What Is the Cerebellum?

The Cerebellum

What Is the Cerebellum?

The cerebellum, which stands for «little brain», is a structure of the central nervous system. It has an important role in motor control, with cerebellar dysfunction often presenting with motor signs. In particular, it is active in the coordination, precision and timing of movements, as well as in motor learning.

During embryonic development, the anterior portion of the neural tube forms three parts that give rise to the brain and associated structures:

  • Forebrain (prosencephalon)
  • Midbrain (mesencephalon)
  • Hindbrain (rhombencephalon)

The hindbrain subsequently divides into the metencephalon (superior) and the myelencephalon (inferior). The cerebellum develops from the metencephalon division.

This article will focus on the anatomy of the cerebellum. It will provide a brief overview of its functions and development, and finally it will highlight the clinical relevance of cerebellar disorders.

Anatomical Location

The cerebellum is located at the back of the brain, immediately inferior to the occipital and temporallobes,and within the posterior cranial fossa. It is separated from these lobes by the tentorium cerebelli, a tough layer of dura mater.

It lies at the same level of and posterior to the pons, from which it is separated by the fourth ventricle.

Fig 1.0 — Anatomical position of the cerebellum. It is inferior to the cerebrum, and posterior to the pons.

Anatomical Structure and Divisions

The cerebellum consists of two hemispheres which are connected by the vermis, a narrow midline area. other structures in the central nervous system, the cerebellum consists of grey matter and white matter:

  • Grey matter — located on the surface of the cerebellum. It is tightly folded, forming the cerebellar cortex.
  • White matter — located underneath the cerebellar cortex. Embedded in the white matter are the four cerebellar nuclei (the dentate, emboliform, globose, and fastigi nuclei).

There are three ways that the cerebellum can be subdivided — anatomical lobes, zones and functional divisions

Anatomical Lobes

There are three anatomical lobes that can be distinguished in the cerebellum; the anterior lobe, the posterior lobe and the flocculonodular lobe. These lobes are divided by two fissures — the primary fissure and posterolateral fissure.

Fig 1.1 — Anatomical lobes of the cerebellum.

Zones

There are three cerebellar zones. In the midline of the cerebellum is the vermis. Either side of the vermis is the intermediate zone. Lateral to the intermediate zone are the lateral hemispheres. There is no difference in gross structure between the lateral hemispheres and intermediate zones

Fig 1.2 — Superior view of an «unrolled» cerebellum, placing the vermis in one plane.

Functional Divisions

The cerebellum can also be divided by function. There are three functional areas of the cerebellum — the cerebrocerebellum, the spinocerebellum and the vestibulocerebellum.

  • Cerebrocerebellum — the largest division, formed by the lateral hemispheres. It is involved in planning movements and motor learning. It receives inputs from the cerebral cortex and pontine nuclei, and sends outputs to the thalamus and red nucleus. This area also regulates coordination of muscle activation and is important in visually guided movements.
  • Spinocerebellum — comprised of the vermis and intermediate zone of the cerebellar hemispheres. It is involved in regulating body movements by allowing for error correction. It also receives proprioceptive information.
  • Vestibulocerebellum — the functional equivalent to the flocculonodular lobe. It is involved in controlling balance and ocular reflexes, mainly fixation on a target. It receives inputs from the vestibular system, and sends outputs back to the vestibular nuclei.

Vasculature

Fig 1.3 — Arterial supply to the cerebellum.

The cerebellum receives its blood supply from three paired arteries:

  • Superior cerebellar artery (SCA)
  • Anterior inferior cerebellar artery (AICA)
  • Posterior inferior cerebellar artery (PICA)

The SCA and AICA are branches of the basilar artery, which wraps around the anterior aspect of the pons before reaching the cerebellum. The PICA is a branch of the vertebral artery.

Venous drainage of the cerebellum is by the superior and inferior cerebellar veins. They drain into the superior petrosal, transverse and straight dural venous sinuses.

