Introduction to Motor Systems

ODonoghue PhD.
 Learning Objectives
1. General plan of how motor control is carried out by the CNS.
2. Compare and contrast the contributions of LMNs vs. UMNs
3. Understand the anatomy and function of lateral motor
systems.
4. Understand the anatomy and function of ventral medial motor
systems.
5. Describe the relationship between posturing reflexes and the
functioning of UMN pathways.
6. Describe the general functions of cortical regions involved in
motor control.
7. Understand motor symptoms which result from damage to
motor cortices.
1.Overview of Motor System
1. General organization of the
Motor system

Fig. 19.1 Essential Neuroscience Sigel and Sapru, LWW 2006

 1.Intro
The brain influences activity of the spinal cord
Voluntary movements
Hierarchy of controls
Highest level: Strategy
Middle level: Tactics
Lowest level: Execution
Sensorimotor system
Sensory information used by all levels of the motor
system
The Basics: division of CNS into gray
matter and white matter
Gray matter contains
Interneurons, projection
neurons, motor neurons,
and endings of sensory
fibers and fibers arriving
from other parts of CNS
White matter contains
Ascending & Descending
pathways
 The Basics: Histology of Motor
Six layers
Cortex
Granule cells
External & internal
Receive information mainly from thalamus and other
regions of cortex
Pyramidal cells
External & internal
Origins of efferent pathways of cortex
In motor regions- pyramidal cell layers are of much
greater size than the granule cell layers, and reverse
holds true for sensory regions
Molecular Layers
of Cerebral
Cortex

Six layers:
1 is outermost &
6 is deepest
layer

9
 Motor tracts
Can be divided in two ways

Descending Lateral pathways

Descending Ventro medial pathways
Or
Descending Pathways from Cortex
Descending Pathways from Brainstem
 Descending Spinal Tracts
Axons from brain and brainstem descend along two
major pathways
(A) Lateral Pathways
(B) Ventromedial Pathways
 Descending Pathways
(A) From Brain= 2 pathways!

(B) From Brainstem = 6 pathways!

 (A) Descending Pathways
Two pathways that descend from cerebral
cortex to spinal cord
1) Corticospinal tract
2) Corticobulbar tract
 1) Corticospinal tract
Corticospinal tract
(pyramidal tract)
Voluntary movement -
originates in cortex

Note : Rubrospinal tract

functionally similar to CST
 The Effects of Corticospinal Lesions
Deficit in fractionated movement of arms and
hands
Paralysis on
(1) contralateral side: lesion above level of decussation
(2) ipsilateral: lesion below the level of decussation
Recovery if rubrospinal tract intact
Subsequent rubrospinal lesion reverses recovery
 CST Animation

http://www.youtube.com/watch?v=9BaWBGR
Vxp8
 Tracts
Pyramidal tracts
Lateral
corticospinal
Ventral
corticospinal

Cells of origin
Premotor, motor,
& sensory cortices
 Corticospinal Tract Trajectory
Gray matter of cortex

Posterior limb of Internal capsule

Middle 3/5th of crus cerebri

Pons

Medulla
Crossed- 90% lateral corticospinal tract
Uncrossed- 10%
8%- anterior corticospinal tract (ACT)
2%- anterolateral corticospinal tract (ALCT)
Corticospinal Tracts
are somatotopically
organised
 Homunculi
(Little humans)

Sensory Motor
 Origin of Corticospinal
(pyramidal) tract
Precentral gyrus [Primary
motor cortex (MI)- area 4]-
30%
Postcentral gyrus [Primary
somatosensory cortex (SI)-
areas 3, 1 & 2)- 40%
Supplemental motor area
(SMA) & premotor cortex
(PMA)- area 6- 30%
 Corticocortical connections
Essential for motor
functions of cerebral cortex
Include
Connections from posterior
parietal cortex (areas 5 and 7)
to premotor and
supplementary motor cortices
Connections from area 6
(supplementary and premotor
cortices) to primary motor
cortex (area 4), and
Connections from primary
somatosensory cortex (areas 3,
1, and 2) to primary motor
cortex.
 Cortical Clinical Correlations
Lesions to primary motor cortex
Initial paralysis and weakness
often due to stroke involving middle cerebral artery or
anterior cerebral artery
Lesions to supplementary motor cortex
reduced ability to coordinate actions on the two sides of
the body
Often akinesia difficulty initiating movement
Lesions to premotor cortex
Apraxia difficulty performing complex motor tasks such
as tying shoelaces despite intact motor and sensory tracts
 UMN/LMN
Primary motor cortex

