Dopamine Neuron Diversity: Recent Advances and Current Challenges in Human Stem Cell Models and Single Cell Sequencing
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Imaging of the Confused Patient: Toxic Metabolic Disorders Dara G
Imaging of the Confused Patient: Toxic Metabolic Disorders Dara G. Jamieson, M.D. Weill Cornell Medicine, New York, NY The patient who presents with either acute or subacute confusion, in the absence of a clearly defined speech disorder and focality on neurological examination that would indicate an underlying mass lesion, needs to be evaluated for a multitude of neurological conditions. Many of the conditions that produce the recent onset of alteration in mental status, that ranges from mild confusion to florid delirium, may be due to infectious or inflammatory conditions that warrant acute intervention such as antimicrobial drugs, steroids or plasma exchange. However, some patients with recent onset of confusion have an underlying toxic-metabolic disorders indicating a specific diagnosis with need for appropriate treatment. The clinical presentations of some patients may indicate the diagnosis (e.g. hypoglycemia, chronic alcoholism) while the imaging patterns must be recognized to make the diagnosis in other patients. Toxic-metabolic disorders constitute a group of diseases and syndromes with diverse causes and clinical presentations. Many toxic-metabolic disorders have no specific neuroimaging correlates, either at early clinical stages or when florid symptoms develop. However, some toxic-metabolic disorders have characteristic abnormalities on neuroimaging, as certain areas of the central nervous system appear particularly vulnerable to specific toxins and metabolic perturbations. Areas of particular vulnerability in the brain include: 1) areas of high-oxygen demand (e.g. basal ganglia, cerebellum, hippocampus), 2) the cerebral white matter and 3) the mid-brain. Brain areas of high-oxygen demand are particularly vulnerable to toxins that interfere with cellular respiratory metabolism. -
Microstimulation of the Midbrain Tegmentum Creates Learning Signals for Saccade Adaptation
The Journal of Neuroscience, April 4, 2007 • 27(14):3759–3767 • 3759 Behavioral/Systems/Cognitive Microstimulation of the Midbrain Tegmentum Creates Learning Signals for Saccade Adaptation Yoshiko Kojima, Kaoru Yoshida, and Yoshiki Iwamoto Department of Neurophysiology, Doctoral Program in Kansei Behavioral and Brain Sciences, University of Tsukuba, Tsukuba, Ibaraki 305-8574, Japan Error signals are vital to motor learning. However, we know little about pathways that transmit error signals for learning in voluntary movements. Here we show that microstimulation of the midbrain tegmentum can induce learning in saccadic eye movements in mon- keys. Weak electrical stimuli delivered ϳ200 ms after saccades in one horizontal direction produced gradual and marked changes in saccade gain. The spatial and temporal characteristics of the produced changes were similar to those of adaptation induced by real visual error. When stimulation was applied after saccades in two different directions, endpoints of these saccades gradually shifted in the same direction in two dimensions. We conclude that microstimulation created powerful learning signals that dictate the direction of adaptive shift in movement endpoints. Our findings suggest that the error signals for saccade adaptation are conveyed in a pathway that courses through the midbrain tegmentum. Key words: motor learning; electrical stimulation; midbrain; saccade; adaptation; macaque; monkey Introduction superior colliculus, a key midbrain structure that issues saccade Motor learning ensures the accuracy of the movements we exe- signals to the premotor reticular circuitry (Scudder et al., 2002). cute daily. Vital to learning is the information about the error that The colliculus also has indirect access to the cerebellum via both results from executed movements. -
Brain Structure and Function Related to Headache