[start-clinical]

Clinical Relevance: Cerebellar Dysfunction

Dysfunction of the cerebellum can produce a wide range of symptoms and signs. The aetiology is varied; causes include stroke, physical trauma, tumours and chronic alcohol excess.

Fig 1.4 — CT scan of a left sided cerebellar stroke.

The clinical picture is dependent on the functional area of the cerebellum that is affected. Damage to the cerebrocerebellum and spinocerebellum presents with problems in carrying out skilled and planned movements and in motor learning.

A wide variety of manifestations are possible. These can be remembered using the acronym 'DANISH':

  • Dysdiadochokinesia (difficulty in carrying out rapid, alternating movements)
  • Ataxia
  • Nystagmus (coarse)
  • Intention tremor
  • Scanning speech
  • Hypotonia

Damage to the vestibulocerebellum can manifest with loss of balance, abnormal gait with a wide stance.

[end-clinical]

Источник: https://teachmeanatomy.info/neuroanatomy/structures/cerebellum/

Cerebellum Functions, Structure, and Location

What Is the Cerebellum?

The cerebellum, which stands for ‘little brain’, is a hindbrain structure that controls balance, coordination, movement, and motor skills, andit is thought to be important in processing some types of memory.

Although the cerebellum only accounts for 10% of the overall brain mass, it contains over half of the nerve cells than the rest of the brain combined. The cerebellum is also one of few mammalian brain structures where adult neurogenesis (the development of new neurons) has been confirmed.

The cerebellum is an older part of the brain, also found in animals. It is even believed that the cerebellum was present in animals which existed before humans, according to scientists.

Where Is It Located?

The cerebellum is located at the back of the brain, behind the brainstem, below the temporal and occipital lobes, and beneath the back of the cerebrum.

The cerebellum is also divided into two hemispheres, the cerebral cortex. Un the cerebral hemispheres, each hemispheres of the cerebellum is associated with each side of the body.

The cerebellum consists of a cortex, which is the outer layer, containing folder brain tissue, filled with most of the cerebellum’s neurons. There is also a fluid filled ventricle and cerebellar nuclei, which is the innermost part, containing neurons that communicate information from the cerebellum to other areas of the brain.

Within the cerebellum, there are thought to be three anatomical lobes which are dividied by two fissures (large furrows)– the primary fissure and the posterolateral fissure:

  • The anterior lobe (anterior meaning ‘to the front’)
  • The posterior lobe (posterior meaning ‘to the back’)
  • The flocculonodular lobe – this is the oldest part of the brain in terms of evolution. This part of the cerebellum is responsible for balance and spatial attention, as well as receiving visual input.

The cerebellum can also be divided into three functional areas:

  • Cerebrocerebellum – this is the largest area of the cerebellum, responsible for planning movements and motor learning. It also works to regulate coordination of muscle activation as well as eye movements.
  • Spinocerebellum – this area functions in regulating body movements by allowing for error corrections.
  • Vestibulocerebellum – this area is involved in controlling balance and flexes of the eyes.

Functions

The cerebellum’s main role is to monitor and regulate motor behavior without any need for conscious awareness.The cerebellum’s main role is to monitor and regulate motor behavior among other functions.

It was once believed that the only function of the cerebellum was in coordinating movements. We now, however, understand that the cerebellum plays a much bigger role in a variety of functions, and communicates signals to other areas of the brain.

Below are a list of some of the associated functions of the cerebellum:

  • Coordination of voluntary movement.
  • Balance.
  • Posture.
  • Motor-learning.
  • Sequence learning.
  • Reflex memory.
  • Mental function.
  • Emotional processing.

The cerebellum receives sensory information, especially regarding the body’s position, so it knows what each body part is doing. Signals can be received from the brain stem, spinal cord, and the cerebrum, to coordinate and control movement.

It receives information from the frontal lobes of the brain, so it knows what movements the frontal lobes intend to make. Although the cerebellum does not initiate movement, it does help to organize the movements to ensure it is a fluid and coordinated action.

On their own, the frontal lobes would produce jerky, uncoordinated, and inaccurate movements, therefore the cerebellum plays an important part in regulating this. Fundamentally, the cerebellum organizes all muscle group actions, including eye movements.

