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Cerebellum Won Taek Lee, M.D. Ph.D.

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Presentation on theme: "Cerebellum Won Taek Lee, M.D. Ph.D."— Presentation transcript:

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

2 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 - longitudinal division Vermis, Paravermal Region, Cerebellar Hemisphere - transverse division Anterior Lobe primary fissure Posterior Lobe posterolateral fissure Flocculonodular Lobe

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

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


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

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

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

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

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

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


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

14 Synaptic Glomerulus

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

16 Archicerebellum (nodulus) (flocculus) Paleocerebellum Neocerebellum

17 Spinocerebellum Pontocerebellum Vestibulocerebellum

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

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

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

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

22 Main Connections of the Paleocerebellum
RED NUCLEUS NUCLEUS INTERPOSITUS rubrospinal tract Inferior Olivry Nucleus ANTERIOR LOBE PARAVERMAL ZONE lower motor neuron PALEOCEREBELLUM SPINAL CORD spinocerebellar tract

23 Main Connections of the Neocerebellum

24 Pyramidal Tract and Associated Circuits
upper motor neuron UMN Cerebellum BASAL GANGLIA pyramidal tract lower motor neuron UMN

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

26 Cerebellum Connections
Corticonuclear Connections A zone fastigial nucleus medial vestibular nucleus B zone lateral vestibular nucleus C1, C3 zone --- emboliform nucleus C globose nucleus D parvocellular portion of dentate nucleus D magnocellular portion of dentate nucleus

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

28 Cerebellum Connections
Olivocerebellar Connections Caudal portion of medial and dorsal accessory olivary nucleus vermis of cerebellar cortex (A and B) fastigial nucleus vestibular nucleus Rostral portion of paravermal region (C1, C2, C3) nucleus interpositus Principal Inferior Olivary Nucleus cerebellar hemisphere (D1, D2) dentate nucleus

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

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

31 Balance

32 Motor Skill Pablo Casals

33 Cerebellum Clinical Syndromes
Ataxia: incoordination of movement - decomposition of movement - dysmetria, past-pointing - dysdiadochokinesia - rebound phenomenon of Holmes - 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 Cerebellar Ataxia a b c d Ataxic gait and position:
Left cerebellar tumor a. Sways to the right in standing position b. Steady on the right leg c. Unsteady on the left leg d. ataxic gait d

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

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