Corona radiata

Internal capsule

Corticospinal fibers Upper Motor Neuron

UMN
Neurons descending from
cortex that innervate the
spinal neurons and
brainstem nuclei
LMN
Motor neurons in ventral
horn of spinal cord and in Lateral corticospinal tract
motor nuclei of cranial
nerves that directly
supply muscles
Lower motor neuron
 UMN Lesions
Spastic paralysis
Hypereflexia
Babinski response
(extensor plantar
response)
No wasting of muscles
Symptoms can be
contralateral (if lesion
is above decussation)
or ipsilateral (if lesion
is below decussation)
Normal Adult
Babinski test Babinski sign

This is the normal response for

infants up to 2 years of age
 LMN Lesions
Symptoms are
ipsilateral and occur
at level of lesion only
Hyporeflexia or
areflexia
Flaccid paralysis and
wasting of muscles
at the level of lesion pyramidal
Fibrillations and decussation

fasciculations X
X
Corticospinal Tracts in
Clinical Orientation
 Injury to corticospinal fibers at
different levels
Site of Injury Condition
Internal capsule Lacunar strokes
Rostral to pyramidal Vascular lesions:
decussation Medulla: Medial medullary
syndrome
Pons: Millard-Gubler syndromes
Midbrain: Weber syndrome
Decussation of pyramids Lesion in rostral portions
Lesion in caudal portions
Clinical features
C/L hemiparesis
May coupled with various CN
signs due to corticonuclear
(corticobulbar) fiber
involvement
All produces C/L hemiplegias
With I/L paralysis of tongue
(medulla), facial muscles or
lateral rectus muscle (pons) and
most eye movements
(midbrain)
B/L paresis of upper limb
B/L paresis of lower limb
 Injury to corticospinal fibers at
different levels continued
Site of Injury Condition Clinical features
Cervical cord U/L- (Brown-Squard syndrome) Hemiplegia (I/L upper &
lower extremities)
Features of UMN lesion
(hyperreflexia, spasticity, loss
of superficial abdominal
reflexes & Babinski sign)
B/L damage to cervical cord above Quadriplegia
C4C5
Thoracic cord U/L I/L monoplegia (lower
extremity)
B/L Paraplegia
 Brown-Squard Syndrome
Causes
Laterally placed tumors in the
spinal cord
gunshot
knife wound
Symptoms
I/L UMN paralysis & loss of
proprioception
C/L loss of pain and temperature
sensation
A zone of I/L LMN weakness and
analgesia
 Brown-Squard
Syndrome

At the level of lesion

= LMN lesion symptoms

Below the level of lesion

= UMN lesion symptoms
 2) Corticonuclear
(Corticobulbar) Fibers
 2) Corticonuclear (Corticobulbar)
Fibers
UMNs
Origin
Frontal eye fields (areas 6 & 8 in caudal portions of
middle frontal gyrus)
Occupy caudal portions of anterior limb of internal
capsule
Precentral gyrus (area 4)
Occupy genu
Postcentral gyrus (areas 3, 1, and 2)
Occupy most rostral portions of posterior limb
 Make synaptic contact direct or indirect (via interneurons
in reticular formation) with all cranial nerves motor
nuclei
Innervate CN motor nuclei bilaterally
Exceptions-
(i) C/L innervation of motor nucleus of
CN VII (Ventral cell group)
Supply muscles of lower quadrants of face (below
the eyes)
CN XII
Supply Genioglossus muscle
(ii) I/L innervation of motor nucleus of
CN XI
Supply trapezius and sternocleidomastoid
Corticonuclear (Corticobulbar)
Fibers in Clinical Orientation
 Injury to corticobulbar fibers
Site of Injury Condition Clinical features
Internal capsule U/L C/L deficits (Predominantly)
(Genu)
No effect on muscles of mastication (input on Trig
motor nucleus is B/L)

C/L paralysis of lower facial muscles

Upper facial muscles normal (B/L innerv by cortex)

Nucleus Ambiguous: Dysphagia, dysarthria, I/L

deviation of uvula on phonation, hoarseness.

Hypoglossal nucleus: Deviation of tongue C/L side

Accessory nucleus (C1-C5): Unable to rotate head on

C/L side against resistance
Unable to elevate shoulder on I/L side against
resistance.
Facial weakness/paralysis due to unilateral LMN
lesion
Facial nucleus LMNs
that project to lower
face receive
contralateral UMN
innervation
Facial nucleus LMNs
that project to upper
face receive bilateral
UMN innervation
 Bells Palsy

Compression/inflammation of
the facial nerve/nucleus
results in Bells palsy
loss of motor control from
ipsilateral face
A LMN disorder

