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Dopaminergic Pathways amp Antipsychotic Side Effect UWorld Psychiatry Review USMLE Step 1
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Dopaminergic pathways • Dopamine is an important neurotransmitter involved in multiple functions including movement, emotional regulation, reward, and cognition. In humans, the four major dopaminergic pathways are the mesolimbic pathway, the mesocortical pathway, the nigrostriatal pathway, and the tuberoinfundibular pathway. • The mesolimbic pathway, sometimes referred to as the reward pathway. The pathway connects the ventral tegmental area in the midbrain to the ventral striatum of the basal ganglia in the forebrain. The ventral striatum includes the nucleus accumbens and the olfactory tubercle. • The release of dopamine from the mesolimbic pathway into the nucleus accumbens regulates incentive salience (eg. motivation and desire for rewarding stimuli) and facilitates reinforcement and reward-related motor function learning. The dysregulation of the mesolimbic pathway and its output neurons in the nucleus accumbens plays a significant role in the development and maintenance of an addiction. • The mesocortical pathway is a dopaminergic pathway that connects the ventral tegmentum to the prefrontal cortex. It is essential to the normal cognitive function, and is thought to be involved in cognitive control, motivation, and emotional response. • The nigrostriatal pathway is a bilateral dopaminergic pathway in the brain that connects the substantia nigra pars compacta (SNc) in the midbrain with the dorsal striatum (ie, the caudate nucleus and putamen) in the forebrain. Nigrostriatal pathway is critical in the production of movement. • Degeneration of dopaminergic neurons in the substantia nigra is one of the main pathological features of Parkinson's disease, leading to a marked reduction in dopamine function and the symptomatic motor deficits of Parkinson's disease including hypokinesia, tremors, rigidity, and postural imbalance. • The tuberoinfundibular pathway transmits dopamine from the hypothalamus to the pituitary gland. Dopamine released at this site inhibits the secretion of prolactin from anterior pituitary gland lactotrophs by binding to dopamine receptor D2. • Some antipsychotic drugs block dopamine in the tuberoinfundibular pathway, which can cause an increase in the amount of prolactin in the blood. • Picture By User:Slashme; Patrick J. Lynch; User:Fvasconcellos - self-made; re-use File:Brain bulbar region.svg, CC BY-SA 4.0, https://commons.wikimedia.org/w/index... • ♢ Follow Sappheiros ♢ • Spotify: https://open.spotify.com/artist/5ZVHX... • Apple Music: / sappheiros • Soundcloud: / sappheirosmusic • Bandcamp: https://sappheiros.bandcamp.com/ • Instagram: / sappheirosmusic
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