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Diencephalon

Diencephalon. Won Taek Lee, M.D., Ph.D . Diencephalon. Thalamus  dorsal thalamus Hypothalamus pituitary gland Epithalamus habenular nucleus and commissure pineal gland Subthalamus  ventral thalamus subthalamic nucleus (STN) field of Forel . Diencephalon.

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Diencephalon

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  1. Diencephalon Won Taek Lee, M.D., Ph.D.

  2. Diencephalon • Thalamus  dorsal thalamus • Hypothalamus • pituitary gland • Epithalamus • habenular nucleus and commissure • pineal gland • Subthalamus  ventral thalamus • subthalamic nucleus (STN) • field of Forel

  3. Diencephalon dorsal surface

  4. Diencephalon ventral surface

  5. Diencephalon Medial Surface

  6. THALAMUS

  7. Classification of Thalamic Nuclei I. Lateral Nuclear Group II. Medial Nuclear Group III. Anterior Nuclear Group IV. Posterior Nuclear Group V. Metathalamic Nuclear Group VI. Intralaminar Nuclear Group VII. Thalamic Reticular Nucleus

  8. Classification of Thalamic Nuclei

  9. 15 mm* 12 mm* * Distance from anterior thalamic pole

  10. 4.02 mm* 2.02 mm* * Distance from anterior thalamic pole

  11. LATERAL NUCLEAR GROUP • Ventral Nuclear Group • Ventral Posterior Nucleus (VP) • ventral posterolateral nucleus • (VPL, V.c.a.e. & V.c.p.e.) • - pars oralis (VPLo, VLp) • - pars caudalis (VPLc, VPL) • ventral posteromedial nucleus (VPM) • - pars principalis (VPM, V.c.a.i. & V.c.a.e.) • - pars parvocellularis (VPMpc, V.c.pc.i., VMb) • ventral posteroinferior nucleus (VPI, V.c.pc.e)

  12. LATERAL NUCLEAR GROUP Ventral Lateral Nucleus (VL) - pars oralis (VLo, V.o.a. VLa) - pars caudalis (VLc, V.o.p., VLp) - pars medialis (VLm, V.o.m. & V.o.i., VMp, VM) Ventral Anterior Nucleus (VA, L.po.) - pars parvicellularis (VApc) - pars magnocellularis (VAmc)

  13. LATERAL NUCLEAR GROUP Prefrontal SMA MI, PM SI Ventral Nuclear Group TTT SNr GPi Cbll ML, STT

  14. LATERAL NUCLEAR GROUP Dorsal or Lateral Nuclear Group Lateral Dorsal Nucleus (LD, D.sf.) Lateral Posterior Nucleus (LP, D.im. & Z.im.) Pulvinar (P, Pu.)

  15. LATERAL NUCLEAR GROUP cingulate gyrus, precuneus Somesthetic Association Area Visual Association area HF SC, Pretectal

  16. MEDIAL NUCLEAR GROUP Dorsomedial Nucleus (MD, M.) - pars magnocellularis, MDmc) - pars parvocellularis, MDpc) - pars paralaminaris (MDpl; pars multiformis, MDmf) - pars densocellularis, MDdc) Midline Nuclear Group Paratenial Nucleus (Pt, Pt.) Reunience Nucleus (Re, Edy.) Submedial Nucleus (Sm) Rhomboid Nucleus (Rh)

  17. ANTERIOR NUCLEAR GROUP • anteroventral nucleus (AV, A.pr.) • anterodorsal nucleus (AD, A.d.) • anteromedial nucleus (AM, A.m.) • POSTERIOR NUCLEAR GROUP • suprageniculate nucleus (SG, Li.) • nucleus limitans (Lim, Li.) • posterior nucleus (PO, Li.por.)

  18. MEDIAL & ANTERIOR NUCLEAR GROUP Prefrontal Cortex Frontal Eye Field MB, HF Medial Frontal Gyrus cingulate gyrus Basal forebrain SNr, SC, RF

  19. METATHALAMIC NUCLEAR GROUP • Medial Geniculate Nucleus (MG) • ventral or principal or • parvocellular nucleus (MGv) • dorsal nucleus (MGd) • medial nucleus (MGm) • Lateral Geniculate Nucleus (LG) • dorsal nucleus (LGd) • ventral nucleus (LGv)

  20. INTRALAMINAR NUCLEAR GROUP • Rostral Intralaminar Nuclei • central lateral nucleus, CL, i.La.) • central medial nucleus, CeM, Co.) • paracentral nucleus, PC, i.La.) • Caudal Intralaminar Nuclei • (CM-PF nuclear complex) • centre median nucleus, CM, Ce.) • parafascicular nucleus, PF, Pf.)

