Diagnosis is difficult and typically done by ruling out Parkinsons Disease (PD) or Spinocerebellar ataxia (SCA). Symptoms include autonomic dysfunctions (supine hypertension and orthostatic hypotension, urinary incontinence). The disease leads to selective neuronal loss, myelin pallor, possible microglial activation and usually involves caudate, putamen, substantia nigra and cerebellum. Neuroimaging does show marked features in the putamen and 'hot cross bun' sign in the pons but these are not specific only to MSA. There are two broad groups MSA-P with more PD like features of bradykinesia and resting tremor and MSA-C with more limb/gait ataxia features. Treatment is symptomatic and definitive diagnosis is possible only post mortem (seen by high density oligodendroglial cytoplasmic inclusions).
In her seminar, Rukmani MR discussed the challenges surrounding Multiple System Atrophy (MSA). This is a relatively rare disorder (1.9 to 4.9 per 100,000), has an adult onset. NIMHANS gets a few cases every month.
Diagnosis is difficult and typically done by ruling out Parkinsons Disease (PD) or Spinocerebellar ataxia (SCA). Symptoms include autonomic dysfunctions (supine hypertension and orthostatic hypotension, urinary incontinence). The disease leads to selective neuronal loss, myelin pallor, possible microglial activation and usually involves caudate, putamen, substantia nigra and cerebellum. Neuroimaging does show marked features in the putamen and 'hot cross bun' sign in the pons but these are not specific only to MSA. There are two broad groups MSA-P with more PD like features of bradykinesia and resting tremor and MSA-C with more limb/gait ataxia features. Treatment is symptomatic and definitive diagnosis is possible only post mortem (seen by high density oligodendroglial cytoplasmic inclusions). Merlin (2nd year MPhil Scholar) presented her seminar on "Role of Basal Ganglia in Cognition".
While the role of basal ganglia in motor activity is very well established, its role in cognition is increasingly being noted. Merlin introduced the anatomical features of the basal ganglia and after looking at studies that showed cognitive impairments in patients in movement disorders such as Huntington's disease and Parkinson's disease, she highlighted a number of cognitive functions where the basal ganglia are implicated. These cognitive functions include:
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AuthorNPhy Times Archives
August 2019
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