Review Cephalalgia 0(0) 1–26 ! International Headache Society 2018 Brain structure and function related Reprints and permissions: sagepub.co.uk/journalsPermissions.nav to headache: Brainstem structure and DOI: 10.1177/0333102418784698 function in headache journals.sagepub.com/home/cep Marta Vila-Pueyo1 , Jan Hoffmann2 , Marcela Romero-Reyes3 and Simon Akerman3 Abstract Objective: To review and discuss the literature relevant to the role of brainstem structure and function in headache. Background: Primary headache disorders, such as migraine and cluster headache, are considered disorders of the brain. As well as head-related pain, these headache disorders are also associated with other neurological symptoms, such as those related to sensory, homeostatic, autonomic, cognitive and affective processing that can all occur before, during or even after headache has ceased. Many imaging studies demonstrate activation in brainstem areas that appear specifically associated with headache disorders, especially migraine, which may be related to the mechanisms of many of these symptoms. This is further supported by preclinical studies, which demonstrate that modulation of specific brainstem nuclei alters sensory processing relevant to these symptoms, including headache, cranial autonomic responses and homeostatic mechanisms. Review focus: This review will specifically focus on the role of brainstem structures relevant to primary headaches, including medullary, pontine, and midbrain, and describe their functional role and how they relate to mechanisms -
The Nervous System: Sensory and Motor Tracts of the Spinal Cord
15 The Nervous System: Sensory and Motor Tracts of the Spinal Cord PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • Millions of sensory neurons are delivering information to the CNS all the time • Millions of motor neurons are causing the body to respond in a variety of ways • Sensory and motor neurons travel by different tracts within the spinal cord © 2012 Pearson Education, Inc. Sensory and Motor Tracts • Communication to and from the brain involves tracts • Ascending tracts are sensory • Deliver information to the brain • Descending tracts are motor • Deliver information to the periphery © 2012 Pearson Education, Inc. Sensory and Motor Tracts • Naming the tracts • If the tract name begins with “spino” (as in spinocerebellar), the tract is a sensory tract delivering information from the spinal cord to the cerebellum (in this case) • If the tract name ends with “spinal” (as in vestibulospinal), the tract is a motor tract that delivers information from the vestibular apparatus (in this case) to the spinal cord © 2012 Pearson Education, Inc. Sensory and Motor Tracts • There are three major sensory tracts • The posterior column tract • The spinothalamic tract • The spinocerebellar tract © 2012 Pearson Education, Inc. Sensory and Motor Tracts • The three major sensory tracts involve chains of neurons • First-order neuron • Delivers sensations to the CNS • The cell body is in the dorsal or cranial root ganglion • Second-order neuron • An interneuron with the cell body in the spinal cord or brain • Third-order neuron • Transmits information from the thalamus to the cerebral cortex © 2012 Pearson Education, Inc. -
Ventral Tegmental Area Glutamate Neurons: Electrophysiological Properties and Projections
15076 • The Journal of Neuroscience, October 24, 2012 • 32(43):15076–15085 Cellular/Molecular Ventral Tegmental Area Glutamate Neurons: Electrophysiological Properties and Projections Thomas S. Hnasko,1,2,3,4 Gregory O. Hjelmstad,2,3 Howard L. Fields,2,3 and Robert H. Edwards1,2 Departments of 1Physiology and 2Neurology, University of California San Francisco, San Francisco, California 94143, 3Ernest Gallo Clinic and Research Center, Emeryville, California 94608, and 4Department of Neurosciences, University of California San Diego, La Jolla, California 92093 The ventral tegmental area (VTA) has a central role in the neural processes that underlie motivation and behavioral reinforcement. Although thought to contain only dopamine and GABA neurons, the VTA also includes a recently discovered population of glutamate neurons identified through the expression of the vesicular glutamate transporter VGLUT2. A subset of VGLUT2 ϩ VTA neurons corelease dopamine with glutamate at terminals in the NAc, but others do not express dopaminergic markers and remain poorly characterized. Using transgenic mice that express fluorescent proteins in distinct cell populations, we now find that both dopamine and glutamate neurons in the medial VTA exhibit a smaller hyperpolarization-activated current (Ih ) than more lateral dopamine neurons and less ϩ consistent inhibition by dopamine D2 receptor agonists. In addition, VGLUT2 VTA neurons project to the nucleus accumbens (NAc), lateral habenula, ventral pallidum (VP), and amygdala. Optical stimulation of VGLUT2 ϩ projections expressing channelrhodopsin-2 further reveals functional excitatory synapses in the VP as well as the NAc. Thus, glutamate neurons form a physiologically and anatom- ically distinct subpopulation of VTA projection neurons. Introduction well as to the amygdala, septum, hippocampus, and prefrontal Dopamine neurons of the ventral midbrain are classically divided cortex (PFC) (Fields et al., 2007; Ikemoto, 2007). -
Imaging Patterns Characterizing Mitochondrial Leukodystrophies
Published April 15, 2021 as 10.3174/ajnr.A7097 ORIGINAL RESEARCH PEDIATRICS Imaging Patterns Characterizing Mitochondrial Leukodystrophies S.D. Roosendaal, T. van de Brug, C.A.P.F. Alves, S. Blaser, A. Vanderver, N.I. Wolf, and M.S. van der Knaap ABSTRACT BACKGROUND AND PURPOSE: Achieving a specific diagnosis in leukodystrophies is often difficult due to clinical and genetic heter- ogeneity. Mitochondrial defects cause 5%–10% of leukodystrophies. Our objective was to define MR imaging features commonly shared by mitochondrial leukodystrophies and to distinguish MR imaging patterns related to specific genetic defects. MATERIALS AND METHODS: One hundred thirty-two patients with a mitochondrial leukodystrophy with known genetic defects were identified in the data base of the Amsterdam Leukodystrophy Center. Numerous anatomic structures were systematically assessed on brain MR imaging. Additionally, lesion characteristics were scored. Statistical group analysis was performed for 57 MR imaging features by hierarchic testing on clustered genetic subgroups. RESULTS: MR imaging features indicative of mitochondrial disease that were frequently found included white matter rarefaction (n ¼ 50 patients), well-delineated cysts (n ¼ 20 patients), T2 hyperintensity of the middle blade of the corpus callosum (n ¼ 85 patients), and symmetric abnormalities in deep gray matter structures (n ¼ 42 patients). Several disorders or clusters of disorders had characteristic features. The combination of T2 hyperintensity in the brain stem, middle cerebellar peduncles, and thalami was associated with complex 2 deficiency. Predominantly periventricular localization of T2 hyperintensities and cystic lesions with a dis- tinct border was associated with defects in complexes 3 and 4. T2-hyperintense signal of the cerebellar cortex was specifically associated with variants in the gene NUBPL. -
Brain Anatomy
BRAIN ANATOMY Adapted from Human Anatomy & Physiology by Marieb and Hoehn (9th ed.) The anatomy of the brain is often discussed in terms of either the embryonic scheme or the medical scheme. The embryonic scheme focuses on developmental pathways and names regions based on embryonic origins. The medical scheme focuses on the layout of the adult brain and names regions based on location and functionality. For this laboratory, we will consider the brain in terms of the medical scheme (Figure 1): Figure 1: General anatomy of the human brain Marieb & Hoehn (Human Anatomy and Physiology, 9th ed.) – Figure 12.2 CEREBRUM: Divided into two hemispheres, the cerebrum is the largest region of the human brain – the two hemispheres together account for ~ 85% of total brain mass. The cerebrum forms the superior part of the brain, covering and obscuring the diencephalon and brain stem similar to the way a mushroom cap covers the top of its stalk. Elevated ridges of tissue, called gyri (singular: gyrus), separated by shallow groves called sulci (singular: sulcus) mark nearly the entire surface of the cerebral hemispheres. Deeper groves, called fissures, separate large regions of the brain. Much of the cerebrum is involved in the processing of somatic sensory and motor information as well as all conscious thoughts and intellectual functions. The outer cortex of the cerebrum is composed of gray matter – billions of neuron cell bodies and unmyelinated axons arranged in six discrete layers. Although only 2 – 4 mm thick, this region accounts for ~ 40% of total brain mass. The inner region is composed of white matter – tracts of myelinated axons. -
How Is the Brain Organized?
