Physiology of
Cerebellum
Dr. Aida A. Korish
Assoc. Prof. Physiology
KSU
1
Dr.Aida A.Korish (
[email protected])
Objectives
At the end of this lecture you will be able to:-
1. Describe the functional divisions of the
cerebellum; vestibulocerebellum,
spinocerebellum and cerebrocerebellum
2. Define the physiological roles of the cerebellum
in regulation of movement.
3. Explain the abnormalities associated with
cerebellar disease: e.g Cerebellar nystagmus,
changes in muscle tone, ataxia, drunken gait,
scanning speech , dysmetria (past-pointing),
intention tremors, rebound phenomenon and
adiadochokinesia.
Dr.Aida A.Korish (
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Cerebellum
Occupies a prominent
position beside the main
sensory and motor systems
in the brain stem.
It is connected to the brain
stem by three cerebellar
peduncles: superior,
middle and inferior.
Various fibers inter and
leave the cerebellum
through these peduncles.
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Dr.Aida A.Korish (
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Functions of cerebellum
1. Maintenance of
equilibrium
2. Balance, posture, eye
movement.
3. Coordination of the
half-automatic
movement of walking and
posture maintenance.
4. Adjustment of muscle
tone.
5. Motor Learning – Motor
Skills. Dr.Aida A.Korish ( [email protected]) 4
Motor learning and motor skill
Pablo Casals
Anatomical & Functional divisions of cerebellum
The anterior &
posterior lobes
on each side
constitute 2 large
cerebellar
hemispheres,
which are
separated by a
narrow band
called the vermis.
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Functional divisions of cerebellum
Structure & connections of the cerebellum
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
Cont…Structure and connections of cerebellum
The CB has an external layer of gray matter (cerebellar cortex),
and an inner white matter.
The cortex is deeply infolded, giving a large surface area ,
and it contains five different cell types,
Golgi, basket, stellate which are inhibitory interneurons,
Granule cells, which are excitatory
Purkinje cells which are the output cells,. inhibit the deep nuclear cells
(DNCs).
The inhibitory neurons in the CB release GABA ( e.g stellate, basket,
Golgi, PC)
The excitatory neurons release glutamate ( e.g. granule cells, that also
has GABA A receptors)
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The white matter contain 3 deep nuclei
1- Dentate
2- Fastigial
3- Interpositous (formed of globose and
emboliform nuclei)
All afferent fibers relay first at the deep
nuclei and the cerebellar cortex, then the
latter discharges to the deep nuclei, from
which the efferent fibers originate and
leave the CB.
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Afferent (input) pathways
The CB receives both
sensory and motor
information through a rich
afferent nerve supply.
This arises from
Other areas of the brain.
Peripheral receptors,
and enters the CB via the 3
cerebellar peduncles.
Cont.. Afferent fibers of CB
1-The climbing fibers:
• From the inferior olivary nucleus.
• It learns the cerebellum to perform new patterns of
movements precisely.
2-The mossy fibers:
▪ From all other afferent fibers that enter the
cerebellum + some fibers coming from the inferior
olivary nucleus (so they are greater than the
climbing fibers).
▪ Help the precise execution of the voluntary
movements (concerning their initiation, duration
and termination), which occurs by controlling the
turn on and turn off output signals from the
cerebellum to the muscles.
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Efferent (out put) pathways
There are 3 main efferent
pathways from the 3 parts
of the CB:-
Are the axons of the 3 deep
nuclei,
Leave the CB through the
superior and inferior
peduncles
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FUNCTIONS OF THE CEREBELLUM
➢ The CB is called the silent area, because its
stimulation does not give rise to any sensation and
cause almost no motor movements.
➢ It is important in the precise execution of rapid
muscular movements.
➢ Damage to the CB cause almost total
incoordination of muscular movements, although
the muscles are not paralyzed.
➢ The cerebellum is concerned only with
subconscious control of motor activity, and its
functions as well as the involved part include
the following :
Cont…Functions of cerebellum
(A) Control of equilibrium & postural
movements:
✓The function of the vestibulocerebellum.
✓It receives information from the vestibular
apparatus.
✓ Through the fastigial nucleus, it
discharges to the brain stem through the
vestibulospinal and reticulospinal tracts.
✓ It controls equilibrium & postural
movements by affecting the activity of the
axial muscles (trunk & girdle muscles).
Lesions of the vestibulocerebellum
e.g Due to a tumor called
medulloblastoma
Leads to trunk ataxia which is
characterized by:
Equilibrium disturbances: the patient
sways on standing, cannot maintain the
erect posture, needs support, and walks by
a staggering or drunken gait and have
nystagmus.
