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CentralNervousSystemControlofMovementXING,GUOGANG(邢国刚),MD.Ph.D.北京大学神经科学研究所NeuroscienceResearchInstitute,PekingUniversityEmailaddress:ggxing@1精选课件Introduction生命在于运动……运动是动物维系个体生存和种族繁衍的基本功能之一2精选课件Howdoesacoordinatedmovementachieved?3精选课件Thementalbodyimageseemstobegeneratedbysomatosensory,proprioceptive,andvisualinputstotheposteriorparietalcortex(area5,area7)Abaseballpitcherplanningapitch…4精选课件Thehighestlevel-

strategyRepresentedbytheassociationareasofneocortexandbasalgangliaoftheforebrainIsconcernedwithstrategy:ThegoalofthemovementandthemovementstrategythatbestachievesthegoalThemotorcontrolhierarchyhavethreelevels5精选课件Themiddlelevel-tacticsRepresentedbythemotorcortexandcerebellumIsconcernedwithtacticsThesequencesofmusclecontractionsArrangedinspaceandtimeRequiredtosmoothlyandaccuratelyachievethestrategicgoalThemotorcontrolhierarchyhavethreelevels6精选课件Thelowestlevel-

execution

RepresentedbythebrainstemandspinalcordIsconcernedwithexecutionActionofthemotorneuronandinterneuronpoolsthatgeneratethegoal-directedmovementandmakeanynecessaryadjustmentsofpostureThemotorcontrolhierarchyhavethreelevels7精选课件Overview脊髓内的“下运动神经元(Lowerneurons)”,除了受到脊髓内局部环路的影响外,还受到大脑皮层运动区及脑干中许多“上运动神经元(Upperneurons)”的支配和协调基底神经节和小脑则向那些上运动神经元提供某种感觉、认知或感性的信息,使运动更加精确和协调8精选课件

9精选课件SensorimotorcortexBasalgangliaCerebellumBrainstemSpinalcordInterneuron

-MotorneuronMotorunit(finalcommonpathway)Receptorsmuscle,skin,joint12345Theseprogramsareaccessed,executed,andmodifiedbydescendingcommandsfromthebrainThebrain’scommandandcontrolofthemotorprogramsinthespinalcordThemotorsystemconsistsofallourmusclesandtheneuronsthatcommandthemThespinalcordcontainscertainmotorprogramsforthegenerationofcoordinatedmovementsThemotorcontrolcanbedividedintotwoparts:Thespinalcord’scommandandcontrolofcoordinatedmusclecontraction10精选课件Part1

SpinalControlofMovement11精选课件Introduction“runningaroundlikeachickenwithitsheadcutoff”

Therhythmicmovementscouldbeelicitedinthehindlegsofcatsanddogslongaftertheirspinalcordshadbeenseveredfromtherestofthecentralnervoussystem–CharlesSherington&GrahamBrown(English)Theimportanceofcircuitrywithinthespinalcordforthecoordinatedcontrolofmovements12精选课件Spinalcircuitry

controlofmovement13精选课件Spinalmotorneurons

Alphamotorneurons

Innervateskeletalmuscle(extrafusalmuscle)

Function:directlycommandmusclecontractGammamotorneurons

Innervatemusclespindle(intrafusalmuscle)

Function:regulatingthemusclespindleInterneurons

AllowscoordinatedmotorprogramstobegeneratedFinalcommonpathway(directlycommandmusclecontract)Compare:

UppermotorneuronsLowermotorneurons14精选课件TheLowerMotorNeurons

-AlphamotorneuronsAlphamotorneuronsaredirectlyresponsibleforthegenerationofforcebymuscleMotorunit:onealphamotor

neuronandallofthemusclefibersitinnervatescollectivelymakeupmotorunit,theelementarycomponentofmotorcontrolMotorneuronpool:Thecollectionofalphamotorneuronsthatinnervatesasinglemuscle15精选课件ThemotorunitisanalphamotorneuronandallofthemuscleAmotorunitandmotorneuronpoolThemotorneuronpoolisallofthealphamotorneuronsthatinnervateonemuscle16精选课件Muscleinnervationbylowermotorneurons30mixedspinalnervescervical1-8thoracic1-12lumbar1-5sacral1-5TheventralhornofthespinalcordcontainsmotorneuronsthatinnervateskeletalmusclefibersVentralroots+Dorsalroot=Spinalnerve17精选课件Thecervicalenlargementofthespinalcordcontainsthemotorneuronsthatinnervatethearmmuscles

Thelumbarenlargementcontainsneuronsthatinnervatethemusclesoftheleg

支配上肢的神经元集群位于颈膨大处,支配下肢的则在腰膨大处ThedistributionofmotorneuronsinthespinalcordThemotorneuronsthatinnervatedistalandproximalmusculaturearefoundmainlyinthecervicalandlumbar-sacralsegmentsofthespinalcordWhereasthoseinnervatingaxialmusculaturearefoundatalllevelsSegmentsC3-T1haveaswollenventralhornthatinnervateskeletalmusculatureinarmsSegmentsL1-S3haveaswollenventralhornthatinnervateskeletalmusculatureinlegs18精选课件Motorneuronscontrollingflexorsliedorsaltothosecontrollingextensors

Motorneuronscontrollingaxialmusclesliemedialtothosecontrollingdistalmuscles支配躯干部肌肉的神经元位于脊髓前角灰质最内侧,由此向外排列的神经元则支配肢体由近及远分布的肌肉Thedistributionoflowermotorneuronsintheventralhorn19精选课件Muscleweaknessandparalysis-所支配的骨骼肌瘫痪、肌张力下降、腱反射消失(软瘫)肌萎缩、纤维颤动或肌束颤动见于如肌萎缩侧索硬化症(amyotrophiclateralsclerosis,

ALS):Selectivedamagetoalphamotorneurons(degeneration)-脊髓-运动神经元的进行性溃变为主下运动神经元的损伤表现20精选课件LouGehrigFarewellSpeech:"Fans,forthepasttwoweeksyouhavebeenreadingaboutthebadbreakIgot.YettodayIconsidermyselftheluckiestmanonthefaceofthisearth.……SoIcloseinsayingthatImayhavehadatoughbreak,butIhaveanawfullottolivefor."LouGehring,astarbaseballplayerwithNewYorkYankees,whodiedofALS(amyotrophiclateralsclerosis)in193621精选课件InputstoalphamotorneuronsThisinputisimportantfortheinitiationandcontrolofvoluntarymovementThisinputmaybeexcitatoryorinhibitoryandispartofthecircuitrythatgeneratesthespinalmotorprogramsThisinputprovidesfeedbackaboutmusclelength22精选课件SPINALCONTROLOFMOTORUNITSHowtheactivityofthemotorneuronisitselfcontrolled?23精选课件ReflexReceptorEffectorSpinalMotorNeuron(center)SkinMuscleJointMusclecontractionHigherCenterVoluntarymovementsNociceptivestimulusStretchmusclesPosturemaintenance24精选课件Themyotaticreflex(stretchreflex)Twotypesofmyotaticreflex

-TendonreflexandmuscletonusA.Tendonreflex

—快速牵拉肌腱而发生的牵张反射Clinicapplication:了解脊髓不同节段的功能状态

reflexmothedCentralsiteeffect肘反射扣击肱二头肌肌腱颈5-7肘部屈曲膝反射扣击股四头肌肌腱腰2-4小腿伸直跟腱反射扣击跟腱腰5-骶2脚向足底方向屈曲单突触反射潜伏期很短,约0.7s只够一次突触传递时间延搁25精选课件+26精选课件B.Muscletonus

