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CerebellumCerebellum Department of Anatomy, Yonsei University College of Medicine Won Taek Lee, M.D. Ph.D.

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Presentation on theme: "CerebellumCerebellum Department of Anatomy, Yonsei University College of Medicine Won Taek Lee, M.D. Ph.D."— Presentation transcript:

1 CerebellumCerebellum Department of Anatomy, Yonsei University College of Medicine Won Taek Lee, M.D. Ph.D.

2 Cerebellum External Configurations Cerebellum External Configurations - located in posterior cranial fossa - tentorium cerebelli (cerebrum), 4th ventricle (brain stem) - communicate with other structure via superior, middle, and inferior cerebellar peduncle superior, middle, and inferior cerebellar peduncle - longitudinal division Vermis, Paravermal Region, Cerebellar Hemisphere Vermis, Paravermal Region, Cerebellar Hemisphere - transverse division Anterior Lobe Anterior Lobe ------------ primary fissure ------------ primary fissure Posterior Lobe Posterior Lobe ------------ posterolateral fissure ------------ posterolateral fissure Flocculonodular Lobe Flocculonodular Lobe

3 Subdivision of Flocculonodular Lobe Subdivision of Flocculonodular Lobe Nodulus Flocculus Nodulus Flocculus Subdivision of Anterior Lobe Subdivision of Anterior Lobe Vermis Hemisphere Vermis Hemisphere Lingula Lingula Central Lobule Ala Central Lobule postcentral fissure postcentral fissure Culmen Quadriangular Lobule Culmen Quadriangular Lobule Cerebellum External Configurations Cerebellum External Configurations

4 Subdivision of Posterior Lobe Subdivision of Posterior Lobe Vermis Hemisphere Vermis Hemisphere Declive Simple Lobule Declive Simple Lobule postcentral fissure postcentral fissure Folium Superior Semilunar Lobule Folium Superior Semilunar Lobule horizontal fissure horizontal fissure Inferior Semilunar Lobule Inferior Semilunar Lobule Tuber Tuber Gracile Lobule Gracile Lobule prepyramidal fissure prepyramidal fissure Pyramis Biventer Lobule Pyramis Biventer Lobule secondary fissure secondary fissure Uvula Tonsil Uvula Tonsil Cerebellum External Configurations Cerebellum External Configurations

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6 Cerebellar Cortex Molecular Layer Molecular Layer Purkinje Cell Layer Purkinje Cell Layer Granular Layer Granular Layer Corpus Medullare (Medullary Center) Deep Cerebellar Nuclei Fastigial Nuclei Fastigial Nuclei Nucleus Interpositus Nucleus Interpositus Emboliform Nucleus Emboliform Nucleus Globose Nucleus Globose Nucleus Dentate Nucleus Dentate Nucleus Cerebellum Internal Configurations Cerebellum Internal Configurations

7 1. fastigial nucleus nucleus 2. globose nucleus nucleus 3. emboliform nucleus nucleus 4. dentate nucleus nucleus Deep Nuclei

8 Cerebellar Cortex Cerebellar Cortex I. Molecular Layer Stellate Cell --- taurine (inhibitory) Stellate Cell --- taurine (inhibitory) afferent: parallel fiber afferent: parallel fiber efferent: Purkinje cell dendrite efferent: Purkinje cell dendrite Basket Cell ---- GABA (inhibitory) Basket Cell ---- GABA (inhibitory) afferent: parallel fiber afferent: parallel fiber efferent: Purkinje cell soma efferent: Purkinje cell soma Parallel Fiber Parallel Fiber granule cell axon granule cell axon Purkinje Cell Dendrite Purkinje Cell Dendrite Cerebellum Internal Configurations Cerebellum Internal Configurations

9 Cerebellar Cortex Cerebellar Cortex II. Purkinje Cell Layer Purkinje Cell Purkinje Cell -- 15,000,000 in number -- 15,000,000 in number -- GABA (inhibitory) -- GABA (inhibitory) afferent: parallel fiber afferent: parallel fiber climbing fiber climbing fiber stellate cell stellate cell basket cell basket cell efferent: deep cortical nuclei efferent: deep cortical nuclei Bergman’s glial cell Bergman’s glial cell Cerebellum Internal Configurations Cerebellum Internal Configurations

10 Cerebellar Cortex Cerebellar Cortex III. Granular Layer Granular Cell Granular Cell -- 50,000,000,000 in number -- 50,000,000,000 in number -- glutamic acid (excitatory) -- glutamic acid (excitatory) afferent: mossy fiber afferent: mossy fiber efferent: Purkinje cell dendrite efferent: Purkinje cell dendrite basket cell, stellate cell basket cell, stellate cell Golgi cell Golgi cell Golgi Cell Golgi Cell -- GABA (inhibitory) -- GABA (inhibitory) afferent: parallel fiber, mossy fiber rosette afferent: parallel fiber, mossy fiber rosette efferent: granule cell dendrite efferent: granule cell dendrite Cerebellum Internal Configurations Cerebellum Internal Configurations

