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ANATOMY OF STRUCTURES
RELATED TO PARKINSON DISEASE

Parkinson Disease is a disease characterized by involuntary tremulous motion,

with lessened muscular power, in parts not in action and even when supported;
with a propensity to bend the trunk forward, and to pass from a walking to a
running paace, the senses and intellect being uninjured.

The most constant and pertinent finding in both idiopathic and postencephalitic
Parkinson disease is a loss of pigmented cells in the substantia nigra and other
pigmented nuclei (locus ceruleus, dorsal motor nucleus of the vagus). Tyrosine-
hydroxylase, the rate-limiting enzyme for the synthesis of dopamine, diminishes
correspondingly. Aging contributes importantly to nigral cell loss, but the cell
depletion is so much more marked in Parkinson disease that some factor other
than aging must also be operative.

Diencephalo Lateral
Main sucli
n Ventricle
Cerebrum
Telencephal Cerebral Basal
Lobes
on Hemisphere Nuclei

Internal White
Structure Matter

Septum
Pellucidum

Tela
Choroidea
INTERNAL STRUCTURE OF THE CEREBRAL HEMISPHERES
The cerebral hemisphere are covered with a layer of gray matter, the cerebral
cortex. Located in teh interior of the cerebral hemisphere are teh lateral
ventricles, masses of gray matter, the basal nuclei, and nerve fibers. The
nerve fibers are embedded in neuroglia and contiture the white matter.

Basal Nuclei
The term Basal Nuclei (Basal Ganglia) is applied to a collection of masses of
gray matter situated within each cerebral hemisphere. They are the corpus
striatumthe amygdaloid nucleus, and the claustrum.

Corpus Striatum
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The corpus striatum is situated lateral to the thalamus. Its almost completely
divided by a band of nerve fibers, teh internal capsule, into the caudate
nucleus and the lentiform nucleus.
The caudate nucleus, a large C-shaped mass of gray matter that is closely
related to the lateral ventricle, lies lateral to thalamus. The lateral surface of the

nucleus is related to the internal capsule, which separates it from the lentiform
nucleus.

The lentiform nucleus is a wedge-shaped mass of gray matter whose broad

convex base is directed laterally and blade medially. Its buried deep in the white
matter of the cerebral hemisphere and is related medially to the internal capsule,
which separates it from the caudate nucleus and the thalamus. The lentiform
nucleus is related laterally to a thin sheet of white matter, the external
capsule, that separates it from a thin sheet of gray matter, called the
claustrum. The claustrum, in turn, separates the external capsule from the
subcortical white matter of the insula. Inferiorly at its anterior end, the lentiform
nucleus is continuous with the caudate nucleus.
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The corpus striatum receives afferent fibers from different areas of the cerebral
cortex, the thalamus, subthalamus, and brainstem. Efferent fibers then travel
back to the same areas of the nervous system. The fuction of the corpus striatum
is concerned with muscular movement, which is accomplished by controlling the
cerebral cortex rather than trough direct descending pathways to the brainstem
and spinal cord.

Amygdaloid Nucleus

The amygdaloid nucleus is situated in the temporal lobe close to the

uncus. The amygdaloid nucleus is considered part of the limbic system.
Claustrum
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The claustrum is a thin sheet of gray matter that is separated from the lateral

Medulla
oblongat
a
Brainste
Midbrain
m

Pons
surface of the lentiform nucleus by the external capsule. Lateral to the
claustrum is the subcortical white matter of the insula. The function of the
claustrum is unknown.

MIDBRAIN
The midbrain comprises two lateral halves, called the cerebral peduncles; each
of these is divided into an anterior part, the crus cerebri, and a posterior part,
the tegmentum, by a pigmented band of gray matter, the substansia nigra.
The narrow cavity of the midbrain is the cerebral aqueduct, which connects the
third and fourth ventricles. The tectum is the part of the midbrain posterior to
the cerebral aqueduct; it has four small surface swelling these are the two
superior and two inferior colliculi. The cerebral aqueduct is lined by
ependyma and is surrounded by the central gray matter. On transverse
section of the midbrain, the interpeduncular fossa can be seen to separate the
crura cerebri, whereas the tegmentum is contiuous across the median plane.
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CEREBELLUM
The median strip contains the cortex of the vermis, together with the fastigial
nucleus in the white matter close to the nodule. This strip is the
vestobulocerebellum. It has two-way connections with the vestibular nucleus. It
contrils the responses of that nucleus to signals from the vestibular labyrinth.
The fastigial nucleus also projects to the gaze centrers of the brainstem.
A paramedian strip, the spinocerebellum, includes the paravermal cortex and the
globose and emboliform nuclei. The two nuclei are together called the
interposed nucleus. The spinocerebellum is rich in spinocerebellar
connections. Its involved in the control of posture and gait.
The remaining, lateral strip is much the largest and takes in the weinkled
dentate nucleus. This strip is the pontocerebellum, because it receives a
massive input from the contralateral nuclei pontis. Its also called the
neocerebellum, because the nuclei pontis convey information from large areas
of the cerebral neocortex.
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The cerebellum has a sophisticated function in relation to postural stabilization.

Postural Stabilization
Displacement of the upper trunk away from the center of gravity by a voluntary
movement of the head or upper limb is anticipated by the cerebellum. Having
read instructions delivered from premotor areas of the frontal lobe concerning
the intended movement, the cerebellum ensures proportionate contractions of
postural muscles in a bottom-up manner, from leg to thigh to trunt, in order to
keep the center of gravity in the midline between the feet.