Limbic system. Dr Devendra Save

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Transcription:

Limbic system Dr Devendra Save

Named by Paul Broca. Introduction Limbic = border (Greek word) It is structure forming border between hypothalamus and cerebral cortex Is functional anatomic system of interconnected cortical and sub cortical structures Area of intimate processing between hypothalamus and cortical information processing Plays role in emotions, learning, autonomic regulation Broad functional divisions Rostral limbic system caudal system

Old theories and concepts Hypothalamus -important role in generating emotional behaviors Amygdala -important role in integrating information and coordinating emotional behaviors in response to sensory stimuli, events, and memories. These findings were demonstrated in animal studies Reward processing occurs in distinct brain circuits. o Stimulation of these circuits can provide powerful reinforcement signals. o Dopaminergic neurons in the ventral tegmental area provide a learning signal that reflects a computation comparing the reward received to the reward expected. o Drugs of abuse act on reward circuits. Limbic system- Psychiatric disorders such as depression, anxiety disorders, and addiction are related to it

Basic structure of mammalian brain

Anatomy of brain

Limbic system- broad functional divisions Rostral limbic system Caudal system Important for emotion Amygdala Septum Orbitofrontal cortex Anterior insula Anterior cingulate Important For memory and visual-spatial functions Hippocampus Posterior cingulate Posterior para hippocampal cortex

Limbic lobe v/s Limbic system Limbic lobe Cortical areas of limbic system Para hippocampal gyrus Hippocampus Orbital frontal Cingulate gyrus insula Limbic system Nucleio Amygdala o Septal nuclei o Mammillary body o Anterior thalamus Connectiono Fornix o Median forebrain bundle o Stria terminalis o Mamillothalamic tract

Components of limbic system Olfactory pathways Anterior perforated substance Pyriform lobe Septal area Amygdaloid body Limbic cortex Hippocampal formation Elements of diencephalon Bundles of axons connecting above regions

Functions of limbic system Olfaction Autonomic response s BP, Respiration Appetite and eating behavior Sleep and dreams Emotional responses like fear, rage& placidity, autonomic & endocrine responses Sexual behavior Addiction & motivation Memory Social cognition

Anatamico functional correlation

Functions of areas of limbic system Cingulate gyrus- autonomic functions regulating HR,BP. Cognitive, attentional, emotional processing Para hippocampal gyrus- spatial memory Hippocampus long term memory Amygdala anxiety,aggression, emotional memory, social cognition, fear conditioning Hypothalamus- regulation of autonomic nervous system via hormone production and release. Also affects& regulates BP, HR, hunger, thirst, sexual arousal, circadian rhythm of sleep& wake cycle Mammillary body - memory Nucleus Accumbens - reward, addiction

Functional division of limbic system physioanatomy

Limbic lobe At inferomedial aspect of cerebral hemispheres Consists of 2 concentric gyri surrounding corpus callosum As per Broca, larger outer gyrus is limbic gyrus and inner smaller gyrus is intra limbic gyrus Limbic gyrus (lobe) consists of isthmus of cingulate gyrus, parahippocampal gyrus and sub callosal area

Cingulate gyrus and para hippocampal gyrus Cingulate gyruso Situated dorsal to corpus callosum o Heavily interconnected with association area of cerebral cortex o Inputs from- anterior nucleus of thalamus, neo cortex, somatosensory areas of cerebral cortex Via cingulum, projects to entorhinal cortex o Related to emotion formation, processing, learning, memory, important role in attention, feeling of safety and security Parahippocampal gyruso Situated in medial temporal lobe o Imp role in memory encoding o ERC funnels highly processed cortical information to hippocampal formation & serves as a major output pathway

The limbic system Amygdala-Thalamus hypo thalamus pituitary peptides Autonomic endocrine system immune system system GI system Adrenals Thymus,lymph,spleen

Fig. 16-9: Links between Limbic System and Effector Systems

Pathways in limbic system

Dopaminergic pathways in CNS

Significance of dopaminergic pathway Mesolimbic pathway- associated with pleasure, rewards, goal directed behavior- Nigrostriatal pathway- associated with coordination of movement (it is part of basal ganglia motor loop) Tuberofundibular pathway-associated with maternal behavior and in regulation of prolactin secretion by pituitary gland Mesocortical pathway- associated with emotional and motivational responses.

Smell and emotional responses

Olfactory pathway

Parts of limbic system Anterior perforated substance- mass of grey matter situated on either side of optic chaisma and perforated by central branch of MCA Pyriform lobeo Uncus-principal region for olfactory awareness o Limen insulae-most medial part of insula o Entorhinal cortex-ant part of parahippocampal gyrus BA28

Septal areao Situated ventrally to corpus callosum o Includes paraterminal gyrus and septum pellucidum o Receives olfactory fibres from medial olfactory stria Through fornix, has reciprocal connections with hippocampus Amygdala o Almond shaped collection of nuclei &lies above Inferior horn of lateral ventricle and has wide efferent connections o Major function: Responding to stimuli with an emotional component.

