PYRAMIDAL TRACT

AND
EXTRAPYRAMIDAL TRACT
Basal Ganglia
subcortical nuclei (gray matter) within the cerebral hemispheres.
Components
1. Caudate nucleus
2. Putamen ,
3. Globus pallidus
4. Amygdala (amygdaloid nuclear complex)
5. Claustrum
Groupings of the basal ganglia
1. Striatum (neostriatum)
caudate nucleus and the putamen,
2. Lentiform nucleus
putamen and the globus pallidus.
3. Corpus striatum
lentiform nucleus and the caudate nucleus.
Striatal Motor System
extrapyramidal motor system.
plays a role in the initiation and execution of somatic motor activity, especially
willed movement.
involved in automatic stereotyped motor activity of a postural and reflex nature.
exerts its influences on motor activities via the
thalamus,
motor cortex,
corticobulbar
corticospinal systems.
Components of the Striatal system
consist of the following nuclei
1. Striatum - neostriatum
Caudate nucleus
Putamen
2. Globus pallidus - paleostriatum
Medial (internal) segment - adjacent to the internal capsule.
Lateral (external) segment - adjacent to the putamen.
3. Subthalamic nucleus
lies between the internal capsule and the thalamus and between the internal
capsule and the lenticular fasciculus.
4. ThaJamus
Ventral anterior nucleus
Ventral lateral nucleus
Centromedian nucleus
5. Substantia nigra
Pars compacts - contains dopaminergic neurons, which contain the
pigment melanin.
Pars reticularis - contains gamma-aminobutyric acid (GABA) -ergic
neurons.
6. Peduncrlopontine nucleus
lies in the lateral tegmentum of the caudal midbrain.
Major connections of the striatal system
Striatum
receives its largest input from the
neocortex, from virtually all neocortical areas.
thalamus (centromedian nucleus)
substantia nigra.
projects fibers to two major nuclei
globus pallidus
pars reticularis
Globus pallidus
receives input from two major nuclei:
striatum and the subthalamic nucleus.
projects fibers to three major nuclei:
subthalamic nucleus, the thalamus (ventral anterior, ventral lateral, and
centromedian nuclei), and the pedunculopontine nucleus.
Subthalamic nucleus
receives input from the
globus pallidus
motor cortex.
projects fibers to the globus pallidus.
Thalamus
A. Input to the thalamus
Globus pallidus - projects to the ventral anterior, ventral lateral, and
centromedian nuclei.
Substantia nigra - projects from the pars reticularis to the ventral anterior,
ventral lateral, and the mediodorsal nuclei of the thalamus.

B. projections from the thalamus

ventral lateral and centromedian nuclei to Motor cortex (area 4)
ventral anterior and ventral lateral nuclei to Premotor cortex (area 6)
ventral lateral and ventral anterior nuclei to Supplementary motor cortex (area 6)
centromedian nucleus to Striatum
Substantia nigra
recieves major input from the Striatum.
project fibers to the
Striatum
thalamus (ventral anterior, ventral lateral, and mediodorsal nuclei).
Pedunculopontine nucleus .
receives GABA-ergic input from the globus pallidus
projects glutaminergic fibers to the
globus pallidus
substantia nigra.
Ventral striatopallidal complex and its connections
play a role in initiating movements in response to motivational and emotional
activity
Ventral striatum
consists of the nucleus accumbens and the olfactory tubercle.
receives input from the olfactory, prefrontai, and hippocampal cortices.
projects to the ventral pallidum.
Ventral pallidum
consists of the substantia innominata.
receives input from the ventral striatum.
projects to the medial dorsal nucleus of the thalamus.
Basal Ganglia
Pathways and Nuclei:
Cortex —» striatum —> globus pallidus —> thalamus —> Cortex
striatum (caudate and putamen) - major site of input to the basal ganglia.
presence of Inhibitory and excitatory interneurons
1. receives afferents
via the
corticostriate projections - excitatory.
sensorimotor cortex (areas 4, 1,2, and 3),
premotor cortex (area 6)
frontal eye fields (area 8)
2. receives inputs from the intralaminar thalamic nuclei,
substantia nigra, and midbrain raphe nuclei
3. send inhibitory (GAB Aer-gic) axons to the
globus pallidus - major outflow nucleus of the corpus striatum.
axon ansa lenticularis and the lenticular fasciculus - H2 field of Forel
sends inhibitory axons (GABAergic) to the
ventral nuclei (ventral anterior, VA; and ventral lateral, VL)
thalamus (which also receives input from the cerebellum, the
subthalamic nucleus, and substantia nigra)
VA and VL thalamic nuclei complete the feedback circuit by sending axons
back to the cerebral cortex
substantia nigra,
dopaminergic neurons in the pars compacta
1. project to the striatum (the nigrostriatal projection) form inhibitory
synapses

