[Clinical pathophysiology of parkinsonian symptoms: from experiences of stereotaxic surgery]. 2000

N Miyashita, and H Narabayashi
Department of Neurology, Juntendo University Urayasu Hospital.

Pathophysiological mechanisms of major symptoms of Parkinson's disease are discussed from experiences of stereotaxic surgery. Tremor completely disappears by a lesion in the ventral intermediate nucleus(Vim) which receives proprioceptive sense from the periphery. Rigidity is alleviated by a lesion in the globus pallidus(GP) and the ventral lateral nucleus(VL) equally. Since GP projects to the prefrontal motor cortex via VL, surgery to either of those structures causes the same result. Akinesia is classified into three types: secondary akinesia, primary akinesia, and akinesia due to psychomotor dysfunction. Gradual spread of neuronal degeneration within the substantia nigra pars compacta may explain the progression of akinesia. Psychological or psychiatric disorder becomes major symptom in the late stage. Posteroventral pallidotomy may change emotional state in some cases by influencing the limbic motor circuit.

UI MeSH Term Description Entries
D009127 Muscle Rigidity Continuous involuntary sustained muscle contraction which is often a manifestation of BASAL GANGLIA DISEASES. When an affected muscle is passively stretched, the degree of resistance remains constant regardless of the rate at which the muscle is stretched. This feature helps to distinguish rigidity from MUSCLE SPASTICITY. (From Adams et al., Principles of Neurology, 6th ed, p73) Cogwheel Rigidity,Extrapyramidal Rigidity,Gegenhalten,Nuchal Rigidity,Rigidity, Muscular,Catatonic Rigidity,Extensor Rigidity,Cogwheel Rigidities,Gegenhaltens,Muscular Rigidity,Rigidities, Cogwheel,Rigidity, Catatonic,Rigidity, Cogwheel,Rigidity, Extensor,Rigidity, Extrapyramidal,Rigidity, Muscle,Rigidity, Nuchal
D009410 Nerve Degeneration Loss of functional activity and trophic degeneration of nerve axons and their terminal arborizations following the destruction of their cells of origin or interruption of their continuity with these cells. The pathology is characteristic of neurodegenerative diseases. Often the process of nerve degeneration is studied in research on neuroanatomical localization and correlation of the neurophysiology of neural pathways. Neuron Degeneration,Degeneration, Nerve,Degeneration, Neuron,Degenerations, Nerve,Degenerations, Neuron,Nerve Degenerations,Neuron Degenerations
D010300 Parkinson Disease A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75) Idiopathic Parkinson Disease,Lewy Body Parkinson Disease,Paralysis Agitans,Primary Parkinsonism,Idiopathic Parkinson's Disease,Lewy Body Parkinson's Disease,Parkinson Disease, Idiopathic,Parkinson's Disease,Parkinson's Disease, Idiopathic,Parkinson's Disease, Lewy Body,Parkinsonism, Primary
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D004298 Dopamine One of the catecholamine NEUROTRANSMITTERS in the brain. It is derived from TYROSINE and is the precursor to NOREPINEPHRINE and EPINEPHRINE. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of receptors (RECEPTORS, DOPAMINE) mediate its action. Hydroxytyramine,3,4-Dihydroxyphenethylamine,4-(2-Aminoethyl)-1,2-benzenediol,Dopamine Hydrochloride,Intropin,3,4 Dihydroxyphenethylamine,Hydrochloride, Dopamine
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders
D013238 Stereotaxic Techniques Techniques used mostly during brain surgery which use a system of three-dimensional coordinates to locate the site to be operated on. Stereotactic Techniques,Stereotaxic Technics,Stereotactic Technique,Stereotaxic Technic,Stereotaxic Technique,Technic, Stereotaxic,Technics, Stereotaxic,Technique, Stereotactic,Technique, Stereotaxic,Techniques, Stereotactic,Techniques, Stereotaxic
D013378 Substantia Nigra The black substance in the ventral midbrain or the nucleus of cells containing the black substance. These cells produce DOPAMINE, an important neurotransmitter in regulation of the sensorimotor system and mood. The dark colored MELANIN is a by-product of dopamine synthesis. Nigra, Substantia,Nigras, Substantia,Substantia Nigras

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