The cerebellum also aids in balance and posture. It monitors information regarding balance and posture, to ensure that when we are standing or walking, we are not falling down, and we are able to keep ourselves steady.

In terms of motor-learning, the cerebellum is vital when learning a new skill. For instance, if someone were learning to ride a bike for the first time, you may expect they would typically start off making mistakes and falling off the bike.

The cerebellum helps to fine-tune the motor skills required to ride a bike, until they get to a point where the action can be completed seamlessly and almost automatically.

Cerebellum Damage

Cerebellar damage results in the break down and destruction of nerve cells which can have long-last effects.

A person who has damage to their cerebellum may experience some of the following symptoms:

  • Walking unsteadily
  • Tremors – involuntary rhythmic contractions
  • Vertigo – which can also lead to swaying, nausea, and headaches.
  • Slurred speech
  • Inaccurate or jerky movements
  • Cognitive impairment – this can affect memory, learning, and thinking.
  • Dystonia – involuntary contractions of muscles, which can result in muscles being held in painful positions as a result
  • Clumsiness – may give someone the appearance of being intoxicated
  • Less refined motor-skills
  • Ataxia – loss of control of voluntary movement

Drinking alcohol has an immediate and temporary effect on the cerebellum as the body’s coordination and movements become clumsy. Someone who is intoxicated with alcohol may not be able to walk in a straight line and lose their balance.

Although these symptoms are temporary, repeated alcohol misuse, becoming an alcohol use disorder, can have long-lasting impacts on the cerebellum and lead to these symptoms being more long-lasting.

Other causes of damage to the cerebellum can come from injury to the head, such as falling backwards and hitting the back of the head where the cerebellum lies. Brain tumors and infections in the brain can also cause long-lasting damage to the cerebellum.

Damage could also occur through medical issues such as having Parkinson’s disease, multiple sclerosis and experiencing a stroke. Similarly, lead or mercury poisoning and the over-use of certain medications (e.g. benzodiazepines) can also cause lasting damage to cerebellar function.

Studies of the Cerebellum

  • Schmahmann & Sherman (1998) investigated behavioral changes in patients who had diseases confined to the cerebellum. They found that these patients had impairments in executive functions such as planning, working memory and abstract reasoning.They also found difficulties in visual and spatial organization and some language deficits.They concluded that the cerebellum plays a big part in the areas of language and cognition.
  • Brown et al., (2005) examined the neural basis of dance and they found evidence of cerebellar activity whilst synchronizing timing and movement to musical rhythm.
  • Ponti, Peretto & Bonfanti (2008) investigated the cerebellums of adult rabbits and found evidence of neurogenesis (the development of new nerve cells).
  • Jimsheleishvili & Dididze (2019) proposed the cerebellum is involved in processing language and mood, attention, the fear response as well as the pleasure and reward response.
  • Stoodley & Schmahmann (2009) conducted neuroimaging studies of the cerebellum. They found that various parts of the cerebellum become activated during tasks involving movement and touch, spatial memory, emotional processing, and verbal memory.They also found that language was associated with the right-hand side of the cerebellum, whereas the left side of the cerebellum was associated with spatial awareness.
  • Leggio et al., (2008) found that there were cognitive sequencing impairments in patients with damage to their cerebellum.
  • Appollonio et al., (1993) found that the ability to produce words fluently, as well as problem-solving, are impaired in patients whose cerebellum has been damaged.
  • Caulfield & Servatius (2013) propose that the cerebellum is involved in those with anxiety disorders. They suggest that because avoidance (which is a trait of anxiety disorders) is a learned process which has been reinforced over time, that this has been learnt through the aid of the cerebellum.They found that lesioning the cerebellum in rats prevented them from using the avoidance response to anxiety-provoking situations.
  • Impairment to the cerebellum has been reported in those with anxiety disorders and may be linked to increased arousal present in posttraumatic stress disorder (PTSD) and generalized anxiety disorder (Abadie et al.,1999).Similarly, cerebellar hyperactivity has been shown to correlate positively with increase blood pressure and heart rate, a possible reason for the cerebellum’s role in anxiety disorders (Critchley et al., 2000.)
  • Stoodley (2016) suggested that the cerebellar dysfunction is found in individuals with developmental disorders such as Autism, attention deficit hyperactivity disorder (ADHD) and developmental dyslexia.They also suggested that early damage to the cerebellum has been shown to be associated with poorer outcomes in comparison to damage in adulthood. This implies that protecting the cerebellum is vital during childhood development.
  • Gowen & Miall (2007) aimed to test whether there was any evidence of cerebellar involvement in motor dysfunctions associated with neuropsychiatric disorders.There was some evidence found that Autism, schizophrenia, and dyslexia is linked to the cerebellum, although they are not restricted to this brain area.
  • Brain imaging studies have found that there are reduced sizes of the cerebellum in patients who are diagnosed with schizophrenia (Nopoulos et al., 1999).There is also evidence from neuroimaging that patients with schizophrenia have less blood flow to the cerebellar cortex during the performance of cognitive tasks, such as attention and tasks which involve using short-term and working memory (Crespo-Facorro et al., 2007).

