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Familial calcification of the basal ganglia: a case report and review of the literature.

Although calcification of the basal ganglia is a relatively common and asymptomatic finding on cranial computed tomography, familial idiopathic calcification of the basal ganglia (ICBG) is a rare disorder with neurological and behavioral manifestations. Attention has recently been drawn to the frequency with which cases are diagnosed as schizophrenic (Cummings et al. 1983; Lowenthal, 1986; Davison, 1987). We report a family in which a mother and son have ICBG, but while the son has a paranoid schizophrenia and intellectual deterioration, the mother shows no psychiatric illness. A review of the relevant literature suggests that psychosis is not as common as usually supposed, and may only be coincidentally associated with familial ICBG. Moreover, we find little convincing evidence that familial ICBG is an independent entity; instead, and in agreement with earlier authorities (Bruyn et al. 1964), we argue that published accounts and our own cases provide evidence that the condition is related to pseudo-hypoparathyroidism (PHP) and, therefore, may be due to a defect in a guanine nucleotide binding protein.

Adult↗

The consequences of long-term antipsychotic drug administration on basal ganglia neuronal function in laboratory animals.

Antipsychotic drugs (APDs) have been widely utilized in the treatment of a variety of psychiatric disorders, most prevalently for schizophrenia. In addition to their desired therapeutic effects, repeated administration of APDs often produces various motor side effects. Experimental evidence has implicated alterations in the nuclei of the basal ganglia as the basis for the motor dysfunctions that may arise during APD treatment. Because APDs are invariably administered for extended periods of time, a great deal of research has focused on the effects of prolonged drug exposure. Animal models have been a particularly valuable tool for studying APD effects on basal ganglia function following several weeks (subchronic) to months or years (chronic) of administration. The present paper reviews the scope of studies that have assessed various aspects of basal ganglia function in laboratory animals treated with APDs for prolonged period of time. Possible mechanisms of action are reviewed regarding subchronic and chronic APD effects on basal ganglia function as well as directions for future research.

Animals↗

Multidimensional sequence learning in patients with focal basal ganglia lesions.

Parkinson's patients have been found to be impaired in learning movement sequences. In the current study, patients with unilateral basal ganglia lesions due to stroke were tested on a serial reaction time task in which responses were based on the spatial location of each stimulus. The spatial locations either followed a fixed sequence or were selected at random, with learning operationalized as the difference in reaction time between these two conditions. In addition, three response-to-stimulus intervals were used, and these either followed a fixed sequence or were randomized. Compared to control participants, the patients showed normal learning of the spatial and temporal sequences, as well as normal cross-dimensional learning. This was true for performance with either the contralesional or ipsilesional hand. Sequence learning was not correlated with maximum tapping rate, a simple measure of motor impairment. These results raise questions concerning the use of Parkinson's disease as a model for studying basal ganglia dysfunction.

Aged↗

Basal ganglia calcifications in a case of biotinidase deficiency.

Biotinidase deficiency leads to a biotin-deficient state, with cardinal symptoms of ataxia, alopecia, and skin rash presenting in infancy. Previous reports of head CTs in patients with biotinidase deficiency did not note basal ganglia calcifications. We report the first case of biotinidase deficiency with basal ganglia calcifications. There were no symptoms referable to basal ganglia dysfunction.

Amidohydrolases↗

The "olfactostriatum" of snakes: a basal ganglia vomeronasal structure in tetrapods.

The olfactostriatum is a portion of the basal ganglia of snakes situated ventromedially to the nucleus accumbens proper. It receives a major vomeronasal input from the nucleus sphericus, the primary target of accessory olfactory bulb efferents. Recently, the ophidian olfactostriatum has been characterized on the basis of chemoarchitecture (distribution of serotonin, neuropeptide Y and tyrosine hydroxylase) and hodology (afferent and efferent connections). In contrast to the nucleus accumbens proper, the olfactostriatum is densely immunoreactive for serotonin and neuropeptide Y and sparsely immunoreactive for tyrosine hydroxylase. The nucleus accumbens proper and the olfactostriatum share most afferent connections except those originating in the nucleus sphericus, which are exclusively directed to the olfactostriatum. Similarly, the nucleus accumbens proper and the olfactostriatum show a similar pattern of efferent connections including those going to the ventral pallidum, although the olfactostriatum alone projects to the main and accessory olfactory bulbs as well as some amygdaloid nuclei. On the basis of its chemoarchitecture, the olfactostriatum resembles the mammalian ventral pallidum (but also the shell of the nucleus accumbens). Its connections, however, suggests that the olfactostriatum could be a specialized portion of the shell of nucleus accumbens extended more ventromedially than previously believed and devoted to processing vomeronasal information. Comparative data suggest that a similar structure is present in the basal ganglia of amphibians and mammals.

