A critical neurotransmitter that controls functions such as memory, attention, sleep, heart rate, and muscular activity.
An electrical charge that travels along the axon to the neuron's terminal, where it triggers the release of a neurotransmitter. This occurs when a neuron is activated and temporarily reverses the electrical state of its interior membrane from negative to positive.
A neurochemical that inhibits wakefulness, serving the purpose of slowing down cellular activity and diminishing arousal. Adenosine levels decrease during sleep.
An endocrine organ that secretes steroid hormones for metabolic functions; for example, in response to stress.
An endocrine organ that secretes epinephrine and norepinephrine in concert with the activation of the sympathetic nervous system; for example, in response to stress.
1.) A neurotransmitter, drug, or other molecule that stimulates receptors to produce a desired reaction. 2.) A muscle that moves a joint in an intended direction.
A major cause of dementia in the elderly, this neurodegenerative disorder is characterized by the death of neurons in the hippocampus, cerebral cortex, and other brain regions. The earliest symptoms of the disease include forgetfulness; disorientation as to time or place; and difficulty with concentration, calculation, language, and judgment. In the final stages, individuals are incapable of self-care and may be bedridden.
Amino Acid Transmitters
The most prevalent neurotransmitters in the brain, these include glutamate and aspartate, which have excitatory actions on nerve cells, and glycine and gamma-amino butyric acid (GABA), which have inhibitory actions on nerve cells.
A structure in the forebrain that is an important component of the limbic system and plays a central role in emotional learning, particularly within the context of fear.
Amyotrophic Lateral Sclerosis (ALS)
Commonly known as Lou Gehrig's disease, ALS causes motor neurons in the brain and spinal cord to disintegrate, resulting in loss of control of voluntary muscle movements such as walking.
Sex steroid hormones, including testosterone, found in higher levels in males than females. They are responsible for male sexual maturation.
1.) A drug or other molecule that blocks receptors. Antagonists inhibit the effects of agonists. 2.) A muscle that moves a joint in opposition to an intended direction.
Disturbance in language comprehension or production, often as a result of a stroke.
Programmed cell death induced by specialized biochemical pathways, often serving a specific purpose in the development of an animal.
A bundle of nerve fibers extending from the cochlea of the ear to the brain that contains two branches: the cochlear nerve, which transmits sound information, and the vestibular nerve, which relays information related to balance.
Autonomic Nervous System
A part of the peripheral nervous system responsible for regulating the activity of internal organs. It includes the sympathetic and parasympathetic nervous systems.
The fiber-like extension of a neuron by which it sends information to target cells.
Structures located deep in the brain that play an important role in the initiation of movements. These clusters of neurons include the caudate nucleus, putamen, Globus pallidus, and substantia nigra. Cell death in the substantia nigra contributes to Parkinson's disease.
Occurring on both sides, as in the case of deep brain stimulation (DBS) lead placement into both the right and left sides of the brain.
In information technology, biometrics refers to technologies that measure and analyze human body characteristics, such as DNA, fingerprints, eye retinas and irises, voice patterns, facial patterns and hand measurements, for authentication purposes.
The major route by which the forebrain sends information to and receives information from the spinal cord and peripheral nerves. The brainstem controls, among other things, respiration and the regulation of heart rhythms.
Slowed movement, such as slow walking, reduced arm swing, or less facial expression. One of the common motor symptoms of Parkinson’s disease (PD).
The brain region located in the frontal lobe of the left hemisphere that is important for the production of speech.
The neurotransmitters dopamine, epinephrine, and norepinephrine, which are active in both the brain and the peripheral sympathetic nervous system. These three molecules have certain structural similarities and are part of a larger class of neurotransmitters known as monoamines.
The part of a neuron that contains the nucleus (with DNA) and the organelles, but not the projections such as the axon or dendrites.
The largest part of the human brain associated with higher order functioning, such as thinking, perceiving, planning, and understanding language, as well as the control of voluntary behavior.
A large structure located at the roof of in the hindbrain that helps control the coordination of movement by making connections to the pons, medulla, spinal cord, and thalamus. It also may be involved in aspects of motor learning.
A sheet of tissue covering the outermost layer of the cerebrum.
A liquid found within the ventricles of the brain and the central canal of the spinal cord.
A cycle of behavior or physiological change lasting approximately 24 hours.
A snail-shaped, fluid-filled organ of the inner ear responsible for converting sound into electrical potentials to produce an auditory sensation.
