Unit 3 BG and Cerebellum Clinical Correlation

voluntary movement originates in the

cerebra cortex

basal ganglia is responsible for

planning and executing voluntary movement

cerebellum is responsible for

comparing and correcting intended movement, allows for smooth and coordinated movements

thalamus is responsible for

relaying all sensory information except smell

basal ganglia subcortical structures include

caudate nucleus, putamen, globus pallidus, substantia nigra, subthalamic nucleus

through the direct pathway, the BG can

initiate correct movement

through the indirect pathway, the BG can

suppress unwanted movement

parkinsons disease

loss of dopamine producing neurons in the substantia nigra

huntingtons disease

degeneration of putamen and caudate, abnormally wide anterior horn and body of lateral ventricles

clinical presentation of parkinsons

TRAP - tremors, rigidity, akinesia (usually bradykinesia), posture/balance

aside from TRAP sx., parkinsons disease can also impact

cognition, speech/swallowing, BP (hypotension is common), etc.

most supported rehab treatment for parkinsons

external cueing - can incorporate into all functional activities

other supported treatments for parkinsons

GAIT training, aerobic exercise, balance training (PWR home/rehab videos)

huntington's disease presents with symptoms impacting

cognitive, behavioral and motor functions (motor usually occurs last)

motor symptoms with huntingtons are

initially subtle and progress in a non-linear trajectory

motor sx for huntingtons include

chorea, decreased coordination with voluntary movement, bradykinesia/akinesia/dystonia, balance/gait disturbances, slurred speech/dyphagia

presymptomatic HD

carry HD-causing gene mutation but have not yet developed any symptoms

prodromal HD

subtle changes in cognition, mood and behavior appearing years before diagnosis or onset of motor signs - brain changes like striatal atrophy are apparent

manifest HD

HD with clear motor symptoms and a clinical diagnosis

chorea

excessive, sudden jerky movements (decreases with disease progression because patients lose overall mobility)

athetosis

slow, writhing, snake-like movement

cerebellum plays a crucial role in

motor learning - fine tunes muscle activity to ensure smooth coordinated movement

cerebellar dysfunction symtpoms

DANISH - dysdiadochokinea/dysmetria, ataxia, nystagmus, intention tremor, slurred sppech, hypotonia

dysdiadochokinesia

inability to complete rapid alternating movements

dysmetria

inaccurate movement, loss of control of speed or direction

ataxia

uncoordinated movement without muscle weakness

nystagmus

rapid eye movement

intention tremor

tremor is enhanced with movement (opposite of parkinsons tremor being more prevelant at rest)

diagnostic tests for cerebellar injuries

finger to nose test, heel to shin test (inability to control distance, speed, and ROM of coordinated movement)