Canedo A
Departamento de Fisiología, Facultad de Medicina, Universidad de Santiago de Compostela. Santiago de Compostela, España.
Rev Neurol. 2003;36(5):438-52.
The pyramidal system is constituted by the cortical fibers reaching the bulbar pyramids at the level of the inferior Olive. Close to 75% of these fibers decussate terminating at bulbar level about half of them while the other half form the crossed corticospinal tract. The majority of the uncrossed fibers descend to the cord forming the direct corticospinal tract. This revision presents evidence demonstrating the functional heterogeneity of the pyramidal system.
The corticobulbar fibers are slower conducting and branch more than the corticospinal fibers. The conduction speed of the corticospinal fibers increases as they reach more caudal segments, thus assuring that the different signals modulating the inter segmental activity reach their targets simultaneously. Those from the somatosensory cortex end in the dorsal horn while those from the primary motor cortex end primarily on interneurons of the reflex pathways to distal limb muscles although in rats, primates and humans about 10% of them terminate directly on motoneurons.
The corticobulbar component of the pyramidal system selects the adequate motor synergies and modulates other descending systems to coordinate the activity of the distal musculature and the associated postural adjustments. The corticospinal component is functionally related to motor activities requiring accuracy, and to motoneuronal recruitment to adjust the contractile force. Both pyramidal subsystems modulate the processing and integration of the ascending somatosensory information generated by the movement itself.
锥体系统由到达延髓锥体(在下橄榄核水平)的皮质纤维构成。这些纤维中近75%发生交叉,约一半在延髓水平终止,另一半形成交叉的皮质脊髓束。大多数未交叉的纤维下行至脊髓,形成直接的皮质脊髓束。本综述展示了证明锥体系统功能异质性的证据。
皮质延髓纤维的传导速度较慢且分支比皮质脊髓纤维更多。皮质脊髓纤维到达更靠尾端的节段时,其传导速度会增加,从而确保调节节段间活动的不同信号能同时到达其目标。来自体感皮层的纤维终止于背角,而来自初级运动皮层的纤维主要终止于支配远端肢体肌肉的反射通路的中间神经元,不过在大鼠、灵长类动物和人类中,约10%的此类纤维直接终止于运动神经元。
锥体系统的皮质延髓部分选择适当的运动协同作用,并调节其他下行系统,以协调远端肌肉组织的活动及相关的姿势调整。皮质脊髓部分在功能上与需要精确性的运动活动以及与调节收缩力的运动神经元募集相关。锥体系统的两个子系统都调节由运动本身产生的上行体感信息的处理与整合。