Prediction and preparation, fundamental functions of the cerebellum

Disconnection syndromes of basal ganglia, thalamus, and cerebrocerebellar systems

Disconnection syndromes were originally conceptualized as a disruption of communication between different cerebral cortical areas. Two developments mandate a re-evaluation of this notion. First, we present a synopsis of our anatomical studies in monkey elucidating principles of organization of cerebral cortex. Efferent fibers emanate from every cortical area, and are directed with topographic precision via association fibers to ipsilateral cortical areas, commissural fibers to contralateral cerebral regions, striatal fibers to basal ganglia, and projection subcortical bundles to thalamus, brainstem and/or pontocerebellar system. We note that cortical areas can be defined by their patterns of subcortical and cortical connections. Second, we consider motor, cognitive and neuropsychiatric disorders in patients with lesions restricted to basal ganglia, thalamus, or cerebellum, and recognize that these lesions mimic deficits resulting from cortical lesions, with qualitative differences between the manifestations of lesions in functionally related areas of cortical and subcortical nodes. We consider these findings on the basis of anatomical observations from tract tracing studies in monkey, viewing them as disconnection syndromes reflecting loss of the contribution of subcortical nodes to the distributed neural circuits. We introduce a new theoretical framework for the distributed neural circuits, based on general, and specific, principles of anatomical organization, and on the architecture of the nodes that comprise these systems. We propose that neural architecture determines function, i.e., each architectonically distinct cortical and subcortical area contributes a unique transform, or computation, to information processing; anatomically precise and segregated connections between nodes define behavior; and association fiber tracts that link cerebral cortical areas with each other enable the cross-modal integration required for evolved complex behaviors. This model enables the formulation and testing of future hypotheses in investigations using evolving magnetic resonance imaging techniques in humans, and in clinical studies in patients with cortical and subcortical lesions.

Differential prefrontal-like deficit in children after cerebellar astrocytoma and medulloblastoma tumor

Background

This study was realized thanks to the collaboration of children and adolescents who had been resected from cerebellar tumors. The medulloblastoma group (CE+, n = 7) in addition to surgery received radiation and chemotherapy. The astrocytoma group (CE, n = 13) did not receive additional treatments. Each clinical group was compared in their executive functioning with a paired control group (n = 12). The performances of the clinical groups with respect to controls were compared considering the tumor's localization (vermis or hemisphere) and the affectation (or not) of the dentate nucleus. Executive variables were correlated with the age at surgery, the time between surgery-evaluation and the resected volume.

Methods

The executive functioning was assessed by means of WCST, Complex Rey Figure, Controlled Oral Word Association Test (letter and animal categories), Digits span (WISC-R verbal scale) and Stroop test. These tests are very sensitive to dorsolateral PFC and/or to medial frontal cortex functions. The scores for the non-verbal Raven IQ were also obtained. Direct scores were corrected by age and transformed in standard scores using normative data. The neuropsychological evaluation was made at 3.25 (SD = 2.74) years from surgery in CE group and at 6.47 (SD = 2.77) in CE+ group.

Results

The Medulloblastoma group showed severe executive deficit (≤ 1.5 SD below normal mean) in all assessed tests, the most severe occurring in vermal patients. The Astrocytoma group also showed executive deficits in digits span, semantic fluency (animal category) and moderate to slight deficit in Stroop (word and colour) tests. In the astrocytoma group, the tumor's localization and dentate affectation showed different profile and level of impairment: moderate to slight for vermal and hemispheric patients respectively. The resected volume, age at surgery and the time between surgery-evaluation correlated with some neuropsychological executive variables.

Conclusion

Results suggest a differential prefrontal-like deficit due to cerebellar lesions and/or cerebellar-frontal diaschisis, as indicate the results in astrocytoma group (without treatments), that also can be generated and/or increased by treatments in the medulloblastoma group. The need for differential rehabilitation strategies for specific clinical groups is remarked. The results are also discussed in the context of the Cerebellar Cognitive Affective Syndrome.

