Putamen = Striatum (or neostriatum)
 Corpus striatum = caudate/putamen + globuspallidus
 Paleostriatum = globuspallidus
 Putamen + globuspallidus = lentiform nuclei
 Globuspallidus contains an external (Gpe) and an internal (Gpi) part
 Circuit loop of motor cortical areas with
basal-motor nuclei and thalamus

Nolte 13-6

 Multiple cortical areas send cortico-striate fibers to ???

 Striatum interconnected with ???
 Two major ??? to motor thalamus (??,??)
 ??? is major output of lentiform nuclei to the ???
 ?? projections to thalamus
 Subthalamus reciprocally interconnected with ???
 ??? inhibit tonic level of activity in motor thalamus, and thus
control ???
 Circuit loop of motor cortical areas with
basal-motor nuclei and thalamus

Nolte 13-6

 Multiple cortical areas send cortico-striate fibers to striatum

 Striatum interconnected with substantianigra
 Two major inputs to motor thalamus (VA, VL)
 Gpi is major output of lentiform nuclei to the motor thalamus
 Nigral projections to thalamus
 Subthalamus reciprocally interconnected with globuspallidus
 Basal-motor nuclei inhibit tonic level of activity in motor thalamus,
and thus control corticospinal output
 Forebrain: Basal Motor Nuclei

Motor cortical areas Motor cortical areas

+CST

loop loop
+
-
E E
-
+ I I
- - +
DIRECT PATHWAY
contra
Nolte 13-6
-
INDIRECT PATHWAY
•Motor loop: ???

•M. cort. areasstriatumGpithalamus (VA/VL)M. cort areas

•Substantia nigra interconnected with striatum (e.g., nigrostriatal proj.)
•Subthalamus reciprocally interconnected with GP

•Gpi: major lentiform output (???) to motor thalamus

• Basal-motor nuclei (-) tonic (spont.) activity of motor thalamus, and thus modulate CST outputs: BMN
modulate ??? movement
18
 Forebrain: Basal Motor Nuclei

Motor cortical areas Motor cortical areas

+CST

loop loop
+
-
E E
-
+ I I
- - +
DIRECT PATHWAY
contra
Nolte 13-6
-
INDIRECT PATHWAY
•Motor loop: ipsilateral

•M. cort. areasstriatumGpithalamus (VA/VL)M. cort areas

•Substantia nigra interconnected with striatum (e.g., nigrostriatal proj.)
•Subthalamus reciprocally interconnected with GP

•Gpi: major lentiform output (-) to motor thalamus

• Basal-motor nuclei (-) tonic (spont.) activity of motor thalamus, and thus modulate CST outputs: BMN
modulate contra movement
19
 Relative Location of Deep Structures

Basal
ganglia
Thalamus

Internal capsule

Hypothalamus

Coronal section at level of Posterior hypothalamus/anterior thalamus 20

 Relative Location of Deep Structures

Basal
ganglia
Thalamus

Internal capsule

Hypothalamus

Coronal section at level of Posterior hypothalamus/anterior thalamus 21

Lesions and Deficits of Basal Motor Nuclei
Lesions and Deficits of Basal Motor Nuclei
 Limbic Lobe
 Limbic lobe
 Parolfactory area
 Subcollosal gyrus
 Cingulate gyrus
 Parahippocampal
gyrus
 Uncus

 Internal Structures
 Hipp, hyp, amyg,
septal n.
 Limbic Lobe
 Limbic lobe
 Parolfactory area
 Subcollosal gyrus
 Cingulate gyrus
 Parahippocampal
gyrus
 Uncus

 Internal Structures
 Hipp, hyp, amyg,
septal n.
 Classifying limbic structures
Accepted limbic structure Mostly Accepted
Cingulate Gyrus* Thalamic nuclei interconnected w/limbic
structures
Parahippocampalgrus* Neocortexinterconnected w/limbic structures
Hippocampal formation* i.e. Frontal cortex, orbital cortex
Amygdala*
Septal Area*
Nucleus Accumbens
Substantiainnominata
Hypothalamus
Mamilliary bodies
Anterior thalamic nuclei
Midbrainreticularformation (parts)
 Papez Circuit

