Title Uloga subtalamičke jezgre u Parkinsonovoj bolesti Title (english) Role of subthalamic nucleus in Parkinson's disease Author Ana Planinić Mentor Goran Sedmak (mentor)Committee member Goran Šimić (predsjednik povjerenstva)Committee member Zdravko Petanjek (član povjerenstva)Committee member Goran Sedmak (član povjerenstva)Granter University of Zagreb Defense date and country 2018-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Subtalamička jezgra (STN) ne ističe se ni veličinom ni brojem neurona, ali ima stratešku poziciju i jedina je glutamatna jezgra bazalnih ganglija te se smatra njihovim pokretačem, što je čini značajnom. STN je glavna jezgra subtalamusa, dijela diencefalona iz kojeg se i razvija. Smatra se trodijelnom jezgrom sastavljenom od dorzolateralnog senzomotoričkog dijela, ventromedijalnog asocijativnog dijela te medijalnog limbičkog dijela, no rezultati istraživanja rađenih metodama električnih lezija,
anterogradnih i retrogradnih obilježivača, klasične citoarhitektonike te magnetne rezonancije govore u prilog topološkoj organizaciji, ali bez jasne podjele u tri dijela. Glavne aferentne projekcije u STN dolaze iz moždane kore i iz vanjskog segmenta globus pallidusa (GPe), a glavne eferentne projekcije odlaze recipročno u GPe te u izlazne jezgre bazalnih ganglija, unutarnji segment globus pallidusa (GPi) i substantia nigra pars reticulata (SNr), preko kojih bazalni gangliji kontroliraju voljne pokrete, a
poremećaji njihove aktivnosti dovode, između ostalog, do Parkinsonove bolesti. Parkinsonova bolest je uzrokovana relativnom dominacijom indirektnog neuronskog puta koji ne prenosi informacije iz strijatuma direktno izlaznim strukturama bazalnih ganglija, nego preko STN i GPe, te tako suprimira pokret. Uočena je i koherentna aktivnost niske frekvencije među jezgrama pa se u skladu s tim, kao adjuvantna terapija koristi visokofrekventna duboka mozgovna stimulacija (DBS). DBS, uz smanjenje
motoričkih simptoma, uzrokuje i nuspojave u obliku promjena ponašanja, psihijatrijskih i kognitivnih promjena što ukazuje na raznolikost funkcije STN. Istraživanja su pokazala da STN podiže prag za donošenje odluka, da je uključena u proces motornog učenja, da je jedina jezgra koja bi mogla imati suprotne uloge u motivaciji za prirodne nagrade i drogu te da je uključena u emocionalno procesiranje i regulaciju ponašanja, čime je naglašena važnost njene uloge u funkciji bazalnih ganglija.
Abstract (english) In terms of its size and number of neurons, the subthalamic nucleus (STN) is a relatively minor component of basal ganglia, but its strategic position and the fact that it is the only primarily glutamatergic nucleus of the basal ganglia and their 'driving force', makes it significant. The STN is the main nucleus of the subthalamus, a part of the diencephalon, which it also develops from. It is considered a tripartite nucleus composed of a dorsolateral sensorimotoric region, a ventromedial associative region and a medial limbic region, but studies that featured electrical lesions, anterograde and retrograde tracers, classical cytoarchitectonics and magnetic resonance imaging (MRI) produced results that supported a topological organization without strict anatomical boundaries within the nucleus. The main afferents to the STN arise from the cortex and the external segment of the globus pallidus (GPe), and the main efferents are projected reciprocally to the GPe and to the output nuclei of the basal ganglia, the internal segment of the globus pallidus (GPi) and the substantia nigra pars
reticulata (SNr), through which the basal ganglia control voluntary movement. Basal ganglia are also the site of pathology in Parkinson's disease (PD) which is caused by the relative dominance of the indirect pathway which relays cortical and thalamic excitation indirectly to the output nuclei, involving the GPe and the STN, and suppresses movement. In PD, activity within and across the nuclei is low frequency and coherent, so high frequency deep brain stimulation (DBS) is used as adjuvant therapy. Aside from relieving motor symptoms, DBS causes side-effects in the form of behavioural, psychiatric and cognitive changes, which suggests that the STN has various functions. Research has shown that the STN elevates the decision threshold, is involved in the process of motor learning, has opposite roles in terms of motivation for natural rewards and drugs of abuse and is involved in emotional processing and regulation of behaviour, which emphasizes its significance in the function of the basal ganglia.
Keywords
subtalamička jezgra
Parkinsonova bolest
duboka mozgovna stimulacija
kognitivni poremećaji
Keywords (english)
subthalamic nucleus
Parkinson's disease
deep brain stimulation
cognitive disorders
Language croatian URN:NBN urn:nbn:hr:105:497006 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2018-12-17 11:43:17
