Transcript for:
Basal Ganglia: Anatomy, Function, and Pathways

iron engineers in this video today we are going to talk about the basal ganglia we'll go over the basic anatomy basic function and then really dig into some of the pathways direct indirect and then that striatal pathway and we'll have a little tidbit on the clinical relevance in these basal ganglia lesions all right ready let's go ahead and get started all right ninja nurse so let's go ahead and start off talking about the basic anatomy of the basal ganglia so i want to cover two points one is kind of the orientation of the basal ganglia and then the components of the basal ganglia right so what we're doing here is we're taking a coronal section so i'm taking here i'm slicing the brain here pulling off the anterior piece and looking at the posterior piece in this fashion there's a bunch of different components here okay the first component that i want you to know here that we're going to label one this is called the caudate nucleus okay the caudate nucleus okay the second part that i want you to know here is this one here in red this right here is called the putamen this is called the putamen then the next one is this entire big blue hunk of cheese here what is this thing called this is called your globus pallidus but there's actually two parts an internal part and an external part okay so we have the caudate nucleus putamen and the globus pallidus internal external component what else is next the next part is here these little pink little egg shaped structures on this and in on the sides of the third ventricle this blue structure here is the third ventricle a little fluid-filled space with cerebrospinal fluid on the sides of it are your thalami so your thalamus is one of the other components of the basal ganglia the next component here is going to be these green structures here that's kind of a little bit inferior to the thalamus these are called your subthalamic nuclei these are called your subthalamic nuclei and the last component of the basal ganglia is actually in the midbrain right in the midbrain you have this very special structure here called the substantia so we know the basic components of the basal ganglia and their orientate orientation in a coronal section now let's name them and a couple other little specifics all right beautiful so we know the components right but let's really write out their names plus there's a couple other terminology that we have to establish so the first component that we mentioned as a part of the basal ganglia is called the caudate nucleus so this is called the caudate nucleus very interesting structure the next one we said the second component this red structure is called the putamen now this is very important the reason why i want to kind of make uh some terminology here is that whenever you take the caudate nucleus and the putamen them together collectively they make a structure called the striatum okay so they make a structure called the striatum so i want you guys to remember that the putamen and the caudate nucleus combine make up the striatum all right beautiful the next thing the third component that we mentioned is the globus pallidus right and we said that there was two components what kind of components there was a internal component so we're going to put globus pallidus in turnis and then there was an external component which is called the globus pallidus externus so again this is globus pallidus internis globus pallidus externus okay now there's another term that we have to establish if you take the putamen and combine it with the globus pallidus this makes a very special type of name or structure and we call this the lentiform nucleus okay so the caudate and the putamen make the striatum and the putamen and the globus pellitus make up the lentiform nucleus beautiful all right the next thing that we have to discuss with my pink marker here is the fourth component which is the thalamus so this is our thalamus but i actually want to be a little bit specific i know you guys remember from the thalamus video there was two motor nuclei dig into your cerebral cortex what were those thalamic nuclei that we were really actually focusing on here do you remember it was the ventral anterior nucleus of the thalamus and the ventral lateral nucleus of the thalamus so when we say that the thalamus is a part of the basal ganglia if we're really being particular it's actually the ventral anterior and ventral lateral nucleus of the thalamus are beautiful the fifth component the fifth component here of the basal ganglia is called what this is called your subthalamic nucleus okay so now we talked about these main ones remember we talked about there was one last component the sixth component what is this this is very important what is this final structure here this final structure here is called the substantia so what are these called here this is called both of these is your substantia now the one that we there's two parts of it we talked about right we're just going to abbreviate them zona compacta and zona reticularis the one that we care about in this pathway is the zona compacta that's the one that contains all that dopaminergic neurons okay so we've established the components we've established some specific terminology that i might use throughout the course of this video the last thing i want us to talk about before we get into the pathways is the basic motor function obviously i kind of give you the idea what the basal ganglia is involved in its motor function so the motor function is coordinated by the cerebral cortex right so if you guys remember we have a couple different regions in the cerebral cortex that are involved in motor movement here's your central sulcus right this black line here behind the central sulcus you have the postcentral gyrus which is your primary somatosensory cortex and then anterior to this you have your precentral gyrus which is where your primary motor cortex is and then