Limbic lobe
Papez circuit

thalamus

hypothalamus

Dysfunction of limbic structures underlies virtually all psychiatric disorders27

27
 Papez Circuit

Limbic lobe
Papez circuit

thalamus

hypothalamus

Dysfunction of limbic structures underlies virtually all psychiatric disorders28

28
 Amygdaloid Complex
Almond shaped structure in the ???,
deep to the ???
 Rostral to anterior end of
temporal horn of lateral ventrical
 Composed of multiple nuclei that
are grouped into:
 ??? – interconnected with cortical
areas
 ??? – closely related to olfaction
 Amygdaloid Complex
Almond shaped structure in the
Rostromedial temporal lobe,
deep to the uncus
 Rostral to anterior end of
temporal horn of lateral ventrical
 Composed of multiple nuclei that
are grouped into:
 Basolateral amygdala –
interconnected with cortical areas
 Corticomedial (AKA extended
amygdala) – closely related to
olfaction
Basolateral Nuclei:
Amygdaloid Complex:
 Prefrontal cortex cingulate/prahippocampalgyri, temporal lobe andinsular cortex
 Dorsal thalamus
Afferents
 Subiculum
Corticomedial Nuclei
 Olfactory fibers from
hypothalamus
 Thalamus (dorsomedial
and median nuclei)
 Brainstem nuclei
associated with visceral
functions (ie. NTS and
periaquiductal grey)
Amygdaloid Complex: Efferents -???

Stria terminalis

Septal
nuclei

AC
AC

Hypothalamus
Amygdala

37
Amygdaloid Complex: Efferents -Striaterminalis

Stria terminalis

Septal
nuclei

AC
AC

Hypothalamus
Amygdala

38
Lesions/deficits of Amygdaloid Complex
 Hippocampal formation
Located in the ???
Superior/lateral aspects
are the floor of the
inferior horn of the
lateral ventricle
Inferior/medial border is
entorhinal cortex
Rostralborder is Amygdala
Caudally becomes
continuous with the
fornix below the
splenium of the corpus
callosum.
 Hippocampal formation
Located in the medial
temporal lobe
Superior/lateral aspects
are the floor of the
inferior horn of the
lateral ventricle
Inferior/medial border is
entorhinal cortex
Rostralborder is Amygdala
Caudally becomes
continuous with the
fornix below the
splenium of the corpus
callosum.
 Hippocampal
Located in the medial
formation
temporal lobe
Superior/lateral aspects
are the floor of the
inferior horn of the
lateral ventricle
Inferior/medial border is
entorhinal cortex
Rostralborder is Amygdala
Caudally becomes
continuous with the
fornix below the
splenium of the corpus
callosum.
Hippocampal
formation cont. Hippocampus

Allocortex of Brodmann
 ???
 Narrow band along medial Dentate
aspect of hipp Gyrus
 Receives most cortical inputs Subiculum
 ???
 Between DG and subiculum
 AKA hippocampus proper,
Ammon’s horn
 ????
 Laterally continuous with cortex
of parahippocampal gyrus
 Loci of most efferent cell of
hippocampal formation
Hippocampal
formation cont. Hippocampus

Allocortex of Brodmann
 Dentate gyrus
 Narrow band along medial Dentate
aspect of hipp Gyrus
 Receives most cortical inputs Subiculum
 Hippocampus
 Between DG and subiculum
 AKA hippocampus proper,
Ammon’s horn
 Subiculum
 Laterally continuous with cortex
of parahippocampal gyrus
 Loci of most efferent cell of
hippocampal formation
 Hippocampal
Afferents
???
 Information from all association
areas of neocortex
 Entorhinal cortex considered
gateway to the hippocampus

???
 Hypothalamus, Septum (ACh),
and contralateral hippocampus

???
 Midbrain reticular formation
 Raphe nuclei – (serotonergic)
 Locus Ceruleus (norepinephrine)
 Hippocampal
Afferents
Entorhinal cortex (Perforant
Pathway)
 Information from all association
areas of neocortex
 Entorhinal cortex considered
gateway to the hippocampus

Fornix
 Hypothalamus, Septum (ACh),
and contralateral hippocampus

Diffuse midbrain afferents

 Midbrain reticular formation
 Raphe nuclei – (serotonergic)
 Locus Ceruleus (norepinephrine)
 Hippocampal
Formation Efferents
Efferent cells (???)
 ???, pyramidal cell of hippocampus
(lesser)
 ??? ?????????