肌肉受到缓慢而持续的牵拉而发生的收缩-使骨骼肌能保持一定的肌肉张力意义:维持身体的姿势(posture),而不表现明显的动作

表现:extensor(伸肌)和flexor(屈肌)都发生肌紧张直立时,以伸肌紧张为主,因重力作用于关节,使关节趋向弯曲,伸肌受到牵拉,引起肌紧张反射,肌紧张度增加以对抗关节屈曲

因重力持续作用于关节,肌紧张也就持续发生。使直立姿势得以维持多突触反射潜伏期较长,经过多个突触传递27精选课件

Musclespindles:ConsistsofspecializedskeletalmusclefibersInthismiddleregion,groupIa

sensoryaxonswraparoundthemusclefibersofthespindleThespindlesandtheirassociatedIaaxons,specializedforthedetectionofchangesinmusclelength(stretch):proprioceptorsandpropriceptionIaaxonsarethethickestmyelinatedaxonssotheyconductactionpotentialsveryrapidlyIaaxonsenterthespinalcordviathedorsalroots,branchrepeatedly,andformexcitatorysynapsesuponbothinterneuronsandalphamotorneuronsoftheventralhornsProprioceptionfrommusclespindlesMusclespindle

是一种可感受肌肉长度变化或感受牵拉刺激的本体感受器梭内肌感受部装置位于中间,收缩成分位于两端,梭内肌收缩时或牵拉梭外肌时,感受装置对牵拉敏感性增高

28精选课件+29精选课件GammamotorneuronsExtrafusalfibersareinnervatedbyalphamotorneuronsIntrafusalfibersreceivetheirmotorinnervationbyanothertypeoflowermotorneuroncalledagammamotorneuronGammamotorneuronsinnervatetheintrafusalmusclefiberatthetwoendsofthemusclespindleActivationofthesefiberscausesacontractionofthetwopolesofthemusclespindle,therebypullingonthenon-contractileequatorialregionandkeepingtheIa

afferentsactive30精选课件ThefunctionofgammamotorneuronsActivationofalphamotorneuronsshortenstheextrafusalmusclefibers.Ifthemusclespindlebecomesslack,itgoes“offtheair”andnolongerreportsthelengthofthemuscleActivationofgammamotorneuronscontractsthepolesofthespindle,keepingit“ontheair”31精选课件TheGammaloopChangingtheactivityofthegammamotorneuronschangesthesetpointofthemyotaticfeedbackloopTheGammaloopGammamotorneuron

intrafusalmusclefiberIaafferentalphamotorneuronextrafusalmusclefibersAlphaandgammamotorneuronsaresimultaneouslyactivatedbydescendingcommandsfromthebrain32精选课件ProprioceptionfromGolgitendonorgansGolgitendonorganActslikeastraingauge,itmonitorsmuscletension,ortheforceofcontractionLocatedatthejunctionofthemuscleandthetendonandareinnervatedbygroupIbsensoryaxonsthatareslightlysmallerthantheIaaxonsinnervatingthemusclespindles33精选课件GolgitendonorgansrespondtoincreasedtensiononthemuscleandtransmitthisinformationtothespinalcordviatypeIbsensoryafferents.Becausetheactivatedmuscledoesnotchangelength,theIaafferentsremainsilentinthisexample当肌肉等长收缩时,腱器官传入冲动频率,肌梭传入冲动频率不变;当肌肉等张收缩时,腱器官传入冲动频率不变,肌梭传入冲动频率Golgitendon