Summary

There is growing research and data to suggest that the cerebellum plays a role, not only in controlling balance and voluntary movement, but also in the control of cognitive and emotional processes. 

There is also evidence through neuroimaging studies to suggest the cerebellum’s involvement in neurological disorders.

In order to preserve the health of the cerebellum, limiting or stopping smoking and drinking alcohol is a suggestion. This is because they both contribute to raising blood pressure which could ultimately lead to a stroke. 

Exercising more and eating a healthy diet both help lower blood pressure, and thus, the risk of a stroke, so this is encouraged to protect the cerebellum.

Finally, protecting the head in general, such as wearing helmets when cycling, wearing seatbelts in the car, and taking care to prevent falls in the home, can limit the risk of damage to this area of the brain.

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

How to reference this article:

Guy-Evans, O. (2021, April 12). Cerebellum functions, structure, and location . Simply Psychology. www.simplypsychology.org/what-is-the-cerebellum.html

APA Style References

Abadie, P., Boulenger, J. P., Benali, K., Barre, L., Zarifian, E., & Baron, J. C. (1999). Relationships between trait and state anxiety and the central benzodiazepine receptor: a PET study. European Journal of Neuroscience, 11(4), 1470-1478. 

Appollonio, I. M., Grafman, J., Schwartz, V., Massaquoi, S., & Hallett, M. (1993). Memory in patients with cerebellar degeneration. Neurology, 43(8), 1536-1536. 

Brown, S., Martinez, M. J., & Parsons, L. M. (2006). The neural basis of human dance. Cerebral cortex, 16(8), 1157-1167. 

Caulfield, M. D., & Servatius, R. J. (2013). Focusing on the possible role of the cerebellum in anxiety disorders. New Insights into Anxiety Disorders (Durbano F, Ed.). InTech, Rijeka, HR, 41-70. 

Crespo-Facorro, B., Barbadillo, L., Pelayo-Terán, J. M., & Rodríguez-Sánchez, J. M. (2007). Neuropsychological functioning and brain structure in schizophrenia. International Review of Psychiatry, 19(4), 325-336. 

Critchley, H. D., Corfield, D. R., Chandler, M. P., Mathias, C. J., & Dolan, R. J. (2000). Cerebral correlates of autonomic cardiovascular arousal: a functional neuroimaging investigation in humans. The Journal of physiology, 523(1), 259-270. 

Gowen, E., & Miall, R. C. (2007). The cerebellum and motor dysfunction in neuropsychiatric disorders. The Cerebellum, 6(3), 268-279. 

Jimsheleishvili, S., & Dididze, M. (2019). Neuroanatomy, cerebellum. StatPearls. 

Leggio, M. G., Tedesco, A. M., Chiricozzi, F. R., Clausi, S., Orsini, A., & Molinari, M. (2008). Cognitive sequencing impairment in patients with focal or atrophic cerebellar damage. Brain, 131(5), 1332-1343. 