out just kind of anterior to that you have your pre-motor cortex right okay so you have your primary motor pre-motor cortex and your primary somatosensory cortex these areas kind of combined make up your basically your entire kind of motor cortices these structures they decide your voluntary motor movement right what happens is is they send information down from these areas to your muscles via these upper motor neurons down to your lower motor neurons which go to your skeletal muscles and cause your skeletal muscles to contract right so this is called your corticospinal tract well in order for this motor plan to go down to the muscles you have to uh kind of have communication with the basal ganglia so what i'm going to do here is in the kind of like this green structure here i'm going to imagine that this is the basal ganglia here okay so imagine for a second this is our basal ganglia these cerebral cortex areas have to communicate their motor plan with the basal ganglia the basal ganglia will take that motor plant and modify it in a particular way and send it back to the cerebral cortex to send now the proper motor plan to start movement stop movement or modulate movement what did i just say what were the three primary functions of the basal ganglia to start movement stop movement and modulate motor movement so this is all involved with movement so it's designed to kind of start or initiate a movement stop kind of unwanted motor movements and modulate motor movements beautiful now let's get into the pathways all right so now we got to do is since we've already talked about the basic anatomy the basic function of the basal ganglia we really got to kind of expand on that function a little bit more and talk about three particular pathways the direct pathway indirect pathway and the niagara striatal pathway the reason why they're important is they basically tell us the three functions to start movement to stop movement or to modulate movement in some way so the first pathway that we have to discuss here is called the direct pathway now let's keep it relatively simple here when we talk about the direct pathway what i want you to know in the most simplistic way is that this is designed to increase or stimulate motor activity that is honestly the easiest way or if you want to expand on that it's designed to help to initiate motor movements but i just like to think about it as increasing or stimulating motor activity how does it do that well there's a pathway here right let's let's provide the basic kind of like scaffolding of this pathway remember i told you that in order for the cortex where you have your motor cortex it is going to send down a motor plant to your skeletal muscles right but in order for it to do that it has to send it to your basal ganglia basal ganglia will then take that information and send it back up to the cortex to completely modify that motor plant so we have to go from the cortex to the basal ganglia back to the cortex how does that look well here you have neurons in your cortex right and what they're going to do is they're going to send their axons down to the striatum do you guys remember what the striatum was it was made up of the putamen and the caudate nucleus then the neurons from the putamen and the caudate nucleus will then move towards the globus pellitus internus then from the globus politus internist these neurons will then go to the thalamus and you know in the thalamus you have the particular types of nuclei here called the ventrolateral and ventral anterior nuclei their axons will then extend back up to the cerebral cortex so this is basically the basic scaffolding of the cerebral cortex involvement with the direct pathway of the basal ganglia now let's dig into this pathway a little bit more okay we got to go over kind of the mechanic you know the nitty gritty stuff from the cortex to the striatum these types of fibers are called glutaminergic fibers what does that mean that means that the neurotransmitter that these red fibers release onto these blue neurons is actually based on a neurotransmitter called glutamate we'll go over a little bit more of the detail of this but for right now the simplistic way that i want you to remember this is that glutamate is a stimulatory neurotransmitter so when it acts on the next neuron the postsynaptic neuron it's going to activate it okay so if that's the case then this neuron is firing lots of action potentials down from the cortex to the striatum right and then what is it going to do it's going to release glutamate which is going to stimulate the neurons present within the striatum right if that's the case these neurons are going to be super active and they're going to send lots of action potentials down their axons from the striatum to where so the globus pellitus internus the neurotransmitter that's being released from the striatum to the globus politus internus is actually gaba gamma amino butric acid what i want you to remember we'll go in more detail later but simplistically it is a inhibitory neurotransmitter so when it is released from this neurons coming from the striatum onto the globus pellitus internus it's going to inhibit that neuron so if we release a lot of gaba because this is sending lots of action potentials it's really going to inhibit this globus pellitus and turnus now the neurons going from the globus polytus and turns to the thalamus they're going to have decreased action potentials right and if there's decreased action potentials that means that there's less neurotransmitter released from the globus pellitus internist onto the thalamus now the type of neurotransmitter that's released here between the globus polyitis internas and the thalamus is again gaba which is a inhibitory neurotransmitter now if i'm having less action potentials i'm releasing less gaba onto the thalamic nuclei gaba is an inhibitory neurotransmitter if i have less gaba being released here that means i have less inhibition so if