CEREBELLUM

DR MINU LIZ ABRAHAM

FUNCTIONS OF CEREBELLUM
I. CONTROL OF BODY POSTURE AND
EQUILIBRIUM

 Concerned with Vestibulocerebellum

 Afferents to cerebellum:

a. Vestibulocerebellar tract : Carry input from vestibular apparatus

regarding position and movement of head - directly or after relay in
vestibular nuclei to flocculonodular lobe .

b. Spinocerebellar and cuneocerebellar tracts : Carry feedback about

 Efferent to cerebellum
 Flocculonodualar lobe and fastigial nucleus project output fibers to
vestibular and reticular nuclei of brain stem and via vestibulospinal
tract and reticulospinal tract influence spinal motor neurons to
maintain body posture

 Patients with lesion of vestibulocerebellum have difficulty in

maintaining balance during standing and walking

II. CONTROL OF GAZE

 Vestibulocerebellum regulates the

position of eyes in relation to movements

of head through medial longitudinal

bundle

 Nystagmus develops in cerebellar lesion

III. ROLE IN MUSCLE TONE

 Spinocerebellum mainly concerned with control of muscle tone through stretch

reflex

 Afferents : Spinocerebellar , Cuneocerebellar , Olivocerebellar tracts – Convey

information regarding tone of muscles and position of limbs and body

 Efferents : Spinocerebellum and deep cerebellar nuclei (Emboliform ,Globossus

and fastigial nucleus ) project output fibres and via reticulospinal tract influence γ
motor neurons to regulate muscle tone

 Cerebellum exerts facilitatory influence on muscle tone

IV. CONTROL OF VOLUNTARY MOTOR ACTIVITY

 Cerebellum not able to initate any motor activity but coordinates movements

initiated by motor cortex

 Regulates rate , range ( extent ) , force and direction of muscular activity

 Lesions of cerebellum not associated with paralysis but disturbance in

smoothness of movements.

 Motor cortex of one cerebral hemisphere is connected to cerebellar

hemisphere of opposite side ( Cortico – ponto- cerebellar pathway )
 Arises in Motor cortex and ends in pontine nuclei.

From pontine nuclei the pontocerebellar fibers

cross to opposite side through middle cerebellar

peduncle.

 Inturn , Cerebral cortex via corticospinal tract

decussates to opposite side controlling the motor

function of opposite half of the body .

 Therefore, due to DOUBLE DECUSSATION or

DOUBLE CROSSING each cerebellar hemisphere

Cerebellum controls the voluntary movements by following
actions

A. COMPARATOR FUNCTION

B. DAMPING ACTION

C. TIMING AND PROGRAMMING THE MOVEMENTS

D. CONTROL OF BALLISTIC MOVEMENTS

A. COMPARATOR FUNCTION

 When motor cortex sends impulse through corticospinal tract to lower

motor neurons it also sends

a. Information to the cerebellum about the intended sequential plan of

movement for next few fractions of second

(Cortico – ponto – cerebellar tract )

b. Cerebellum also gets information from peripheral parts of body about

actual performance in periphery ( Spinocerebellar tract )

 Cerebellum compares these signals and if

movement is fast or slow , error is detected and

corrective signals are sent to cerebral cortex from

cerebellum , and firing from cerebrum is corrected

( Dentato – rubro thalamic cortical fibers )

 Dentarubral fibers start from dentate nucleus

and pass via superior cerebellar peduncle end

in red nucleus of opposite side

 Rubrothalamic fibers start from red nucleus

and go to thalamus

 Thalamocortical fibers connect thalamus to

 This property is called ERROR DETECTION AND CORRECTION

function

 The spontaneous correction after detection of error by altering output is

called SERVOMECHANISM
B . DAMPING AND BRAKING ACTION
 Dampening - retarding

 When movement is initiated , simultaneously cerebellum receives

impulses from motor cortex as well as signals from muscle

 However the rate of firing from cerebral cortex is much more than what
is needed ( Tendency to overshoot )

 Cerebellum is capable of producing a suppressor effect on cerebral

firing level : Reduces exaggerated muscular activity- Movement
becomes smooth and accurate – DAMPENING EFFECT
 Loss of dampening effect causes dysmetria and pendular
reflexes

