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Internal Structure · 243 5

Internal Structure

Although the cerebellum accounts for only about 10% of the brain by weight, it contains more than 50% of all the brain’s neurons. The neurons of the cerebellum are located in the gray matter of the highly convoluted cerebellar cortex and in the four deep cerebellar nuclei on either side (see below).

Cerebellar Cortex

The cerebellar cortex is composed of three layers (Fig. 5.3). Proceeding from the outermost inward, these layers are:

Molecular layer (stratum moleculare). This layer consists mainly of cellular processes,ofwhichthemajorityaregranulecellaxons—parallelfibers,seebelow— and Purkinje cell dendrites. A few neurons are found among the fibers (stellate cells, basket cells, Golgi cells), which function as inhibitory interneurons.

Pukinje cell layer (stratum ganglionare). This thin layer contains nothing but the large cell bodies of the Purkinje cells, arranged side by side in rows. The elaborate, highly branched dendritic trees of these cells are directed outward into the molecular layer, where the dendritic tree of each individual Purkinje cell lies in a plane perpendicular to the long axis of the folium. The Purkinje cell axons are the only efferent fibers leaving the cerebellar cortex. They project mainly to the deep cerebellar nuclei and release the inhibitory neurotransmitter GABA (γ-aminobutyric acid). Efferent fibers from the cortex of the vestibulocerebellum bypass the deep cerebellar nuclei and project directly to sites outside the cerebellum.

Granulecelllayer(stratumgranulosum).Thislayerconsistsalmostentirelyofthe denselypackedcellbodiesofthesmallgranulecells,whichaccountformorethan 95% of all cerebellar neurons. The axons of these cells are mainly found in the molecular layer, where they travel along individual folia as parallel fibers and form synapses with the perpendicularly oriented dendritic trees of the Purkinje cells(approximately200 000parallelfibersformsynapseswithasinglePurkinje cell). The cerebellar granule cells are glutamatergic and are the only neurons of the cerebellar cortex that exert an excitatory influence on their target cells.

Afferent Input to the Cerebellar Cortex

The afferent input to the cerebellar cortex is mainly derived from the ipsilateral vestibular nuclei (a small part, in fact, comes directly from the vestibular organ,

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5 244 · 5 Cerebellum

Granule cell

Purkinje cell

Basket cell

Purkinje cell axons

Climbing fiber

Parallel fibers

Molecular layer

Purkinje cell layer

Granular layer

White matter

Neurons in the dentate nucleus

Mossy fiber

Fig. 5.3 Structure of the cerebellar cortex with its afferent and efferent connections (schematic drawing)

without any intervening synaptic relay), the ipsilateral spinal cord, the contralateral pontine nuclei (and thus, indirectly, from the contralateral cerebral cortex), and the contralateral olivary nuclear complex in the medulla (olive, for short). The olivary fibers are the so-called climbing fibers, which terminate on the Purkinje cells of the cerebellar cortex, climbing up their dendritic trees like ivy. All other afferent fibers terminate as mossy fibers on the granule cells of the cerebellar cortex, which then relay further impulses along their axons (parallel fibers of the molecular layer) to the Purkinje cell dendrites. Both mossy

Baehr, Duus' Topical Diagnosis in Neurology © 2005 Thieme

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Internal Structure · 245 5

fibers and climbing fibers give off important collaterals to the deep cerebellar nuclei on their way to the cortex.

In view of the fact that both the mossy fibers and the granule cells (and thus the overwhelming majority of synapses in the cerebellum) are glutamatergic, it is not surprising that the administration of glutamate antagonists causes a marked worsening of cerebellar function in patients with cerebellar lesions.

Cerebellar Nuclei

A horizontal section of the cerebellum reveals four deep nuclei within each cerebellar hemisphere (see Fig. 5.5). The fastigial nucleus (“roof nucleus”) is found most medially, in the roof of the fourth ventricle. It receives most of its afferent fibers from the Purkinje cells of the flocculonodular lobe (vestibulocerebellum). Its efferent fibers travel directly to the vestibular nuclei (fastigiobulbar tract) (Fig. 5.5) or cross to the opposite side of the cerebellum and then continue to the reticular formation and the vestibular nuclei (uncinate fasciculus).

Lateral to the fastigial nucleus, one finds two smaller nuclei, the globose nucleus (usually divided into two or three subnuclei) and the emboliform nucleus. Both of these nuclei receive afferent input from the cortex of the paravermian zone and vermis (spinocerebellum) and send efferent fibers to the contralateral red nucleus (Fig. 5.5).