Nopoulos, P. C., Ceilley, J. W., Gailis, E. A., & Andreasen, N. C. (1999). An MRI study of cerebellar vermis morphology in patients with schizophrenia: evidence in support of the cognitive dysmetria concept. Biological psychiatry, 46(5), 703-711. 

Phillips, J. R., Hewedi, D. H., Eissa, A. M., & Moustafa, A. A. (2015). The cerebellum and psychiatric disorders. Frontiers in public health, 3, 66. 

Ponti, G., Peretto, P., & Bonfanti, L. (2008). Genesis of neuronal and glial progenitors in the cerebellar cortex of peripuberal and adult rabbits. PLoS One, 3(6), e2366. 

Schmahmann, J. D., & Sherman, J. C. (1998). The cerebellar cognitive affective syndrome. Brain: a journal of neurology, 121(4), 561-579.

Stoodley, C. J. (2016). The cerebellum and neurodevelopmental disorders. The Cerebellum, 15(1), 34-37. 

Stoodley, C. J., & Schmahmann, J. D. (2009). Functional topography in the human cerebellum: a meta-analysis of neuroimaging studies. Neuroimage, 44(2), 489-501.  

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Источник: https://www.simplypsychology.org/what-is-the-cerebellum.html

Cerebellum

What Is the Cerebellum?

The cerebellum is a vital component in the human brain as it plays a role in motor movement regulation and balance control. The cerebellum [1] (see image on R, horizontal fissure marked red)

  • Coordinates gait
  • Maintains posture,
  • Controls muscle tone and voluntary muscle activity
  • Is unable to initiate muscle contraction.

Damage to this area in humans results in a loss in the ability to control fine movements, maintain posture, and motor learning

The cerebellum is neuron-rich, containing 80% of the brain’s neurones organized in a dense cellular layer, and it's surface area when unfolded is nearly 75% of the surface area of the cerebrum.[1]

Anatomical Position[edit | edit source]

The cerebellum is located at the back of the brain, immediately inferior to the occipital and temporal lobes, and within the posterior cranial fossa. It is separated from these lobes by the tentorium cerebelli, a tough layer of dura mater.

It lies at the same level of and posterior to the pons, from which it is separated by the fourth ventricle.

Structure[edit | edit source]

The cerebellum consists of two hemispheres which are connected by the vermis, a narrow midline area. The cerebellum consists of grey matter and white matter:[2]

  • Grey matter – located on the surface of the cerebellum. It is tightly folded, forming the cerebellar cortex. The gray matter of the cortex divides into three layers: an external — the molecular layer; a middle — the Purkinje cell layer; and an internal — the granular layer. The molecular layer contains two types of neurons: the outer stellate cell and the inner basket cell.[1]
  • White matter – located underneath the cerebellar cortex. Embedded in the white matter are the four cerebellar nuclei (the dentate, emboliform, globose, and fastigi nuclei).

There are three ways that the cerebellum can be subdivided – anatomical lobes, zones and functional division[2]

  1. Anatomical Lobes
    There are three anatomical lobes that can be distinguished in the cerebellum. These lobes are divided by two fissures – the primary fissure and posterolateral fissure;
    • The anterior lobe,
    • The posterior lobe
    • The flocculonodular lobe. It is the oldest part of the brain in evolutionary terms (archicerebellum) and participates mainly in balance and spatial orientation. Its primary connections are with the vestibular nuclei, although it also receives visual and other sensory input.[3]
  2. Zones
    There are three cerebellar zones. In the midline of the cerebellum is the vermis. Either side of the vermis is the intermediate zone. Lateral to the intermediate zone are the lateral hemispheres. There is no difference in gross structure between the lateral hemispheres and intermediate zones
  3. Functional Divisions
    The cerebellum can also be divided by function. There are three functional areas of the cerebellum – the cerebrocerebellum, the spinocerebellum and the vestibulocerebellum.
    • Cerebrocerebellum – the largest division, formed by the lateral hemispheres. It is involved in planning movements and motor learning. It receives inputs from the cerebral cortex and pontine nuclei and sends outputs to the thalamus and red nucleus. This area also regulates coordination of muscle activation and is important in visually guided movements.
    • Spinocerebellum – comprised of the vermis and intermediate zone of the cerebellar hemispheres. It is involved in regulating body movements by allowing for error correction. It also receives proprioceptive information.
    • Vestibulocerebellum – the functional equivalent to the flocculonodular lobe. It is involved in controlling balance and ocular reflexes, mainly fixation on a target. It receives inputs from the vestibular system, and sends outputs back to the vestibular nuclei.