The role of the cerebellum in schizophrenia: an update of clinical, cognitive, and functional evidences

The role of the cerebellum in schizophrenia has been highlighted by Andreasen's hypothesis of "cognitive dysmetria," which suggests a general dyscoordination of sensorimotor and mental processes. Studies in schizophrenic patients have brought observations supporting a cerebellar impairment: high prevalence of neurological soft signs, dyscoordination, abnormal posture and propioception, impaired eyeblink conditioning, impaired adaptation of the vestibular-ocular reflex or procedural learning tests, and lastly functional neuroimaging studies correlating poor cognitive performances with abnormal cerebellar activations. Despite those compelling evidences, there has been, to our knowledge, no recent review on the clinical, cognitive, and functional literature supporting the role of the cerebellum in schizophrenia. We conducted a Medline research focusing on cerebellar dysfunctions in schizophrenia. Emphasis was given to recent literature (after 1998). The picture arising from this review is heterogeneous. While in some domains, the role of the cerebellum seems clearly defined (ie, neurological soft signs, posture, or equilibrium), in other domains, the cerebellar contribution to schizophrenia seems limited or indirect (ie, cognition) if present at all (ie, affectivity). Functional models of the cerebellum are proposed as a background for interpreting these results.

Cerebellar lesion studies of cognitive function in children and adolescents - limitations and negative findings

An increasing number of human lesion and functional brain imaging studies appear to support the hypothesis that the cerebellum contributes to a wide range of non-motor functions, including attention, language and visuospatial functions. Various abnormalities have been reported in standard neuropsychological tests in children and adolescents who have been treated for cerebellar tumors. This review focuses on limitations of lesion studies and negative findings in children and adolescents with focal cerebellar lesions. Frequently cited early findings have not been replicated in later studies or have been explained by motor components of the tasks. Such discrepancies may relate to a number of methodological problems. In addition to impaired motor function, it is unclear to what extent deficits in neuropsychological tests are caused by unspecific effects such as increased intracranial pressure and depression. Effects of extracerebellar lesions are frequently not considered. Although a role of the cerebellum in specific aspects of non-motor functions seems obvious it is still an open question which cognitive functions are involved, why and to what extent. It is a matter of ongoing discussion whether or not cognitive dysfunction belongs to the symptoms of cerebellar disease. Overall, disorders appear to be mild and far less frequent than disorders observed following lesions of cerebral areas. The aim of the review is to demonstrate that many findings frequently cited to support cerebellar involvement in cognition are insufficient to prove the hypothesis. There is ongoing need of well-controlled lesion studies, which show that disorders are due to cerebellar lesions independent of motor dysfunction and other confounding factors.

Fractional anisotropy correlates with auditory simple reaction time performance

During the last two decades, modern imaging studies focused intensively on the broad field of reaction time paradigms and significantly enhanced the understanding of behavioral performance. However, interindividual variations of simple reaction time (SRT) have been barely investigated. In this study, we intended to identify neural correlates of interindividual variation in auditory SRT (aSRT) employing the Poffenberger paradigm with auditory stimuli, in order to investigate neural processing speed performance. We conducted a whole-head voxel based morphometry analysis of fractional anisotropy (FA) in 19 healthy, right handed subjects. Simple regression analysis between FA and interindividual aSRT measures was performed for each voxel. Significant positive correlation (R(2): 0.44/0.78 min/max) for FA vs. individual mean aSRT was found in the right central cerebellum dorso-cranial of the dentate nucleus. A significant correlation (R(2): 0.453/0.633 min/max) was also detected between FA and the hand performance index, which characterizes the intraindividual RT difference between left and right hand, within the precentral portion of the pyramidal tract in the left hemisphere. Fast right handed response correlated with high local FA values located within neural structures participating in right hand control. Against the background of only right handed participants in our study, the hypothesis of local myelination as one basic condition influencing reaction time performance is strongly supported. The presented results identify brain areas involved in the processing speed of the aSRT tasks. We propose that the presented findings are due to an influence of participants' right hand preference on both FA and aSRT measures.

Duchenne muscular dystrophy: a cerebellar disorder?