there's less inhibition this is sometimes referred to as disinhibition or it's released from inhibition and now these neurons in the thalamus are going to be stimulated and if they are stimulated they're going to send lots of action potentials back up to your motor cortex and the end goal is that now from your motor cortex going down to your skeletal muscles what is it going to do it's going to increase the motor activity of the desired skeletal muscles isn't that cool how the direct pathway does that so that's what i want you to remember for the basics now we talked about glutamate gaba a lot let's go over the basic ways that these are inhibitory and stimulatory neurotransmitters down here in the bottom all right so now let's go over the neurotransmitters a little bit more now remember i said gaba right so gaba is a inhibitory neurotransmitter let's expand on that a little bit gaba has different types of receptors we're not going to go into the details of but there is a b and c but what i want you to know here the main thing that we're talking about is that gaba binds on to what's called these ligand-gated ion channels so here's your gaba it'll bind on to a particular neuron right so here's your postsynaptic neuron in this case gabel will then bind onto this receptor when it binds onto this receptor what it'll do is let's say the before there was like a little kind of like thing here a gate blocking the entry of ions when gaba binds what it does is is it opens up that gate and allows for what certain types of ions to move in or out now if that's the case then it has to be inhibitory right so what happens is very interesting but positive ions like potassium can leave this neuron or negative ions like chloride can enter this neuron either way i'm losing positives or i'm gaining negatives what's the overall result inside of the cell the cell is going to become extra negative if the cell becomes extra negative i take the resting membrane potential and drop it below way below the resting membrane potential what is that called whenever you drop the voltage below the resting membrane potential it's called hyper polarization and this type of hyperpolarization is actually called an i p s p an inhibitory postsynaptic potential so that is how this does that and so there's going to be no action potentials carried down this neuron because of how gaba works in the same way we talked about glutamate and how glutamate we said in the most simplistic sense is a stimulatory neurotransmitter the same concept happens here glutamate binds onto this ligand-gated ion channel generally the gate is closed whenever that ligand is not bound but when glutamate binds it opens up the gate and then allows for positive ions to flow in maybe positive ions like sodium maybe positive ions like calcium and these ions will flow into the cell and cause the cell to become extra positive as you increase the positive voltage in the cell what do you do you take resting membrane potential and move it towards threshold potential and whenever you hit a particular threshold inside of the cell that may trigger a action potential so this is referred to as a e p s p so glutamate has a stimulatory effect via this mechanism and gaba has an inhibitory effect via this mechanism okay now that we've established the basic concepts of that with the direct pathway we can blast through the indirect pathway all right so now we talked about the direct pathway designed to stimulate motor movement start motor movement initiate motor movement what's the other function of the basal ganglia it's designed to inhibit motor activity in other words and particularly inhibit unwanted motor movements undesired motor movements so the other function of the basal ganglia is carried out via the via the activity of the in direct pathway of the basal ganglia and again the basic function i want you to easily remember this is to decrease motor activity or inhibit motor activity but particularly if we're really digging into the detail it's inhibiting or decreasing unwanted let's actually add that in decreasing unwanted or undesired motor activity i really want us to understand that okay so same concept we've got to communicate from the cortex to the basal ganglia back to the cortex but it's just a different route let's build our scaffolding for this so coming from the cortex we're going to have neurons going to the striatum same thing like we have with the direct pathway they're going to act on the neurons present within the striatum then from the neurons of the striatum instead of them glowing to the globus pilitis internus they go to the globus politis externus then from the globus politus externus these neurons will then move downwards to the subthalamus right the subthalamic nuclei one of the other components of the basal ganglia then from the subthalamic nucleus it will have neurons that will go back up to the globus pallidus but to the internal component of the globus pallidus then from the neurons of the globus pallidus internis which are acted on by the subthalamic nuclei it will then go to the thalamus what type of nuclei of the thalamus are we saying particularly the ventral anterior and ventral lateral nuclei of the thalamus and then the fibers from these are sent back up to the cortex this is our basic scaffolding now let's dig into it again neurons coming from the cortex to the striatum what type of neurotransmitter are released here this is glutamate glutamate is what an a stimulatory neurotransmitter so what is it going to do it's going to stimulate these neurons present within the striatum what does that mean if they're stimulated there's going to be lots of epsps and lots of action potentials being traveling down these axons from where from the striatum to the globus politis externus now these neurons release gaba gaba is a inhibitory neurotransmitter if there's lots of action potentials that means lots of gaba is being released here if lots of gaba is being released