Basal nuclei (ganglia) &

Cerebellum
Dr Yasrul Izad Abu Bakar
Medical Faculty, UniSZA

Strictly for intructional use only

 Learning outcomes
Basal nusclei:

Describe the basal nuclei and their connections

Cerebellum:
1. Describe the gross anatomical features of the cerebellum

2. List the deep nuclei of cerebellum

3. State the connections of cerebellum

4. Discuss the clinical aspects

 Introduction (motor function)
• Normal movement (motor function) is produced by
complex interaction of basal nuclei, cerebellum &
cerebral cortex

• Cerebral cortex involved in planning & execution of

voluntary movement

• Although voluntary movement signals originate in

the cerebral cortex, they are modulated by a variety
of subcortical structures

• One such group of structures is the basal nuclei and

their functionally associated cell groups.

• Basal nuclei initiate motor activity & modulate

cortical output related to motor function

• Cerebellum coordinates the movement

• Cerebellum & basal ganglia influence the motor

activity at subconscious level
 Basal nuclei (ganglia)

Describe the basal nuclei and their

connections
 Introduction: basal nuclei
Basal
nuclei

Is a collection of masses
of gray matter that
involved in motor
function embedded
deep in cerebrum*
(close to the basal aspect of cerebrum)

Horizontal sections
through cerebrum
 Basal nuclei: components
The basal ganglia consist: Corpus
striatum

Nuclei embedded deep in cerebrum:

Corpus striatum
1. Caudate nucleus
2. Lentiform nucleus

Related nuclei (clinical perspective):

Functionally connected to corpus striatum & produce
movement disorders if damaged (thalamus, nucleus accumbens
& amygdala do not produce movement disorder if damaged)

1. Substantia nigra*
Horizontal sections
2. Subthalamic nucleus* through cerebrum
 Cross section of cerebrum
showing the corpus striatum
 Nuclei related to corpus
striatum
• Nuclei functionally
close to corpus
striatum / basal
nuclei:
1. Subthalamic nuclei
(component of subthalamus,
located in diencephalon)

2. Substantia nigra
(located in
midbrain/mesencephalon)
 Basal nuclei
• The term basal ganglia refers to a group of closely
connected cell masses extending from the base
of the telencephalon, via the central part of the
diencephalon, into the tegmentum of the
mesencephalon.

• This complex classically encompasses the corpus

striatum, the subthalamic nucleus and the
substantia nigra.
The Human Central Nervous System (2008). Springer, Berlin, Heidelberg
https://doi.org/10.1007/978-3-540-34686-9_14
 Components of basal ganglia

Corpus striatum
(caudate & lentiform / lenticular nuclei)
 Corpus striatum
Caudate
• Located lateral to thalamus nucleus

* Thalamus & amygdaloid nucleus do not produced

movement disorders when damaged (so not considered as
basal ganglia even though located deep in the cerebrum)

• Composed of 2 nuclei (divided by

internal capsule) :

1. Caudate nucleus
2. Lentiform nucleus
Lentiform
• Exhibits alternating stripes of gray Thalamus
nucleus

matter & white matter (corpus striatum =

“striped body”)
Horizontal sections
through cerebrum
 Corpus striatum
Caudate
nucleus

Caudate = “having a tail”

Lentiform = “shaped like a

biconvex lens” Lentiform
nucleus
 1. Caudate nucleus
• Is a C-shaped
structure
Body
• Subdivided:
1. Head Head
2. Body Lentiform
nucleus
3. Tail
Tail
• Located in the walls
of lateral ventricle
Caudate nucleus = green
 Lateral ventricle of the brain
• Two lateral Lateral ventricles

ventricles
 Caudate nucleus

Head
• Ventrally continuous
with putamen (of lentiform
nucleus) Lateral Caudate
ventricle nucleus
(head)

Location: Putamen

• Lateral to anterior
horn of lateral
ventricle
Horizontal sections
through cerebrum
Caudate nucleus
Body
• Long, curved
Lateral
ventricle
(body)
Location: Caudate
nucleus
(body)
• Inferior to body of
lateral ventricle

Coronal/vertical sections
through cerebrum
 Caudate nucleus
Tail
• Long, narrow

• Lies within the

lateral ventricle &
passing along the
roof of inferior
horn

• Extends into
temporal lobe as
amygdaloid
nucleus
 2. Lentiform nucleus
Anterior limbs
• Wedge-shaped of Internal
capsule Lentiform
nucleus

