The Cerebellum and its Disorders - Hardcover

Hardcover

ISBN 10: 0521771560 ISBN 13: 9780521771566

Publisher: Cambridge University Press, 2001

Synopsis

Recent years have seen major advances in the understanding of motor and nonmotor operations of the cerebellum, including its role in cognition, and important discoveries in the genetics of the cerebellar ataxias. This comprehensive text on the cerebellum and its disorders ranges from embryology and basic neuroanatomy to a thorough survey of the sporadic and hereditary disorders of the cerebellum. Models of cerebellar function and clinical-pathophysiological correlations are thoroughly covered, and there is an extensive and authoritative review of recent advances in the genetics of cerebellar diseases. The chapters are written by the leading international authorities on the cerebellum.

About this title

Book Description:

This is a comprehensive text on the cerebellum and its disorders. It ranges from embryology and basic neuroanatomy to a thorough survey of the sporadic and hereditary disorders of the cerebellum. The chapters are written by the leading international authorities on the cerebellum, including many of those who made fundamental discoveries in the field. The first comprehensive text on the cerebellum to be published for many years, this book will be essential reading for a wide range of basic and clinical neuroscientists, neurologists and others studying or treating cerebellar disorders.

From The New England Journal of Medicine:

On the first page of this big book, the editors tell us that "there have been major advances in the understanding of motor and non-motor operations of the cerebellum." But one must read between the lines of this and other books that summarize our knowledge of the structure and function of the cerebellum. There is a secret lurking behind all of the words: we do not really know much about what the cerebellum does or how it does it. Everyone agrees that people and animals with cerebellar lesions have impaired movement, but there is no agreement among the authorities about why this should be so. Such ignorance is particularly frustrating because the cerebellum is so big and so obviously an important part of the brain. Although it represents only 10 percent of the weight of the brain, it contains more neurons than the rest of the brain put together. The essential embryology and cell types of the cerebellum have been known for over 100 years. The synaptic connections and some of the major transmitters have been known for more than 30 years. But there are still profound disagreements among the experts about how it all works. Some authors view the cerebellum as essentially a motor structure that initiates movement and adjusts reflexes. Others see it as an entirely sensory structure that uses sensory input to predict the sensory consequences of a motor act. Most treat the cerebellum as a sensory-motor link that receives sensory input and influences or guides motor output. There are disagreements among scientists and clinicians on specific as well as general questions. As the chapter on cerebellar histology makes clear, there are two completely different routes of afferent input to the cerebellar cortex -- the mossy fibers and the climbing fibers. Both are essential for normal functioning of the cerebellum. But there is no agreement among the experts as to the different functions of these totally disparate types of input. Some authors view the climbing-fiber input as essentially sensory. Others see the climbing fibers as providing input for the control of movement. Another fundamental question is that of localization. Do all parts of the cerebellum do the same thing? The book presents good clinical and experimental evidence of major differences in the functions of the midline and lateral cerebellum. But although there are interesting suggestions about possible cognitive functions of the massive cerebellar hemispheres in humans, the evidence remains controversial. The book deals with two related themes: experimental data and clinical information. The first chapters in the book summarize the state of our knowledge about the normal structure and function of the cerebellum. The remainder of the book deals with clinical problems. The cerebellum, like other regions of the brain, is subject to damage from tumors, strokes, toxic agents, and degenerative diseases. The book assembles an impressive list of authors, each of whom specializes in one or another aspect of cerebellar study. As in many multiauthored books, there is variation among the chapters. Some provide a good summary of the field that they cover, whereas others are rather sparse or emphasize the particular approach of the author. One of the most useful and complete of the early chapters is the one by Bastian and Thach, who have written an excellent summary of the evidence -- based on both recordings from single cells in animals and the effects of regional ablation or inactivation of the cerebellar cortex or nuclei -- supporting a role for the cerebellum in behavior. Some of the other chapters are not quite as valuable. The chapter on the embryology of the cerebellum, although accurate, is regrettably very brief. Three pages cannot do justice to this fascinating story. The chapter on magnetic resonance imaging is rather specialized and is more a presentation of the authors' own approach than a summary of the field. There have been many attempts to model the functions of the cerebellum, usually in engineering terms. Although the chapter on cerebellar models offers a useful summary of these approaches, the mode of presentation may tax the understanding of many readers. Most of the book's contents are more directly clinical. A number of clinical experts describe the effects of trauma, tumors, toxic agents, and degenerative diseases on the cerebellum. In many ways, our understanding of cerebellar functioning resembles the understanding of the cerebral cortex 150 years ago. At that time, the weight of scientific and clinical evidence was against the idea of localization of function in the cerebral cortex. The pioneering physiological studies of Gustav Fritsch and Eduard Hitzig on the role of the cerebral cortex in movement and the observation by Hermann Munk of visual deficits after ablation of the occipital cortex were essential steppingstones toward our modern, deeper understanding of the functions of the cerebral cortex. Localization was the first step. My hope is that with improvements in scanning resolution, clinical scientists will contribute to our understanding of the localization of functions in the human cerebellum as a first step toward a more complete understanding of the cerebellum in health and disease. Mitchell Glickstein, Ph.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About this edition

• Publisher: Cambridge University Press
• Publication date: 2001
• ISBN 10: 0521771560
• ISBN 13: 9780521771566
• Binding: Hardcover
• Edition number: 1
• Number of pages: 612
• Editor: Manto Mario-Ubaldo, Pandolfo Massimo