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Understanding Motor Behavior Disorders: Hypokinetic vs. Hyperkinetic Conditions

Discover how motor behavior is influenced by striatal outputs, leading to hypokinetic and hyperkinetic disorders like Parkinson's and Huntington's diseases. Learn about the pathophysiology, symptoms, and treatment options for these conditions.

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Understanding Motor Behavior Disorders: Hypokinetic vs. Hyperkinetic Conditions

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  1. Motor behavior is determined by the balance between direct/indirect striatal outputs Hypokinetic disorders • insufficient direct pathway output • excess indirectpathway output Hyperkinetic disorders • excess directpathwayoutput • insufficient indirectpathway output

  2. SNc Michael J. Fox Muhammad Ali Parkinson’s disease Pathophysiology Primary: loss of nigrostriatal DA projection Striatum

  3. Parkinson’s disease Treatment Dopamine Acetylcholine Deep brain stimulation subthalamicnucleus (STN)/ globus pallidus interna (GPi) high frequency stimulation inactivates the STN or GPi.

  4. Motor behavior is determined by the balance between direct/indirect striatal outputs Hypokinetic disorders • insufficient direct pathway output • excess indirectpathway output Hyperkinetic disorders • excess directpathwayoutput • insufficient indirectpathway output

  5. Hyperkinetic symptoms • Involuntary (unwanted) movements • Chorea • Ballismus • Dystonia • Athetosis

  6. Hyperkinetic disorders: choreatic syndromes • Huntington’s Chorea • Sydenham Chorea • Dystonia • Tardive dyskinesia • DOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome

  7. Huntington’s disease Pathophysiology • Atrophy of striatum • Loss of striatal neurons • Neuropathological sequence • start , rostral and medial then caudal and lateral

  8. Huntington’s disease Choreatic gait Symptoms Early motor signs • chorea (brief, involuntary movements) • later have dystonia episodes Dystonic movements

  9. Hyperkinetic disorders: • Huntington’s Chorea • Sydenham Chorea • Dystonia • Tardive dyskinesia • DOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome

  10. Hyperkinetic disorders: choreatic syndromes Cervical dystonia • Huntington’s disease • Dystonia • Tardive dyskinesia • DOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome After botulinum toxin

  11. Hyperkinetic disorders: choreatic syndromes Huntington’s disease Dystonia Tardive dyskinesia DOPA-induced dyskinesia Hemiballismus – unilateral STN stroke Tourette’s syndrome After treatment with the D2-R blocker sulpiride

  12. Hyperkinetic disorders: • Huntington’s Chorea • Sydenham Chorea • Dystonia • Tardive dyskinesia • DOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome

  13. Hyperkinetic disorders: • Huntington’s Chorea • Sydenham Chorea • Dystonia • Tardive dyskinesia • LDOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome

  14. Hyperkinetic disorders: • Huntington’s Chorea • Sydenham Chorea • Dystonia • Tardive dyskinesia • LDOPA-induced dyskinesia • Hemiballismus • Tourette’s syndrome

  15. Hyperkinetic disorders: • Tourette’s syndrome https://www.youtube.com/watch?v=e8HtTb0Vk_o https://www.youtube.com/watch?v=jYRa-fpNonY

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