Neurology - Movement disorders

YEAR 2 BRAIN AND BEHAVIOUR

Movement disorders

Movement

7. Huntingtons

6. Parkinsons

5. Pathways

11. Treatment

4. Substantia Nigra

10. Seizures

3. Basal Ganglia

9. Definition

2. Brain areas

8. Epilepsy

1. Movment

INDEX

BASAL GANGLIA AND CEREBELLUM

How movement works

Senstory motor cooridination or ongoing movementYour timing and accuracy system

Cerebellum

Gating proper initiation of movementYour all or nothing system

Basal ganglia

VERSUS

The BRAINSTEM is the oldest part of the bain, evolutionary.It does BASIC movement and postural controls

The MOTOR CORTEX is high functioning, doing the planning, initiating and directing of voluntary movements

Cortex and Brainstem

Execution

Organising

Planning

Intention or desire to move Lesions disrupt awareness of the intention to move

Posterior parietal cortex

Controls sequences of motion (behavioural sequences) Damage disrupts the ability to do well-learned responses

Supplementary motor area

Decision to move Region activated prior to the decision to move Plans for movement

Involved in learning and executing complex movement that are guided by sensory information

Frontopolar cortex

Causes movements of particular parts of the body

Premotor cortex

Primary motor cortex

Regulates movement as well as processing emotion, motivation and cognitionSTOP or START protocolForce controlInhibit antagonistic movement

Basal Ganglia

Lentiform nucleus

Dorsal striatum

02

Outputs are:Globus pallidus externaGolbus pallidus Interna - to the ThalamusSubstantia nigra

01

Inputs go to the Dorsal Striatum - Caudate and PutamenFrom the:

• Cerebral cortex- primary motor cortex and somatosensory contex (glutaminergic inputs)
• Substantial nigra (dopaminergic inputs)
• Local corpus striatum circuits (GABAergic)

The substantia nigra is a critical brain region for the production of dopamine and this neurochemical affects many systems of the central nervous system ranging from movement control, cognitive executive functions, and emotional limbic activity.

SubstantiA Nigra

D2-family of receptors send projections to the GPe as part of the “Indirect pathway.” Overall Inhibitory

Indirect Pathway

The neurons that express the D1-family of receptors send projections to the GPi/SNpr to form the “Direct pathway” The “Direct pathway” is comprised of inhibitory projections from the caudate or putamen.Overall Exitatory

Direct pathway

VERSUS

IT IS EASIER TO FIGURE OUT HO WTHE SUBSTANTIA NIGRA WORKS WHEN IT DOESN'T WORK

Parkinsons

• Resting tremor
• Slowness of movement (“bradykinesia”)
• Muscular rigidity
• Lack of associated movements (e.g., arm-swinging during walking)
• Minimal facial expressions

Due to the loss of dopaminergic neurons in the substantia nigra, which project to and innervate the dorsal striatumOver 80% of the dopaminergic neurons need to degenerate before the clinical signs of the disease become overt

Characteristics

MAINLY LEARN THE WORDS

Huntingtons

The direct pathway becomes domient so no smoothing of movment

• Chorea refers to nonrhythmic, jerky, rapid, nonsuppressible involuntary movement, mostly of the distal muscles and face

• Athetosis: slow, involuntary regular writhing movements of the fingers, hands, toes and feet (in some cases, arms, legs, neck and tongue

• Ballismus: a type of chorea, usually involving violent, involuntary flinging of one arm and/or one leg - from damage to the subthamalic nucleus

Characteristics

SOMETHING COMPLETLY DIFFERENT

Epilepsy

Seizure - Syncronised firing of cortical neuronsEpileptic seizure - recurrent, unpredictable seizuresAbsense seizure (petite mal) - generalisied seizure with the loss of awarness or control

Definition

Post-ictal

Not really a seizure, but the period after the seizure where there is impaired awareness

Generalised

Tonic - Sudden continuous contraction, falling backwardsClonic - Rhythmic muscle contractionsAtonic - Sudden relaxation, falling forwardsTonic-clonic - Tonic then clonicMyoclonic - Muscle jerks (falling asleep)Absence

Focal

Can be aware or impairedA specific part of the brainMotorSensoryAutonomicAwareness - automatisms (lip smacking)

Types of Seizure

-pines-pamsand your long term medications

Treatment

THANKS

Language disorder caused by damage in a specific area of the brain that controls language expression and/or comprehension

APhasia

Areas

PROCESS 03

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PROCESS 02

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Broca's

LEFT HemisphereDanage leads to MOTOR APHASIAShort or incomplete sentencesDifficulty writingSubsitutionUnderstanding is preserved

Areas

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LOREM IPSUM 02

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LOREM IPSUM 01

VERSUS