onto this neuron this neuron is going to be heavily inhibited if it's inhibited via the ipsps in hyperpolarization then this neuron when it's inhibited it's going to send less action potentials from the globus pallidus externus to the subthalamic nuclei so decrease action potentials if there's decreased action potentials going from the globus polytus externus to the subthalamic nucleus guess what type of neurotransmitter is released here onto the subthalamic nucleus what type of neurotransmitter is being released here gaba and what do we say gaba is gaba is a inhibitory neurotransmitter so what happens here is that means that we're releasing less gaba now remember what do we say whenever there is less gaba that means there is decreased inhibition decreased inhibition is kind of what's called disinhibition which means that this neuron is released from inhibition and is actually stimulated now because this neuron the subthalamic nucleus a neuron is actually stimulated what's it going to do send lots of action potentials from the subthalamic nucleus to the what the nucleus are neurons present within the globus pellitus internus if there's lots of action potentials going from the subthalamic nucleus to the globus pallidus internist that means lots of neurotransmitters being released here what type of neurotransmitters being released here glutamate glutamate is a stimulatory neurotransmitter that means you're going to have heavy stimulation of these neurons present within the globus pallidus internis if there's heavy stimulation of the neurons on the globus pallidus internist that means that you're going to have increased activation and increased action potentials traveling down this neuron if there's increased action potentials between the neurons from the globus pallidus internus to the thalamus that means lots of neurotransmitters being released here what type of neurotransmitter is being released here gaba gaba is a inhibitory neurotransmitter so that means lots of gaba is going to be released onto the thalamic nuclei if lots of gaba is released that means strong inhibition of these thalamic nuclei that means that from the thalamus if there's decreased stimulation of the thalamus that means that these thylamic nuclei are going to send decreased action potentials via their axons to the cortex and if there's decreased action potentials going to the cortex guess what that's going to tell the motor cortex that we want to decrease particular motor activity of a given body part doesn't that make sense so that's how the indirect pathway is more particularly when we really get down to the nitty-gritty is actually working now we talked about initiating motor movement preventing unwanted motor movement or stimulating decreasing motor activity now we got to talk about how we can modulate the activity of both the direct and indirect pathway let's come over to this last part all right so the last function of the basal ganglia remember i told you that it's actually kind of a modulation type of action the particular name of this pathway that we have to discuss here is called the nigro striatal pathway all right so the nigrostriatal pathway is technically really important and it's involved within what the modulation okay of the direct and indirect pathway so it's going to modulate the activities now the best way i like to remember the nigro stradal pathway is it's trying to amplify the activity of movement so how does it actually kind of modulate the direct and indirect pathway the really the the particular way that i want you to remember is that it's designed to kind of amplify motor activity to really kind of stimulate it how does it do that well let's first talk about how it influences the direct pathway and then how it influences the indirect pathway okay so again have your scaffolding we can actually kind of blast through this from the cortex coming down to the striatum then from the striatum to the globus pallidus internist from the globus pallidus internist to the thalamus from the thalamus we go back to the via the two nuclei back to the cortex right so this is our basic scaffolding now here's where we add in this extra pathway remember we had the substantia right well what happens is from the actually the zona compacta you have neurons that actually ascend upwards and go to the striatum we're going to kind of loop this one here and what they do is they release dopamine onto the actual neurons of the striatum now the type of a dopamine receptor is actually what's really specific what i want you to remember is the dopamine receptor here is actually a d1 receptor okay and what i want you to remember right now is that this is a stimulatory receptor we'll talk about a little bit how that actually is happening but again it's the same neurotransmitter in both pathways it's just the receptor that's different in both pathways so d1 receptor is important for direct pathway in its stimulatory okay so what does that mean right okay so let's follow this down from the cortex coming down to the striatum what did we say we were releasing glutamate glutamate is stimulating these neurons right on top of that you also have this dopamine that's also being released and what do we say dopamine is acting on the d1 receptors on these nuclei and also stimulating them now you have an extra kick or stimulus coming from the cortex and from the substantia now these neurons these neurons going from here it is these neurons going from the striatum to the globus pellitus internist are going to fire like a mofo and they're going to send tons and tons and tons of action potentials really really powerfully to the globus pallidus internus what does that mean the neurotransmitter that's released here it's it's actually going to be released in large amounts onto this globus pelitus internist what's that neurotransmitter gaba if there's lots of gaba there's lots of inhibition so that means that this nucleus here right to this nucleus this