En este episodio, realizo una síntesis de conocimiento y experiencia sobre el cerebelo y la ataxia, desde la anatomía y fisiología, describiendo la ataxia, hasta la evaluación y el tratamiento neurorrehabilitador. El objetivo es hilar el conocimiento anatómico y neurofisiológico con el aprendizaje motor y la plasticidad del cerebelo y tratar de establecer un marco de evaluación y tratamiento de los pacientes atáxicos. Referencias bibliográficas: 1. Stephan, M. A., et al (2011). Effect of long-term climbing training on cerebellar ataxia: a case series. Rehabilitation research and practice, 2011, 525879. (https://pubmed.ncbi.nlm.nih.gov/22191034/). 2. Aprigliano, F., et al (2019). Effects of repeated waist-pull perturbations on gait stability in subjects with cerebellar ataxia. Journal of neuroengineering and rehabilitation, 16(1), 50. (https://pubmed.ncbi.nlm.nih.gov/30975168/9. 3. Benussi, A.,et al (2017). Long term clinical and neurophysiological effects of cerebellar transcranial direct current stimulation in patients with neurodegenerative ataxia. Brain stimulation, 10(2), 242–250. (https://pubmed.ncbi.nlm.nih.gov/27838276/). 4. Bostan, A. C., & Strick, P. L. (2018). The basal ganglia and the cerebellum: nodes in an integrated network. Nature reviews. Neuroscience, 19(6), 338–350. (https://pubmed.ncbi.nlm.nih.gov/29643480/). 5. Cabaraux, P., et al (2023). Consensus Paper: Ataxic Gait. Cerebellum (London, England), 22(3), 394–430. (https://pubmed.ncbi.nlm.nih.gov/35414041/). 6. D'Angelo E. (2014). The organization of plasticity in the cerebellar cortex: from synapses to control. Progress in brain research, 210, 31–58. (https://pubmed.ncbi.nlm.nih.gov/24916288/). 7. D'Angelo E. (2018). Physiology of the cerebellum. Handbook of clinical neurology, 154, 85–108. (https://pubmed.ncbi.nlm.nih.gov/29903454/). 8. França, C., et al (2018). Effects of cerebellar neuromodulation in movement disorders: A systematic review. Brain stimulation, 11(2), 249–260. (https://pubmed.ncbi.nlm.nih.gov/29191439/). 9. Gong, C., et al (2023). Efficacy and safety of noninvasive brain stimulation for patients with cerebellar ataxia: a systematic review and meta-analysis of randomized controlled trials. Journal of neurology, 270(10), 4782–4799. (https://pubmed.ncbi.nlm.nih.gov/37460852/). 10. Gorgas, A. M., et al (2015). Gait changes with balance-based torso-weighting in people with multiple sclerosis. (https://pubmed.ncbi.nlm.nih.gov/24930996/). 11. Ilg, W., et al (2023). Quantitative Gait and Balance Outcomes for Ataxia Trials. Cerebellum 10.1007/s12311-023-01625-2. Advance online publication. (https://pubmed.ncbi.nlm.nih.gov/37955812/). 12. Ilg, W., et al (2009). Intensive coordinative training improves motor performance in degenerative cerebellar disease. Neurology, 73(22), 1823–1830. (https://pubmed.ncbi.nlm.nih.gov/19864636/). 13. Jacobson, G. A. et al (2008). A model of the olivo-cerebellar system as a temporal pattern generator. Trends in neurosciences, 31(12), 617–625. (https://pubmed.ncbi.nlm.nih.gov/18952303/). 14. Kelly, G., & Shanley, J. (2016). Rehabilitation of ataxic gait following cerebellar lesions: Applying theory to practice. Physiotherapy theory and practice, 32(6), 430–437. (https://pubmed.ncbi.nlm.nih.gov/27458875/). 15. Marsden J. F. (2018). Cerebellar ataxia. Handbook of clinical neurology, 159, 261–281. (https://pubmed.ncbi.nlm.nih.gov/30482319/). 16. Morton, S. M., & Bastian, A. J. (2003). Relative contributions of balance and voluntary leg-coordination deficits to cerebellar gait ataxia. Journal of neurophysiology, 89(4), 1844–1856. (https://pubmed.ncbi.nlm.nih.gov/12612041/). 17. Ruggieri, S., et al (2021). A matter of atrophy: differential impact of brain and spine damage on disability worsening in multiple sclerosis. Journal of neurology, 268(12), 4698–4706. (https://pubmed.ncbi.nlm.nih.gov/33942160/). 18. Serrao, M., et al (2017). Use of dynamic movement orthoses to improve gait stability and trunk control in ataxic patients. European journal of physical and rehabilitation medicine, 53(5), 735–743. (https://pubmed.ncbi.nlm.nih.gov/28627859/). 19. Shah, V. V., et al (2021). Gait Variability in Spinocerebellar Ataxia Assessed Using Wearable Inertial Sensors. Movement disorders : official journal of the Movement Disorder Society, 36(12), 2922–2931. (https://pubmed.ncbi.nlm.nih.gov/34424581/). 20. Wang, Y., et al (2023). Effects of transcranial magnetic stimulation on cerebellar ataxia: A systematic review and meta-analysis. Frontiers in neurology, 14, 1049813. (https://pubmed.ncbi.nlm.nih.gov/36779066/). 21. Wright, R. L., et al (2016). Metronome Cueing of Walking Reduces Gait Variability after a Cerebellar Stroke. Frontiers in neurology, 7, 84. (https://pubmed.ncbi.nlm.nih.gov/27313563/).
