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Control of Movement and Posture
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
The CPGs are under the control of the motor cortex as well as through the reticulospinal, rubrospinal, and vestibulospinal tracts (Section 12.2.5). An important region for locomotion is the mesencephalic locomotor region (MLR), located ventral to the inferior colliculus and anatomically generally considered to include the lateral cuneiform nucleus, the pedunculopontine nucleus (PPN), and surrounding mesencephalic reticular formation. The MLR receives inputs from the basal ganglia and the thalamus and projects to the cells of origin of the reticulospinal tract in the reticular formation. In primates, the MLR also has a direct projection to the spinal cord. The MLR contains a diverse population of neurons that are glutamatergic, cholinergic, or GABA-ergic. The excitatory drive from the MLR to the CPGs is involved in initiating and stopping locomotion and determining the period of the generated rhythm. Lesions of the MLR are associated with gait disturbances, such as gait hesitation and gait ataxia manifested as abnormalities in direction, amplitude, and rhythmicity of locomotion.
Noninvasive vagus nerve stimulation in Parkinson’s disease: current status and future prospects
Published in Expert Review of Medical Devices, 2021
Hilmar P. Sigurdsson, Rachael Raw, Heather Hunter, Mark R. Baker, John-Paul Taylor, Lynn Rochester, Alison J. Yarnall
Further alterations associated with cardinal symptoms of PD including gait problems and cognitive dysfunction arise due to alterations in cholinergic neurotransmission in the cholinergic basal forebrain, particularly in the nucleus basalis of Meynert (nbM) and the pedunculopontine nucleus (PPN) in the brainstem [52–54], and serotonergic neurons in the raphe nuclei [55], decreased neurotropic factor signaling in the SN and basal ganglia [56] and possibly due to an abnormal inflammatory response in the brain [57]. This suggests that PD is underpinned by multi-system pathology subserved by several neurotransmitter systems in addition to age-related neurodegeneration that may be related to the function of the vagus nerve.