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    Dr. Rene V. YatDr. Rene V. Yat

    The Brain and HumanThe Brain and Human

    BehaviorBehavior

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    Parts of basal gangliaParts of basal ganglia

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    The brain structures that compriseThe brain structures that comprise

    The Basal GangliaThe Basal Ganglia

    Putamen,Putamen,

    Caudate nucleus,Caudate nucleus,

    Globus pallidusGlobus pallidusSubstantia nigraSubstantia nigra

    Subthalamic nucleus of LuysSubthalamic nucleus of Luys

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    Conditions that cause basal gangliaConditions that cause basal ganglia

    dysfunctiondysfunction

    Drug overdoseDrug overdose

    Head injuryHead injury

    InfectionInfection

    Liver diseaseLiver diseaseMetabolic processesMetabolic processes

    Multiple sclerosisMultiple sclerosis

    StrokeStrokeTumoursTumours

    Side effects of medicationsSide effects of medications

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    Brain Disorders associated withBrain Disorders associated with

    Basal ganglia dysfunctionBasal ganglia dysfunction

    DystoniasDystonias

    Huntingtons diseaseHuntingtons disease

    Parkinsons diseaseParkinsons diseaseSupranuclear PalsySupranuclear Palsy

    Wilsons diseaseWilsons disease

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    The dopamine pathways in schizophrenia

    In schizophrenia there is an increase in dopaminetransmission between the substantia nigra to the

    caudate nucleus-putamen (neostriatum) compared

    with normal. While in the other major dopaminergic

    pathways to the mesolimbic forebrain and the

    tubero-infundibular system dopamine

    transmission is reduced. The dopamine hypothesis

    of schizophrenia proposes that increased levels of

    dopamine or dopamine receptors in the dorsal and

    or ventral striatum underlie the disorder.

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    The glutamate pathways in a brain affected by schizophr

    In the normal brain the prominent glutaminergicpathways are: the cortico-cortical pathways; the

    pathways between the thalamus and the cortex; and

    the extrapyramidal pathway (the projections between

    the cortex and striatum). Other glutamate projections

    exist between the cortex, substantia nigra, subthalamicnucleus and pallidum. The glutaminergic pathways are

    hypoactive in the brains of people diagnosed with

    schizophrenia and this is thought to cause the

    confusion and psychosis associated with the disorder.

    http://www.cnsforum.com/imagebank/item/Neuro_path_GLUT_SCH/default.aspxhttp://www.cnsforum.com/imagebank/item/Neuro_path_GLUT_SCH/default.aspx
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    The serotonergic pathway showing the effects

    of schizophrenia

    The two key serotonergic pathways in schizophrenia

    are the projections from the dorsal raphe nuclei into the

    substantia nigra and the projections from the rostral

    raphe nuclei ascending into the cerebral cortex, limbic

    regions and basal ganglia. The up-regulation of these

    pathways leads to hypofunction of the dopaminergicsystem, and this effect may be responsible for the

    negative symptoms of schizophrenia. The serotonergic

    nuclei in the brainstem that give rise to descending

    serotonergic axons remain unaffected in schizophrenia.

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Biogenic aminesBiogenic amines

    Amino acidsAmino acids

    PeptidesPeptides

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Biogenic aminesBiogenic amines

    DopamineDopamine

    NorepinephrineNorepinephrineEpinephrineEpinephrine

    SerotoninSerotonin

    HistamineHistamineAcetylcholineAcetylcholine

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino Acids

    Amino acids are the mostAmino acids are the most

    abundant neurotransmitters in the brain.abundant neurotransmitters in the brain.

    Nichols suggested: amino acids synapsesNichols suggested: amino acids synapsesexceed those of all the otherexceed those of all the other

    neurotransmitters combinedamino acidsneurotransmitters combinedamino acids

    are responsible for almost all the fastare responsible for almost all the fast

    signaling between neurons, leavingsignaling between neurons, leaving

    predominantly modulatory roles for thepredominantly modulatory roles for the

    other transmitters.other transmitters.

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    Amino acidAmino acid

    NEUROTRANSMITTERSNEUROTRANSMITTERS

    The second neurotransmitter family is composedThe second neurotransmitter family is composed

    ofofamino acidsamino acids, organic compounds containing, organic compounds containing

    both an amino group (NH2) and a carboxylic acidboth an amino group (NH2) and a carboxylic acid

    group (COOH). Amino acids that serve asgroup (COOH). Amino acids that serve as

    neurotransmitters include glycine, glutamic andneurotransmitters include glycine, glutamic andaspartic acids, and gamma-amino butyric acidaspartic acids, and gamma-amino butyric acid