organslieinseriesbetweenthemusclefibersandtheirpointsofattachmentMusclespindlesarearrangedparalleltotheextrafusalfibers34精选课件TheIbafferentsenterthespinalcord,branchrepeatedly,andsynapseoninterneuronsintheventralhornSomeoftheseinterneuronsforminhibitoryconnectionswiththealphamotorneuronsinnervatingthesamemuscle.ThisisthebasisforthereversemyotaticreflexCircuitryofthereversemyotaticreflex+-Musclespindlesituatedinparallelwiththemusclefibers,GolgitendonorgansaresituatedinseriesIaactivityfromthespindleencodesmusclelengthinformationWhileIbactivityfromtheGolgitendonorganencodesmuscletensioninformation腱器官是张力感受器,其传入冲动对同一肌肉运动神经元起抑制作用肌梭是长度感受器,其传入冲动对同一肌肉运动神经元起兴奋作用当肌肉被动牵拉时,二者传入冲动频率均:首先兴奋肌梭发动牵张反射,肌肉收缩,牵拉力大到一定程度,兴奋腱器官而抑制牵张反射牵张反射的特点:反射弧简单,感受器和效应器在同一块肌肉35精选课件SignificanceofthereversemyotaticreflexInextremecircumstances,thisreflexarcprotectsthemusclefromoverloadThenormalfunctionistoregulatemuscletensionwithinanoptimalrangeAsmuscletension

increases,theinhibitionofthealphamotorneuronslowsmusclecontractionAsmuscletensionfalls,theinhibitionofthealphamotorneuronisreduced,andmusclecontractionincreasesThistypeofproprioceptivefeedbackisthoughttobeparticularlyimportantfortheproperexecutionoffinemotoracts,suchasthemanipulationoffragileobjectswiththehands,whichrequireasteadybutnottoopowerfulgrip36精选课件SpinalinterneuronsMostoftheinputtothealphamotorneuronscomesfrominterneuronsofthespinalcordInterneuronsreceivesynapticinputfromprimarysensoryaxons,descendingaxonsfromthebrain,andcollateralsoflowermotorneuronaxonsTheinterneuronsarethemselvesnetworkedtogetherinawaythatallowscoordinatedmotorprogramstobegeneratedinresponsetotheirmanyinputs37精选课件Reciprocalinhibitionofflexorsandextensorsofthesamejoint+++-InhibitoryinputContractionofonesetofmusclesaccompaniedbytherelaxationoftheantagonistmusclesiscalled

reciprocalinhibitionReciprocalinhibitionisalsousedbydescendingpathwaystoovercomethepowerfulmyotaticreflex38精选课件(A

&Cfibers)ExcitatoryinputFlexorreflex:usedtowithdrawalimbfromanaversivestimulus,suchasthewithdrawalofyourfootfromthethumbtackThepainfibersenteringthespinalcordbranchprofusedlyandactivateinterneuronsinseveralspinalsegments.Thesecellseventuallyexcite

thealphamotorneuronsthatcontrolalloftheflexormusclesoftheaffectedlimb(andinhibitoryinterneuronsarealsorecruitedtoinhibitthealphasthatcontroltheextensors)++++Circuitryofthepolysynapticflexorreflex39精选课件Circuitryofthecrossed-extensorreflexSpinalcordIpsilateralextensorsinhibitedContralateralextensorsactivated(contract)Ipsilateralflexorsactivated(contract)ContralateralflexorsinhibitedIpsilateralkneejointclosesuptoremovefootfromtackContralateralkneejointopensuptosupportgreaterweight40精选课件ThegenerationofspinalmotorprogramsforwalkingHeadlesschickens;behaviorAcompletetransectionofacat’sspinalcordatthemid-thoraciclevelleavesthehindlimbscapableofgeneratingcoordinatedwalkingmovementsWhenyouwalk,youalternatelywithdrawandextendyourtwolegs

Whatisthemechanismtocoordinatethetiming?Thiscouldbedescendingcommandsfromuppermotorneurons?No!Thiscontrolisexertedfromwithinthespinalcord?Yes!41精选课件42精选课件CentralpatterngeneratorswithinthespinalcordThecircuitforthecoordinatedcontrolofwalkingmustresidewithinthespinalcordIngeneral,circuitsthatgiverisetorhythmicmotoractivityarecalledcentralpatterngenerators