The process or processes by which an organism gains knowledge or becomes aware of events or objects in its environment and uses that knowledge for comprehension and problem solving.
A primary receptor cell for vision located in the retina. It is sensitive to color and is used primarily for daytime vision.
Computed axial tomography (CAT) scan
A special X-ray that takes detailed pictures of the brain and other body regions. Used with DBS to help locate the target site for the brain leads. Connecting wire A wire that connects the brain electrode to the neurostimulator or battery source. The connecting wire is surgically placed under the scalp and the skin and soft tissue of the neck and threaded to the neurostimulator under the skin of the upper chest.
The large bundle of nerve fibers linking the left and right cerebral hemispheres.
The wrinkled layers of cells covering the surface of the brain sometimes called gray matter.
A neurological disease in which several areas of the brain degenerate.
A hormone manufactured by the adrenal cortex. In humans, cortisol is secreted in the greatest quantities before dawn, readying the body for the activities of the coming day.
12 pairs of nerves that can be seen on the bottom surface of the brain. Some of these nerves transmit sensory information; some control the movement of face, head, and neck muscles; others transmit information to internal organs to regulate functions such as blood pressure and heart rate.
Deep brain stimulation (DBS)
A type of surgical therapy for the treatment of PD and essential tremor. The therapy involves placing a metal wire (brain lead) into a specific site in the brain, and then stimulating the site with continuous electrical pulses.
The ability to learn and consciously remember everyday facts and events.
A psychiatric disorder characterized by sadness, hopelessness, pessimism, loss of interest in life, reduced emotional well being, and abnormalities in sleep, appetite, and energy level.
A treelike extension of the neuron cell body. The dendrite is the primary site for receiving and integrating information from other neurons.
Involuntary, irregular, rapid, dance-like movements of the body that may involve the head, face, neck, trunk, and limbs. This can occur as a side effect from long-term use of PD medications and with a number of other neurological conditions.
Involuntary, irregular, slow, sustained contraction of muscles that results in painful twisting or positioning of the body, such as turning of the head or neck, cramping and flexion or extension of the toes, fingers, feet, arms, or facial muscles. This can occur as part of PD or as a side effect from medications used to treat it.
A type of ultrasound therapy that involves applying a heat coil to the skin or body. Most often used by dentists, pain specialists, and physical therapists to help reduce pain. Diathermy should never be used on someone who has DBS therapy as it can heat the brain electrodes, causing serious brain damage and even death.
A catecholamine neurotransmitter present in three circuits of the brain: one that regulates movement; a second thought to be important for cognition and emotion; and a third that regulates the endocrine system. Deficits of dopamine in the motor circuit are associated with Parkinson's disease. Abnormalities in the second circuit have been implicated in schizophrenia.
A surgical technique that involves the use of heat to cut through body tissues and stop small blood vessels from bleeding during surgery. There are some special guidelines outlined in chapter 13 for use in patients who have had DBS therapy. There is a small risk of the heat being transmitted to the implanted neurostimulator, connecting wires, or even the brain lead.
Lipid-derived messengers sometimes referred to as the brain's marijuana. These messengers control the release of neurotransmitters, usually by inhibiting them, and can affect the immune system and other cellular parameters. Endocannabinoids also play an important role in the control of behaviors.
A technology used to record electrical activity of the human brain in response to a variety of stimuli and activities.
An organ that secretes a hormone directly into the bloodstream to regulate cellular activity of certain other organs.
Neurotransmitters produced in the brain that generate cellular and behavioral effects like those of morphine.
A disorder characterized by repeated seizures, which are caused by abnormal excitation of large groups of neurons in various brain regions. Epilepsy can be treated with many types of anticonvulsant medications.
A hormone released by the adrenal medulla and specialized sites in the brain. During times of stress, epinephrine, also known as adrenaline, is quickly released into the bloodstream. It then serves to put the body into a general state of arousal, which enables it to cope with the challenge.
Also known as familial tremor, usually affects both hands, and often involves a head tremor and tremulous quality of voice. Essential tremor is relatively easy to distinguish from PD.
A group of sex hormones found more abundantly in females than males. They are responsible for female sexual maturation and other functions.
A change in the electrical state of a neuron that is associated with an enhanced probability of action potentials.
A hormone released by the pituitary gland that stimulates the production of sperm in the male and growth of the follicle (which produces the egg) in the female.
The largest part of the brain, which includes the cerebral cortex and basal ganglia. The forebrain is credited with the highest intellectual functions.
The centermost part of the eye located in the center of the retina and contains only cone photoreceptors.