Nerves[edit | edit source]

The cerebellum attaches to the brainstem by three groups of nerve fibers called the superior, middle and inferior cerebellar peduncles, through which efferent and afferent fibers pass to connect with the rest of the nervous system.

Function[edit | edit source]

Function by regions

  • The cortex of the vermis coordinates the movements of the trunk, including the neck, shoulders, thorax, abdomen, and hips.
  • Control of the distal extremity muscles is by the intermediate zone of cerebellar hemispheres, located adjacent to the vermis.
  • The remaining lateral area of each cerebellar hemisphere provides the planning of sequential movements of the entire body along with involvement in the conscious assessment of movement errors

Main Functions overall[3]

  • The cerebellum is essential for making fine adjustments to motor actions. Cerebellar dysfunction primarily results in problems with motor control.
  • Four principles are important to cerebellar processing: feedforward processing, divergence and convergence, modularity, and plasticity.
  • Signal processing in the cerebellum is almost entirely feedforward. Signals move through the system from input to output with very little internal transmission.
  • The cerebellum both receives input and transmits output via a limited number of cells.
  • The cerebellar system is divided into thousands of independent modules with similar structure.

Blood Supply[edit | edit source]

The cerebellum receives its blood supply from three paired arteries (originate from the vertebrobasilar anterior system)[2]

  • Superior cerebellar artery (SCA)
  • Anterior inferior cerebellar artery (AICA)
  • Posterior inferior cerebellar artery (PICA)

The SCA and AICA are branches of the basilar artery, which wraps around the anterior aspect of the pons before reaching the cerebellum. The PICA is a branch of the vertebral artery.

Venous drainage of the cerebellum is by the superior and inferior cerebellar veins. They drain into the superior petrosal, transverse and straight dural venous sinuses.

Clinical Significance[edit | edit source]

The cerebellum receives afferent information about voluntary muscle movements from the cerebral cortex and from the muscles, tendons, and joints. It also receives information concerning balance from the vestibular nuclei. Each cerebellar hemisphere controls the same side of the body, thus if damaged the symptoms will occur ipsilaterally.[1]

Dysfunction of the cerebellum can produce a wide range of symptoms and signs. 

The most common cause of cerebellar dysfunction is alcohol poisoning, but also trauma, multiple sclerosis, tumors, thrombosis of the cerebellar arteries and stroke.[1]

The clinical picture depends on the functional area of the cerebellum that is affected[3].

  • Damage to the flocculonodular lobe (vestibulocerebellum): loss of equilibrium causing an altered walking gait
  • Lateral zone damage: problems with skilled voluntary and planned movements leading to errors in intended movements (eg., dysdiadochokinesia, the inability to perform rapid alternating movements).
  • Damage to the midline portion: disruption of whole-body movements
  • Damage to the upper part of the cerebellum: gait impairments and other problems with leg coordination (ie, ataxia).