p CHAPTER 2 How Is the Brain Organized? An Overview of Brain Structure The Functional Organization Brain Terminology of the Brain The Brain’s Surface Features Principle 1: The Sequence of Brain Processing The Brain’s Internal Features Is “In Integrate Out” Microscopic Inspection: Cells and Fibers Principle 2: Sensory and Motor Divisions Exist Focus on Disorders: Meningitis and Throughout the Nervous System Encephalitis Principle 3: The Brain’s Circuits Are Crossed Focus on Disorders: Stroke Principle 4: The Brain Is Both Symmetrical and Asymmetrical Principle 5: The Nervous System Works A Closer Look at Neuroanatomy Through Excitation and Inhibition The Cranial Nervous System Principle 6: The Central Nervous System Has The Spinal Nervous System Multiple Levels of Function The Internal Nervous System Principle 7: Brain Systems Are Organized Both Focus on Disorders: Magendie, Bell, and Bell’s Hierarchically and in Parallel Palsy Principle 8: Functions in the Brain Are Both Localized and Distributed A. Klehr / Stone Images Micrograph: Carolina Biological Supply Co. / Phototake 36 I p hen buying a new car, people first inspect the In many ways, examining a brain for the first time is outside carefully, admiring the flawless finish similar to looking under the hood of a car. We have a vague W and perhaps even kicking the tires. Then they sense of what the brain does but no sense of how the parts open the hood and examine the engine, the part of the car that we see accomplish these tasks. We may not even be responsible for most of its behavior—and misbehavior. able to identify many of the parts. -
Midbrain Tegmental Lesions Affecting Or Sparing the Pupillary Fibres
J7ournal ofNeurology, Neurosurgery, and Psychiatry 1996;61:401-402 401 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.61.4.401 on 1 October 1996. Downloaded from SHORT REPORT Midbrain tegmental lesions affecting or sparing the pupillary fibres Naokatsu Saeki, Naohisa Murai, Kenro Sunami Abstract lesion in the upper midbrain and close to the Two patients with oculomotor palsy third ventricle (fig 1). caused by midbrain infarction are Three months later the oculomotor palsy reported. In the first, pupillary reaction improved. The patient returned to his previ- was affected and in the second this reac- ous work after a further three months. tion was spared. Because the lesions in the anterior part of the tegmentum were CASE 2 in the upper midbrain in the first patient A 68 year old woman with hypertension for and in the lower midbrain in the second, eight years suddenly developed vertigo and it is suggested that the pupillary compo- nents of the oculomotor nerve are located in the upper midbrain. (7 Neurol Neurosurg Psychiatry 1996;61:401-402) Keywords: midbrain; oculomotor nerve; pupil sparing We report the details of two patients with a small midbrain infarction, the first with impairment of pupillary reaction to light and the second in which this reaction was pre- served. The aim of this study was to elucidate the topography of oculomotor pupillary fibres in the midbrain tegmentum based on findings using MRI. http://jnnp.bmj.com/ Case studies CASE 1 A 67 year old man with a 10 year history of hypertension presented with difficulty in open- ing his left eye on waking up in the morning. -
Neurons in the Ventral Tegmentum Have Separate Populations
332 Brain Research, 321 (1984) 332-336 Elsevicr BRE 20426 Neurons in the ventral tegmentum have separate populations projecting to telencephalon and inferior olive, are histochemically different, and may receive direct visual input JAMES H. FALLON, LAURENCE C. SCHMUED, CHARLES WANG, ROSS MILLER and GERALD BANALES Department of Anatomy, University of California, lrvine, CA 92 717 (U.S.A.) (Accepted June 5th, 1984) Key words: visual system -- basal ganglia -- prefrontal cortex -- inferior olive -- ventral tegmental area -- dopamine The connections of the ventral tegmental area (VTA) and medial terminal nucleus (MTN) of the accessory optic system were stud- ied in the albino rat. Using injection of two fluorescent retrograde tracers it was found that individual neurons of the VTA project to frontal cortices or the inferior olive but not both structures. Using combined retrograde fluorescent tracers and glyoxylic acid histo- chemistry, it was found that although a third of the cells projecting to frontal cortex contained catecholamine, none of the cells projecting to the inferior olive contained catecholamine. Thus, these portions