striatonigral projection - reciprocal projections travel from the striatum

to the substantia nigra and are also inhibitory
cortex —> striatum —> substantia nigra —> striatum —> —> cortex

2. dopaminergic neurons in the substantia nigra also project to the

thalamus (ventral anterior and ventral lateral), which, in
turn, sends projections to the sensorimotor cortex - this pathway
involves the following circuit:
cortex —> striatum —> substantia nigra —> thalamus —> cortex

subthalamic nucleus
also receives inhibitory inputs from the globus pallidus and from the cortex;
efferent fibers return to the globus pallidus.
cortex —> globus pallidus —> subthalamic nuclei —> —» globus pallidus —> cortex
 Another loop involves the cerebellum.
Portions of the thalamus project by way of the central tegmental tract to the
inferior olivary nucleus

sends fibers to the contralateral cerebellar cortex.

loop to the thalamus is closed via the dentate and

contralateral red nuclei.
thalamus —> inferior olivary nucleus —> contralateral cerebellar cortex
via dentate and contralateral
red nuclei
thalamus
Although there are no direct projections from the caudate nucleus, putamen, or
globus pallidus to the spinal cord,
subthalamic region, including the pre-rubral field and the red nucleus, is an
important relay and modifying station.
Projections from the globus pallidus to the
red nucleus converge with inputs from the motor cortex and the deep
cerebellar nuclei.
Efferent fibers from the red nucleus descend in the spinal cord as the
rubrospinal tract, which modulates the tone of flexor muscles
Major neurotransmitters of the neurons of the striatal system
Glutamate-containing neurons
project from the
cerebral cortex to the striatum.
subthalamic nucleus to the globus pallidus.
excite striatal GABA-ergic and cholinergic neurons.
GABA-containing neurons
predominant neurons of the striatal system.
found in the
striatum, globus pallidus, and substantia nigra (pars reticularis).
give rise to the following GABA-ergic projections:
striatopallidal, striatonigral, pallidothalamic, and nigrothalamic projections.
degenerate in Huntington disease.
Dopamine-containing neurons
found in the pars compacta of the substantia nigra.
give rise to the dopaminergic nigrostriatal projection.
thought to regulate the production of striatal peptides and peptide mRNA
degenerate in Parkinson disease.
Neurons containing acetylcholine
local circuit neurons found in the striatum
Neuropeptide-containing neurons
enkephalin, dynoiphin, substance P, somatostatin, neurotensin, neuropeptide Y,
and cholecystokinin.
also found in the basal ganglia.
coexist with the major neurotransmitters
Clinical correlations
Parkinson disease
degeneration and depigmentation of neurons in the substantia nigra.
results in the depletion of dopamine in the caudate nucleus and putamen.
clinical manifestations of
bradykinesia and hypokinesia
(difficulty in initiating and performing volitional movements);
rigidity (cog-wheel and lead-pipe rigidity); and
resting tremor (pill-rolling tremor).
MPTP-induced parkinsonism
caused by l-methyl-4-phenyl-l,2,3,6-tetrahydropyridine (MPTP), a meperidine
analog found in illicit recreational drugs.
results in the destruction of dopaminergic neurons, which are located in the
substantia nigra.
Progressive supranuclear palsy
associated with Parkinson disease.
Parkinson-plus syndrome - progressive supranuclear palsy together with Parkinson
disease
characterized by
supranuclear ophthalmoplegia, primarily downgaze paresis, which is followed
by paresis of other eye movements.
 As the disease progresses, the remainder of the motor cranial nerves become
involved, resulting in the clinical picture of pseudobulbar palsy.