Animals↗

The role of the basal ganglia and cerebellum in language processing.

The roles of the cerebellum and basal ganglia have typically been confined in the literature to motor planning and control. However, mounting evidence suggests that these structures are involved in more cognitive domains such as language processing. In the current study, we looked at effective connectivity (the influence that one brain region has on another) of the cerebellum and basal ganglia with regions thought to be involved in phonological processing, i.e. left inferior frontal gyrus and left lateral temporal cortex. We analyzed functional magnetic resonance imaging data (fMRI) obtained during a rhyming judgment task in adults using dynamic causal modeling (DCM). The results showed that the cerebellum has reciprocal connections with both left inferior frontal gyrus and left lateral temporal cortex, whereas the putamen has unidirectional connections into these two brain regions. Furthermore, the connections between cerebellum and these phonological processing areas were stronger than the connections between putamen and these areas. This pattern of results suggests that the putamen and cerebellum may have distinct roles in language processing. Based on research in the motor planning and control literature, we argue that the putamen engages in cortical initiation while the cerebellum amplifies and refines this signal to facilitate correct decision making.

Adult↗

Altered spontaneous discharge rate and pattern of basal ganglia output neurons in the circling (ci2) rat mutant.

The circling rat is an autosomal recessive mutant (homozygous ci2/ci2) characterized by lateralized rotational behavior, locomotor hyperactivity, ataxia, stereotypic head movements, and deafness. Previous neurochemical investigations showed that ci2 rats of both genders have a lower tissue content of dopamine in the striatum ipsilateral to the preferred direction of circling. For further evaluation as to whether this striatal imbalance has functional consequences within basal ganglia structures, the spontaneous extracellular single unit activity of GABAergic neurons located in the striatum and, downstream to the dopaminergic nigrostriatal system, the substantia nigra pars reticulata (SNr) was recorded bilaterally in anesthetized ci2 rats. Heterozygous (ci2/+) littermates that display normal behavior, and rats from the background strain (LEW/Ztm) served as controls. No significant hemispheric imbalances in striatal discharge rate and firing pattern were evident in ci2 rats. Furthermore, there were no significant intergroup differences in striatal activity. However, the mean spontaneous discharge rate of SNr neurons was significantly increased in both brain sides, and there was a significant shift toward rhythmic burst-like firing in ci2 mutants. Again, no hemispheric differences were detected. The data substantiate previous findings of altered basal ganglia function in ci2 rats. The abnormal basal ganglia output activity, i.e. of the SNr, is likely to contribute to the complex behavioral disturbances seen in ci2 rats.

Action Potentials↗

Reduced volume of limbic system-affiliated basal ganglia in mood disorders: preliminary data from a postmortem study.

Volumes of basal ganglia in postmortem brains of 8 patients with mood disorders and 8 control subjects without neuropsychiatric disorder were determined. Morphometry of serial whole-brain sections under the control of postmortem artifacts revealed reduced volumes of the left nucleus accumbens (-32%, P = 0.01), the right and left external pallidum (-20%, P = 0.04), and the right putamen (-15%, P = 0.04) in the patient group compared with the control group. These results suggest that, in particular, the limbic loop of the basal ganglia involving the nucleus accumbens and the pallidum is affected in mood disorders.

Adult↗

Obsessive-compulsive and other behavioural changes with bilateral basal ganglia lesions. A neuropsychological, magnetic resonance imaging and positron tomography study.

Eight patients are reported who shared the combination of bilateral basal ganglia lesions and a frontal lobe-like syndrome. The main features were inertia and loss of drive, with preservation of intellectual function. Some patients showed stereotyped activities with compulsive and obsessive behaviour which were sometimes highly elaborate in pattern. Extrapyramidal clinical signs were absent or mild. Brain damage, related to anoxic or toxic encephalopathy, was demonstrated by CT scans and MRI. The lesions appeared to be confined to the lentiform nuclei, particularly affecting the pallidum, although there was generalized brain atrophy in 2 cases. Positron emission tomography (PET) in 7 patients revealed hypometabolism of the prefrontal cortex relative to other parts of the brain. The PET studies suggest dysfunction of the prefrontal cortex as a result of damage to the lentiform nuclei. These clinical, anatomical and functional observations emphasize the role of the circuits linking the prefrontal associative cortex and some specific areas of the neostriatum, including the pallidum. The existence of distinct nonoverlapping circuits in the motor field or in the associative field can explain the fact that basal ganglia lesions may give rise to a clinical picture that is either purely motor, purely behavioural (as in some of our patients), or both. Similarities existed between some symptoms found in our patients and certain features of major psychiatric illnesses such as severe depression, catatonic schizophrenia, and obsessive-compulsive disorder. This raises the hypothesis that some aspects of these psychiatric disorders could be related to structural and physiological disturbances in the systems linking the frontal associative cortex and the basal ganglia.