    (GABA). Glutamic acid and GABA are the most(GABA). Glutamic acid and GABA are the most

    abundant neurotransmitters within the centralabundant neurotransmitters within the central

    nervous system, and especially in the cerebralnervous system, and especially in the cerebralcortex, which is largely responsible for such highercortex, which is largely responsible for such higher

    brain functions as thought and interpretingbrain functions as thought and interpreting

    sensationssensations

    http://encarta.msn.com/encyclopedia_761555775/Amino_Acids.htmlhttp://encarta.msn.com/encyclopedia_761555775/Amino_Acids.htmlhttp://encarta.msn.com/encyclopedia_761555775/Amino_Acids.htmlhttp://encarta.msn.com/encyclopedia_761555775/Amino_Acids.html
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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino AcidsGlutamateGlutamate

    GABAGABA

    GlycineGlycine

    L-ArginineL-Arginine

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino AcidsGlutamateGlutamate is the major excitatory neurotransmitteris the major excitatory neurotransmitter

    and is distributed in all regions of the brain.and is distributed in all regions of the brain.

    Aspartate is closely related to glutamate and theAspartate is closely related to glutamate and thetwo amino acids are often found together at axontwo amino acids are often found together at axon

    terminals. Neurons synthesize glutamate andterminals. Neurons synthesize glutamate and

    aspartate and are independent of dietary supply.aspartate and are independent of dietary supply.

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino AcidsGamma amino butyric acid (GABA)Gamma amino butyric acid (GABA) is the majoris the major

    inhibitory neurotransmitter in the brain, derivedinhibitory neurotransmitter in the brain, derived

    from glucose, which is transaminated in the Krebsfrom glucose, which is transaminated in the Krebscycle to glutamine and then converted to GABA bycycle to glutamine and then converted to GABA by

    the enzyme, glutamic acid decarboxylase. Thethe enzyme, glutamic acid decarboxylase. The

    production of GABA appears to be independent ofproduction of GABA appears to be independent of

    the dietary supply of glutamine but requires dietarythe dietary supply of glutamine but requires dietary

    pyridoxinepyridoxine

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino AcidsGlycineGlycine is an inhibitory neurotransmitter foundis an inhibitory neurotransmitter found

    mostly in the brain stem and spinal cord. A majormostly in the brain stem and spinal cord. A major

    discovery that adds complexity to the alreadydiscovery that adds complexity to the alreadyconfusing story of neurotransmitters is that glycineconfusing story of neurotransmitters is that glycine

    acts as a co-transmitter in excitatory NMDAacts as a co-transmitter in excitatory NMDA

    synapses.synapses.

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    NEUROTRANSMITTERSNEUROTRANSMITTERS

    Amino AcidsAmino AcidsL-ArginineL-Arginine is the precursor of endogenous nitric oxide (NO),is the precursor of endogenous nitric oxide (NO),which is a vasodilator acting via the intracellular second-which is a vasodilator acting via the intracellular second-messenger cGMP. In healthy humans, L-arginine inducesmessenger cGMP. In healthy humans, L-arginine inducesperipheral vasodilation and inhibits platelet aggregation dueperipheral vasodilation and inhibits platelet aggregation due

    to an increased NO production. Prostaglandin E1 (PGE1)to an increased NO production. Prostaglandin E1 (PGE1)induces peripheral vasodilation via stimulating prostacyclininduces peripheral vasodilation via stimulating prostacyclinreceptors.receptors.

    A mixture of branch-chain amino acids, leucine, valine andA mixture of branch-chain amino acids, leucine, valine andisoleucine will reduce tardive dyskinesia and movementisoleucine will reduce tardive dyskinesia and movement

    disorder that is caused by anti-schizophrenic drugs. Tarvil,disorder that is caused by anti-schizophrenic drugs. Tarvil,has been marketed in the USA that delivers 6.0 grams of thehas been marketed in the USA that delivers 6.0 grams of the3 amino acids per packet. A dose of 6 gm three times a day3 amino acids per packet. A dose of 6 gm three times a dayhas been recommended.has been recommended.

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    Neuropeptides

    Function of Neuropeptides:

    There are cells in the brain that produce various neuropeptides, andthese neuropeptides do just about everything.

    They can be either pro-inflammatory or anti-inflammatory, with anti-

    inflammatory being preferred. They are responsible for many

    functions:

    They control our mood, energy levels, pain and pleasure reception,

    body weight, and ability to solve problems; they also form memories

    and regulate our immune system.

    These active little messengers in the brain actually turn on cellular

    function in the skin.

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    Characteristics of Neuropeptides:

    Peptides are compounds consisting of two or more amino acids (thebuilding blocks of proteins), chained together by what is called a

    peptide bond.

    Neuropeptides are peptides released by neurons (brain cells) as

    intercellular messengers. Some neuropeptides function as

    neurotransmitters, and others function as hormones.

    Peptides and neuropeptides, like many substances in our bodies (think

    cholesterol) can work both for and against us. Anti-inflammatory

    neuropeptides work for us to reduce inflamation fo the skin.