A metal box-like device that is placed over the head and attached to the scalp of the person having DBS therapy. By immobilizing the patient’s head, it allows the surgeon to precisely locate the target for the brain lead and to place the lead safely.
One of the four subdivisions of the cerebral cortex. The frontal lobe has a role in controlling movement and in the planning and coordinating of behavior.
Functional Magnetic Resonance Imaging (fMRI)
A technology that uses magnetic fields to detect activity in the brain by monitoring blood flow.
Gamma-Amino Butyric Acid (GABA)
An amino acid transmitter in the brain whose primary function is to inhibit the firing of nerve cells.
Specialized cells that nourish and support neurons.
Globus pallidus internus (GPi)
A specific region of the brain that is involved in motor pathways. It is one target site for DBS therapy.
Hormones that produce an array of effects in response to stress. Some of the actions of glucocorticoids help mediate the stress response, while other, slower actions counteract the primary response to stress and help re-establish homeostasis.
An amino acid neurotransmitter that acts to excite neurons. Glutamate stimulates N-methyl-d-aspartate (NMDA) and alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA). AMPA receptors have been implicated in activities ranging from learning and memory to development and specification of nerve contacts in developing animals. Stimulation of NMDA receptors may promote beneficial changes, whereas overstimulation may be a cause of nerve cell damage or death in neurological trauma and stroke.
Portions of the brain that are gray in color because they are composed mainly of neural cell bodies, rather than myelinated nerve fibers, which are white.
Sensory receptors in the cochlea that convert mechanical vibrations to electrical signals; they in turn excite the 30,000 fibers of the auditory nerve that carry the
signals to the brainstem.
The most posterior part of the brain comprises the pons, medulla oblongata, and cerebellum.
A seahorse-shaped structure located within the brain and considered an
important part of the limbic system. One of the most studied areas of the brain, it is involved in learning, memory, and emotion.
The normal equilibrium of body function.
Chemical messengers secreted by endocrine glands to regulate the activity of target cells. They play a role in sexual development, calcium and bone metabolism, growth, and many other activities.
A genetic disorder characterized by involuntary jerking movements of the limbs, torso, and facial muscles, often accompanied by mood swings, depression, irritability, slurred speech, and clumsiness.
A complex brain structure composed of many nuclei with various functions,
including regulating the activities of internal organs, monitoring information from the autonomic nervous system, controlling the pituitary gland, and regulating sleep and appetite.
A neuron that exclusively signals another neuron.
A synaptic message that prevents a recipient neuron from firing.
Implantable pulse generator (IPG) also called the neurostimulator; the IPG is the battery-powered device that is used to deliver electricity to the brain lead. A similar generator is also used for heart pacemakers. It is most often surgically implanted under the skin of the upper chest just below the collarbone.
A thin, metal wire that allows for transmission of electricity. In DBS therapy the lead is surgically implanted into the brain. There are four different electrodes along the tip that deliver electrical pulses to exact locations of the brain.
Lewy body disease
A neurological disease in which abnormal protein deposits called Lewy bodies are found in certain areas of the brain. Symptoms can be similar to PD and Alzheimer’s disease.
Magnetic resonance imaging (MRI)
A special scan that allows for detailed pictures of the brain and other body regions. It is used to help locate the brain target for DBS therapy and sometimes used after surgery to check for proper lead placement. MRI should only be done under close supervision by staff at the DBS center.
Magnetic Resonance Spectroscopy (MRS)
Using the same machinery as MRI, MRS measures the concentration of certain chemicals, such as neurotransmitters, instead of blood flow.
Magneto encephalography (MEG)
A technique that can quantitatively measure the strength of activity in various regions of the brain at millisecond resolution.
The sum of all physical and chemical changes that take place within an organism
and all energy transformations that occur within living cells.
The most anterior segment of the brainstem. With the pons and medulla, the midbrain is involved in many functions, including regulation of heart rate, respiration, pain perception, and movement.
The process whereby new neurons find their proper position in the brain.
Small cylindrical organelles inside cells that provide energy for the cell by converting sugar and oxygen into special energy molecules, called adenosine triphosphate (ATP).
A neuron that carries information from the central nervous system to muscle.
A functional unit made up of an alpha motor neuron and all the muscle fibers it contains and controls, ranging from a few to a hundred or more.
Movement disorders neurologist
A neurologist who has specialized training in PD and other movement disorders such as dystonia and essential tremor.
Multiple system atrophy
A progressive neurological disease involving more than one system. Symptoms affect movement, blood pressure, and other body functions.