Cyrulnik, S.C., and V.J. Hinton. Duchenne muscular dystrophy: A cerebellar disorder? NEUROSCI. BIOBEHAV. REV. Duchenne muscular dystrophy (DMD) is a genetic disorder that is often associated with cognitive deficits. These cognitive deficits have been linked to the absence of dystrophin, a protein product which is normally found in multiple tissues throughout the body. In the current paper, we argue that it is the absence of dystrophin in the cerebellum that is responsible for the cognitive deficits observed. We begin by reviewing data that document structural and functional abnormalities in the brains of individuals with DMD and mdx mice. We briefly review the cognitive deficits associated with DMD, and then present neuroimaging and neuropsychological evidence to indicate that the cerebellum is involved in the same aspects of cognition that are impaired in children with DMD. It is our contention that the development of brain pathways in the cerebellum (e.g., cerebro-cerebellar loops) without dystrophin may result in altered brain function presenting as cognitive deficits in DMD.

fMRI during natural sleep as a method to study brain function during early childhood

Many techniques to study early functional brain development lack the whole-brain spatial resolution that is available with fMRI. We utilized a relatively novel method in which fMRI data were collected from children during natural sleep. Stimulus-evoked responses to auditory and visual stimuli as well as stimulus-independent functional networks were examined in typically developing 2-4-year-old children. Reliable fMRI data were collected from 13 children during presentation of auditory stimuli (tones, vocal sounds, and nonvocal sounds) in a block design. Twelve children were presented with visual flashing lights at 2.5 Hz. When analyses combined all three types of auditory stimulus conditions as compared to rest, activation included bilateral superior temporal gyri/sulci (STG/S) and right cerebellum. Direct comparisons between conditions revealed significantly greater responses to nonvocal sounds and tones than to vocal sounds in a number of brain regions including superior temporal gyrus/sulcus, medial frontal cortex and right lateral cerebellum. The response to visual stimuli was localized to occipital cortex. Furthermore, stimulus-independent functional connectivity MRI analyses (fcMRI) revealed functional connectivity between STG and other temporal regions (including contralateral STG) and medial and lateral prefrontal regions. Functional connectivity with an occipital seed was localized to occipital and parietal cortex. In sum, 2-4 year olds showed a differential fMRI response both between stimulus modalities and between stimuli in the auditory modality. Furthermore, superior temporal regions showed functional connectivity with numerous higher-order regions during sleep. We conclude that the use of sleep fMRI may be a valuable tool for examining functional brain organization in young children.

The role of cognitive control in cocaine dependence

While hedonic and reward-related processes are central to drug use and dependence, this article focuses on the contribution that cognitive processes may make to addiction. In particular, attention is drawn to those processes involved in exercising control over behavior as drug dependence is characterized by risky, impulsive behavior. Functional neuroimaging implicates prefrontal deficits in cocaine dependence with an emerging picture of cocaine users having attentional biases towards drug-related stimuli, poor performance in laboratory tests of inhibitory control, and compromised monitoring and evaluation of their behavior. Combined, these deficits may contribute to the continuation of use in dependent individuals and may qualify as important targets for therapeutic interventions.

Habit learning dissociation in rats with lesions to the vermis and the interpositus of the cerebellum

After cerebellar tumors resection, patients show motor skill learning impairments but also cognitive deficits. However, their exact origins remain controversial. Using a rat model of cerebellar injury, we assessed the involvement of two structures often damaged during resection (vermis and interpositus nuclei) on habits development. During extended training of an instrumental task, rats develop response routines that are no longer voluntary or goal-directed but habit-based, evidenced by their insensitivity to changes in the value of the reward. Here we showed that, in contrast to sham or vermis lesioned rats, discrete lesions to interpositus nuclei prevented rats from developing habits with overtraining, without motor difficulties, nor alteration of the instrumental task acquisition. Our results suggest that the role of the cerebellum can be extended from motor skill learning to cognitive routines learning. Similar habit impairment could possibly account for some of the long-term outcome difficulties observed in cerebellar-damaged patients.

Phonology, rapid naming and academic achievement in very preterm children at eight years of age

AIM

To examine the impact and additive effect of phonology and rapid naming deficits on reading, spelling and mathematics achievement in a group of very preterm children at 8 years of age.

