Treatment of Basal Ganglia Disorders

Treatment of Basal Ganglia Disorders

Introduction

The basal ganglia are key areas in the brain, together with the cerebellum have a big impact on the overall motor skills, i.e. position and posture, standing up and walking, fine and gross motor skills. They are involved in the implementation of automatic, learned movements and in the control of muscle reflexes. They belong to the extra-pyramidal motor system of the central nervous system. Via chemical messengers, called neurotransmitters, information is transmitted from one nerve cell to another. The transmitter dopamine and acetylcholine are among the most important substances. These must be in equilibrium; otherwise the movement may not be coordinated and controlled.

In one class of extrapyramidal disorders, Parkinson's disease presented, the main defect appears hypokinesia or akinesia, which characterizes the patient's failure to make rapid movements of the limbs. Decrease in motor activity (hypokinesia, or depletion of movements) applies to small automated movement, the constant presence of a healthy person (patient, who suffers from Parkinson's disease, sits motionless, face masklike). Voluntary movements and movements on the instructions are executed with some delay (slow response time), and slow (bradykinesia). At the heart apparently is a violation of the fast (ballistic) movements. To make a voluntary movement for repeatedly re-activation of muscle-agonists, implementation of alternating movements is difficult. Bradykinesia, usually accompanied by rigidity, but not caused by it.

Discussion

Etiology of Disease

Although the etiology of Parkinson's disease is not entirely clear, it is now accepted the hypothesis of a multi-factorial etiology of the disease, they interact with environmental and genetic components. Possible etiological factors are heredity, brain damage, infection, endogenous neurotoxins, environmental factors and altered gene pressures. It is noted in particular that the occurrence of gradients in the metal SNPC in the absence of efficient homeostatic responses can be cytotoxic and lead to oxidative damage.

Some environmental factors and employment may increase the risk of developing the disease. Among these are included exposure to exogenous toxins such as pesticides, metals, other xenobiotics and industrial chemicals, lifestyle (diet and smoking), place of residence (rural areas) and occupation (agricultural work).

A positive family history may increase the risk of developing the disease. Hereditary forms of the disease are caused by mutations identified for the following genes: alpha-synuclein, parkin, dardarin, DJ-1. Approximately 5-10% of patients show an autosomal dominant pattern of inheritance. In other studies of Parkinson's disease has been associated with brain lesions, particularly trauma accompanied by bleeding, ...