11 1. Purkinje cell 2. granule cell 3. basket cell 4. Golgi cell 5. stellate cell 6. climbing fiber 7. mossy fiber 8. parallel fiber 9. inferior olivary nucleus 10. deep cerebellar nuclei

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13 Synaptic Glomerulus Synaptic Glomerulus Afferent terminals on granular layer Afferent terminals on granular layer  Mossy Fiber Rosette  Mossy Fiber Rosette -- afferent fibers except -- afferent fibers except inferior olivary input inferior olivary input -- 2/3 of medullary center -- 2/3 of medullary center  Granular Cell Dendrite  Granular Cell Dendrite -- main afferent input -- main afferent input  Golgi Cell Axon  Golgi Cell Axon -- synapse on granule cell dendrite -- synapse on granule cell dendrite -- GABA (inhibitory) -- GABA (inhibitory) - Surrounded by Astrocyte Foot Process - Surrounded by Astrocyte Foot Process Cerebellum Internal Configurations Cerebellum Internal Configurations

14 Synaptic Glomerulus

15 Classification by Phylogenetic and Ontogenic Development Archicerebellum Archicerebellum Paleocerebllum Paleocerebllum Neocerebellum Neocerebellum Classification by Afferent Connection Vestibulocerebellum Vestibulocerebellum Spinocerebellum Spinocerebellum Pontocerebellum Pontocerebellum Classification by Efferent Connection Vermis Vermis Paravermal Region Paravermal Region Cerebellar Hemisphere Cerebellar Hemisphere Cerebellum Classifications Cerebellum Classifications

16 Archicerebellum (nodulus) Archicerebellum (flocculus) Paleocerebellum Neocerebellum

17 Spinocerebellum Pontocerebellum Vestibulocerebellum

18 Afferent Connections (1): 1. Inferior Cerebellar Peduncle Restiform Body Restiform Body Posterior Spinocerebellar Tract Posterior Spinocerebellar Tract Olivocerebellar tract Olivocerebellar tract Cuneocerebellar Tract Cuneocerebellar Tract Reticulocerebellar Tract Reticulocerebellar Tract Juxtarestiform Body Juxtarestiform Body Vestibulocerebellar Tract Vestibulocerebellar Tract Primary Vestyibular Fiber Primary Vestyibular Fiber Cerebellum Connections Cerebellum Connections

19 Afferent Connections (2): 2. Middle Cerebellar Peduncle Pontocerebellar fiber Pontocerebellar fiber Corticopontocerebellar Fiber Corticopontocerebellar Fiber Reticulocerebellar Fiber Reticulocerebellar Fiber 3. Superior Cerebellar Peduncle Anterior Spinocerebellar Tract Anterior Spinocerebellar Tract Cerulocerebellar fiber Cerulocerebellar fiber Raphecerebellar fiber Raphecerebellar fiber Rubrocerebellar fiber Rubrocerebellar fiber Hypothalamocerebellar fiber Hypothalamocerebellar fiber Cerebellum Connections Cerebellum Connections

20 Efferent Connections : 1. Superior Cerebellar Peduncle Cerebellothalamic fiber Cerebellothalamic fiber - from 3 deep nuclei to VPLo, VLc, CL - from 3 deep nuclei to VPLo, VLc, CL Cerebellorubral fiber Cerebellorubral fiber - from nucleus interpositus - from nucleus interpositus and dentate nucleus and dentate nucleus ascending portion of ascending portion of uncinate fasciculus of Russell uncinate fasciculus of Russell 2. Inferior Cerebellar Peduncle Fastigiovestibular fiber Fastigiovestibular fiber descending portion of descending portion of uncinate fasciculus of Russell uncinate fasciculus of Russell Cerebellum Connections Cerebellum Connections

21 MLF Main Connections of the Vestibulocerebellum lower motor neuron lower motor neuron LMN LMN vestibulospinal tract FASTIGIAL NUCLEUS NUCLEUS Vestibular Organ Organ Floculonodular Lobe Lobe Vermis Vermis ARCHICEREBELLUM VESTIBULAR NUCLEUS

22 Main Connections of the Paleocerebellum lower motor neuron lower motor neuron SPINAL CORD rubrospinal tract tract NUCLEUS NUCLEUSINTERPOSITUS Inferior Inferior Olivry OlivryNucleus ANTERIOR ANTERIOR LOBE LOBEPARAVERMAL ZONE ZONE PALEOCEREBELLUM RED NUCLEUS RED NUCLEUS spinocerebellar tract