nucleus of the globus polytus and internus is going to be super let's make a big negative sign super inhibited that means it's going to send very little action potentials very little action potentials from the globus politis and turnus to the thalamic nuclei if there's very little here we're going to make like a teensy little arrow very little gaba or here we'll do this lots of down arrows if there's very little gaba released there is a significant decrease in inhibition right so if there's a significant decrease in inhibition that's going to result in extra stimulation of the thalamic nuclei so again less action potentials less gaba less inhibition more than normal on the thalamic nuclei now those thylamic nuclei are released from inhibition significantly and they're going to fire like a mofo and they're going to send lots and lots and lots of action potentials back up to the cerebral cortex telling that cerebral cortex stimulating it and then doing what what was already normal increase in motor activity it's going to increase the motor activity even more so it's going to want to really help to start motor movements why is this so important whenever there's damage of the direct pathway in some way shape or form where you want to increase motor activity if you damage this pathway right particularly damaging the substantia you know what disease can result that from this parkinson's disease so the clinical relevance here is with respect to a particular disease called parkinson's disease right so parkinson's disease what's kind of the characteristic of this they have difficulty initiating movement maintaining movement right why because you've damaged the the direct pathway with the nigrostratal involvement and now what you're supposed to be doing to increase motor activity now you can't perform that motor activity very well and so that's kind of one of the classic things that i want you to remember so direct pathway with involvement of the niger striatal pathway damage of that pathway can result in parkinson's disease okay beautiful now let's talk about how the striatal pathway influences the indirect pathway all right so next one is the involvement of the niger striatal pathway with the indirect pathway okay so again get build your scaffolding right so from the cerebral cortex to the striatum right then from the striatum this is also a good recap right good review from the striatum to the globus politis externus from the globus politus externus to the subthalamic nucleus from the subthalamic nucleus back up to the globus politis in turnus and from the globus politis internist to the thalamic nuclei particularly ventral anterior and ventral lateral thalamic nuclei and then from here back up to the cortex good we've built our scaffolding now we have to add in that next extra pathway what's that next extra pathway that we said is really important here that's coming from the substantia the nigrostriatal pathway again neurons from the zona compacta come here and send axons onto the striatum so the neurons of the putamen and we'll hear kind of loop this around here and neurons of the caudate nucleus now the type of receptors present on the striatum in this indirect pathway okay is actually called what d2 receptors d r2 receptors what i want you to remember here is that they are inhibitory okay we'll talk about how they do that but i just want you to remember where dopamine is released onto these neurons within the indirect pathway it's going to cause inhibition all right now let's follow this pathway from the cortex what do you have what do we say you're releasing lots of glutamate on the to the striatum right glutamate has a stimulatory effect onto these neurons but then you have dopamine that's being released onto the d2 receptors here of the striatum what's that trying to do that's trying to inhibit these neurons so now think about this you have normal stimulation but then coming from the substantia you have increasing inhibition what does that mean well normally you'd be sending lots of action potentials from the stratum to the globus politus externus but because we have some inhibition to these neurons now there's going to be decreasing action potentials so now what used to be a lot of action potentials is decreasing action potentials moving from the striatum to the globus pellitus externus what does that mean that means less neurotransmitter is released here what kind of neurotransmitter is released here gaba gaba is inhibitory so if there's less action potentials that means less gaba less gaba means less inhibition if there's less inhibition of this neuron it means it's disinhibited and it will be stimulated and fire so now this neuron is going to fire more and it's going to send increasing action potentials from the globus pallidus externus to the subthalamic nucleus if there's increasing action potentials that means that there's increased neurotransmitter released here what type of neurotransmitter is released here gaba gaba is inhibitory so if there's lots of gaba released onto the subthalamic nucleus what does that mean that means that there is increasing inhibition because gaba is an inhibitory neurotransmitter if that's the case then what does that mean that means well i have two red markers that means that if there's a lot of inhibition here there is decreasing action potentials carried from the subthalamic nucleus to the globus pellitus internus if there's decreasing action potentials that means less neurotransmitter is released what type of neurotransmitter is released here glutamate if there's less glutamate what does that mean that means that there's less stimulation if there's less stimulation of this neuron then we can now kind of say that it is actually slightly inhibited and so that means that there's going to be decreasing action potentials moving from the globus politis internist to the thalamus if there is decreasing action potentials going from the globus politus and is to the thalamus