METHODS

All surviving children with a gestational age less than 30 weeks, admitted to the neonatal intensive care unit at Royal Prince Alfred Hospital, in 1994 and 1995, were prospectively enrolled in developmental follow-up. Children with a neurosensory disability or a low intelligence score (FSIQ<or=85 points) were excluded. At 8 years of age standardised psychometric measures of cognition, linguistic ability and academic achievement were administered to a sample of 63 children.

RESULTS

Twenty-four (38.1%) children showed low achievement in reading, spelling or mathematics. Of these, 18 (75%) children showed low achievement in reading. Reading achievement was significantly correlated to phonological awareness, rapid naming and expressive vocabulary. Children with phonological awareness and rapid naming deficits showed significantly more delay in reading than children without such deficits. Children who had rapid naming deficits were more likely to show multiple skill delays. Rapid naming showed significant, though modest correlations with immaturity and illness variables. Maternal education was significantly associated with achievement.

CONCLUSIONS

Phonological awareness does predict reading performance in very preterm children. Rapid naming appears to be related to complex multiple academic delays, and may reflect a neurological timing or efficiency factor with effects independent of intelligence and significantly influenced by immaturity and illness.

Unity and diversity of tonic and phasic executive control components in episodic and working memory

The present study aimed to delineate the extent to which unitary executive functions might be shared across the separate domains of episodic and working memory. A mixed blocked/event-related functional magnetic resonance imaging (fMRI) design was employed to assess sustained (tonic control) and transient (phasic control) brain responses arising from incrementing executive demand (source versus item episodic memory - vis-à-vis - two-back versus one-back working memory) using load-dependent activation overlaps as indices of common components. Although an extensive portion of the regional load effects constituted differential control modulations in both sustained and transient responses, commonalities were also found implicating a subset of executive core mechanisms consistent with unitary or domain general control. 'Unitary' control modulations were temporally dissociated into (1) shared tonic components involving medial and lateral prefrontal cortex, striatum, cerebellum and superior parietal cortex, assumed to govern enhanced top-down context processing, monitoring and sustained attention throughout task periods and (2) stimulus-synchronous phasic components encompassing posterior intraparietal sulcus, hypothesized to support dynamic shifting of the 'focus of attention' among internal representations. Taken together, these results converge with theoretical models advocating both unity and diversity among executive control processes.

Coupling between cerebellar hemispheres: behavioural, anatomic, and functional data

Although the cerebellum has been related to emotional, cognitive, and sensory processes, its outstanding significance for motor behaviour has attracted a vast variety of studies. Specifically, the role of cerebellar activity for appropriate movement timing has been investigated intensively. Behavioural studies, particularly of patients following cerebellar lesions, gave rise to the hypothesis that each hand is controlled by separate timing mechanisms most likely localized within lateral portions of each cerebellar hemisphere. Reduced timing variability during simultaneous bimanual tasks implies that both timing signals are integrated prior to movement execution, probably by information transfer between both cerebellar hemispheres. However, this raises the question for functional and anatomic fundamentals of such an integration process. The present article reviews behavioural, functional, and anatomic data to shed light on possible interactions between both cerebellar hemispheres during the execution of timed motor behaviour.

The mouse Engrailed genes: a window into autism

The complex behavioral symptoms and neuroanatomical abnormalities observed in autistic individuals strongly suggest a multi-factorial basis for this perplexing disease. Although not the perfect model, we believe the Engrailed genes provide an invaluable "window" into the elusive etiology of autism spectrum disorder. The Engrailed-2 gene has been associated with autism in genetic linkage studies. The En2 knock-out mouse harbors cerebellar abnormalities that are similar to those found in autistic individuals and, as we report here, has a distinct anterior shift in the position of the amygdala in the cerebral cortex. Our initial analysis of background effects in the En1 mouse knock-out provides insight as to possible molecular mechanisms and gender differences associated with autism. These findings further the connection between Engrailed and autism and provide new avenues to explore in the ongoing study of the biological basis of this multifaceted disease.