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    Transmitter names are shown in bold.

    Norepinephrine (noradrenaline). In neurons of the

    A2 cell group in the nucleus of the solitary tract),

    norepinephrine co-exists with:Galanin

    Enkephalin

    NeuropeptideY

    GABA

    Somatostatin (in the hippocampus)Cholecystokinin

    NeuropeptideY (in the arcuatenucleus)

    Acetylcholine

    VIP

    Substance P - Originally nown as Tachykinins.Because they are rapidly absorbed they now known as

    neurokinins. They play a key role in modulation of

    pain and emotions. Hence possibly in the future this

    could be a source of new antidepresants

    PEPTIDES

    http://en.wikipedia.org/wiki/Norepinephrinehttp://en.wikipedia.org/wiki/Nucleus_of_the_solitary_tracthttp://en.wikipedia.org/wiki/Galaninhttp://en.wikipedia.org/wiki/Enkephalinhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Somatostatinhttp://en.wikipedia.org/wiki/Hippocampushttp://en.wikipedia.org/wiki/Cholecystokininhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Arcuate_nucleushttp://en.wikipedia.org/wiki/Arcuate_nucleushttp://en.wikipedia.org/wiki/Acetylcholinehttp://en.wikipedia.org/wiki/Vasoactive_intestinal_peptidehttp://en.wikipedia.org/wiki/Substance_Phttp://en.wikipedia.org/wiki/Substance_Phttp://en.wikipedia.org/wiki/Vasoactive_intestinal_peptidehttp://en.wikipedia.org/wiki/Acetylcholinehttp://en.wikipedia.org/wiki/Arcuate_nucleushttp://en.wikipedia.org/wiki/Arcuate_nucleushttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Cholecystokininhttp://en.wikipedia.org/wiki/Hippocampushttp://en.wikipedia.org/wiki/Somatostatinhttp://en.wikipedia.org/wiki/GABAhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Enkephalinhttp://en.wikipedia.org/wiki/Galaninhttp://en.wikipedia.org/wiki/Nucleus_of_the_solitary_tracthttp://en.wikipedia.org/wiki/Norepinephrine
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    Dopamine

    CholecystokininNeurotensin

    Epinephrine (adrenaline)

    NeuropeptideY

    NeurotensinSerotonin (5-HT)

    Substance P

    TRH

    Enkephalin

    PEPTIDES

    http://en.wikipedia.org/wiki/Dopaminehttp://en.wikipedia.org/wiki/Cholecystokininhttp://en.wikipedia.org/wiki/Neurotensinhttp://en.wikipedia.org/wiki/Epinephrinehttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neurotensinhttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Substance_Phttp://en.wikipedia.org/wiki/Enkephalinhttp://en.wikipedia.org/wiki/Enkephalinhttp://en.wikipedia.org/wiki/Substance_Phttp://en.wikipedia.org/wiki/Serotoninhttp://en.wikipedia.org/wiki/Neurotensinhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Neuropeptide_Yhttp://en.wikipedia.org/wiki/Epinephrinehttp://en.wikipedia.org/wiki/Neurotensinhttp://en.wikipedia.org/wiki/Cholecystokininhttp://en.wikipedia.org/wiki/Dopamine
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    UPREGULATION HYPOTHESIS OF NEURONAL RECEPTORS

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    Supersensitivity is a compensatory response of the

    postsynaptic neuron when it receives too little stimulation.

    The neuron tries to make up for a lack of stimulation by

    increasing receptor responsiveness. Over time, the

    postsynaptic neuron may also compensate for lack ofstimulation by synthesizing additional receptor sites. This

    process is known as up-regulation.

    Upregulation theory

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    By increasing the amount of neurotransmitter in

    the cleft, you can normalize responsiveness.

    Increased neurotransmitter increases stimulationof receptor sites, which prompts the postsynaptic

    neuron to compensate by decreasing receptor

    sensitivity, a process known as desensitization

    DESENSITIZATION THEORY

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    The postsynaptic neuron is also thought to compensate

    for increasing stimulation by decreasing the number of

    receptor sites, a process known as down-regulation.

    Downregulation hypothesis

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    Prolonged sitting can causeProlonged sitting can cause

    ischial bursitis.ischial bursitis.

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    To study medicine without books andTo study medicine without books and

    mentors is like a shaman who professesmentors is like a shaman who professeswho know everything but deep inside hewho know everything but deep inside he

    knows nothing at all.knows nothing at all.

    You can shake, rattle, and roll. But at theYou can shake, rattle, and roll. But at theend of the day, you wish that you haveend of the day, you wish that you have

    studied hard for the life you are handling instudied hard for the life you are handling in

    front of you is not a guinea pig at all.front of you is not a guinea pig at all.

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    END OF THE LECTUREEND OF THE LECTURE