Adult↗

Method of construction of a MRI-based tabular database of 3D stereotaxic co-ordinates for individual structures in the basal ganglia of Macaca mulatta.

Primate models are commonly used in Parkinson's disease research to study stereotaxic strategies that demand accurate localization of the structures in basal ganglia. We demonstrate a method to construct an extensive tabular database of 3D stereotaxic co-ordinates of various basal ganglia structures from high-quality magnetic resonance (MR) images of 47 adult female 3-5 kg rhesus monkeys. For each animal, the structures in the basal ganglia were traced as they appeared on the axial MR images. Their maximal outlines were projected in the axial plane to create a stack of images and X, Y, Z co-ordinates were calculated for margins of each structure. These co-ordinates and the outlines of the individual nuclei help delineate a "common area," which was further narrowed down to a point that represents the 'most reliable target point' (MRTP) in subthalamic nucleus, globus pallidum, caudate and putamen on both sides. Common area and MRTP represent the region that can most definitely be associated with a structure and hence the most definite target for a given structure. The goal of this study is to demonstrate the method of construction, discuss the feasibility and usefulness of such a tabular database that could potentially add to accuracy of localization while using atlas-based stereotaxy. Though use of MRI remains a standard practice and advances in imaging have made targeting for functional surgery more accurate, in developing countries that implies prohibitive costs per procedure. Population based human databases similar to the monkey database described here, when used along with less expensive imaging modalities can reduce the costs considerably as well as add to the accuracy of targeting.

Animals↗

Patterns of termination of cerebellar and basal ganglia efferents in the rat thalamus. Strictly segregated and partly overlapping projections.

There is a widely held view that the cerebellum and basal ganglia act via separate subcortical channels. In rodent, however, electrophysiological evidence suggests that the output of these two systems is partly sent to a common set of thalamic neurons. In this study, the pattern of thalamic innervations provided by the deep cerebellar nuclei, the entopeduncular nucleus, and the substantia nigra pars reticulata was reinvestigated in the rat using the anterograde tracers Phaseolus vulgaris leucoagglutinin and wheat germ agglutinin. Although the results confirm the existence of some overlap in the cerebellar and basal ganglia projection fields, they also show that in such convergent areas the cerebellar innervation is modest and consists of sparsely distributed fibers of thin diameter that provide a few scattered terminal boutons. These observations are consistent with the view that, in rodent as in higher mammalian species, the cerebellum and the basal ganglia act mainly via distinct thalamo-cortical channels.

Animals↗

Distribution of neuropeptide Y immunoreactivity in the rat basal ganglia: effects of excitotoxin lesions to caudate-putamen.

The distribution of neuropeptide Y-like immunoreactivity (NPY-LI) within the rat basal ganglia was studied using microdissection with a sensitive radioimmunoassay, and excitotoxin lesions were made in an attempt to characterise the neurones containing NPY in this brain area. Immunoreactivity was unevenly distributed in the basal ganglia of control rats, with concentrations in the caudate-putamen (CP) and nucleus accumbens being appreciably higher than those found in the globus pallidus and substantia nigra (SN). Within the CP, immunoreactivity was concentrated in caudal and extreme rostral aspects. N-Methyl-D-aspartate lesions of the rostral CP significantly reduced immunoreactivity in this area, whilst levels in other regions of the basal ganglia were unaffected. Neurones containing NPY-LI are likely to be intrinsic to the CP and do not appear to project to the globus pallidus or SN.

Animals↗

Deep intracerebral (basal ganglia) haematomas in fatal non-missile head injury in man.