  21. THALAMIC RETICULAR NUCLEUS Cerebral Cortex Thalamocortical Neuron Thalamic Reticular Nucleus Subcortical Structure

  22. Summary of Thalamic Connectivity I. Sensory Input general sensation special sensation taste, equilibrium, hearing, vision II. Motor Input cerebellum, basal ganglia III. Reticular Formation IV. Limbic System mammillary nucleus hippocampal formation

  23. Sensory Input (1) General Sensation 1. Medial lemniscus VPLc ----------- S I, S II 2. Spinothalamic tract VPLc ----------- S I, S II POm ----------- retroinsular cortex Sm ------------- frontal lobe(?) CL ------------- diffuse cortical areas 3. Trigeminothalamic tract VPM ------------- S I, S II

  24. Sensory Input (2) Taste sensation VPM pc ------- gustatory area (Brodmann area 43) (3) Sense of equilibrium VPLo ---------- S I (4) Auditory sensation MGv ----------- A I (Brodmann area 41, 42) MGd ----------- A II (5) Vision LGd ---------- V I (Brodmann area 17) Pi, Pl ---------- V I, V II (Brodmann area 17, 18, 19)

  25. Motor Input (1) Cerebellum VLc, VPLo, Nucleus X (cell sparse zone) ---------- M I (Brodmann area 4), Premotor area CL ----------- diffuse cortical areas (2) Basal ganglia 1. GPi (internal segment of globus pallidus) VLo -------- SMA (supplementary motor area) VApc ------- frontal cortex CM --------- diffuse cortical areas, striatum, subthalamic nucleus 2. SNr (pars reticularis of substantia nigra) VLm, VAmc - fronal cortex MDpc --------- medial frontal cortex MDpl ---------- frontal eye field (Brodmann area 8)

  26. Reticular Formation & Limbic System Reticular formation rostral intralaminar nuclei (CL, Cem, PC), Rh ----- diffuse cortical areas thalamic reticular nucleus (R), LGv ----- adjacent thalamic nucleus Limbic System Mammillary Body AV, AD, AM ----- cingulate gyrus Hippocampal Formation AV, AD, AM ----- cingulate gyrus LD ------------------ cingulate gyrus, precuneus Re ------------------- medial cortex, entorhinal cortex

  27. Clinical Syndromes of the Thalamus Posterolateral thalamic syndromes sensory disorders Thalamic (Dejerine-Roussy) syndrome ----- VP nucleus - pain Medial thalamic syndromes disorders of consciousness thalamic neglect, thalamic amnesia, akinetic mutism Anterolateral thalamic syndromes motor disorders paresis, ataxia, motor incoordination, dysphagia

  28. Thalamic (Dejerine-Roussy) Syndrome Joseph Jules Dejerine (1849-1917) Gustave Roussy (1874-1948)

  29. Visual (Optic) Pathway Modality: Vision Receptor:Photoreceptor Cell of Retina Cranial Nerve: II (Optic nerve) 1st Neuron:Bipolar Cell 2nd Neuron:Ganglion Cell optic nerve optic chiasm optic tract 3rd Neuron:Lateral Geniculate Nucleus optic radiation Termination:Visual Areas (V I, V II) Brodmann area 17 (V I), 18, 19 (V II)

  30. RETINA - Pars Nervosa 1. Pigment Epithelium - retinal detachment 2. Neuronal Layer (1) Photosensitive Cell Layer Rod Cell, Cone Cell (2) Bipolar Cell Layer Bipolar Cell Horizontal Cell Amacrine Cell (3) Ganglion Cell Layer Ganglion Cell Optic Nerve (II)

  31. Visual Pathway 1. Optic nerve 2. Optic chiasm 3. Optic tract 4. Lateral geniculate body 5. Optic radiation 6. Visual cortex

  32. Visual (Optic) Pathway

  33. Visual PathwayLateral Geniculate Nucleus (LGd) Dorsal Nucleus (LGd) Magnocellular Part 1, 2 Parvocellular Part 3, 4, 5, 6 contralateral afferents 1, 4, 6 ipsilateral afferents 2, 3, 5 Ventral Nucleus (LGv) part of thalamic reticular nucleus dorsolateral ventromedial

  34. Optic Radiation (Geniculocalcarine Tract) Meyer’s loop

  35. Clinical Features of Visual Pathway Lesion 1. optic nerve 2. optic chiasm 3. optic tract 4. 5. optic radiation A. unilateral blindness B. bitemporal hemianopsia C. left homonymous hemianopsia D. left inferior homony- mous quadranopsia E. left superior homony- mous quadranopsia

  36. Signs of Visual Pathway Lesion Optic nerve - ipsilateral blindness Optic chiasm - bitemporal hemianopsia Optic tract - contralateral homonymous hemianopsia Optic radiation - contralateral homonymous quadranopsia - intact light reflex Visual Cortex - contralateral homonymous quadranopsia - macular sparing

  37. Visual Field Defect left inferior optic radiation lesion right superior quadranopsia

  38. Hypothalamus Limbic System

  39. Epithalamus Limbic System Habenular Nucleus Medial Habenular Nucleus Lateral Habenular Nucleus Habenular Commissure Pineal Gland

  40. Subthalamus Basal Ganglia Subthalamic nucleus zona incerta Field of Forel H ansa lenticularis H1 thalamic fasciculus H2 lenticular fasciculus

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