Which side of the face is affected

in the patient shown?
 Supranuclear (Cranial Nerve VII) palsy

a unilateral lesion of
the facial region of
primary motor cortex
results in a central
seven
loss of motor input to
the lower portion of the
contralateral face
An UMN disorder
Facial weakness/paralysis due to unilateral UMN
lesion (Supranuclear -Cranial Nerve VII - palsy)
 Hypoglossal Nerve (CN XII)
UMN input to CN XII nucleus is from contralateral cortex
Normally tongue presents medially upon protrusion
a lesion of one hemisphere (i.e. UMN lesion) results in tongue
deviation away from the lesioned side

Accessory Nerve (CN XI)

UMN input to CN XI nucleus is from ipsilateral cortex
a lesion of one hemisphere (i.e. UMN lesion) results in:
(i) Unable to rotate head on C/L side against resistance
(ii)Unable to elevate shoulder on I/L side against resistance.
 Trigeminal Nerve (CN V)
UMN input to CN V nucleus is bilateral with a contralateral
predominance
Normally muscles of mastication
a lesion of one hemisphere (i.e. UMN lesion) results in No
Deficit!! i.e. compensation!

Vagus Nerve (CN X)

UMN input to CN X nucleus (nucleus ambiguous) is bilateral

with a contralateral predominance
Normally uvula presents medially upon phonation
a lesion of one hemisphere (i.e. UMN lesion) results in uvula
deviation towards the lesioned side
 Descending Motor Systems From
Brainstem
Six pathways.
Tectospinal Tract
Reticulo-spinal Tract (RST)
Lat RST
Med RST
Rubrospinal Tract
Vestibulo-Spinal Tracts (VST)
Lateral VST
Medial VST
Tectospinal tract
 Reticulospinal tract
The Med (Pontine) and
Lat (Medullary)
Reticulospinal tract
Medial: enhances
antigravity reflexes
Lateral: liberates
antigravity muscles
from reflex
 Tectospinal &
Reticulospinal Tracts
Tract Origin Decussation Terminate Function

Tectospinal Tract Superior dorsal Cervical Sp C. Unknown; thought

colliculus tegmental Lamina VI, VII (VIII) to prod postural
decussation changes as a result
to visual stim.

Med Pons None All levels of Sp. C. Fas Vol. or cortically

RST (nucleus remains Lamina VIII (VII, IX) induced
reticularis pontis ipsilateral movements.
oralis and muscle tone
nucleus =actions on MNs
reticularis pontis
Reticulo- caudalis)
spinal Lat Medulla Medulla All levels of Sp. C. Inhib vol &
Tract RST (nucleus Partial Lamina VII (VI, VIII, cortically induced
(RST) reticularis decussation IX) movements.
gigantocellularis muscle tone by
further inhibiting
muscle spindle
activity =actions on
MNs
 Clinical Correlations
Isolated lesions of tectospinal & reticulospinal fibers
Never seen

Tectospinal fibers
Project to upper cervical levels
Influence reflex movement of head and neck
Diminished or slowed in patients with damage to these
fibers
 Medial reticulospinal fibers (Pontoreticulospinal
fibers)
Excitatory to extensor motor neurons and to
neurons innervating axial musculature
Some fibers may inhibit flexor motor neurons

Lateral reticulospinal fibers (Bulboreticulospinal

fibers)
Inhibitory to extensor motor neurons and neurons
innervating muscles of neck and back
Some fibers also may excite flexor motor neurons
 Reticulospinal (and vestibulospinal) fibers contribute
to spasticity that develops in patients having lesions
of corticospinal fibers

Reticulospinal & vestibulospinal fibers also

contribute to tonic extension of arms and legs seen
in decerebrate rigidity
 Rubrospinal &
Vestibulospinal Tracts
Vestibulospinal tract
Rubrospinal Tract
Tracts Origin Decussation Terminate Function
Rubrospinal tract caudal Midbrain Cervical cord Facil. MNs that
magnocellular (ventral (predominantly) innervate flexor
part of the red tegmental Lamina V-VIII muscles
nucleus, decussation) Functionally parallel
to CST
Lat VST lateral None All levels of Cord Facil and MNs
vestibular Lamina VII and that innervate
nucleus of the VIII extensor muscles.
medulla Maintain posture
Modulated by act.
of vestibular
apparatus or
cerebellum
Vestibulo
-Spinal
Med VST medial partially Cervical cord Cause rotation &
Tracts
vestibular crosses to the Lamina VII and lifting of head as
(VST)
nucleus, lateral C/L in the VIII well as rotation of
vestibular medulla shoulder blade.
nucleus and Produces changes
inferior in posture and
vestibular balance
nucleus
 Clinical Correlations
Isolated injury to rubrospinal & vestibulospinal fibers
Not seen
Deficits in fine distal limb movements seen
These deficits are overshadowed by hemiplegia associated
with injury to adjacent corticospinal fibers
Contralateral tremor seen in patients with the Claude
syndrome (a lesion of medial midbrain) is partially related
to damage to red nucleus as well as the adjacent
cerebellothalamic fibers
Paucity of most eye movement on ipsilateral side and
mydriasis
Due to concurrent damage to exiting rootlets of
oculomotor nerve
 Medial vestibulospinal fibers
Primarily inhibit motor neurons innervating extensors
and neurons serving muscles of back and neck