Changes in DNA, such as “misspellings” in the gene sequence or incorrect amounts of DNA that can prevent a gene from functioning properly.
Multiple Sclerosis (MS)
An autoimmune disease in which the body's natural defenses attack the myelin sheath covering the axons of neurons in the central nervous system. Symptoms include numbness, clumsiness, and blurred vision.
A disease in which acetylcholine receptors on muscle cells are destroyed so that muscles can no longer respond to the acetylcholine signal to contract. Symptoms include muscular weakness and progressively more common bouts of fatigue. The disease's cause is unknown but is more common in females than in males. It usually strikes between the ages of 20 and 50.
Compact fatty material that surrounds and insulates the axons of some neurons and accelerates the transmission of electrical signals.
N-methyl-d-aspartate (NMDA) receptors, one of three major classes of glutamate receptors, which have been implicated in activities ranging from learning and memory to development and specification of nerve contacts in a developing animal.
Nerve Growth Factor
A substance whose role is to guide neuronal growth during embryonic development, especially in the peripheral nervous system. Nerve growth factor
also probably helps sustain neurons in the adult.
The tip of the axon where neurotransmitters are released.
The process during embryonic development whereby molecules trigger ectoderm tissue to become nerve tissue.
The production and growth of new nerve cells during development and, in select brain regions, throughout life.
A nerve cell specialized for the transmission of information and characterized by long, fibrous projections called axons and shorter, branch like projections called dendrites.
A psychologist who specializes in relating the nervous system to how we think and behave.
A series of tests that measure various aspects of memory and thinking.
A physician who specializes in surgery of the nervous system.
A scientist who specializes in understanding brain cell firing patterns. A neurophysiologist or neurologist may use these patterns to map your brain
function during a DBS operation.
Scientists who specialize in the study of the brain and the nervous system.
A chemical released by neurons at a synapse for the purpose of relaying information to other neurons via receptors.
In animals, nerve endings that signal the sensation of pain. In humans, they are called pain receptors.
Symptoms of PD that do not relate to movement, such as mood changes, sweating, drooling, and constipation.
A catecholamine neurotransmitter produced both in the brain and in the peripheral nervous system. Norepinephrine is involved in arousal and sleep regulation, mood, and blood pressure.
One of the four subdivisions of the cerebral cortex. The occipital lobe plays a role in processing visual information.
The time during which a person with PD feels as though the motor symptoms (tremor, bradykinesia, rigidity) are worse; often when the medication is not working properly, upon waking before taking medication, or just before taking the next dose of medication.
The time during which a person with PD feels as though the medication is working well, or that they are functioning well and the motor symptoms of PD (tremor, bradykinesia, rigidity) are minimal or absent.
A round, knoblike structure of the brain responsible for processing the sense of smell. Specialized olfactory receptor cells are located in a small patch of mucous membrane lining the roof of the nose. Axons of these sensory cells pass through perforations in the overlying bone and enter two elongated olfactory bulbs lying on top of the bones
Specialized neurons that provide an excitatory signal to the arousal system, particularly to the norepinephrine neurons. Orexin activation plays a critical role in preventing abnormal transitions into REM sleep during the day, as occurs in narcolepsy.
Parasympathetic Nervous System
A branch of the autonomic nervous system concerned with the conservation of the body's energy and resources during relaxed states.
One of the four subdivisions of the cerebral cortex. The parietal lobe plays a role in sensory processes, attention, and language.
A movement disorder caused by death of dopamine neurons in the substantia nigra, located in the midbrain. Symptoms include slowness of movement, muscular rigidity, and walking and balance impairment.
Chains of amino acids that can function as neurotransmitters or hormones.
Peripheral Nervous System
A division of the nervous system consisting of all nerves that are not part of the brain or spinal cord.
A nerve ending, cell, or group of cells specialized to sense or receive light.
An endocrine organ closely linked with the hypothalamus. In humans, the pituitary gland is composed of two lobes and secretes several different hormones that regulate the activity of other endocrine organs throughout the body.
The ability of the brain to modify its neural connections to adapt to challenges in the environment.
A part of the hindbrain that, with other brain structures, controls respiration and regulates heart rhythms. The pons is a major route by which the forebrain sends information to and receives information from the spinal cord and peripheral
Positron Emission Tomography (PET)
A method of measuring brain function based on the detection of radioactivity emitted when positrons, positively charged particles, undergo radioactive decay in the brain. Computers then build three-dimensional images of changes in blood flow based on the amount of radiation emitted in different brain regions. The more brain activity, the more vivid the picture that is created.
