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MSc Addiction Studies: CNS Structure and Function I Gross Anatomy DR. ALANNA EASTON 1 9 TH N O V E M B E R 2 0 1 3 [email protected] Lecture Overview 1). What is the CNS and how it is protected 2). Terminology and brain dimensions 3). Deconstruction of the brain: Hemisphere, lobular categorisation, region and system 4). What happens when things go wrong? A look at neurodegenerative diseases and related alterations in structure and function 5). Brain imaging techniques and how they can be used to visualise disease Brief look at MRI and PET imaging Learning Objectives 1. To understand the relationship between structure and function of the CNS 2. To be able to name and describe the structures of the brain and their key functions 3. To have a knowledge of the various ways to visualise the CNS/brain systems and structures What is the CNS Central Nervous System PNS CNS Nerves and Ganglia outside of the brain and spinal cord Brain and Spinal Cord Terminology and Brain Dimensions Right Hemisphere Lateral Dorsal / Superior Medial Rostral/ Anterior Caudal/ Posterior Left Hemisphere Ventral / Inferior Terminology and Brain Planes The CNS is traditionally examined in 3 perpendicular planes Coronal Horizontal / Transverse Sagittal Protection of the Brain 1). Skull/Spinal column 2). Meninges Series of tough membranes surrounding the brain and spinal cord (dura mater, arachnoid mater & pia mater) Both are intended to provide mechanical protection for the brain 3). Cerebrospinal Fluid (CSF) Produced in the Choroid Plexus and acts as a shock absorber Protection of the Brain 4). Ventricular System Cavities in the brain containing CSF Act like big cushions in the brain Brain Blood Supply A highly specialised system by which each artery is the only means to supply blood to a CNS region. Circle of Willis Blood Brain Barrier Deconstructing the Brain Cerebral Hemispheres Left Right Personality Logic Language Mechanistic Intuitive Music Detail Science Artistic Design Creativity Reason Math Strategy Imagination Emotional Expression Developmental Categorisation Forebrain (Prosencephalon) Midbrain (Mesencephalon ) Hindbrain (Rhombencephalon) Spinal cord Development of the CNS 4wk old human Neural tube development Telencephalon Prosencephalon Diencephalon CNS Brain Mesencephalon Brain stem Rhinencephalon, Amygdala, Hippocampus, Neocortex, Basal ganglia, Lateral ventricles Epithalamus, Thalamus, Hypothalamus, Subthalamus, Pituitary gland, Pineal gland, Third ventricle Tectum, Cerebral peduncle, Pretectum, Mesencephalic duct Metencephalon Rhombencephalon Myelencephalon Spinal Cord Pons, Cerebellum Medulla oblongata Lobular Organisation Frontal Lobe Central Fissure Lateral Fissure Parietal Lobe Temporal Lobe Occipital Lobe Cerebellum Regions of Interest Thalamus Cerebral Cortex Substantia Nigra Corpus Callosum Hypothalamus Nucleus Accumbens Cerebellum Hippocampus Mid Brain Amygdala Pituitary Gland Pons Medulla Oblongata Brain Stem Functional Systems: The Limbic System Limbus = ‘Border’ or ‘Margin’ Collection of structures that lie in the cortical border where the cortex meets the sub cortex, in the region between the cerebral cortex and the hypothalamus Includes structures which are concerned with emotion, learning, memory and motivation Functional Systems: The Motor System Three level hierarchy Spinal Cord Brain Stem Cerebral Cortex / Motor Cortex Three major areas in the frontal lobe Primary Motor Cortex Premotor Cortex Supplementary Motor Cortex Functional Systems: The Sensory System A means to get information from the outside world into the CNS. Once there: Integration with other sensory information Integration with limbic/regulatory influences Calculation and execution of appropriate response Components of a sensory system Higher centres Spinal reflex When things go wrong Neuroscience as a basis for understanding neuronal dysfunction. Neurodegeneration Toxins Vascular Disorders Tumours Trauma Neuropsychiatric Disorders Infections Normal Aging Neurodegeneration: Alzheimer’s Disease AD is the most common form of dementia First described by Alois Alzheimer in 1906 Most cases occurring age 65 yrs + Alzheimer's is predicted to affect 1 in 85 people globally by 2050 Symptoms: confusion, irritability, aggression, trouble with language, long-term memory loss Cause and progression of the disease Gyri and Sulci more pronounced is not well understood. Current treatment only helps the symptoms of the disease Neurodegeneration: Parkinson’s Disease First recognised by James Parkinson in 1817 death of dopamine-generating cells in the substantia nigra Most cases occurring age 50 yrs + Symptoms: shaking, rigidity, bradykinesia, akinesia, tremor Modern treatments: L-Dopa, DA agonists, stem cell treatment, deep brain stimulation Surgery 30 yrs old 42 yrs old Neurodegeneration: Huntington’s Disease Genetic disorder (autosomal dominant mutation) More common in people of Western European descent than in those of Asian or African ancestry Affects both men and women Usually manifests age 35-44 yrs Mood and cognitive problems followed by lack of coordination and a decrease in mental ability Neurodegeneration: Motor Neuron Disease A group of neurological disorders affecting the body’s motor neurons Damage to the nervous system What causes motor neurones to stop working properly is unclear Not thought to be a link with factors such as race, diet and lifestyle Affects muscles controlling; speech, gripping, walking, swallowing and general bodily movements Stephen Hawking Currently there is no cure Diagnosed aged 21 Brain Imaging Techniques Computerised Tomography (CT Scan) Uses x-rays to image internal organs, blood vessels, bones and tumours Mangentic Resonance Imaging (MRI) Brain function based on local metabolism Positron Emission Tomography (PET) Activity dependent changes in blood flow, tissue metabolism or biochemical activity Magnetic Resonance Imaging Makes use of the fact that body tissue contains lots of water, and therefore protons, which align under the application of a strong magnetic field and then relax at different rates in different tissues of the body fMRI and BOLD contrast: measures brain activity by detecting associated changes in blood flow. When an area of the brain is in use, blood flow to T2 weighted image: Stroke vs. Control that region also increases. Positron Emission Tomography Involves the injection of precursor molecules or specific neurotransmitters or radio-labelled glucose Red = highest level of glucose utilisation Yellow = less utilisation Blue = least glucose utilisation Allows us to see how the brain uses glucose Glucose provides energy to each neuron so it can perform work The reduction in a neurons ability to use glucose (energy) results in disruption of many brain functions MRI & PET in Alzheimer’s Disease PET MRI References and Reading Key Texts: • “Principals of Neural Science”. Kandel and Schwartz • “Neuroscience at a glance”. Barker and Barasai How to find out more: • Wikipedia • Brain facts. www.brainfacts.org • Text Book: “Pharmacology”. Rang and Dales [email protected]