Motor Cortex & Corticospinal Tract

By Prof. Dr. Abdul Majid MBBS, M.Phil, FCPS

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Motor Areas
1. Primary motor area. 2. Pre-motor area. 3. Supplementary motor area. Primary motor area: Extent. Brodmanns area 4. Representation of body parts. Greater representation.
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Electrical stimulation-contraction of group of muscles. Initiation of voluntary movements.

Motor & Somato Sensory Cortical Areas

Degree of Representation of Different Muscles of the Body

Pre-Motor Area
Location. Extent. Brodmanns area 6. Electrical stimulation produces more complex patterns of movements. Sends signals to primary motor area directly as well as indirectly through basal ganglia. 6

Specialized Areas in Pre-Motor Cortex

Specialized Areas in the Pre-Motor Cortex

From below upwards these include: Brocas area for speech: Brodmanns area 44 Word formation area. Damage to this area does not prevent a person from vocalization but he can not speak whole words.
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Voluntary eye movement field area: Location. Brodmanns area 8. This area is concerned with voluntary moving of eyes towards different objects. Also controls eye movements such as blinking. 9

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Head rotation area: Location. Stimulation of this area rotates the head toward different objects. Area for hand skills: Location. Damage to this area results in uncoordinated & non-purpose full movements in the hands called motor apraxia. 10

Transmission of Signals from the Motor Cortex to the Muscles Motor signals are transmitted directly from cortex to the spinal cord through the corticospinal (pyramidal) tract & indirectly through multiple accessory pathways (rubrospinal, olivospinal, tactospinal, vestibulospinal & reticulospinal tracts)
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that involve the basal ganglia, cerebellum & various nuclei of the brain stem. In general, the direct pathways are concerned more with discrete & detailed movements, especially of distal segments of the limbs, particularly the hands & fingers.
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Pyramidal Tract

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Formation: 30% from the primary motor cortex. 30% from premotor & supplementary motor cortex. 40% from the somato sensory areas.
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Course: After leaving the cortex it passes through the posterior limb of the internal capsule (b/w caudate nucleus & putamen of basal ganglia) & then through the brain stem, forming the pyramids of the medulla.
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the majority of pyramidal fibers then cross in the lower medulla to the opposite side & descend into lateral corticospinal tracts. The fibers which do not cross in the lower medulla they descend down words ipsilaterally in the ventral corticospinal tracts. Many if not most of these fibers eventually cross to 16

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the opposite side of the cord either in the neck or in the upper thoracic region. Termination: The majority of pyramidal tracts finally terminate mainly on interneuron's, a few terminate on sensory relay neurons in the dorsal horn,
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& a very few terminate on the anterior motor neurons. The fibers of ventral corticospinal tracts may be concerned with the control of bilateral postural movements by the supplementary motor cortex. Number of fibers: in each corticospinal tract there are more then 1 million fibers.
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Out of these 3% of the total fibers are large myelinated fibers heaving diameter 16 micron meters which come from 34 thousand giant pyramidal cells, called Betz cells. 97% of the fibers are mainly smaller then 4 micron in diameter
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which conduct background tonic signals to the motor areas of the cord. Role of lower motor neurons: Finally motor fibers from anterior horn cells pass to skeletal muscles. Function of corticospinal tract: It controls fine, discrete movements of fingers which become impaired if 20 there is lesion of this tract.

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Effect of lesions in the motor cortex or in the corticospinal pathway: In stroke there is loss of blood supply to the cortex or to the corticospinal tract were it passes through the internal capsule b/w the caudate nucleus & the

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putamen due to rupture of blood vesicle or by thrombosis of 1 of the major arteries supplying to the brain. This results in upper motor neuron lesion disease called hemiplegia. In hemiplegia there is loss of voluntary movements in the opposite half of the body.
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Monoplegia: Means paralysis of muscles of one limb. Quadriplegia: Means paralysis of muscles of all the four limbs. Paraplegia: paralysis of muscles of both legs due to lesion at lumber region of the spinal cord due to gun short wound or fall from a tree or roof.
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When there is lesion of primary motor cortex along this results into hypotonia in the affected muscles due to loss of continual tonic stimulatory effect on motor neurons of the spinal cord. When lesion is wide spread involving adjacent areas & basal ganglia than there will be excessive spastic tone due to loss of inhibition to vestibular & reticular nuclei of the brain stem.
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Corticorubrospinal Pathway

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Corticorubrospinal tract receives a large number of its fibers directly from primary motor cortex & also from branches of corticospinal tract. These fibers synapse in the lower portion of red nucleus heaving large neurons. Rubrospinal tract, which crosses to the opposite side in the lower brain stem & 26

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fallows a course immediately adjacent and anterior to the corticospinal tract. Final termination: The fibers mostly terminate on inter neurons, but some terminate directly on anterior motor neurons.

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Function: This tract controls fine discrete movements of the wrist joint. Anatomically this tract belongs of extra pyramidal tracts but functionally it provides accessory pathway to corticospinal tract.

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Role of the Brain Stem in Controlling Motor Functions

Control of respiration. Control of CVS. Partial control of GIT functions. Control of many stereo typed movements of the body. Control of equilibrium. Control of eye movements. Serves as a way station for command signals from higher neural centers.

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Location of Nuclei in the Brain Stem

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Reticular & vestibular nuclei support the body against gravity. The reticular nuclei are divided in to two major groups; 1. Pontine reticular nuclei, located slightly posteriorly & laterally in the pons & extending into mesencephalon.
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2. Medullary reticular nuclei which extend through the entire medulla, lying ventrally & medially near the medal eye. 3. The two sets of nuclei function mainly antagonistically to each other, with a pontine exciting the antigravity muscles & the medullary relaxing the same 32 muscles.

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Pontine reticular system: The pontine reticular nuclei transmit excitatory signals through pontine reticulospinal tract in the anterior column of the cord. The fibers terminate on medial anterior motor neurons to excite axial muscles
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(muscles of the vertebral column & muscles of the limbs) of the body, which support the body against gravity. Pontine reticular nuclei have high degree of natural excitability. In addition, the receive excitatory impulses from vestibular nuclei & deep nuclei of the cerebellum.
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Medullary reticular system: Medullary reticular nuclei transmit inhibitory signals to the same antigravity neurons by way of a medullary reticulospinal tract located in the lateral column of the cord. The medullary reticular nuclei receive strong input signals from;
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1. Corticospinal tract. 2. Rubrospinal tract. 3. Other motor pathways. When pontine & medullary reticular systems are working normally the body muscles are not abnormally tense.
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Vestibulospinal & Reticulospinal Tracts

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