. 3 Nuclear components: A) Basolateral attaching emotional significance to a stimulus. Sensory cortices (higher-order) BL limbic association cortex, prefrontal cortex, hippocampal formation (for learning emotional significance). B. Central Nucleus mediates emotional responses. B) Visuosensory input from solitary, para brachial nuclei CN dorsal motor n. of X, other parasympathetic n. reticular formation and hypothalamus autonomic responses. C) Cortico medial nuclei mediates behaviors triggered by olfactory stimuli. Olfactory bulb CM hypothalamus (lateral zone) regulation of appetitive behaviors ; i.e., eating in response to smells

Amygdala stimulation produces emotional behaviors through subcortical pathways

Hypothalamus and effects

Links Between Limbic System and Effector (Behavioral) Systems A. Neuroendocrine by amygdala (central and CM) via para ventricular n. of hypothalamus. B. Autonomic by amygdala (central n.?) lateral hypothalamus descending pathways via autonomic nuclei. C. Somatic Motor by several limbic components reticular formation stereotypic behaviour via reticulospinal tract.

Substances and their effects Dopamine: Excessive transmission in limbic structures may contribute to schizophrenia. 5-HT: Ascending projections control mood; increase appears to help in many forms of anxiety and depression (mood disorders). Norepinephrine: Excessive transmission may contribute to anxiety and aggression. Under-reaction, along with that of 5-HT, may contribute to depression. Acetylcholine: Important in cognition, activating a number of neocortical, as well as limbic areas the 1 st system to degenerate in Alzheimer s Disease.

Links between Limbic System and Effector Systems

Network, functions and related disorders

Limbic system clinical syndromes Hyper limbic- mania, OCD Hypo limbic-depression, apathy, amnesia(hippocampus), anxiety/panic, psychosis, kluver- Bucy syndrome(amygdala), social disdecorum Limbic epilepsy Limbic encephalitis Rage (hypothalamus and amygdala)

Limbic system - clinical implications Temporal lobe epilepsy Form of focal epilepsy Recurrent seizures arising from one or both temporal lobes Types- Mesial (MTLE) and lateral Temporal lobe epilepsy (LTLE) Mesial temporal sclerosiso 47-70% of all temporal lobe epilepsy o severe neuronal loss inca1, may spread to CA3 & CA4 o CA2 & dentate only mildly involved o Pathological abnormalities- specific hippocampal neuronal cell loss pattern, associated hippocampal atrophy &gliosis, o Patient complains- fear. Deja vu., jamaisvu, elementary & complex visual hallucinations, forced thinking, emotional distress

Limbic encephalitis Form of encephalitis Inflammatory process involving hippocampi,amygdala,insular,etc C/F- o severe impairment of short term memory o Confusion o Changes in behavior & mood, irritability, depression, sleep disturbances o seizures 60% times is para neoplastic in origin which is commonly associated with small cell lung carcinoma but majority of encephalitis are viral

Alzheimer s disease o Neurogenerative changes in limbic system o Hippocampus first area to degenerate >> leads to anterograde amnesia o Early cortex degeneration >> retrograde amnesia, dementia o Pathology- Amyloid proteins build up & form plaques Neurofibrillary tangles(inside cells) >>neuronal death

Kluver Bucy syndrome Neurobehavioral syndrome associated with bilateral lesions in medial temporal lobe, especially amygdala C/Fo Facial blunting (may not respond appropriately to stimuli) o Hyperphagia o Hyperorality o Hypermetamorphosis o Inappropriate sexual behavior o Visual Agnosia / psychic blindness

Limbic system in schizophrenia Ventricular enlargement Reduced limbic volumes Decreased size of hippocampus an d thalamus Decreased amygdala response during facial recognition tasks Decreased activity in dorsolateral pre frontal cortex (PET) Papez circuit probably involved is schizophrenia Distortion of cortical neuronal organization of layer Ii of ERC Reduced number of GABAergic cells in cingulate and anterior thalamus with resultant glutamatergic excitotoxicity

Schizophrenia- pathophysiology& drug effects

Limbic system in bipolar disorder & ADHD Limbic system in bipolar disorder Reductions in volumes of frontal lobes, basal ganglia, amygdala, hippocampus Functional studies revealed decreased activity in prefrontal cortex and anterior cingulate gyrus which is center for integration of attentional and emotional output and helps effortful control of emotional arousal Limbic system in ADHD Disrupted connections between amygdala and orbitofrontal cortex >> may contribute to behavioral disinhibiton

Limbic system in OCD and autism OCDo Neuro imaging has implicated the cortical-striatal-thalamic circuit o PET imaging shows increased glucose metabolism in orbital gyri o Postulation- orbitofrontal-thalamic hyperactivity gives rise to obsessive thoughts Autism- Involvement of cingulate gyrus, amygdala(mediate cognitive & affective processing) In autism spectrum disorders, basolateral circuit (imp for social recognition) is disrupted

Limbic system in anxiety disorders May be result of failure of anterior cingulate and hippocampus to modulate activity of amygdala ( tap down regulation) A fear circuitry involving amygdala, prefrontal and anteriorcingulate (bottoms up regulation ) Limbic system (involved in storing memories & creating emotions) thought to play central role in all anxiety related information People with OCD often show increased activity in basal nuclei, particularly striatum and other frontal lobe areas of forebrain

references Squire L, Zola S PNAS 1996;93:13515-135Adapted from Squire, Knowlton 1994