01.12.2014 Views

Neurological Examination, clinical cases and neuropsychological ...

Neurological Examination, clinical cases and neuropsychological ...

Neurological Examination, clinical cases and neuropsychological ...

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

23/07/54<br />

Brain mechanisms<br />

for olfaction<br />

(Smell), the nose<br />

brain or<br />

“Rhinencephalon”<br />

<strong>and</strong> associated<br />

limbic structures<br />

7/23/2011 NEUROPSYCHIATRY 248<br />

The limbic system (or Paleomammalian brain) is a set of brain structures<br />

including the hippocampus, amygdala, anterior thalamic nuclei, septum, limbic<br />

cortex <strong>and</strong> fornix, which seemingly support a variety of functions including<br />

emotion, behavior, long term memory, <strong>and</strong> olfaction.<br />

The limbic system operates by influencing the endocrine system <strong>and</strong> the<br />

autonomic nervous system. It is highly interconnected with the nucleus<br />

accumbens, the brain's pleasure center, which plays a role in sexual arousal <strong>and</strong><br />

the "high" derived from certain recreational drugs. These responses are heavily<br />

modulated by dopaminergic projections from the limbic system. In 1954, Olds<br />

<strong>and</strong> Milner found dthat t rats with metal tlelectrodes implanted dinto their nucleus<br />

accumbens as well as their septal nuclei repeatedly pressed a lever activating<br />

this region, <strong>and</strong> did so in preference to eating <strong>and</strong> drinking, eventually dying of<br />

exhaustion.<br />

The limbic system is also tightly connected to the prefrontal cortex. Some<br />

scientists contend that this connection is related to the pleasure obtained from<br />

solving problems. To cure severe emotional disorders, this connection was<br />

sometimes surgically severed, a procedure of psychosurgery, called a prefrontal<br />

lobotomy (this is actually a misnomer). Patients who underwent this procedure<br />

often became passive <strong>and</strong> lacked all motivation.<br />

The limbic system is the set of brain structures that forms the inner border of the cortex. The cortical<br />

components generally have fewer layers than the classical 6‐layered neocortex, <strong>and</strong> are usually classified as allocortex<br />

or archicortex.<br />

The limbic system includes many structures in the cerebral pre‐cortex <strong>and</strong> sub‐cortex of the brain. The term has been<br />

used within psychiatry <strong>and</strong> neurology, although its exact role <strong>and</strong> definition have been revised considerably since the<br />

term was introduced.<br />

The following structures are, or have been considered to be, part of the limbic system:<br />

Hippocampus <strong>and</strong> associated structures:<br />

Hippocampus: Required for the formation of long‐term memories <strong>and</strong> implicated in maintenance of<br />

cognitive maps for navigation.<br />

Amygdala:Involved in signaling the cortex of motivationally significant stimuli such as those related<br />

to reward <strong>and</strong> fear in addition to social functions such as mating.<br />

Fornix: carries signals from the hippocampus to the mammillary bodies <strong>and</strong> septal nuclei.<br />

Mammillary body:Important for the formation of memory;<br />

Septal nuclei: Located anterior to the interventricular septum, the septal nuclei provide critical<br />

interconnections<br />

Limbic lobe<br />

Parahippocampal gyrus: Plays a role in the formation of spatial memory<br />

Cingulate gyrus: Autonomic functions regulating heart rate, blood pressure <strong>and</strong> cognitive <strong>and</strong><br />

attentional processing<br />

Dentate gyrus: thought to contribute to new memories <strong>and</strong> to regulate happiness.<br />

In addition, these structures are sometimes also considered to be part of the limbic system:<br />

Entorhinal cortex: Important memory <strong>and</strong> associative components.<br />

Piriform cortex: The function of which relates to the olfactory system.<br />

Fornicate gyrus: Region encompassing the cingulate, hippocampus, <strong>and</strong> parahippocampal gyrus<br />

Nucleus accumbens: Involved in reward, pleasure, <strong>and</strong> addiction<br />

Orbitofrontal cortex: Required for decision making.<br />

Clinical Correlates of Limbic System:<br />

Amygdala ,,,,,, Fear, Anxiety, Aggressive, Violence, Rage<br />

Hippocampus… Episodic Memories<br />

Cingulate Gyrus …. Instinctive Behaviours, Parenting,<br />

Social bonding, Moral reasoning,<br />

Delayed alternating tasks<br />

Septal Nucleus … Docility,<br />

Hypothalamus ……ANS, Endocrine, Drive, Motivation<br />

Mammillary Body….. Memory retrieval, recall<br />

7/23/2011 NEUROPSYCHIATRY 251<br />

42

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!