• Located: between insula

& limbs of internal Insula

capsule (IC)

• Separated from caudate

nucleus by ant. limb of IC

• Separated from
thalamus by post. limb Posterior
of IC limbs of
Internal
Thalamus capsule
 Lentiform nucleus
Putamen

• Composed of Lateral
medullary
1. Globus pallidus lamina
(medial)
2. Putamen (lateral)

• Putamen & globus

pallidus are divided
by lateral (external)
medullary lamina Globus
pallidus
 1. Globus pallidus
• Pale in fresh specimen
- due to high concentration of
myelinated nerve fibres GPl

• Divided into 2 segment by

internal medullary lamina:
i. Medial segment (GPm)
ii. Lateral segment (GPl)

*GPm: give rise to major output from

basal ganglia

GPm
 2. Putamen
Putamen

• Darker & lateral

• Rostral end connected

to head of caudate
nucleus by nucleus
accumbens (bridge-like
extensions of gray matter)

Putamen
Important terminology
Nuclei associated with basal
ganglia
i. Substantia nigra
ii. Subthalamic nuclei
 Substantia nigra
Is the largest nucleus of
midbrain
(mesencephalon)

• Consists of 2 parts:
i. Pars reticulata
ii. Pars compacta

• Have many
connections with:
- corpus striatum
Substantia
Substantia nigra = “black substance” nigra
 Substantia nigra
Pars compacta:
• Consists of pigmented dopamine neurons
(neuromelamin)
• Give rise to nigrostriatal dopaminergic
pathway (release dopamine to striatum)

Pars reticulata:
1. Consists neuron terminals arising from
midbrain which release serotonin
2. Striatonigral nerve terminals which
release GABA (receives input from striatum &
sends its GABA neurons to thalamus)

• Similar with GPm:

 Histologic characteristics
 Output nuclei
 Subthalamic nuclei
• Component of subthalamus
(diencephalon)

• Have many connections with:

i. globus pallidus
ii. substantia nigra

• Due to its interconnections

with the basal nuclei,
especially the globus
pallidus, the subthalamus
plays an important role in
somatomotor activity
Fundamental Neuroscience for Basic and Clinical Applications
(Fifth Edition) 2018, Pages 377-393.e1
Connections of basal ganglia
 Connections of basal ganglia
• The basal ganglia are
extensively interconnected
with various regions of
central nervous system (CNS)

• In general, the nuclei

component of basal ganglia
can be divided into 3
categories:
1. Input nuclei
2. Intrinsic nuclei
3. Output nuclei
 Input nuclei: striatum
• Include of: *striatum
1. Caudate nucleus
2. Putamen

• Receive input fibres from outside

basal ganglia (cerebral cortex, thalamus,
subthalamus, substantia nigra & brainstem)

• Excitatory input

• Then relay the information to

intrinsic or output nuclei

• Function in initiation &

modulation of gross voluntary
movements at subconscious level
 Intrinsic nuclei
• Include:
1. GPl
2. Subthalamic nucleus
3. Pars compacta of SN

• Interconnected by local
circuit
• Also connected with input &
output nuclei

• Function to position and

stabilize the trunk &
proximal limb muscles
(so that the distal limb muscles are able to
perform more discreet movements controlled by
motor cortex)
 Output nuclei
• Consist:
1. GPm
2. Pars reticulata of SN

• Project output to other area of

brain (involved in motor function: thalamus,
brainstem & cerebral cortex)

• Inhibitory (GABA)

• Function by influencing motor

activity by indirectly controlling
premotor & supplementary
motor areas of cerebral cortex
 Connections

Afferent fibres Efferent fibres

(to input nuclei) (from output
nuclei)
 Corticostriate Pallidonigral

 Thalamostriate Pallidothalamic

 Nigrostriate

 Brainstem
striatal
 Diagnosis?
• A 70 years old male came
with
1. resting tremor
2. bradykinesia (slowness)
3. stiffness
4. difficulty moving

• Symptoms improved with

levodopa
 Clinical application

• 2 general types of disorders of

basal nuclei

1. Hyperkinetic disorders
- excessive abnormal movements
- e.g. Huntington’s disease

2. Hypokinetic disorders
- lack or slowness of movements
- e.g Parkinson’s disease
 Huntington’s disease (HD)
• Autosomal dominant inherited
disease