Howdoneuralcircuitsgeneraterhythmicpatternsofactivity?Thesimplestpatterngenerators,aresingleneuronswhosemembranepropertiesendowthemwithpacemakerproperties(pacemakerneurons)43精选课件Rhythmicactivityinaspinalinterneuron(Pacemakerneuron)SomeneuronsrespondtotheactivationofNMDAreceptorswithrhythmicdepolarization(a)Intherestingstate,theNMDAreceptorchannelsandthecalcium-activatedpotassiumchannelsareclosed(b)GlutamatecausestheNMDAreceptorstoopen,thecellmembranetodepolarize,andCa2+ionstoenterthecell(c)Theriseinintracellular[Ca2+]causestheCa2+-activatedpotassiumchannelstoopen.K+ionsleavetheneuron,hyperpolarizingthemembrane.ThehyperpolarizationallowsMg2+ionstoenterandclogtheNMDAchannel,arrestingtheflowofCa2+(d)As[Ca2+]falls,thepotassiumchannelsclose,resettingthemembraneforanotheroscillation44精选课件Apossiblecircuitforrhythmicalternatingactivity(walking)Walkingisinitiatedwhenasteadyinputexcitestwointerneuronsthatconnecttothemotorneuronscontrollingtheflexorsandextensors,respectively.Theinterneuronsrespondtoacontinuousinputbygeneratingburstsofoutputs.Theactivitiesofthetwointerneuronsalternatebecausetheyinhibiteachotherviaother(inhibitory)interneurons.Thus,aburstofactivityinoneinterneuronstronglyinhibitstheother(Pacemakerneuron)(Pacemakerneuron)45精选课件Part2

BrainControlofMovement46精选课件Howdoesthebraincommunicatewiththemotorneuronsofthespinalcord?47精选课件Overview来自高级中枢的下行投射对脑干和脊髓环路的运动控制主要影响随意运动和朝向目标的运动发出下行投射的中枢位于脑干某些部位以及大脑皮质的运动区域脑干内的两个主要结构-前庭核和网状结构对维持姿势很重要皮质主要运动区和次要运动区(运动前区)主要对运动进行计划并使运动高效率执行,皮质的这种作用是通过对脑干内的某些高级中枢以及脑干、脊髓中运动神经元和环路中间神经元的控制来完成的48精选课件Thedescendingspinaltractscontrolofmovement49精选课件ThedescendingspinaltractsControlpostureandunderbrainstemcontrolContolvoluntary

movementsofthedistalmusculatureandunderdirectcorticalcontrol50精选课件(Pyramidaltract)ControlfinemovementsofthearmsandfingersTheeffectsoflateralpathwaylesions(inmonkeys)-byDonaldLawrence&HansKuypers(inthelate1960s)TheLateralPathwaysXJoinincorticospinaltractinthelateralcolumnofthespinalcordTerminateinthedorsolateralregionoftheventralhornsandintermedialgraymatterWheremotorneuronsandinterneuronscontrolthedistalmuscles,particularlyflexorsInputfromfrontalcortexX51精选课件TheVentromedialPathwaysContainfourdescendingtracts

thevestibulospinaltractthetectospinaltractthepontinereticulospinaltractthemedullaryreticulospinaltract

Oringinateinthebrainstem

TerminateamongthespinalinterneuronsControllingproximalandaxialmusclesUsesensoryinformationaboutbalance,bodyposition,andthevisualenviromenttoreflexivelymaintainbalanceandbodyposture52精选课件Thevestibulospinalandtectospinaltractskeeptheheadbalanceontheshouldersasthebodymovesthroughspace,andtheyturntheheadinresponsetonewsensorystimuli(midbrain)RecivedirectinputfromretinaReciveprojectionsfromvisualcortex,aswellasafferentscarringsomatosensoryandauditoryinform

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