The largest of the cerebellar nuclei, the dentate nucleus, occupies a lateral position in the deep white matter of each cerebellar hemisphere. Its afferent input comes mainly from the cortex of the cerebellar hemispheres (cerebrocerebellum), and, to a lesser extent, from the cortex of the paravermian zone. Its efferent fibers travel by way of the superior cerebellar peduncle to the contralateral red nucleus and thalamus (ventral lateral nucleus, VL) (Fig. 5.5). The thalamus is the site of a synaptic relay, with further projection to the motor areas of the cerebral cortex (Brodmann areas 4 and 6) (Fig. 6.4, p. 266).

Afferent and Efferent Projections of the Cerebellar Cortex

and Nuclei

Synaptic transmission within the cerebellum follows a uniform scheme (Fig. 5.4): the cerebellar afferent pathways project to the cerebellar cortex and, through collateral fibers, to the deep cerebellar nuclei. In the cortex, afferent information is processed in a complex polysynaptic pathway that eventually converges onto the Purkinje cells. The Purkinje cells, in turn, transmit the results of this processing to the deep cerebellar nuclei, in the form of inhibitory, GABAergic impulses. In the deep nuclei, integrative processing of both primary

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5

246 · 5 Cerebellum

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Granule cells

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purkinje

 

 

 

 

 

 

 

 

 

Inhibitory

 

 

 

cells

 

 

 

Afferent

 

 

 

interneurons

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

supply to

 

 

 

 

 

 

 

 

 

 

 

 

 

cerebellum

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Neurons

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

cerebellar

 

 

 

 

 

 

 

 

 

 

 

 

 

nuclei

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cerebellar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mossy fibers

 

 

Climbing fibers

 

 

 

 

 

 

 

 

 

 

 

 

efferent

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

output

 

 

Pontine nuclei

 

 

 

 

 

 

 

Thalamus

 

 

Spinal cord

 

 

 

 

 

 

 

Red nucleus

 

 

Vestibular nuclei

 

 

Vestibular nuclei

 

 

Olive

 

 

 

 

 

 

Reticular formation

Fig. 5.4 The basic scheme of neuronal connections within the cerebellum

information (from the collateral fibers of the cerebellar afferent pathways) and modulated information (from the Purkinje cells/from the cortex) takes place and the result is then transmitted, by way of cerebellar efferent fibers, to the targets of the cerebellar projections.

Connections of the Cerebellum with Other Parts of the Nervous System

All sensory modalities that are important for orientation in space (vestibular sense, touch, proprioception, vision, and hearing) convey information to the cerebellum. The cerebellum receives input from widely diverse sensory areas of the nervous system by way of the three cerebellar peduncles, and sends its output by way of the deep cerebellar nuclei to all motor areas.

This section concerns the many afferent and efferent connections of the cerebellum and their distribution among the three cerebellar peduncles. The more important pathways are shown schematically in Fig. 5.5.

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license of conditions and terms to subject Usage .reserved rights All

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.

 

Globose and

Fastigial nucleus

emboliform

Dentate nucleus

nuclei

Planes of section

Emboliform nucleus

Dentate nucleus

Dentatorubral and dentatothalamic tracts

Pontocerebellar tract

Olive

Anterior and posterior spinocerebellar tracts

Spino-olivary tract

Rubrospinal tract

Olivocerebellar tract Pontocerebellar tract

Thalamocortical tract

Thalamus

Corticopontine tract

Red nucleus

Central tegmental tract

Pontine nuclei

Reticular formation

Central lobule

Lingula

Vestibular nuclei

Nodulus

Uvula

Pyramid

Vestibulospinal tract

Reticulospinal tract

Emboliform and globose nuclei

Culmen

Fastigial nucleus

Declive

Folium

Tuber

Fig. 5.5 Afferent and efferent connections of the cerebellum (schematic drawing). (a): The planes of section (left through the dentate nucleus, right through the vermis).

247 · System Nervous the of Parts Other with Cerebellum the of Connections

5

5248 · 5 Cerebellum

Inferior Cerebellar Peduncle

The inferior cerebellar peduncle (restiform body) contains the following afferent pathways:

Fibers from the vestibulocochlear nerve and the vestibular nuclei to the flocculonodular lobe and fastigial nucleus (Fig. 5.5).

Axons from the contralateral olive in the olivocerebellar tract, which continue as climbing fibers to the dendrites of the Purkinje cells of all areas of the cerebellar cortex (the inferior olivary nucleus projects mainly to the cerebrocerebellum, while the accessory olivary nuclei project mainly to the vestibuloand spinocerebellum).

The posterior spinocerebellar tract, whose fibers arise in the neurons of the nucleus dorsalis (thoracic nucleus or Clarke’s column) at the base of the posterior horn of the spinal gray matter (Figs. 2.16 and 2.17, pp. 42f.); this tract mainly conveys impulses from the muscle spindles of the lower limbs and trunk to the paravermian zone of the anterior and posterior lobes.