Fornix projections
 ??? (to contralateral hippocampus)
 Anterior commissure divides:
 ??? (terminations)
 Mammillary nucleus (majority)
 Thalamus (anterior dorsal)
 Hypothalamus (ventromedial)
 ??? (trerminations)
 Septal nuclei, medial frontal cortex,
hypothalamus, nucleus accumbens
 From the hippocampus pyramidal cells
 Hippocampal
Formation Efferents
Efferent cells (Glutamatergic)
 Subiculum, pyramidal cell of
hippocampus (lesser)
 Axons alveusFimbriaFonix

Fornix projections
 Hippocampal decussation (to
contralateral hippocampus)
 Anterior commissure divides:
 Postcommissural fornix (terminations)
 Mammillary nucleus (majority)
 Thalamus (anterior dorsal)
 Hypothalamus (ventromedial)
 Precommissural fornix (trerminations)
 Septal nuclei, medial frontal cortex,
hypothalamus, nucleus accumbens
 From the hippocampus pyramidal cells
 Limbic control of Memory
Association
Cortex

Acetyl Choline
Lesions/deficits of Hippocampal Form.
Lesions/deficits of Hippocampal Form.
 Limbic System Structures/Funct.
 ???: Involved in signaling the cortex of motivationally significant stimuli
such as those related to reward and fear in addition to social functions such
as mating.
 ???: Required for the formation of long-term memories
 ???: Plays a role in the formation of spatial memory and is part of the
hippocampus
 ???: Autonomic functions regulating heart rate, blood pressure and
cognitive and attentional processing
 ???: Major white matter tract, carries signals from the hippocampus to the
mammillary bodies and septal nuclei – involved in memory formation.
 ???: Regulates the autonomic nervous system via hormone production and
release. Affects and regulates blood pressure, heart rate, hunger, thirst,
sexual arousal, and the sleep/wake cycle
 ???: The "relay station" to the cerebral cortex
 Limbic System Structures/Funct.
 Amygdala: Involved in signaling the cortex of motivationally significant
stimuli such as those related to reward and fear in addition to social
functions such as mating.
 Hippocampus: Required for the formation of long-term memories
 Parahippocampal gyrus: Plays a role in the formation of spatial memory and
is part of the hippocampus
 Cingulate gyrus: Autonomic functions regulating heart rate, blood pressure
and cognitive and attentional processing
 Fornix: Major white matter tract, carries signals from the hippocampus to the
mammillary bodies and septal nuclei – involved in memory formation.
 Hypothalamus: Regulates the autonomic nervous system via hormone
production and release. Affects and regulates blood pressure, heart rate,
hunger, thirst, sexual arousal, and the sleep/wake cycle
 Thalamus: The "relay station" to the cerebral cortex
 Limbic System Structures/Funct.
 ???: Important for the formation of memory

 ???: secretes hormones regulating homeostasis

 ???: thought to contribute to new memories and to regulate

happiness.
 ??? cortex and ???: Receive smell input in the olfactory system.

 ???: Region encompassing the cingulate, hippocampus, and

parahippocampal gyrus
 ???: Olfactory sensory input

 ???: Involved in reward, pleasure, and addiction

 ???: Required for decision making

 Limbic System Structures/Funct.
 Mammillary body: Important for the formation of memory

 Pituitary gland: secretes hormones regulating homeostasis

 Dentate gyrus: thought to contribute to new memories and to

regulate happiness.
 Entorhinal cortex and piriform cortex: Receive smell input in the
olfactory system.
 Fornicate gyrus: Region encompassing the cingulate,
hippocampus, and parahippocampal gyrus
 Olfactory bulb: Olfactory sensory input

 Nucleus accumbens: Involved in reward, pleasure, and addiction

 Orbitofrontal cortex: Required for decision making