that means less neurotransmitter is released here less neurotransmitter like which one gaba if there's decreasing gaba that means there's decreasing inhibition so if there's decreasing inhibition that's called disinhibition so it's released from inhibition and now it's going to be stimulated and now these thalamic nuclei are going to do what they're going to fire like a mofo and send increasing action potentials now that they're released from inhibition up to the cerebral cortex so now the cerebral cortex is going to be stimulated and now the motor activity that you were designed to decrease now you're going to increase the activity the motor activity but again what type increase the motor activity of particularly maybe unwanted motor movements okay so you're going to increase the motor activity of the unwanted motor movements and in the direct pathway it also increases the activity of wanted motor movements all right so the last thing that i wanted to talk about is remember i said that there was a little discussion here with the d1 receptors and d2 receptors again so we're going to say here we're going to talk about the d1 receptor and we said that this is a stimulatory type of receptor and then over here we're going to talk about the d2 receptor and we said how this is a inhibitory receptor let's explain this very basically okay so dopamine right it's the same in both of these pathways it's the same neurotransmitter that's released but when it binds onto that d1 receptor right the thing is it binds onto a g protein couple receptor particularly a g-stimulatory protein and if you guys remember from the the plethora videos that we've done g-stimulatory leads to an increase eventually in cyclic amp cyclic amp will then do what it'll activate protein kinases and these protein kinases will do what will the phosphorylate particular channels and allow four positive ions to flow into the cell leading to stimulation of increasing voltage inside of the cell so normally you have a resting membrane potential if you bring in lots of positive ions that'll bring it to threshold potential if you bring it to threshold potential eventually you'll activate voltage-gated channels in the axon and lead to a action potential okay so the d1 receptors that's how they function is by increasing cyclic amp guess what the d2 receptors are just the exact opposite they work via the g-inhibitory protein and g-inhibitory protein will actually do what to cyclic amp it will decrease the cyclic amp levels that means decrease protein kinase levels that means decreased phosphorylation of channels in the membrane and that means what less positive ions are moving in here if less positive ions are moving into the cell that means that you're going to have a difficult time of getting that resting membrane potential to threshold potential right and so because of that this won't be able to reach threshold potential and therefore it will actually lead to decreasing action potentials moving down this neuron okay so that's kind of the basic that i want you guys to understand with the dopamine receptors so i wanted to take a quick little time to just kind of again recap bring a clinical point of the basal ganglia why why are we learning this right so we talked a little bit about parkinson's disease i kind of wanted to expand on that just a little bit more and provide a little bit more clarification so remember when we talked about direct pathway that was designed to increase the you know the motor activity to start motor activity to initiate motor activity well what happens if you damage the direct pathway which wants to start initiate perform motor activity well now you have difficulty in being able to initiate start and maintain motor activity there's a particular disease process and this is called parkinson's disease right so we kind of touched on that a little bit right in the same concept the indirect pathway is designed to decrease motor activity but particularly unwanted motor activity so now the indirect pathway right if it's designed to decrease motor activity so to prevent unwanted motor movements right so if you damage this pathway you damage the indirect pathway this can result in unwanted motor movements right and these can lead to conditions particularly like huntington's disease huntington's disease or you know there's another condition where if you have a lot of copper built up in the liver the liver stops functioning and then it can lead to damage to the actual central nervous system is called wilson's disease also known as apato lenticular degeneration or in someone who has rheumatic fever you know in rheumatic fever we talked about how they can have what's called syndenham's chorea where the antibodies can attack the actual basal ganglia the other thing that's actually really interesting is drugs there's what's called extra pyramidal syndrome particularly common in patients who taking first generation antipsychotics right what happens is that really alters this pathway particularly the d2 receptors and can lead to problems like tardive dyskinesia right it can lead to acathy which is kind of like a restless movement it can lead to dystonic reactions okay so this is kind of important to provide a clinical correlation of the basal ganglia with particular types of hypokinetic movement disorders and hyperkinetic movement disorders okay all right so that covers the basal ganglia all right ninja nurse so in this video we talk about the basal ganglia the anatomy the function the pathways and a little bit about the clinical relevance i hope you guys like this video i hope you guys learned a lot and enjoyed it if you guys did hit that like button comment down in the comment section and please subscribe please subscribe also down in the description box we have links to our facebook instagram go follow us on there also we have access to our patreon account if you guys are willing to 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