Cerebellum

An Inclusive Overview

Neurosciences

Layer
Molecular layer (outermost
layer)
Purkinje cell layer (middle
layer or ganglionic layer)
Granular layer of the
cerebellum (inner layer)
▪ The cortex is primarily an inhibitory structure; all cerebellar cells except granule cells are
inhibitory
Cerebellar Cortex Layers (from Amboss)
Cell types
• Basket cells: large axons with sparse dendrites (inhibitory)
• Cerebellar stellate cells: star-shaped neurons with
multiple arborizations (inhibitory)
• Parallel fibers (axons of granule cells) and dendrites of
Purkinje cells
• Cerebellar Purkinje cells (inhibitory):
- Flat neurons with fan-like dendritic projections
- Axons run perpendicular to the parallel fibers of the
granule cells
- The only output of cerebellar cortex
• Golgi cells: located in the upper portion of the granular
layer
• Granule cells (excitatory): small, densely packed neurons
that secrete glutamate
- Most abundant cell type in the cerebellum
Function
• Receives excitatory input from parallel
fibers
• Sends inhibitory impulses to Purkinje
cells
• Receive excitatory input from climbing
fibers and granule cells
• Send inhibitory impulses to the deep
cerebellar nuclei and thereby control the
output of all motor coordination of the
cerebellum
• Golgi cells: receive excitatory impulses
from the molecular layer and send
inhibitory impulses to the granule cells
• Granule cells: receive excitatory input
from mossy fibers and send excitatory
efferents to the Purkinje cells

▪ GABA is the inhibitory neurotransmitter of all cerebellar cells except granule cells

▪ Glutamate is the excitatory neurotransmitter of granule cells

 Functional Zones of Cerebellum (from Amboss)
Zone Input Function Effect of Lesion
• Cerebral cortex • Planning and execution of movements • Abnormal coordination of ipsilateral
Cerebrocerebellum • The inferior olivary • Coordination of complex and sequential voluntary movements
(lateral hemispheres) nucleus of the motor movements • Scanning speech (ataxic dysarthria)
medulla • Nonmotor functions: cognition,
language, learning, and emotions
• Spinal cord • Coordination of body and limb • Vermis: trunk and proximal limb
- Vermis: input from movement muscles affected:
the trunk and - Vermis: central body (trunk, head, and - Truncal ataxia, Gait ataxia (wide-
proximal portions proximal limbs) based, unsteady gait), Tilting of the
Spinocerebellum of the limbs - Intermediate zones: distal limbs (hands, head
(vermis and - Intermediate zones: fingers, feet, toes)
intermediate zones) distal portion of the - Maintenance of muscular tone • Intermediate zones: ipsilateral distal
limbs limb muscles affected
- Limb ataxia, Intention tremor,
Hypotonia
• Vestibular nuclei of • Balance • Vertigo
Vestibulocerebellum cranial nerve VIII • Ocular movements and gaze stability • Nystagmus
(flocculonodular lobe) • Superior colliculi
and visual cortex
• A tip to remember the symptoms of cerebellar lesions: lesions of the medial part of cerebellum (i.e., vermis, flocculonodular lobe, and corresponding deep
nuclei) affect medial structures (i.e., axial and proximal limb musculature), resulting in symptoms including truncal ataxia and nystagmus
• Lesions of the lateral parts of cerebellum (i.e., the hemispheres) affect lateral structures (distal limb musculature), resulting in symptoms such as ipsilateral
limb ataxia
• Afferent tracts arise from three main sources: the cerebral cortex, the spinal cord, and the vestibular nerve
• Afferent tracts are excitatory and travel to the cerebellum via mossy fibers and climbing fibers
• Afferent tracts travel mainly through the inferior and middle cerebellar peduncles
• Efferent tracts originate from the four deep cerebellar nuclei and travel mainly via the superior cerebellar peduncle

• The tracts of the fastigial nucleus travel via the inferior cerebellar peduncle

• Deep cerebellar nuclei (from lateral to medial): "Don't Eat Greasy Food" (Dentate, Emboliform, Globose, Fastigial)
 Flocculonodular Lobe Syndrome
❖ This syndrome is the result of a lesion of the
flocculonodular lobe or its afferents or efferents

❖ It is most commonly seen in children with a

medulloblastoma

❖ The syndrome is characterized by truncal ataxia due

to the inability to stabilize or balance the axial
musculature

❖ This results in a wide-based stance as well as swaying

❖ In addition to truncal ataxia, a nystagmus is often

diagnosed due to damage to the vestibuloocular
pathways
 References

➢ Inderbir Singh’s Textbook of Human Neuroanatomy – 10th Edition

➢ Sherwood’s Physiology – 7th Edition
➢ Lippincott’s Neuroanatomy
➢ Ahmed Farid “Cerebellum” video
➢ Amboss Website
➢ “Anatomy of Cerebellum” Lecture, Batch 16 – Riyadh
➢ KSU Medical Cloud