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Neuroanatomy
Published in Ibrahim Natalwala, Ammar Natalwala, E Glucksman, MCQs in Neurology and Neurosurgery for Medical Students, 2022
Ibrahim Natalwala, Ammar Natalwala, E Glucksman
ix – Anterior spinal artery. The ventral corticospinal tract lies alongside the ventral part of the spinal cord and is closely related to the anterior spinal artery, which perfuses two-thirds of the spinal cord, including this tract.
Leg Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
The corticospinal tract is the largest descending tract present in humans2 and is comprised of a lateral (85%) and an anterior (ventral) tract (15%) (Rea 2015). The lateral corticospinal tract sends fibers predominantly to the muscles of the extremities to control the voluntary movement of the limbs, and the cortical innervation is contralateral; in other words, the left motor cortex controls the right extremities. When a stimulus is engaged, the cell body of the lateral corticospinal tract will send an impulse through the tract that travels to the anterior horn of the spinal cord, proceeds through the spinal nerve root, plexus, and peripheral nerve, and is then transmitted via the lower motor neurons into the muscle fibers, resulting in contraction of the limb muscles. The anterior corticospinal tract sends fibers mainly to the trunk or axial muscles. The control is both ipsilateral and contralateral. Therefore, the trunk muscles are generally bilaterally cortically innervated.3
Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Microscopic pathology shows: Numerous, large pale (achromatic) ballooned neurons in the basal ganglia and the motor and premotor cortex (layers III, V, and VI). These are intensely neurofilament protein positive (NFP+). These are not specific for CBD, but are found less prominently in PSP, Pick's disease, frontotemporal dementia with parkinsonism linked to chromosome 17 (FTDP-17), and AD.Neuropil threads: numerous and widespread threadlike processes in gray and white matter in the cortex, cerebral white matter, internal capsule, striatum, thalamic fasciculus, cerebral peduncle, and pons (Figures 16.59–16.61).Globose NFTs in the substantia nigra, locus ceruleus, and raphe nuclei.Pick's body–like tau inclusions in the cortex (layers II and III).Astrocytic plaques in focal atrophic cortices.Coiled bodies in oligodendrocytes (tau-positive fibers coiled around nucleus).Corticospinal tract degeneration.
Exploring Clinical and Neurophysiological Factors Associated with Response to Constraint Therapy and Brain Stimulation in Children with Hemiparetic Cerebral Palsy
Published in Developmental Neurorehabilitation, 2022
Hsing-Ching Kuo, Jennifer Litzenberger, Alberto Nettel-Aguirre, Ephrem Zewdie, Adam Kirton
Additionally, a finding worth noting was that relative ipsilateral corticospinal tract status did not appear to be associated with responsiveness in this cohort (Figures 2 and Figures 3). Such corticospinal arrangements have consistently been associated with worse clinical function in HCP.9,10 Based on rudimentary models, the relative absence of cortical MEP contralateral to the affected limb was even considered a relative contraindication, leading to exclusion of such patients from the first rTMS trial in HCP.15 Yet Friel and colleagues42 recently reported no direct relevance between the corticospinal tract status and children’s improvement after intensive therapies. Given the conflicting findings among studies, a closer look into the potential underlying explanations is warranted through further and larger clinical trials.
Longitudinal Changes in the Sensorimotor Pathways of Very Preterm Infants During the First Year of Life With and Without Intervention: A Pilot Study
Published in Developmental Neurorehabilitation, 2021
Sonia Khurana, Megan E Evans, Claire E Kelly, Deanne K Thompson, Jennifer C. Burnsed, Amy D. Harper, Karen D. Hendricks-Muñoz, Mary S Shall, Richard D Stevenson, Ketaki Inamdar, Gregory Vorona, Stacey C Dusing
DTI metrics (FA and MD) and volume were calculated for five white matter regions of interest (ROIs): i) corticospinal tract (CST), ii) posterior limb of internal capsule (PLIC), iii) corona radiata (CR), iv) cerebral peduncles (CP), and v) cerebellar peduncles (CBP). In case of cerebellar peduncle we averaged superior, middle, and inferior cerebellar peduncle together to obtain one single value each for FA and MD. However, volume was derived by adding the values of all three regions together into one. The CST was chosen to be the primary region of interest based on its importance in the output of voluntary movement, as well as the extensive literature on CST dysfunction in preterm infants.25 Likewise, the PLIC is commonly used to predict the development of cerebral palsy based on the amount of myelination.26 Lastly, the corona radiata, cerebral peduncles, and cerebellar peduncles (superior, middle, and inferior) were included based on their role in motor learning and motor processing.27,28
Paired corticospinal-motoneuronal stimulation and exercise after spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Hang Jin Jo, Michael S. A. Richardson, Martin Oudega, Monica A. Perez
Spinal cord injury (SCI) can lead to devastating consequences predominantly resulting from impairment in motor function. To date, there is no medical treatment that improves recovery of motor function after SCI. Considering that SCI rarely results in a complete spinal cord transection,1 promoting neuroplasticity to strengthen residual connections is key to restoration of motor function. The corticospinal tract is a major descending pathway in the spinal cord that contributes to the control of voluntary movement.2 Therefore, interventions that successfully engage residual corticospinal neurons and strengthen the connections between corticospinal neurons and spinal motoneurons are crucial to increase corticospinal transmission to facilitate functional recovery. The conventional approach to promote plasticity following SCI is rehabilitative exercise training.3,4 While exercise training aims to drive neural networks in an activity-dependent manner to facilitate functional recovery,3,4 the functional gains remain limited.