and/or less controlled motor movements, which may result in the tremors often experienced by those with Parkinson's. Oxidative stress and oxidative damage in the SNpc are likely key drivers in the etiology of Parkinson’s disease as individuals age. DNA damages caused by oxidative stress can be repaired by processes modulated by alpha-synuclein. Alpha synuclein is expressed in the substantia nigra, but its DNA repair function appears to be compromised in Lewy body inclusion bearing neurons. This loss may trigger cell death. Schizophrenia Increased levels of dopamine have long been implicated in the development of schizophrenia. However, much debate continues to this day surrounding this dopamine hypothesis of schizophrenia. Despite the controversy, dopamine antagonists remain a standard and successful treatment for schizophrenia. These antagonists include first generation (typical) antipsychotics such as butyrophenones, phenothiazines, and thioxanthenes. These drugs have largely been replaced by second-generation (atypical) antipsychotics such as clozapine and paliperidone. In general, these drugs do not act on dopamine-producing neurons themselves, but on the receptors on the post-synaptic neuron. Other, non-pharmacological evidence in support of the dopamine hypothesis relating to the substantia nigra include structural changes in the pars compacta, such as reduction in synaptic terminal size. Other changes in the substantia nigra include increased expression of NMDA receptors in the substantia nigra, and reduced dysbindin expression. Increased NMDA receptors may point to the involvement of glutamate-dopamine interactions in schizophrenia. Dysbindin, which has been (controversially) linked to schizophrenia, may regulate dopamine release, and low expression of dysbindin in the substantia nigra may be important in schizophrenia etiology. Due to the changes to the substantia nigra in the schizophrenic brain, it may eventually be possible to use specific imaging techniques (such as neuromelanin-specific imaging) to detect physiological signs of schizophrenia in the substantia nigra. Wooden Chest Syndrome Wooden chest, also called fentanyl chest wall rigidity syndrome, is a rare side effect of synthetic opioids such as Fentanyl, Sulfentanil, Alfentanil, Remifentanil. It results in a generalised increase in skeletal muscle tone. The mechanism is thought to be via increased dopamine release and decreased GABA release in the nerves of the substantia nigra/striatum. The effect is most pronounced on the chest wall muscles and can lead to impaired ventilation. The condition is most commonly observed in anaesthesia where rapid and high doses of these drugs are given intravenously. Multiple system atrophy Multiple system atrophy characterized by neuronal degeneration in the striatum and substantia nigra