A wide variety of manifestations are possible (remembered by acronym ‘DANISH‘)[2]

  • Dysdiadochokinesia — the lack of ability to perform rapidly alternating movements. Ask the patient to quickly supinate and pronate both forearms simultaneously. Movements will be slow and incomplete on the side of the cerebellar lesion.[1]
  • Ataxia — voluntary movement disturbance involves tremor with fine movements eg writing or buttoning the clothes. Finger to nose test is performed to examine the coordination of the muscle movements, testing tip of the nose with the index finger test the movements are not properly coordinated, and tremor is observed at the end of the movement, called intention tremor. A similar test can be performed on the lower limbs ask patient to place the heel of one foot against the shin of the opposite leg.[1]
  • Nystagmus (coarse) — Ataxia of ocular muscles, a rhythmical oscillation of the eyes. To provoke nystagmus, the patient should rotate eyes horizontally
  • Intention tremor
  • Dysarthria/Scanning speech —  ataxia of the larynx muscles, speech is slurred and syllables are separated from one another.
  • Hypotonia — the muscles lose resistance to palpation due to diminished influence of the cerebellum on gamma motor neurons. The patient walks with a broad-based gait and leans toward the affected side.[1]

Occlusion of PICA cause Wallenberg syndrome

The short video below gives a good picture of the manifestations of cerebellum damage

[4]

The cerebellum appears to play a role in many types of behaviours. Cerebellar damage not only affects movement coordination but also disrupts some perceptual abilities such as visual motion discrimination.

The cerebellum acts to make predictions for different cerebral areas of the brain to optimize their abilities— helping to predict optimal motor commands for movement control and upcoming sensory events for sensory perception possibly explaining how cerebellar damage affects other behaviours.[5]

Physiotherapy[edit | edit source]

Physical therapy intervention is the primary treatment for gait ataxia and imbalance in individuals with cerebellar damage. Physical therapy aims to restore movement and function following cerebellum injury using movement, exercise and manual therapy, as well as education and advice.

Physical therapy may include exercises such as

  • Task-specific training with the aim of (re)acquiring a motor skill (with or without using robotic exoskeletons)
  • Exercises that focus on regaining or sustaining control of the proximal muscles of the trunk, shoulder and pelvic girdle
  • Exercises that aim to improve static and dynamic balance and proprioception as a component of postural control
  • Stretching exercises that aim to improve range of movement.
  • Adjuncts, such as treadmill training with or without partial body weight support, functional electrical stimulation of voluntary muscles and exergames that use computer technologies to provide an interactive environment which requires limb movement to react to on-screen gameplay (e.g. Wii, X Box).[6]

An important finding of a recent study[7] was that the level of challenge to balance was more important than the duration of exercise in producing Neurorehabilitation and neural repair.

Cerebellar patients with ataxia can benefit from a home exercise program focused on balance training (with significant improvements after just six weeks). Highlighted was the importance of the 1. level of challenge to balance being of upmost importance 2.

individualizing the program and offering continued training and progression if necessary to see effect retention.

Regeneration ? ![edit | edit source]

Current research is going on into the search for neurogenesis of the central nervous system. An exciting prospect. Some of the news is reported below.

  • A current project is exploring the degree to which the brain can be repaired after neuron loss and identify factors that can stimulate stem cells to regenerate neurons.[8]
  • A 2019 [9]) report shows compelling evidence that the mature central nervous system (CNS) harbours stem cell populations outside conventional neurogenic regions. It has been demonstrated that brain pericytes (PCs) in both mouse and human exhibit multipotency to differentiate into various neural lineages following cerebral ischemia. Importantly putative ischemia-induced multipotent stem cells are present in poststroke cerebellum and possess region-specific traits, suggesting a potential capacity to regenerate functional cerebellar neurons following ischemic stroke[9].
  • Another 2019 study reported «Nerves in the central nervous system of adult mammals do not usually regenerate when injured. The granule cell, a nerve cell located in the cerebellum, is different. When its fibres, called parallel fibres, are cut, rapid regeneration ensues and junctions with other neurons called «synapses» are rebuilt. The precise mechanism for this was unclear»

Further Viewing[edit | edit source]

The below 4-minute video gives a great 3D view of the cerebellum and highlights it's similar structure to that of the cerebrum.

[10]

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Jimsheleishvili S, Dididze M. Neuroanatomy, Cerebellum. InStatPearls [Internet] 2019 Mar 2. StatPearls Publishing.Available from:https://www.ncbi.nlm.nih.gov/books/NBK538167/ (last accessed 19.1.2020)

Источник: https://www.physio-pedia.com/Cerebellum

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