Top Banner
CEREBELLUM Institute of Anatomy, Second Faculty of Medicine R. Druga
65

CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Aug 21, 2019

Download

Documents

tranthien
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Page 1: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

CEREBELLUM

Institute of Anatomy, Second Faculty of

Medicine

R. Druga

Page 2: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 3: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cerebellar folia

Cortex, subcortical white

matter, nuclei

Excessive folding of the cerebellar surface

(cortex)

Page 4: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

The cerebellum – relations and structure

Located in the posterior cranialfossa

Connected with the brain stem-by peduncles (inferior, middle, superior)

Is covered by the cerebellarcortex (3 layers). Cortex isextensively folded (folia-orientedmediolaterally)

In the white matter are thecerebellar nuclei

Fossa cranii posterior

Pedunculi cerebellares (inferior, medius,

superior)

Cortex – 3 vrstvy

V bílé hmotě mozečková jádra

Page 5: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

MR

examination

Posterior cranial

fossa

MR vyšetření

Fossa cranii

posterior

Page 6: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Arterial

supply

AICA PICA

Arteriae

cerebellares

Page 7: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Weigert

staining

Page 8: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Marchi

Staining

Kluver –

Barrera

Marchiho

metoda

Kluver - Barrera

Page 9: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Unfolded surface

of the cerebellum

Dvourozněrná

rekonstrukce

povrchu (kůry)

Mozečku

Two-dimensional

reconstruction of the

cerebellar surface

Length x width

Page 10: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 11: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Dvourozměrná

Rekonstrukce

lalůčků mozečku

Dvourozměrní

rekonstrukce

lalůčků mozečku

Page 12: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cerebellar

lobes and

lobuli

Lobus 3

Lobulus - 10

Mozečkové

Laloky (3) a

Lalůčky (10)

Vermis

Paravermální

oblast (zóna)

Laterální část

hemisféry

Page 13: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 14: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

CEREBELLAR NUCLEI, neurons

glutamatergic, excitatory, high

spontaneous activity

Mozečková jádra

Neurony glutamátergní (excitační), vysoká

spontánní aktivita

Page 15: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Structure of the cerebellar cortex -3 layers:

I.molecular layer - inhibitory interneuronsI.Molekulární vrstva – inhibiční interneurony

II. Purkyně cell layer – inhibitory projecting neuronsII. Vrstva Purkyňových buněk (stratum purkinjese)– inhibiční, projekční neurony

III. granular layer - prevail excitatory neurons

III. Vrstva granulárních buněk – převaha excitačních neuronů

Mozečková kůra – 3 vrstvy

Page 16: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 17: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

J.E. Purkyně 1837

1832 první mikroskop

Univerzita ve Vratislavi

Prof. Heidenheim :

………“ hatte Purkyně den

charakteristischen,

allgemainen Unterschied

zwischen Tier und

Pflanzenzellen zun erstmale

mit vollkommener Klarheit

erkannt „

Page 18: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

R. y Cajal : Histologie du systeme nerveux, 1911.

Page 19: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Santiago Ramon y Cajal 1911

Page 20: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 21: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 22: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Basket cells, inhibitory interneurons,

GABAergicKošíčkové buňky,

inhibiční interneurony

Page 23: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 24: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 25: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Mossy fibers –

Granule cells-

Parallel fibers

–Purkyně cells

Climbing

fiber –

Purkyně

cell

Mechová

Vlákna-

granulární b.

Paralelní vl.

Šplhavá

Vlákna –

Purkyňovy

bb.

Page 26: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Afferent and efferent connections

Tracts

Vestibulocerebellar (from the labyrinth and vestibular nuclei)

Spinocerebellar ant., post.,

rostral, cuneocerebellar

Olivocerebellar

Reticulocerebellar

Nucleocerebellar

Pontocerebelar !! (cortico-ponto-cerebellar)

Corticonuclear (fromthe cerebellar cortexto the nuclei)

Vermis – ncl. fastigii

Paravermal zone – ncl. Emboliformis + globosus

Lateral hemisphere – ncl. dentatus

From cerebellar nucleito the brain stem and to the thalamus

Aferentní a eferentní spoje kůry mozečku

Page 27: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Spinocerebellar

Pathways

Posterior T1 – L2,

uncrossed

ICP, proprioceptors

Anterior L3 – L5

2x-crossed, SCP,

cutaneous signals

Rostral C4 – C8

Uncrossed, ICP

Cutaneous signals

Cuneocerebellar

C2 – T4

uncrossed

Lateral cuneate nc.,

propriocept.

ICP

Lamina V-

- VIII

Page 28: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Dorsal (posterior) spinocerebellar

projection- uncrossed

Ventral (anterior) spinocerebellar

projection - crossed

a b

Origin of the spinocerebellar pathways

Page 29: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

FMI – increased blood flow during flexion and

extension of ipsilateral hand (red, orange signal) and

foot (blue signal)

Funkční MR, flexe a extense ruky

(červený, oranžový signál), nohy (modrý

signál)

Zvýšení průtoku krve ve spinálním

mozečku (lobus anterior)

Page 30: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 31: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Afferent

projections

Aferentní

Spoje

Mossy

fibers

Page 32: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Lobulus I – V, VIII.