Cont… function of cerebellum
(B) Control of the Stretch Reflex
▪ The cerebrocerebellum exerts a facilitatory effect
on the stretch reflex and increases the muscle tone.
▪ The spinocerebellum probably exerts an inhibitory
effect.
▪ Normally the facilitatory effect predominates
(so cerebellar diseases often result in hypotonia).
C- Control of voluntary movements
N.B:
➢ Each cerebellar hemisphere is connected by efferent and
afferent pathways to the contra lateral cerebral cortex
(the cortico –ponto-crebello-dentato- thalamo- cortical
circuit).
➢ The cerebellum exerts its effects on the same side of the
body:
The vermis controls muscle movements of the axial
body, neck, shoulders and hips.
The intermediate zones controls muscle contractions in
the distal portions of both the upper and lower limbs
(especially the hands, fingers, feet and toes).
The lateral zones help in the planning of sequential
movements.
Defects produced by cerebellar
lesions in humans
The neocerebellar syndrome
This is due to damage of the deep cerebellar nuclei as
well as the cerebellar cortex;
The manifestations occur on the same side of the lesion
(ipsilateral) i.e. a lesion of the left cerebellar hemisphere
produces its effects on the left side of the body.
Bilateral dysfunction of the cerebellum is caused by
alcoholic intoxication, hypothyroidism, inherited
cerebellar degeneration (ataxia), multiple sclerosis or non
metastatic disease.
Neocerebellar syndrome
Video
https://www.youtube.com/watch?v=R6KBVCkurM0
https://www.youtube.com/watch?v=knwKmfiaAFk
Ataxia
This is incoordination of voluntary
movements.
It is either sensory or motor (or mixed).
Motor ataxia: Is due to defect in the
coordination of the voluntary movements.
It commonly occur in lesions of
The cerebellum or spinocerebellar tracts
Manifestations of neocerebellar syndrome
A) Hypotonia: Due to loss of the facillitatory
effect of the CB on the stretch reflex, and it is
associated with pendular knee jerk.
b) Asthenia: (muscle weakness): This is due to
difficulty in initiation and maintenance of muscle
contraction secondary to loss of the potentiating
signals by the mossy fiber circuit.
c)Motor ataxia: Incoordination of the voluntary
movements, specially the rapid movements
(becoming abnormal in rate, range, force and
direction).
Posture
Gait – Ataxia
Tremor
Left cerebellar tumor
Ataxic gait and position:
a. Sways to the left in
standing position
b. Steady on the
right leg
c. Unsteady on the
left leg
d. Ataxic gait
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Manifestations of Motor ataxia
1-Dysmetria: Inability to control the
distance of the motor act, which may
either overshoot the intended point
(=hypermetria or past pointing) or
stop before it.
2-Kinetic (intension, action or
terminal ) tremors:
➢ It appears on performing a
voluntary movement (especially at
its end) but is absent at rest.
➢ Demonstrated by the finger nose
test.
➢ It is secondary to dysmetria.
Signs of neocerebellar syndrome
Cont… motor ataxia
3-Rebound phenomenon: Overshooting of a limb when a
resistance to its movement is suddenly removed. (loss of the
braking function of the CB), (the arm pulling or flexion test).
4- Asynergia: This is loss of the harmony between the three
groups of muscles involved in performance of voluntary
movement the agonists, protagonists, and antagonists).
5-Failure of progression of movements manifested by:
a- Adiadokokinesia (dysdiadokokinesia): Inability to
perform alternate (opposite) movements successively at a
rapid rate e.g pronation and supination of the forearm or
upward and downward movement the hand.
b- Decomposition (fragmentation of movements): Inability
to perform actions involving simultaneous movements at
more than one joint.
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Cont…of manifestations of motor ataxia
6-Dysartheria: This is difficulty in producing clear
speech. It is due to incoordination of the speech
muscles secondary to loss of the predictive functions
of the CB. The syllables may be too long or too short,
loud or weak and speech may be also staccato or
scanning i.e. cut off into separate syllables.
7-Nystagmus: This is tremor of the eyeballs that
occurs on looking to an object placed at one side of
the head (mainly in vestibulocerebellar damage).
Nystagmus is a very common feature of multiple
sclerosis).
8-Staggering (drunken) gait: The patient walks
unsteady – on a wide base (zigzag-like gait) in a
drunken (swaying) manner, and tends to fall on the
diseased side. Such gait is more apparent with
vestibulocerebellar damage.
Dr.Aida A.Korish (
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Dr.Aida A.Korish (
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