Putamen

Anatomy

• The lateral part of the lentiform nucleus (together with the globus pallidus).
• Separated from the claustrum by the external capsule and from the caudate and thalamus by the internal capsule.
• Input: primary motor and somatosensory cortex, SMA (motor loop); substantia nigra pars compacta.
• Blood supply: lenticulostriate arteries (MCA).

Functions

• Initiation and scaling of movement.
• Habits (stimulus–response learning) and automatic behaviors.
• Motor sequence learning and procedural memory.
• Rhythm and timing; speech articulation.
• Receiving dopaminergic reward prediction error signals.

Connections and chemistry

• Motor and somatosensory cortex, SMA
• Globus pallidus (direct/indirect pathway)
• Thalamus VL
• Substantia nigra pars compacta (nigrostriatal dopamine)

Development

Developmental course through childhood and adolescence.

• Habit systems function early; motor automatization accelerates in childhood.
• Putamen volume increases in childhood.

Clinical

• Tourette syndrome and tic disorders: motor loop dysfunction; tics are habit-like behaviors.
• ADHD: in the ENIGMA study, putamen, caudate, accumbens, amygdala and hippocampus volumes were smaller in children (Hoogman et al., 2017).
• ASD: relationship between repetitive motor behaviors and striatal size.
• Wilson disease: may begin with psychiatric symptoms in adolescence; copper deposition in the putamen.
• Antipsychotic-related extrapyramidal side effects (striatal D2 blockade).

Treatment

This region from the perspective of medication, psychotherapy and neuromodulation. Letter badges are evidence levels.

• First line for tics is behavior therapy (CBIT: noticing the urge before the tic and a competing movement incompatible with the tic): in 126 children aged 9–17, marked improvement in 52.5% vs 18.5% with supportive therapy (number needed to treat 3); the effect lasted 6 months in 87% of responders (Piacentini et al., 2010). A
• Tic medications: α2 agonists (guanfacine, clonidine; when ADHD co-occurs), D2 blockers (aripiprazole, haloperidol, pimozide). A
• Ecopipam (D1 antagonist, a new mechanism): in a phase III trial (167 children) relapse among responders was 41.9% vs 68.1% with placebo; no weight or movement disorder side effects. Not yet FDA-approved; the application was accepted for priority review in August 2026, with a decision expected in the first quarter of 2027. B
• Wilson disease: copper chelation (penicillamine, trientine) and zinc; with early diagnosis neurological and psychiatric symptoms can reverse. B
• Antipsychotic-induced tardive dyskinesia: VMAT2 inhibitors (valbenazine, deutetrabenazine) are approved in adults. A

Assessment

Neuropsychological tasks and measures that probe this region's function.

• Serial reaction time task (SRTT — implicit learning)
• Mirror drawing, rhythm synchronization (tapping)
• Rotary pursuit

Lesions and damage

Clinical findings expected with damage or dysfunction.

• Dystonia, parkinsonism (dopamine loss).
• Impaired procedural learning.

In the model

How this structure is defined in the 3D model, and the data source.

CerebrA putamen label.

References

Full citations for the card; links go to the paper (DOI) or a PubMed search.

1. Piacentini J et al. Behavior therapy for children with Tourette disorder: a randomized controlled trial. JAMA 2010;303(19):1929–1937. Search PubMed
2. Ekopipam DIAMOND faz III, JAMA Neurol (Mayıs 2026) and şirket duyuruları. Search PubMed