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Summary Drugs for the Central Nervous System lectures

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Drugs for the Central Nervous System

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  • 20 oktober 2021
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  • 2020/2021
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Drugs for the central nervous system
Lecture 1, Dolga, 06/05/2021, evolution of the human brain
Midsagittal = front to back
Frontal/coronal = left to right
Transverse = horizontal

Body planes:
- Radial symmetrically: starfish
- Bilateral symmetrically: cat




Spinal cord: basic function
Hindbrain: circulation, digestion, breathing
Forebrain: decision making

Frontal lobe: decision making
Parietal lobe: sensory, interpretation
Occipital lobe: vision
Temporal lobe: memory, hearing (hippocampus: learning, memory, retrieval)




Brainstem: medulla oblongata, pons, midbrain
- Basic function
- Sensory/motor nerves (filtering and routing information)

Cerebellum: ‘Arbor vitae’, control of the voluntary movements
- Motor coordination
- Motor memory
The right hemisphere communicates with the right part of the spinal cord (posture, gait), and
communicates with the left part of the cerebral hemisphere.
Cerebellar patients usually do not have loss of strength, and no loss of sensation.

,Thalamus:
- Data sorting
- Hypothalamus: thermoregulation
- Pituitary gland: hormonal activity (oxytocin, water balance)

Cerebrum: a lot of fibres, integration of all information and helps to act accordingly. Also, for
emotion, and action.
To obtain images of the brain, structural magnetic resonance imaging (MRI) is used. It is used to
determine the borders of cortical grey matter, precisely the thickness. The white matter is for the
communication between the neuron, where the grey matter is for the cell bodies of the neurons.
This can be used for diagnosis.
Functional magnetic resonance imaging (fMRI) can be used to determine the changes in blood flow
(activity) in the brain.
Diffusion tensor imaging (DTI) allows measuring of water movement in the brain, to determine the
functioning of the white matter. Corticospinal tract can be observed.
- Ipsilateral: less fibers
- Contralateral: more fibers

Cerebral cortex: total covers threequarters of the brain, and is essential for consciousness (mind)
Five parts (laminar structure)
- Frontal cortex (50%)
- Parietal cortex (somatosensory)
- Occipital cortex (vision)
- Temporal cortex (smell, hearing, memory)
- Insular cortex (taste, visceral, feelings)
Six-layered sheet (about 5mm thick)
- Processing units (mini-columns)
- Primary sensory (topographical)
- Association parts (relates info)

Corpus collosum: connects the right and the left hemisphere, made by white matter (fibers). The
right hemisphere is important for facial recognition, where the left hemisphere is important for
reasoning, and logic.

Broca’s (B), Geschwind’s (G), and Wernicke’s (W) neocortical areas:
Important for language, produced in the Broca’s area, and understood in the Wernicke’s area
(temporal lobe).

,Basal ganglia: involuntary movements. Composed of caudate, putamen, and striatum (internal
capsule). Diseases in this area leads to Huntington and Parkinson disease.
The nucleus accumbens is important in reward seeking behaviour, pleasure, and thus addiction.




Midbrain – substantia nigra:
Important production of dopamine, and thus can lead to Parkinson’s disease.
Dopamine pathways: nigrostriatal pathway, mesolimbic pathway, tubero-hypophyseal pathway,
mesocortical pathway.

Hippocampus: learning, memory. Alzheimer’s disease




1. Primary forebrain of the lamprey: 560 mya
- Dominant olfactory bulb
- Small hemisphere: striatum > pallidum > brainstem, GPh > habenula > brainstem
- Thalamus
- Medial pallium (hippocampus)
- Hypothalamus (output)
- Upper brainstem (output): motor output, monoaminergic feedback

Primary brain: two essential forces are necessary for survival of the individual and species. The
motivation to obtain food/water/warmth/comfort (reward driven), and the motivation to escape
from threat/heat/cold (discomfort/misery driven). Very ancient mechanisms regulate behaviour.
Amygdala, hippocampus, hypothalamus, habenula.

2. Secondary forebrain of the frog: 370 mya
- Larger hemisphere: no cerebral cortex, ventral striatum > extrapyramidal system, pallium
similar to the limbic system, rest > amygdaloid complex (centromedial nucleus = striatum)

Secondary brain: regulation of intensity reward driven system, and thus intensity of distress avoiding
behaviour.

, - Intensity of reward driven behaviour in the Nc accumbens core, anhedonia (lack of pleasure)
- Intensity of distress avoiding behaviour in the Nc accumbens shell, dysphoria (feeling
unhappy)

3. Tertiary forebrain of the monkey: 145 mya
- Small olfactory bulb
- Appearance of cerebral cortex (early mammals): frontal/parietal/occipital/temporal lobe
- Basal ganglia
- Cerebellum
- Small brainstem

Tertiary brain: cerebral cortex (dorsal thalamus), dorsal extrapyramidal system. Consciousness,
perception, language (speech/reading/writing), inhibition of emotional response (primary forebrain),
execution of voluntary response (initiation/planning/execution,
working memory), controlling motor response.

Dorsal vs ventral spinal cord:
- Dorsal root: afferent fibers of spinal nerve, ascending
tracts of spinal cord
- Posterior cerebral cortex: cerebral processing of sensory
input
- Ventral root: efferent fibers of spinal nerve
(musculoskeletal), preganglionic autonomic nervous
system, descending tracts
- Anterior cerebral cortex: generation of behavioural
output

Lower vs higher functions:
- Spinal cord: specific motor and autonomic control centres, central motor pattern generator
and spinal micturition centre
- Brainstem: control/coordination of autonomic regulation
- Cerebellum: control/coordination of movements
- Forebrain: control of complex emotional response (neuronal and endocrine), control of
rational behaviour, generating mind activity and speech

Cortical vs subcortical functions:
Cerebral cortex and dorsal thalamus: processing sensory input, perception, planning and executing
rational behaviour, inhibiting complex emotional response
Subcortex: extrapyramidal control of rational behaviour and intensity of motor function, generating
complex emotional response, recognition and memory formation.

Voluntary motor behaviour:
- Initiated by frontal cortex (glutamate): motor output
- Coordinated by cerebellum (GABA): different movements (ataxia)
- Coordinated by basal ganglia (dopamine): different contractions (dyskinesia/Parkinson’s)



Extrapyramidal system: cerebral cortex
Cortex > striatum > pallidum > thalamus > cortex
- Direct pathway: activation (hyperkinesia)
- Indirect pathway: inhibition (hypokinesia)

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