Motor Pathways: Cerebellum March 31, 2010 1.

Compare the general functions and effects of dysfunction of the three major motor control systems System
Corticospinal/corticonucl ear (UMN/LMN)

Functions
Regulates voluntary movements of the skilled variety (cortical UMN) and the more automatic stereotyped movements (e.g. walking w/ swinging of arms via subcortical UMN) Facilitates desired motor programs and activities & inhibits unwanted motor programs and activities Coordinates motor activity by adjusting the timing, speed of contraction and relaxation of various muscle groups involved in voluntary activity Coordinates the muscles involved in postural adjustment and gait Influences cortex and subcortical UMN *Control is ipsilateral for extremities and bilateral for trunk

Effects of dysfunction
Damage of UMN = spastic paralysis

Basal nuclei

Hypokinetic (Parkinsons) and hyperkinetic (Huntingtons) disorders Can still contract muscles voluntarily Motor incoordination (ATAXIA) of the limbs and trunk (i.e. you can still move the muscles but you lose the fine movement)

Cerebellum

2. Learn the functional subdivisions of the hemispheres and vermis of the cerebellum Subdivision
Anterior lobe

Structures
Superior vermis, paravermal zones anterior to primary fissure Most of vermis, hemisphere posterior to the primary fissure and inferior surface Two flocculi on either side

Deep nuclei associated

Emboliform, globose, fastigial Dentate

Posterior lobe

Flocculonodular lobe

Fastigial

of hemispheres, connected by nodule (inferior vermis)

3. Gain a basic understanding of the neuroanatomical connections of the cerebellum a. Cerebellum influences LMNS by acting through the three major UMNs: motor cortex, red nuclei, reticular formation, and vestibular nucleus (like basal nuclei!) b. Indirect connections influence the ipsilateral LMNs for the extremities 4. Know the specific functions of the three subdivisions of the cerebellum Tract
Spinocerebellu m

Afferents
Anterior: carries inputs from the trunk (crosses in spinal cord ascends into SCP crosses back into white matter) Posterior: carries inputs from the lower limbs (travels in ICP ipsilaterally only) *Both tracts convey unconscious proprioception info to the cerebellar white matter projects to emboliform, globose, and fastigial nuclei

Efferents
From emboliform, globose, and fastigial nuclei CROSS in SCP decussation (lower midbrain) to two targets: synapse on RED NUCLEI (majority) decussation becomes rubrospinal tract that descends to end on LMN for distal limbs synapse on VL nucleus of THALAMUS projects to motor cortex descend as corticospinal tract From dentate nucleus CROSS in SCP decussation & ascend to synapse in VL nucleus of thalamus (DENTATOTHALAMIC) fibers project to premotor and supplementary motor areas of cerebral cortex descend as corticospinal tract **CEREBELLAR regulation is ipsilateral, but motor cortex

Function
Response to inputs from sensory receptors primarily from NM spindles uses info to adjust muscle length and tension to COORDINATE ongoing muscle contractions Vermis muscles neck, trunk, and proximal limbs Paravermal zone distal limb muscles

Corticocerebellu m

Axons come from cerebral association cortices corona radiata all parts of internal capsule (CORTICOPONTINE) Descend through outer ends of crus cerebri to enter pons & end ipsilaterally on pontine nuclei PONTOCEREBELLAR axons CROSS midline enter cerebellar

Regulates highly skilled voluntary movements involving the distal parts of the extremities FINE-TUNING of movement from premotor/supplementary motor areas in cerebral cortex = smooth motor activity

cortex in MCP synapse on dentate nucleus Vestibulocerebe llum From CN VIII & nucleus cerebellar cortex (ICP) fastigial nucleus

regulation is contralateral Fastigial nucleus vestibular nucleus/brain stem RF (through ICP) influence LMN coming from vestibulospinal and reticulospinal tracts going to POSTURAL muscles Responds to changes in position and movements of the head to adjust contractions of neck, trunk, and proximal limb muscles to coordinate gait and posture

5. Learn the nature of motor deficits that result from midline and hemispheric cerebellar lesions. Type
MIDLINE

Location
Vermal part of spinocerebellum +/paravermal zone

Tract affected
Spinocerebellu m

Clinical presentation
TRUNK ATAXIA loss of equilibrium: swaying side to side when standing or walking limbs unaffected when trunk is supported (e.g. lying down) *E.g. medulloblastoma LIMB ATAXIA decrease in muscle tone, incoordination of motor activity evident on VOLUNTARY movements Dysynergia: error in timing of components of multi-joint movements Dysmetria: error in range of movements (over/undershooting of

HEMISPHER IC

Corticocerebellum +/- paravermal zone

Corticocerebell um

targets) Dysdiadochokinesia: lack of a regular rhythm and force of repeated/alternating movements Intention tremor: occurs at end of movement Dysarthria *E.g. astrocytoma, hemangioblastoma, abscess, infarct