Lateral vestibulospinal fibers

May inhibit some flexor motor neurons, but they mainly
facilitate spinal reflexes via their excitatory influence on
spinal motor neurons innervating extensors
Vestibulospinal and reticulospinal fibers contribute to
spasticity seen in patients with damage to corticospinal
fibers or to tonic extension of extremities in patients
with decerebrate rigidity
 Clinical Orientation:
Rubrospinal,
Reticulospinal, and
Vestibulospinal Fibers
Decerebrate Vs Decorticate Rigidity
Decerebrate Rigidity Decorticate Rigidity
Damage: Brain including Damage: Brain above
midbrain area (MR, LV midbrain (Rubrospinal
intact!) intact!)
Symptoms: Symptoms:
Extensor Posturing Flexor Posturing
(All limbs extended) (Arms flexed and adducted)
Jaws clenched Legs and often trunk
Neck retracted extended
Spinal Control of Muscles
 Introduction
Motor Programs
Motor system: Muscles and neurons that control
muscles
Role: Generation of coordinated movements
Parts of motor control
Spinal cord coordinated muscle contraction
Brain motor programs in spinal cord
 The Somatic Motor System
Types of Muscles
Smooth: digestive tract,
arteries, related
structures
Striated: Cardiac (heart)
and skeletal (bulk of
body muscle mass)
 Lower Motor Neurons
Somatic Musculature
and distribution of
lower motor neurons in
spinal cord
Axial muscles: Trunk
movement
Proximal muscles:
Shoulder, elbow, pelvis,
knee movement
Distal muscles: Hands,
feet, digits (fingers and
toes) movement
 Lower Motor Neurons
Distribution of lower
motor neurons in the
ventral horn
Motor neurons
controlling flexors lie
dorsal to extensors
Motor neurons
controlling axial muscles
lie medial to those
controlling distal muscles
 Lower Motor Neurons
Inputs to Alpha Motor
Neurons
 Lower Motor Neurons
Types of Motor Units
Red muscle fibers: Large number of mitochondria
and enzymes, slow to contract, can sustain
contraction
White muscle fibers: Few mitochondria, anaerobic
metabolism, contract and fatigue rapidly
Fast motor units: Rapidly fatiguing white fibers
Slow motor units: Slowly fatiguing red fibers
 Spinal Control of Motor Units
The Myotatic Reflex
Stretch reflex: Muscle pulled tendency to pull
back
Feedback loop
Monosynaptic
e.g., Knee-jerk reflex
 Spinal Control of Motor Units
Gamma Motor neurons
Innervate intrafusal fibres
Regulates sensitivity of muscle spindle so
sensitivity can be maintained during contraction
 Spinal Control of Motor Units
Golgi Tendon Organs
Reverse myotatic reflex function: Regulate muscle
tension within optimal range
 Spinal Control of Motor Units

Proprioception from the joints

Proprioceptive axons in joint tissues
Respond to angle, direction and velocity of
movement in a joint
Information from joint receptors: Combined with
muscle spindle, Golgi tendon organs, skin
receptors
Most receptors are rapidly adapting, bring
information about a moving joint
 Spinal Control of Motor Units

Spinal Interneurons
Synaptic inputs to spinal interneurons:
Primary sensory axons
Descending axons from brain
Collaterals of lower motor neuron axons
Other interneurons
 Spinal Control of Motor Units

Inhibitory Input
Reciprocal inhibition: Contraction of one muscle
set accompanied by relaxation of antagonist
muscle
Example: Myotatic reflex
 Spinal Control of Motor Units

Excitatory Input
Flexor reflex: Complex
reflex arc used to
withdraw limb from
aversive stimulus
 Spinal Control of Motor Units

Excitatory Input
Crossed-extensor reflex:
Activation of extensor
muscles and inhibition of
flexors on opposite side
 Spinal Control of Motor Units

Generating Spinal Motor Programs for Walking

Circuitry for walking resides in spinal cord
Requires central pattern generators

Spinal control of movement

Sensation and movement linked!!
Direct feedback
Intricate network of circuits
 Summary
Motor System
Influenced by Association cortex, Basal ganglia and
Cerebellum via thalamus
Descending tracts (Lateral and ventromedial)
2 brain pathways
6 brainstem pathways
Clinical correlations
Spinal cord control of muscles
Somatic Motor System
LMNs: Motor unit, Motor pools, Alpha and Gamma
Spinal control of motor units
Reflexes: Stretch, Flexor, Crossed extensor.