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Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Stages 3 and 4 (lower and upper brainstem): thereafter, the disease process ascends in the brainstem, affecting the substantia nigra and mesocortex (transentorhinal region and CA2-plexus).
Discussions (D)
Published in Terence R. Anthoney, Neuroanatomy and the Neurologic Exam, 2017
♦ 1. Terms for cerebral cortex transitional between allocortex and neocortex include “mesocortex,” “juxtallocortex,” “mesallocortex,” and “periallocortex.” Are these terms all synonymous? If not, how do their meanings differ?♦ 2. Does the mesocortex include the cortex of only the cingulate gyrus, or does it also include the cortex of other areas, such as the parahippocampal gyrus, the insula, the orbital surface of the frontal lobe, and/or the temporal pole ?♦ 3. Related to Semantic Conflicts 1 and 2, is the cortex of the cingulate gyrus mesocortex, neocortex, or allocortex?, is the cortex of the parahippocampal gyrus allocortex, mesocortex, or neocortex?♦ 4. Are the terms “koniocortex” and “granular cortex” synonymous?♦ 5. Can koniocortex be hornotypical?♦ 6. Can granular cortex be hornotypical?
The Central Nervous System Organization of Behavior
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
The dopaminergic system has cortical and limbic components that are activated by the LC-NE/sympathetic noradrenergic system. Projections to the frontal cortex are thought to be involved in anticipatory phenomena and cognitive functions, while mesolimbic neurons of the nucleus accumbens are believed to be involved in motivation, reinforcement, and reward (Tsigos & Chrousos, 1996). Dopaminergic neurons are preferentially activated in the mesocortex by cues conditioned to stressors. The dopaminergic innervation of the prefrontal cortex is very sensitive to stress. They arise from mesencephalic neurons (Deutch & Young, 1995). Chronic stress and repeated cocaine exposure increase dopamine transmission in response to acute stress (Southwick et al., 1992).
Clinical characteristics and quality of life in Chinese patients with Parkinson’s disease beyond 20 years
Published in Neurological Research, 2018
Ruwei Ou, Yanbing Hou, Wei Song, Qianqian Wei, Yongping Chen, Bei Cao, Xiaoqin Yuan, Huifang Shang
The frequencies of NMS have barely been described in patients who have survived more than 20 years after disease onset. The Sydney multicenter study [5] on 30 LPD patients indicated that dementia is present in 83% of 20-year survivors, with excessive daytime sleepiness in 70%, symptomatic postural hypotension in 48%, urinary incontinence in 71% and hallucinations in 74%. In the current study, the three most common NMSs in LPD patients were ‘forget things or events’ (74.6%), ‘difficulty falling asleep’ (73.2%) and ‘nocturia’ (70.4%). Our findings showed differences when compared with a previous report [16] on 25 British patients using the same scale to assess NMS. That study found that the five most outstanding problems in patients who had a confirmed diagnosis of PD for equal to or more than 15 years were fatigue, change in sense of smell or taste, sleep difficulties, daytime sleepiness and nocturia. Differences in sample size, disease duration, genetic background and disease severity may account for this discrepancy. Although the MMSE total score was not significantly different between LPD and CPD patients after adjusting for education, impaired memory was detected as a frequent phenomenon in our samples at the end phase of PD. This is in accordance with the Braak staging theory [17], which suggested that the damage incurred by important limbic structures (amygdala, hippocampal formation, anteromedial temporal mesocortex) as well as by extensive neocortical territories during advanced stages (5–6) might well pave the way for declining intellectual faculties [17]. However, it is notable that the MMSE and NMSS we performed in the current study are poor tools for screening cognitive decline in PD. Further specific neuropsychological instruments will help to verify this issue. In terms of the high prevalence of sleep difficulties and nocturia, our results demonstrate the hypothesis that the nuclei in the brain that are responsible for regulating and controlling sleep may be more susceptible to degeneration in the late stages of PD [18]. This suggests that nocturnal disturbances should be carefully monitored when managing PD patients with long-term survival.