characterized by neuronal cell loss in the globus pallidus, red nucleus,
substantia nigra, periaqueductal gray, and dentate nucleus.
spares the cerebral and the cerebellar cortices.
results in: neurofibrillary tangles, in the surviving neurons.
Huntington disease
inherited autosomal dominant movement disorder associated with severe
degeneration of the cholinergic and GABA-ergic neurons, which are located in
the caudate nucleus and putamen.
usually accompanied by gyral atrophy in the frontal and temporal lobes.
can be traced to a single gene defect on chromosome 4.
characterized by impaired initiation and slowness of saccadic eye movements;
patients cannot make a volitional saccade without moving the head.
results in, clinical manifestations of choreiform movements and progressive
dementia.
results in hydrocephajus ex vacuo due to the loss of neurons located in the head
of the caudate nucleus, and to a lesser extent in the putamen.
Other choreiform dyskinesias
Sydenham chorea
most common cause of chorea overall.
occurs mainly in girls as a sequela to rheumatic fever,
Chorea gravidarum
occurs usually during the second trimester of pregnancy.
in many cases, a history of Sydenham chorea can be obtained.
Ballism and hemiballism
extrapyramidal motor disorders most often resulting from a vascular lesion
(infarct) of the subthalamic nucleus.
characterized by violent flinging (ballistic) movements of one or both extremities;
symptoms appear on the contralateral side.
may be treated with dopamine-blocking drugs or with GABA-mimetic agents,
may be treated surgically by ventrolateral thalamotomy.
Hepatolenticular degeneration (Wilson disease)
autosomal recessive disorder due to a defect in the metabolism of copper
(ceruloplasmin).
gene locus on chromosome 13.
results in clinical manifestations of tremor, rigidity, and choreiform or athetotic
movements. Tremor is the most common neurologic sign
marked by lesions in the liver (cirrhosis) and in the lentiform nuclei
(necrosis and cavitation of the putamen).
Tardive dyskinesia
syndrome of repetitive choreic movements affecting the face, limbs, and trunk.
results from treatment with antipsychotic drugs
Pyramidal tract
Lateral corticospinal tract
not fully myelinatcd until the end of the second year.
Function:
concerned with volitional skilled motor activity, primarily of the digits of the
upper limb.
modulates the transmission of sensory input via the ascending sensory
pathways.
receives input from the paracentral lobule, a medial continuation of the
motor and sensory cortices, and subserves the muscles of the
contralateral leg and foot,
Origin and termination:
arises from lamina V of the cerebral cortex from three cortical areas, in
equal proportions
premotor cortex (area 6)
precentral motor cortex larea 4)
postcentral sensory cortex (areas 3, 1, and 2).
terminates via interneurons on ventral horn motor neurons and sensory
neurons of the dorsal horn.
Fibers number approximately 1 million,
usually (90%) between 1 and 4 um in diameter.
usually (67%) mvelinated.
 axons of the giant cells of Betz - represent 4% of the fibers of the tract, with
diameters greater than 20 um.
precentral gyrus
anterior paracentral lobule.
Course:
passes through the posterior limb of the internal capsule.
passes through the middle three-fifths of the crus cerebri of the mid-brain. '
passes through the base of the pons.
constitutes the pyramid of the medulla.
undergoes a 90% decussation in the caudal medulla.
lies in the dorsal quadrant of the lateral funiculus of the spinal cord.
Transection
results in spastic hemiparesis with the Babinski sign.

Ventral corticospinal tract

small uncrossed tract that decussates at spinal cord levels in the ventral white
commissure.
concerned with the control of axial muscles. :.