• Cerebellum is capable of completely stopping the range of

movement by BRAKING ACTION
C. TIMING AND PROGRAMMING THE MOVEMENTS

I. Planning of sequence of movements : Lateral parts of Cerebellar

hemisphere communicate with cerebral cortex ( plan is transmitted
from cerebral cortex to cerebellum )

II. Timing function : Lateral part of cerebellar hemisphere also provides

appropriate timing for each movement ,without which movements
begin far early or too late

III. Predicting events : Cerebellum capable of predicting events

D. CONTROL OF BALLISTIC MOVEMENTS :

 Rapid alternate movements which take place in different parts

of body while doing any skilled work ( Dancing )

 Cerebellum co –ordinates the action of agonist and antagonist

muscles
E. SERVOMECHANISM

 Cerebellum plays an important role in learning motor skills

 Sequential movements can be executed without any interruption

 Cerebral cortex discharges the signals which are already programmed

and stored at cortex

 If there is any disturbance , the cortico-cerebellum immediately

influences the cerebral cortex and corrects movements.

 This Action of Corticocerebellum is known as servomechanism.

E. SERVOMECHANISM

 Cerebellum plays an important role in learning motor skills

 Sequential movements can be executed without any interruption

 Cerebral cortex discharges the signals which are already programmed

and stored at cortex

 If there is any disturbance , the cortico-cerebellum immediately

influences the cerebral cortex and corrects movements.

 This Action of Corticocerebellum is known as servomechanism.

 CEREBELLAR FUNCTION TESTS
I. Test for coordination

Upper limb

a. Finger nose test

b. Finger to finger test

c. Rapid alternating movements

Lower limb

d. Straight line test

e. Heel – Knee test

III. Assessment of gait and speech

IV. Assessment of various aspects

of ataxia
LEISONS OF CEREBELLUM
A. DISTURBANCES IN TONE
 Characterized by atonia OR hypotonia due to
loss of tone in muscles
 Develops on same side

B. DISTURBANCE IN EQUILIBRIUM
 Seen when there is damage to flocculonodular
lobe
 Stands or walks on wide base by spreading his
feet and sways side to side( DRUNKEN GAIT
C. CEREBELLAR NYSTAGMUS

 Occurs due to lesion of flocculonodular

lobe of cerebellum

 Occurs when attempts to fix the eyes –

Results in rapid ,regular, rhythmic, to- fro
oscillatory eye movement

 Due to lack of co- ordination of extraocular

muscles.
D. ATAXIA

 There is incoordination of movements due to errors in rate , range , force and

direction of movement

 Tests which reveal in-cordination are

A. FINGER NOSE TEST

B. FINGER – FINGER TEST

DISTURBANCE IN MOVEMENTS

A. ADIADOCHOKINESIS OR DYSDIADOCHOKINESIA

 Inability to perform alternate movements rapidly ( Rapid pronation

and supination of forearm )

 Due to absence of proper timing of movements and lack of

coordination of against and antagonist muscles.
B. PAST POINTING ( DYSMETRIA )

• When a movement is attempted to touch an

object with a finger , it overshoots the mark
and lands beyond the object.

• Movements are incorrect in

rate ,range ,direction and force

• Failure to terminate the movement at

proper time
C. INTENTION TREMOR

 These are the oscillatory movements that is not

present at rest but occurs during voluntary
movement

 Absent at rest ,appears when the patient

attempts to perform voluntary action.

 Failure of cerebellum to inhibit the cerebral

D. REBOUND PHENOMENON

 Subject is asked to flex the

forearm against resistance and
withdraw the resistance suddenly

 Forearm strikes against the body

due to absence of braking
action ( Inability to stop
movements promptly )
E. DECOMPOSITION OF MOVEMENT

: Inability to perform movement that

involves more than one joint
simultaneously

Dissects complex movement and

performs movement at each joint slowly
and seperately
 F. PENDULAR KNEE JERK :

Hypotonia and lack of braking

action results in pendular
movement

Patellar tendon reflex , limb will

swing back and forth like
pendulum few times
I. SPEECH :

 Slurred or scanning speech due

to incordination of various
muscles and structures involved
in speech

 Speech is slurred , prolonged with

pause at wrong places
CHARCOT’S TRIAD

 Presence of Nystagmus ,
Intention tremor and Scanning
speech

 Seen in cerebellar lesion