of the ascending and descending VTA systems are inde- pendent. In addition, using injections of the anterograde transneuronal tracer [3H]adenosine into one eye, it was found that cells in the VTA, as well as the MTN, contained the tracer. Therefore, there is a basis for direct retino-mesentelencephalicpathways through the VTA. The ventral tegmental area (VTA) is a functionally to the ipsilateral flocculus 3, which then projects to and anatomically diverse region of the midbrain. The the ipsilateral vestibular nuclei 15,25,27. The vestibular VTA contains both dopaminergic (A10 cell group) nuclei affect eye movements via projections to crani- and non-dopaminergic neurons that project to telen- al nuclei III, IV and VI. -
White Matter Anatomy: What the Radiologist Needs to Know
White Matter Anatomy What the Radiologist Needs to Know Victor Wycoco, MBBS, FRANZCRa, Manohar Shroff, MD, DABR, FRCPCa,*, Sniya Sudhakar, MBBS, DNB, MDb, Wayne Lee, MSca KEYWORDS Diffusion tensor imaging (DTI) White matter tracts Projection fibers Association Fibers Commissural fibers KEY POINTS Diffusion tensor imaging (DTI) has emerged as an excellent tool for in vivo demonstration of white matter microstructure and has revolutionized our understanding of the same. Information on normal connectivity and relations of different white matter networks and their role in different disease conditions is still evolving. Evidence is mounting on causal relations of abnormal white matter microstructure and connectivity in a wide range of pediatric neurocognitive and white matter diseases. Hence there is a pressing need for every neuroradiologist to acquire a strong basic knowledge of white matter anatomy and to make an effort to apply this knowledge in routine reporting. INTRODUCTION (Fig. 1). However, the use of specific DTI sequences provides far more detailed and clini- DTI has allowed in vivo demonstration of axonal cally useful information. architecture and connectivity. This technique has set the stage for numerous studies on normal and abnormal connectivity and their role in devel- DIFFUSION TENSOR IMAGING: THE BASICS opmental and acquired disorders. Referencing established white matter anatomy, DTI atlases, Using appropriate magnetic field gradients, and neuroanatomical descriptions, this article diffusion-weighted sequences can be used to summarizes the major white matter anatomy and detect the motion of the water molecules to and related structures relevant to the clinical neurora- from cells. This free movement of the water mole- diologist in daily practice. -
Pain-Relieving Mechanisms in Neuromodulation 10
Pain-Relieving Mechanisms in Neuromodulation 10 Vikram Sengupta, Sascha Qian, Ned Urbiztondo, and Nameer Haider Introduction painful disease state being treated. Although clinical evi- dence will be provided, more exhaustive summaries of the Since its inception more than 50 years ago, the forms and clinical data will be reserved for later chapters in Part VI, applications of modern neuromodulation have undergone each of which is dedicated to the clinical aspects of a particu- tremendous expansion. The International Neuromodulation lar form of neuromodulation. Society defines neuromodulation as “the alteration of nerve activity through targeted delivery of a stimulus, such as elec- trical stimulation or chemical agents, to specific neurological Background and Historical Perspective sites in the body,” most commonly to reduce pain or improve neurologic function. All forms of neuromodulation are The earliest documented use of electrical current for the reversible. Neurostimulation is the most common form of treatment of pain was around 63 AD, when the Mesopotamian neuromodulation technology used today, and it refers to the physician, Scribonius Largus, discovered that shocks deliv- use of electrical or electromagnetic stimuli upon target tis- ered by the electrical torpedo fish could relieve bodily aches sues to elicit a therapeutic response. Although the focus of and pains. In the eleventh century, the Islamic philosopher this chapter will be on neurostimulation, other non-electrical Avicenna used cranial shocks delivered by the electric catfish therapies, such as intrathecal drug delivery systems, may fall to treat epilepsy. In the 1600s, the natural philosopher, into the category of neuromodulation. William Gilbert, reported using the magnetic lodestone to On August 10, 2017, the CDC recommended that the opi- treat headaches and psychiatric illness.