Progressive supranuclear palsy
An atypical parkinsonian syndrome that involves limitations in eye movements, severe balance problems, and difficulty swallowing.
A severe symptom of psychiatric disorders characterized by an inability to perceive reality. Psychosis can occur in many conditions, including schizophrenia, bipolar disorder, depression, and drug-induced states.
Rapid Eye Movement (REM)
Part of the sleep cycle when active dreaming takes place. It is characterized by neocortical EEG waves similar to those observed during waking. This state is accompanied by paralysis of the body's muscles; only the muscles that allow breathing and control eye movements remain active.
Considered the simplest and most fundamental movements, they are relatively fixed, automatic muscle responses to particular stimuli, such as the slight extension of the leg when a physician taps the knee with a small rubber hammer.
A multi-layered sensory tissue that lines the back of the eye and contains the receptor cells to detect light.
A process by which released neurotransmitters are absorbed for later reuse.
Muscle stiffness or an increase in muscle tone; one of the motor symptoms of PD. It is sometimes associated with achy pain or cramping sensations.
A sensory neuron located in the periphery of the retina. The rod is sensitive to light of low intensity and is specialized for nighttime vision.
Substances that trigger communication after the actions of neurotransmitters at
their receptors have been completed. Second messengers convey the chemical message of a neurotransmitter (the first messenger) from the cell membrane to the cell's internal biochemical machinery. Second-messenger effects may endure for a few milliseconds to as long as many minutes. They also may be responsible for long-term changes in the nervous system.
A monoamine neurotransmitter believed to play many roles, including but not limited to temperature regulation, sensory perception, and the onset of sleep. Neurons using serotonin as a transmitter are found in the brain and gut. Several antidepressant drugs are targeted to brain serotonin systems.
A phase of memory in which a limited amount of information may be held for
several seconds or minutes.
The extension of the brain through the vertebral column that primarily functions to facilitate communication between the brain and the rest of the body.
Unspecialized cells that renew themselves for long periods through cell division.
An environmental event capable of being detected by sensory receptors.
Any external stimulus that threatens homeostasis — the normal equilibrium of body function. Many kinds of stress have a negative effect on the body, but some kinds can be helpful.
A block in the brain's blood supply. A stroke can be caused by the rupture of a blood vessel, a clot, or pressure on a blood vessel (as by a tumor). Without oxygen, neurons in the affected area die, and the part of the body controlled by those cells cannot function. A stroke can result in loss of consciousness and death.
Subthalamic nucleus (STN)
A specific part of the brain that is involved in the motor pathways. It is one of the target sites for DBS therapy.
A small group of nerve cells in the hypothalamus that express clock proteins, which go through a biochemical cycle of about 24 hours. This sets the pace for daily cycles of activity, sleep, hormone release, and other bodily functions.
Sympathetic Nervous System
A branch of the autonomic nervous system responsible for mobilizing the body's energy and resources during times of stress and arousal.
A physical gap between two neurons that functions as the site of information transfer from one neuron to another.
One of the four major subdivisions of each hemisphere of the cerebral cortex. The temporal lobe functions in auditory perception, speech, and complex visual perceptions.
A structure consisting of two egg-shaped masses of nerve tissue, each about the size of a walnut, deep within the brain. The key relay station for sensory information flowing into the brain, the thalamus filters out information of particular importance from the mass of signals entering the brain.
A rhythmic shaking, involuntary movement of a body part such as a the arm, leg, head or chin. One of the motor symptoms of PD.
Small proteins in the brain that are necessary for the development, function, and survival of specific groups of neurons.
Unified Parkinson Disease Rating Scale (UPDRS)
A specific tool used by Parkinson specialists to score the presence and degree of Parkinson’s motor symptoms. Often used in research studies and with patients before and after having DBS therapy.
Occurring on one side. In the case of DBS therapy, placing a DBS lead on only one side of the brain.
Comparatively large spaces filled with cerebrospinal fluid. Of the four ventricles, three are located in the forebrain and one in the brainstem. The lateral ventricles, the two largest, are symmetrically placed above the brainstem, one in each hemisphere.
The column of bones, or vertebrae, that extends down the back and functions as a structural element for the body while also surrounding and protecting the spinal cord.
A brain region responsible for comprehension of language and production of meaningful speech.
The part of the brain that contains myelinated nerve fibers. The white matter gets its color from myelin, the insulation covering nerve fibers.