• Single gene defect on

chromosome 4 (encodes a
protein, Huntington)

• Atrophy (degeneration) of basal

ganglia

• Symptoms: choreiform
movements (involuntary
movements of extremities &
twitching of face)
 Parkinson’s disease
• Most prevalent disorder related to
basal ganglia (1% over age 65)

• Degeneration of neurons in pars

compacta of substantia nigra

• Results: reduction in release of

dopamine in corpus striatum

• The 2 major neuropathologic findings in

Parkinson disease are loss of pigmented
dopaminergic neurons of the substantia
nigra pars compacta and the presence
of Lewy bodies and Lewy neurites.

• Symptoms: bradykinesia (slow in

initiating & executing voluntary
movements) , expressionless face
 Cerebellum
1. Describe the gross anatomical features of the
cerebellum

2. List the deep nuclei of cerebellum

3. State the connections of cerebellum

 Introduction: cerebellum
• Cerebellum influence the motor
activity at subconscious level

• Cerebellum functions in
coordination of movement

• Cerebellum plays key function in

motor activity related with
timing, speed & precision of
muscular activity (balancing,
walking, posture control etc.)
Cerebellum
 Cerebellum: location

Located in posterior cranial fossa

• Lies posterior to:

1. 4th ventricles
2. Pons
Cerebellum
3. Medulla oblongata (MO) Pons

• It is separated from occipital lobe MO

by tentorium cerebelli
 Cerebellum: Peduncles
• Cerebellum is connected to posterior
aspect of brainstem by 3 pairs of
prominent fibre bundles:

1. Superior cerebellar peduncle Superior C.P

– connect it with midbrain

2. Middle cerebellar peduncle (largest) Middle

– connect it with pons C.P

3. Inferior cerebellar peduncle

– connect it with medulla oblongata
Inferior C.P
 Cerebellum: surface
Folded surface resulting in the
formation of:
1. folia (ridges)
2. sulci (small depressions)
3. fissures (deep grooves)

• Each folium consists of thin

outer layer of gray matter
(contains cell bodies) & centre of white
matter (myelinated axon, neuroglia)

• The folding surface provides

great increase in surface area
of cerebellar cortex (85% of Folium Fissure
cerebellar cortex is hidden from the surface)

Cerebellum = “little brain”

 Cerebellum: fissures
• Most important fissures are:
Primary fissure

1. Primary fissure (separating

anterior lobe from posterior lobe)
Anterior
lobe
2. Horizontal fissure (separate
posterior lobe into 2 regions)

Posterior
3. Posterolateral fissure lobe
(separate posterior lobe from
flocculonodular lobe)

Horizontal fissure
 Cerebellum: fissures

• These fissures divide cerebellum into 3 lobes

 Subdivision of Cerebellum
A) Anatomic subdivision
1. Lobe subdivision
1) Anterior
2) Posterior
3) Flocculonodular

2. Longitudinal zone
1) Vermis
2) Paravermal zone
3) Lateral hemispheric zone

B) Functional subdivision
- vestibulocerebellum, spinocerebellum, cerebrocerebellum
 Cerebellum: lobes
Dorsal view
Primary
fissure
• Cerebellum has 3 lobes:
Anterior lobe

1. Anterior lobe
2. Posterior (middle) lobe Posterior lobe

3. Flocculonodular lobe
 composed of 2 flocculi & 1 nodulus
Flocculus nodulus
 located at the ventral surface of cerebellum

• These lobes can be further

divided into lobules Posterolateral
fissure

Ventral view
 Central lobule

Lobules Culmen

Declive

Folium

Lingula Central lobule

Tonsil

Uvula Pyramid
Lobules of cerebellum
 Cerebellum: zones
Cerebellum can be divided into 3
longitudinal zones:
1) Vermis (median)
2) Paravermal (intermediate)
• medial strip of cerebellar hemisphere
adjacent to vermis (1-2 cm on either side of
vermis) 1
3) Hemispheric (lateral) 3 2
• lateral part of cerebellar hemisphere
 Functional division of cerebellum
Based on specific functions & connections,
cerebellum can be divided into 3 functional
divisions:

1) Cerebrocerebellum
 Corresponds to hemispheric zone

2) Spinocerebellum
 Corresponds to vermis & paravermal
zone

3) Vestibulocerebellum
 Corresponds to flocculonodular
lobe
 Cerebellum: internal features
Cerebellum consists of outer
layer of gray matter (cortex)
& a core of white matter
containing deep gray matter
(nuclei)

Cerebellar
Gray matter is found in 2 cortex
regions:

1. Cerebellar cortex
(surround the white matter)

2. Deep cerebellar nuclei

(embedded within white matter)

Deep cerebellar nuclei

 Deep cerebellar nuclei
From lateral to medial, they are:

1. Dentate
2. Emboliform
3. Globose
4. Fastigial nuclei
D- don’t
E- eat
G- greasy
F- food
 Deep cerebellar nuclei
Dentate nucleus
• largest
• has irregular shape of collapsed bag Globose Emboliform

Fastigial Dentate
Emboliform nucleus
• is larger single mass (compare to globose)

Globose nucleus
• consists of 2 or 3 small masses

Fastigial nucleus
• lies close to midline

*Emboliform & globose nuclei are collectively

known as interposed nuclei
 Deep cerebellar nuclei
• Are the main source of
cerebellar output

• Also receive input from:

1. Cerebellar cortex
2. Sources outside the
cerebellum (eg. Cerebral cortex,
spinal cord)
 Deep cerebellar nuclei
• Each deep cerebellar nucleus receive
input from specific area of the cerebellar
cortex:

1. Fastigial nucleus receives input from

the cortex of flocculonodular lobe
and vermis

2. Globose & emboliform

(interposed) nuclei receive input
from paravermal zone cortex

3. Dentate nucleus receive input from

lateral hemispheric zone cortex
 Cerebellum: white matter
• Greater part of cerebellum composed of
white matter a.k.a medullary centre

• White matter contains neuroglia and

myelinated axons.

• There are 3 categories of axons:

1. Intrinsic fibers
(arise from Purkinje cells of the cerebellar cortex and terminate
in deep cerebellar nuclei)

2. Afferent (input) fibers

(extra-cerebellar source and terminate in deep cerebellar
nuclei)

3. Efferent fibers
(originate from deep cerebellar nuclei and exit the cerebellum)
White matter
Connections of cerebellum
 Summary: afferent to cerebellum
• Cerebellum receive inputs from 3 main sources:
1) Cerebral cortex
- terminates in cerebrocerebellum
2) Spinal cord
- terminates in spinocerebellum
3) Vestibular system
- terminate in vestibulocerebellum

Cerebral cortex

Spinal cord Cerebellum

Vestibular apparatus
 Afferents from cerebral cortex

• Inputs from cerebral cortex are transmitted to

the cerebellum via:

1) Cortico-ponto-cerebellar pathway
- through pontine nucleus

Pontine
nucleus

Cerebral cortex Cerebro

cerebellum
Input from cerebral cortex
 Afferent from spinal cord

• Spinal cord sends inputs to cerebellum by 4 pathways:

1) Anterior spinocerebellar tract
2) Posterior spinocerebellar tract
3) Cuneocerebellar tract
4) Rostral spinocerebellar tract

• These tracts relay proprioceptive information from muscle,

tendons, joints and skin to the cerebellum

• These tracts terminate in the cortex of spinocerebellum (vermis &

paravermis) and also send collaterals to interposed nuclei
(ipsilateral)
• These fibers terminate in cerebellar cortex as mossy fibers
 Afferent from vestibular system

 Cerebellum receives input from

vestibular apparatus of inner
ear

 These fibers sends collateral to

fastigial nucleus and terminate
in the vestibulocerebellum as
mossy fibers (ipsilateral)
 Extra-cerebellar output (main)
Cerebral cortex

Thalamus
Dentate
Red
nucleus
Interposed
Reticular
nuclei
Fastigial
Vestibular
nuclei
Cerebellum
 Output from cerebellum
• The main output pathways include:

1. Interpositorubro pathway
2. Dentothalamic pathway
3. Fastigial vestibular pathway
4. Fastigial reticular pathway
 Efferent from the cerebellum
In general:

• All output is through axon of

the Purkinje cells

• Deep cerebellar nuclei provide

main extracerebellar output

• All efferents leave the

cerebellum through either
superior or inferior cerebellar
peduncle (not middle cerebellar
peduncle)
 Cerebellum: peduncles
• Cerebellar peduncles are the only way
whereby nerve fibres enter or exit the
cerebellum

1. Superior cerebellar peduncle Superior C.P

– connect it with midbrain

2. Middle cerebellar peduncle (largest) Middle

C.P
– connect it with pons

3. Inferior cerebellar peduncle

– connect it with medulla oblongata
Inferior C.P
 Superior Cerebellar Peduncle (SCP)
• Contains predominantly cerebellar efferent that originate
from dentate and interposed nuclei

• Main efferent pathways carry by SCP:

1. Dentothalamic pathway
2. Dentorubro pathway
3. Interpositothalamic pathway
4. Interpositorubro pathway

• SCP also carries afferent pathways to the cerebellum:

1. Anterior spinocerebellar tract
2. Tectocerebellar tract (from superior colliculus)
 Middle Cerebellar Peduncle:
pontocerebellar

• MCP connects cerebellum

to pons

• This peduncle consists of

almost entirely of afferent
pontocerebellar fibers
 Inferior Cerebellar Peduncle
This peduncle consists of 2
divisions:
1. Restiform body
• laterally located
• contains purely afferent system (from
spinal cord or medulla)

2. Juxtarestiform body
• smaller, medially located
• mainly efferent system (from
vestibulocerebellum)
 Inferior Cerebellar Peduncle
• Afferents to cerebellum via restiform body:
1. Posterior spinocerebellar
2. Rostral spinocerebellar
3. Cuneocerebellar
4. Olivocerebellar

• Efferents via juxtarestiform body:

1. fastigial vestibular fibers
2. fastigial reticular fibers

• Afferents via juxtarestiform body:

1. Vestibulocerebellar fibers
Connection tracts in Cerebellar Peduncles
Cerebellar Afferent Tract Efferent Tract
Peduncle
Superior Anterior spinocerebellar Dentothalamic
Rubrocerebellar Dentorubro
Tectocerebellar Interpositorubro
Interpositothalamic

Middle Pontocerebellar

Inferior Posterior spinocerebellar Fastigial vestibular

Rostral spinocerebellar Fastigial reticular
Cuneocerebellar
Olivocerebellar
Vestibulocerebellar
 Clinical application
A patient came to you with symptoms of:
• Swaying & falling to the right side
• Inability to coordinate movement on the right
side of limbs
 Clinical application
Cerebellar hemisphere syndrome
• May be due to tumour

• Cerebellar disorders have numerous causes,

including congenital malformations, hereditary
ataxias, and acquired conditions

• The signs & symptoms involve muscle on the

side of disease cerebellar hemisphere

Symptoms include:
• Symptoms vary with the cause but typically
include ataxia (impaired muscle coordination).
• Swaying & falling to the side of lesion
• Inability to coordinate movement
Other causes of Cerebellar hemisphere
syndrome
Congenital malformations
• Dandy-Walker malformation (cystic enlargement of the 4th ventricle)

Hereditary ataxias
• Friedreich ataxia (autosomal recessive)
• Results from a gene mutation

Acquired conditions
• Acquired ataxias may result from nonhereditary neurodegenerative disorders (e.g.
multiple system atrophy), systemic disorders (e.g. alcoholism), multiple sclerosis,
cerebellar strokes, repeated traumatic brain injury, or toxin exposure (e.g. Carbon
monoxide, toxic level of anticonvulsants), or they may be idiopathic.

In children, primary brain tumors (medulloblastoma, cystic astrocytoma) may be the

cause; the midline cerebellum is the most common site of such tumors.
• A 30 year-old male came with
complaint of involuntary movement
of extremities.

• The patient has several siblings and

his mother (deceased) all of whom
are affected with this disease to
various degrees.
Huntington’s
disease:
Atrophy
(degeneration) of
basal ganglia (lateral
ventricles became
distended as result
of atrophy of
caudate nuclei)
 References:
1. Clinical Neuroanatomy. Snell, Richard S. 7th
edition. 2010. Lippincott Williams & Wilkins.

2. A textbook of neuroanatomy. Maria A.

Patestas. 4th edition. 2010. Blackwell
Publishing.

3. Atlas of Human Anatomy. 4th edition. 2006.

Frank H. Netter. Saunders Elsevier.