Cerebral Palsy

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From the course by The University of Chicago

Understanding the Brain: The Neurobiology of Everyday Life

822 ratings

The University of Chicago

Understanding the Brain: The Neurobiology of Everyday Life

822 ratings

Learn how the nervous system produces behavior, how we use our brain every day, and how neuroscience can explain the common problems afflicting people today. We will study functional human neuroanatomy and neuronal communication, and then use this information to understand how we perceive the outside world, move our bodies voluntarily, stay alive, and play well with others.

From the lesson

Neuroanatomy

Neuroanatomy tells us how the nervous system is organized. Understanding the form of the brain is essential to understanding its function. By comparing the structure of the brain with a patient's symptoms, neurologists are able to identify the location of certain disorders. Studying how the human brain develops provides insight to why it is organized as it is. This module, you will learn about how the brain develops during gestation, some major pathways in the nervous system, and what can go wrong!

Introduction to Neuroanatomy7:47

Neural Tube Formation5:28

Neural Tube Defects10:57

Brain Vesicles8:00

Expansion of the Cerebral Cortex12:11

Two Forebrain Tracts8:32

Cerebral Palsy9:36

Meet the Instructors

Peggy Mason
Professor
Neurobiology

[MUSIC]

Okay, development does not end once we have a structure that looks brainish.

Once we have the brain, development continues for quite a while.

There are a few things that have to happen.

First of all, we still have to make more cells.

As you saw, the telencephalon and the cerebral cortex takes a lot of cells and

those cells are continuing to be made up until birth.

And then, in the hind brain about half of

all the neurons in the brain are contained in the cerebellum.

And those neurons get born primarily after birth.

So for several years after birth babies are making the neurons for the cerebellum.

No surprise that a five-month-old is not as coordinated as a ten year old or

an adult because the cerebellum is simply not even structurally complete.

Once all the neurons are made and

the structure's complete, development still is not over.

Because we have to hook up the brain correctly.

We have to get the physiology correct.

We have to make sure that the right neurons are talking to the right audiences

and we do that through the general way that the nervous

system does this is to make lots and lots of connections, exuberant connections,

and then prune them back, take away some.

So you make a lot, you decide which ones are good, strengthen those and

let the weaker ones, the less useful ones die back.

It's called synaptic pruning.

And they might start, we might with all of these inputs.

A blue input, a yellow or orange input and the yellow input, and

then with some amount of time these are going to die back,

and now this neuron is only going to be listening to this neuron, to this input.

So how does that make a difference?

Well, there are several diseases that where

a disorder of synaptic pruning or synaptic pruning does not occur normally and

that produces a dysfunction or condition and

one of them is autism.

Autism is thought to have a contribution.

One of the problems in autism is thought to be a problem with synaptic pruning.

Another one is cerebral palsy.

And cerebral palsy is pretty darn common.

It effects roughly two out of a thousand kids.

And so I thought it would be useful just to go into that a little bit more.

Now what we have here is just a schematic or

the cortico spinal tract, we talked about that in the last segment I believe.

So this is the tract that carries motor information from the cerebral hemisphere

down to the spinal cord to a motor neuron that then innovates a muscle.

So Simon says raise your hand.

That information has to go from the other side.

So if I want to raise my right hand, information has to come from left

hemisphere to my right spinal chord to a motoneuron in my right spinal chord and

then out to a muscle on the right side of my body in my arm.

But that's not how it starts,

it actually starts with input from both sides,

from both the left and the right motor cortex project to the motoneuron.

They're both telling the motoneuron what to do.

In normal individuals,

this same side input starts to die back during development.

And then by the time the child is out of being

a toddler this is now retreated and is no longer.

This motoneuron is getting one input instead of two inputs.

It started with two but there's a synaptic pruning so

now it only listens to one drummer.

It only listening to the correct side, the motor context.

This is the normal situation, in the situation with cerebral palsy,

there are variety of type of cerebral palsy.

But in one type called spastic cerebral palsy which is due to

injuries to the motor cortex.

What happens is that these motoneurons receive input from

neurons in both sides, and that persists, it never goes away.

So this is the start and this is in the adult.

In the adult with cerebral palsy,

the motoneurons are getting input from both sides, both sides of the cortex.

And the result is that the circuits down in the spinal cord and

even the muscles change their properties and

there are enduring permanent changes that occur in motor function.

So the important thing about understanding

cerebral palsy is that it is a developmental disorder.

It happens during development, but

it is not a progressive disorder, it does not change.

Once the initial insult has happened, it is a permanent disorder.

The implications of the problem may change across the lifecycle,

but the actual neural changes don't change.

Pseudo palsy is only a deficit in any of the motor circuits.

So it can be for example most commonly perhaps damage to motor cortex.

But it could also be damage to vassal ganglia.

It could be damage to cerebellum, produce other types of cerebral palsy.

Cerebral palsy can produce, can have a severity that ranges from very mild,

almost imperceptible to completely debilitating or

very debilitating, challenging shall we say.

So probably the most common form of spastic

cerebral palsy is a scissoring gait, and all it is is this.

Is that the two Legs come, are what are called abducted, they're brought in.

And so the gait's off, but these people can get around.

And notably, in this and other forms of cerebral palsy,

there is no necessary impairment in intellectual ability.

You can have a bigger insult to the brain that does produce

intellectual impairment but the default is, the typical situation

is that a person with cerebral palsy does not have an intellectual disability.

In this case the only problem, the only non-typical

Issue that a person with scissoring gait has is this abnormal gait.

And on the other hand, it can be extremely debilitating.

It can make a person depend on a wheelchair, for example, for mobility.

And this is one of our wonderful MOOC students from couple sessions ago.

And Laura has cerebral palsy.

And I show this picture simply because Laura is an example of a person with

severe cerebral palsy who's living a fabulous life and having a good time.

I'm in radio contact with her and she's a happy person.

So this diseases are the profound and

yet they don't need to define a person's take on life.

Okay, great, so that pretty much does it for

development and we're going to move on and look at neuroanatomy.

[MUSIC]

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