Deep intracerebral (basal ganglia) haematomas were found post mortem in 63 of 635 fatal non-missile head injuries. In patients with a basal ganglia haematoma, contusions were more severe, there was a reduced incidence of a lucid interval, and there was an increased incidence of road traffic accidents, gliding contusions and diffuse axonal injury than in patients without this type of haematoma. Intracranial haematoma is usually thought to be a secondary event, that is a complication of the original injury, but these results suggest that a deep intracerebral haematoma is a primary event. If a deep intracerebral haematoma is identified on an early CT scan it is likely that the patient has sustained severe diffuse brain damage at the time of injury. In the majority of head injuries damage to blood vessels or axons predominates. In patients with a traumatic deep intracerebral haematoma, it would appear that the deceleration/acceleration forces are such that both axons and blood vessels within the brain are damaged at the time of injury.

Adolescent↗

Methanol intoxication with bilateral basal ganglia infarct.

Methanol is a toxic agent that affects the central nervous system, especially the optic nerves and basal ganglia. Symmetrical hypodense lesions in the basal ganglia, which can be demonstrated by CT or MRI, is accepted as the most characteristic radiological feature of the disease. A case of a patient with bilateral putaminal hypodense infarcts due to methanol intoxication is presented.

Basal Ganglia Diseases↗

[Endogenous interaction of neurotransmitters and aging: studies on the basal ganglia of awake rats].

The interaction of glutamate and dopamine in the basal ganglia of the awake rat during the normal process of aging is revised. Using a novel approach, that of blocking the reuptake of glutamate, the effects of increasing concentrations of endogenous glutamate on the extracellular concentrations of dopamine in striatum and nucleus accumbens in the young rat were investigated. It was found that increasing concentrations of glutamate correlated significantly with increasing concentrations of dopamine in striatum and nucleus accumbens. Moreover the increase of dopamine in both structures was significantly reduced after blockade of NMDA and AMPA/kainate glutamate receptors, suggesting that the increase of dopamine was mediated by glutamate. The interaction glutamate/dopamine expressed by its ratio showed a significant age-related decrease in nucleus accumbens but not in neostriatum, so that to a given amount of glutamate less increase of dopamine is produced. It is suggested that the interaction glutamate-dopamine represents a balanced input to the GABA neuron in the basal ganglia and that during aging this balance is disrupted. It is speculated on the significance of this glutamate-dopamine disruption in relation to the changes in motor behavior found with age.

Aging↗

Sequential MRI findings in a patient with a germ cell tumor in the basal ganglia.

Serial changes of MRI scanning of an 11-year-old boy with hemiparesis due to a germ cell tumor in the basal ganglia are presented. Initial brain MRI T1-weighted images revealed a subtle mixed signal intensity lesion at left anterior and posterior limbs of the internal capsule. This lesion was not enhanced with Gd-DTPA, however, T2-weighted images showed a misty high signal intensity lesion in the same region. The MR images also showed hemiatrophy of the left basal ganglia. Histologic examination of biopsy specimens of the tumor revealed an embryonal carcinoma. The patient was treated with chemotherapy with subsequent improvement in the hemiparesis. Our case suggests that germ cell tumors must be considered in the differential disorders of lesions in the ipsilateral hemiatrophic basal ganglia in pediatric patients with hemiparesis.

Basal Ganglia↗

High affinity serotonin binding sites in human brain: a comparison of cerebral cortex and basal ganglia.

The high-affinity binding of 3H-serotonin and 3H-DPAT was studied in membrane preparations and tissue sections of cerebral cortex and basal ganglia of human brain. In tissue sections, 3H-serotonin bound to sites present at high density in the cerebral cortex, hippocampus and basal ganglia. 3H-DPAT bound predominantly to the outer layers of the cerebral cortex and the hippocampus, no significant binding was observed in the basal ganglia. In cortical membranes 3H-serotonin bound to a heterogeneous population of sites, one of which was similar to a binding site labelled by 3H-DPAT (the putative 5HT-1A receptor). 3H-serotonin binding to membranes prepared from the putamen displayed low affinity for DPAT, mesulergine and spiperone, RU24969 was considerably less potent than serotonin itself. This 3H-serotonin binding site does not have the properties of those sites described in rodent brain (5HT-1A, 5HT-1B, and 5HT-1C), and may represent a novel serotoninergic binding site.

8-Hydroxy-2-(di-n-propylamino)tetralin↗

Basal ganglia hemorrhage related to lightning strike.

We describe a case of bilateral basal ganglia hemorrhage after a lightning strike to the head documented by a CT scan. Review of the literature shows this to be the most common brain imaging finding that can be attributed to a lightning strike. Several mechanistic theories are discussed, with the most plausible one being related to preferential conduction pathways through the brain.

Adult↗