A pathway arising in neurons of the cervical spinal cord above the level of the thoracic nucleus, which ascends in the lateral portion of the fasciculus cuneatus and undergoes a synaptic relay in the accessory cuneate nucleus of the medulla; this pathway accompanies the posterior spinocerebellar tract on its way into the cerebellum.

Fibers from the reticular formation (not shown in Fig. 5.5).

The inferior cerebellar peduncle contains the following efferent pathways:

The fastigiobulbar tract (largest efferent pathway of the inferior cerebellar peduncle) to the vestibular nuclei; this tract closes a vestibulocerebellar regulatory feedback loop through which the cerebellum influences the motor function of the spinal cord.

Fibers from the fastigial nucleus to the reticular formation (cerebelloreticular tract) and from the dentate nucleus to the olive (cerebello-olivary tract).

Middle Cerebellar Peduncle

The middle cerebellar peduncle (brachium pontis) exclusively contains afferent fibers, of the following types:

The pontocerebellar tract decussates in the pons and then travels in a thick bundle, by way of the middle cerebellar peduncle, to the cerebellar hemispheres. These fibers originate in the basal pontine nuclei and are thus the continuation, after a synaptic relay, of the corticocerebellar projections, which are derived from all of the lobes of the cerebrum, but in greatest number from the frontal lobe. The fibers cross the midline as soon as they emerge from the relay nuclei in the basis pontis.

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Connections of the Cerebellum with Other Parts of the Nervous System · 249

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Further afferent fibers from the monoaminergic raphe nuclei travel by way of the middle cerebellar peduncle to the cerebellum.

Superior Cerebellar Peduncle

Efferent pathways. The superior cerebellar peduncle (brachium conjunctivum) contains most of the cerebellar efferent fibers. These fibers originate in the deep cerebellar nuclei and project mainly to the following structures:

The contralateral thalamus (ventral lateral and centromedian nuclei, Figs. 6.4 and 6.6, p. 266ff.)

The contralateral red nucleus

The reticular formation

Efferent fibers to the thalamus. Efferent fibers in the superior cerebellar peduncle traveling to the thalamus arise mainly in the dentate nucleus (cerebrocerebellum). After a synaptic relay in the thalamus, further fibers ascend to the motor and premotor cerebral cortex, which, in turn, projects back to the pontine nuclei by way of the corticopontine tract. A long regulatory loop is thus created, traveling from the cerebral cortex to the pontine nuclei, cerebellar cortex, dentate nucleus, thalamus, and finally back to the cortex (Figs 5.5 and 5.6).

Efferent fibers to the red nucleus and reticular formation. A further regulatory circuit comprises the so-called triangle of Guillain and Mollaret, traveling from the red nucleus by way of the central tegmental tract to the olive, then to the cerebellum and back to the red nucleus (Fig. 5.7). The cerebellum influences spinal motor function by way of fibers traveling from the red nucleus and reticular formation down into the spinal cord (cf. Fig. 3.5, p. 62).

Afferent pathways. One of the few afferent pathways in the superior cerebellar peduncle is the anterior spinocerebellar tract, which terminates in the same area (spinocerebellum) as the posterior spinocerebellar tract. Both convey proprioceptive impulses from the periphery, i.e., from muscle spindles, Golgi tendon organs, and joint receptors.

Fibers from the tectum travel to the cerebellar vermis in the tectocerebellar tract, which occupies a medial position in the superior cerebellar peduncle, at its transition to the superior medullary velum. These fibers convey auditory information from the inferior colliculi, and probably also visual information from the superior colliculi.

Topography of Cerebellar Afferent Pathways

Each half of the cerebellum is responsible for motor function on the ipsilateral half of the body. Some of the efferent fiber systems are doubly crossed: thus,

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5 250 · 5 Cerebellum

Fig. 5.6 Cerebellar regulatory cir-

Cerebral cortex

cuits involving the pontine nuclei

 

Thalamocortical tract

Corticospinal tract

Corticopontine tract

Dentato-

 

rubral and

 

dentato-

Pontine

thalamic

nuclei

tracts

 

Dentate

 

nucleus

 

Cerebral cortex

Thalamo- Neocerebellar cortical tract cortex

Corticospinal and corticorubral tracts

Thalamus

Dentato-

 

rubral and

 

dentato-

Red nucleus

thalamic

 

tracts

Central

 

Dentate

tegmental

nucleus

tract

 

Olive

 

Olivocere-

 

bellar tract

Neocerebellar

cortex

Fig. 5.7 Cerebellar regulatory circuits involving the olive. The triangle of Guillain and Mollaret passes from the red nucleus by way of the central tegmental tract, the olive, and the cerebellum back to the red nucleus.

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