23 CEREBRAL CORTEX CORTEXCEREBRAL DENTATENUCLEUSDENTATENUCLEUS Main Connections of the Neocerebellum lower motor neuron lower motor neuron LMN LMN pyramidal tract tract POSTERIORLOBECEREBELLAR HEMISPHERE HEMISPHEREPOSTERIORLOBECEREBELLAR THALAMUSTHALAMUS NEOCEREBELLUM PontineNucleusPontineNucleus

24 upper motor neuron UMN UMN BASALGANGLIABASALGANGLIA Pyramidal Tract and Associated Circuits lower motor neuron UMN UMN pyramidal tract CerebellumCerebellum

25 Reticular Formation Reticular Formation CEREBELLUM Cerebellum and Automatic Motor Control Lower Motor Neuron (LMN) Motor Cortex Red Nucleus Vestibular Nucleus Vestibular Nucleus ProprioceptorsProprioceptors

26 Corticonuclear Connections Corticonuclear Connections A zone ---------- fastigial nucleus medial vestibular nucleus medial vestibular nucleus B zone ---------- lateral vestibular nucleus C 1, C 3 zone --- emboliform nucleus C 2 ---------------- globose nucleus D 1 ---------------- parvocellular portion of dentate nucleus D 2 ---------------- magnocellular portion of dentate nucleus Cerebellum Connections Cerebellum Connections

27 1. vermis 1. vermis 2. paravermal region 2. paravermal region 3. cerebella hemisphere 3. cerebella hemisphere 4. nodulus 4. nodulus 5. flocculus 5. flocculus 6. fastigial nucleus 6. fastigial nucleus 7. globose nucleus 7. globose nucleus 8. emboliform nucleus 8. emboliform nucleus 9. dentate nucleus 9. dentate nucleus 10. medial vestibular nucleus 11. lateral vestibular nucleus

28 Olivocerebellar Connections Olivocerebellar Connections Caudal portion of medial and dorsal accessory olivary nucleus medial and dorsal accessory olivary nucleus ----------------- vermis of cerebellar cortex (A and B) ----------------- vermis of cerebellar cortex (A and B) fastigial nucleus fastigial nucleus vestibular nucleus vestibular nucleus Rostral portion of medial and dorsal accessory olivary nucleus medial and dorsal accessory olivary nucleus ----------------- paravermal region (C 1, C 2, C 3 ) ----------------- paravermal region (C 1, C 2, C 3 ) nucleus interpositus nucleus interpositus Principal Inferior Olivary Nucleus ----------------- cerebellar hemisphere (D 1, D 2 ) ----------------- cerebellar hemisphere (D 1, D 2 ) dentate nucleus dentate nucleus Cerebellum Connections Cerebellum Connections

29 medial and dorsal accessory olivary nucleus caudal portion rostral portion Principal Inferior Olivary Nucleus

30 Cerebellum Function Cerebellum Function  Maintenance of Equilibrium - balance, posture, eye movement - balance, posture, eye movement  Coordination of half-automatic movement of walking and posture maintenace walking and posture maintenace - posture, gait - posture, gait  Adjustment of Muscle Tone  Motor Leaning – Motor Skills  Cognitive Function

31 Balance

32 Motor Skill Pablo Casals

33 Cerebellum Clinical Syndromes Cerebellum Clinical Syndromes Ataxia: incoordination of movement - decomposition of movement - decomposition of movement - dysmetria, past-pointing - dysmetria, past-pointing - dysdiadochokinesia - dysdiadochokinesia - rebound phenomenon of Holmes - rebound phenomenon of Holmes - gait ataxia, truncal ataxia, titubation - gait ataxia, truncal ataxia, titubation Intention Tremor Hypotonia, Nystagmus Archicerebellar Lesion: medulloblastoma Paleocerebellar Lesion: gait disturbance Neocerebellar Lesion: hypotonia, ataxia, tremor

34 Posture Gait – Ataxia Tremor

35 CerebellarAtaxia Ataxic gait and position: Left cerebellar tumor Left cerebellar tumor a. Sways to the right in a. Sways to the right in standing position standing position b. Steady on the b. Steady on the right leg right leg c. Unsteady on the c. Unsteady on the left leg left leg d. ataxic gait d. ataxic gait abc d

36 Cerebellar tumors on vermis - Truncal Ataxia - Truncal Ataxia - Frequent Falling - Frequent Falling The child in this picture: - would not try to stand - would not try to stand unsupported unsupported - would not let go of the bed rail - would not let go of the bed rail if she was stood on the floor. if she was stood on the floor. CerebellarMedulloblastoma


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