Page 33: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 34: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

AFFERENTS TO THE CEREBELLAR CORTEX I.

Climbing fibers (Šplhavá vlákna)

– inferior olive (each P.cell receives only 1 c.f., many synapses with P.c.), excitatory (glutamate), firing frequencyof the c.f. is very low (1 impulse/sec), c.f. elicit burst ofaction potentials in the P.c.

C.f. inform about errors in the execution of movements –error indicators !!

Page 35: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Climbing

Fibers

Olivo-

cerebellar

projections

(crossed)

Šplhavá vlákna

Olivocerebelární

Projekce

(zkřížená)

Page 36: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Olivocerebellar

projection

Climbing fibers

Šplhavá

vlákna

Page 37: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

AFFERENTS TO THE CEREBELLAR CORTEX II

Mossy fibers (Mechová vlákna) - spinal cord, RF, pontine

nuclei, ncll. of cranial nerves.

End in the granular layer and each of which contacts large numberof granular neurons. Granular cell axon contacts large number of P. c. via parallel fibers.

Mossy fibers are excitatory (glutamate).

Each mossy fiber influences many P.c. but the excitatory effect isweak. Many mossy fibers must be active together to providesufficient excitation to fire a P.c.

Mossy fibers provide precisely graded information aboutmovements, skin stimulations, joint position and aboutmotor comands issued from the cerebral cortex.

Page 38: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cortico-pontine

pathway, 17 millions

fibers

Neocortex –

ipsilat. pontine ncll. -

pontocerebellar

pathway –

contralateral cerebellar

cortex (mossy fibers)

Pontocerebellar fibers =

largest contingent of

mossy fibers

Kortiko-pontinní dráha

17 milionů vláken

Neokortex – ipsilaterální

pontinní jádra

Pontocerebelární dráha –

Kontralaterální

mozečková kůra (mechová

vlákna)

Page 39: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cortico – ponto – cerebellar pathway

Cortico-ponto-cerebellar pathway

Page 40: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

J. Eccles 1967

Nobel Prize in

Physiology and

medicine 1963

Page 41: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 42: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 43: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Efferent connections of the cerebellar cortexEferentní spoje mozečkové kůry

Cerebellar cortex – cerebellar nucleivermis – ncl. fastigii, ncll. vestibulares

pavermal zone – ncl. emboliformis, globosus. lateral hemisphere – ncl. dentatus

Page 44: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Corticonuclear projection

Page 45: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 46: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Efferent connections of the cerebellar nucleiEferentní spoje mozečkových jader

Fastigial nucleus – vestibular nuclei, reticular formation

Emboliformis + globosus nucleus - reticular formation, ncl. ruber, thalamus

Nucleus dentatus – ncl. ruber, contralateral thalamus (ventrolateral nucleus, intralaminar thalamic nuclei, ventralanterior nc.,

Ventrolateral nucleus (VL) – primary motor cortex(area 4)

Page 47: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 48: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Thalamus

Ncl. Ventralis

Lateralis

Ncl. VL –

Motor cortex

Page 49: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 50: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cortico-

ponto-

cerebello-

cortical circuit

(Transcerebellar

Circuit)

Page 51: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Mozeček

Přijímá sensitivní signály, ale neúčastní se volní diskriminace, nebo interpretace

Ovlivňuje motorické funkce, ale resekce mozečku nevyvolává obrny

Stimulace mozečku nevyvolává pohyb

Ovlivňuje kognitivní funkce, zejména motorické učení a vyšší mentální funkce (uvažování, plánování)

Page 52: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Mozečkové syndromy

Vestibulární mozeček a vermis (zejména v lobus anterior) – poruchy rovnováhy, stoje a chůze, chůze o široké bazi, nystagmus

Spinální mozeček – kontroluje axiální svalstvo a proximální svaly končetin. Při poškození zvýšení tonu extensorů.

Pontinní mozeček (hemisféry) - přestřelování pohybů (hypermetrie, prst – lalůček, prst- špička nosu). Adiadochokinéza, třes(méně než 5 Hz- zhoršuje se na konci zacíleného pohybu), poruchy řeči a výslovnosti (dysartrie, skandovaná řeč), poruchy plánování, paměti, uvažování (kognitivní poruchy).

Cerebellární kognitivně - afektivní syndrom (1998) –vermis, lobus posterior

Page 53: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 54: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Paleocerebellar lesions

(syndrome)

equilibrium

Page 55: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Neocerebellar syndrome (lesion of the hemisphere)

Page 56: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cerebellar - cognitive affective syndrome

Schmahmann and Sherman (1998) in patientswith cerebellar lesions described CCAS

Executive dysfunction (disturbances in planning, abstract reasoning, memory)

Language symptoms (agrammatisms)

Behavior – affective disturbances (blunting ofaffect, disinhibited and inappropriate behavior

Lesions of the cerebellum interruptcommunication with the motor systems, association cortex.

Psychiatric disorders result from midline vermislesions (communication with the limbic system)

Page 57: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

THE END

Page 58: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,

Cajal 1911

Page 59: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 60: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 61: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 62: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 63: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 64: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,
Page 65: CEREBELLUM - Univerzita Karlova · The cerebellum –relations and structure Located in the posterior cranial fossa Connected with the brain stem-by peduncles (inferior, middle,