Increased oculomotor deficits during target blanking as an indicator of mild traumatic brain injury

Given the susceptibility of cerebellar-cortical tracts to shearing injury from traumatic brain injury (TBI), we investigated impairment in the generation of predictive eye movements and its relationship to cognitive deficits in mild TBI patients using a smooth pursuit target-blanking paradigm. Compared to a target-tracking paradigm without blanking, this paradigm more greatly necessitates the generation of predictive eye movements, which are subserved by brain regions involved in cognitive processing. Mild TBI patients showed impaired prediction of target trajectories during target blanking, demonstrated by generation of saccades at earlier and more variable time points, as well as greater and more variable oculomotor error compared to controls. In addition, California Verbal Learning Test (CVLT-II) scores related to working memory, learning, and executive function were more highly correlated with oculomotor variability during target blanking than during target tracking. Our results suggest that a disruption of cerebellar-cortical connections in TBI may account for both oculomotor and cognitive impairment, and that measures of predictive eye movements during target blanking may be a sensitive metric of cognitive deficits after mild TBI.

En2 knockout mice display neurobehavioral and neurochemical alterations relevant to autism spectrum disorder

Autism spectrum disorder (ASD) is a prevalent and inheritable neurodevelopmental disorder. Recent human genetic studies are consistent with the homeobox transcription factor, ENGRAILED 2 (EN2), being an ASD susceptibility gene. En2 knockout mice (En2(-/-)) display subtle cerebellar neuropathological changes similar to what has been observed in the ASD brain. To investigate whether En2(-/-) mice displayed abnormal behavior relevant to ASD, they were monitored in tasks designed to assess social maturation as well as learning and memory. Deficits in social behavior were detected in En2(-/-) mice across maturation that included decreased play, reduced social sniffing and allogrooming, and less aggressive behavior. Deficits in two spatial learning and memory tasks were also observed. Because locomotor activity was a component of many of the behavioral tasks, this was measured at various stages of development. Locomotor activity was not compromised in the knockout. However, a more thorough analysis of motor behavior in En2(-/-) mice revealed deficits in specific motor tasks. To determine whether neurochemical changes were associated with these behavioral phenotypes, monoamine levels in specific brain regions were assessed. A cerebellar-specific increase in serotonin and its metabolite was observed. Interestingly, several reports have suggested that the serotonin pathway is affected in ASD. We conclude that En2(-/-) mice display behavioral and neurochemical changes, in addition to genetic and neuropathological changes, relevant to ASD. Therefore, these mice may be useful as an animal model of autism.

Dexterity in cerebellar agenesis

Given the well established role of the cerebellum in motor control, deficient motor performance during life time appears to be common in cerebellar agenesis. However, behavioural data on motor performance in living subjects with cerebellar agenesis are scarce. Dexterity during object manipulation was comparatively investigated in a 63-year old female with cerebellar agenesis and three healthy age- and gender-matched control subjects. Participants performed a transport task with an instrumented object and caught a weight that was dropped into a hand-held receptacle either expectedly from the opposite hand or unexpectedly from the experimenter's hand. Compared to healthy subjects, the subject with cerebellar agenesis generated greater grasping forces. For the transport task the patient showed a clear impairment of the predictive adjustment of grasping forces to the differential loading requirements of movement direction. For the weight-catching task, the patient established an accurate reactive mode of control when the weight was dropped unexpectedly. In case the weight was dropped expectedly from the opposite hand, predictive control mechanisms were severely disturbed in the subject with cerebellar agenesis. These data highlight the role of the cerebellum for predictive force control and are interpreted within the concept of internal models reflecting the causal relationship between actions and their consequences.

MEG reveals different contributions of somatomotor cortex and cerebellum to simple reaction time after temporally structured cues

Magnetoencephalography (MEG) was used to measure brain activity while participants performed a simple reaction to targets after either a random interval (uncued targets) or a series of isochronous warning stimuli with 200-ms intervals that acted as a countdown. Targets could arrive "on time" or "early" relative to the preceding warning stimuli. Cerebellar activity before any stimulus onset predicted uncued simple reaction time. Onset of activity in somatomotor cortex relative to the target predicted reaction time after two warning stimuli when the target arrived on time or early. After three warning stimuli, when the target arrived on time and was certain to occur, prestimulus cerebellar activity and somatomotor onset were significant predictors of reaction time. When the target arrived early after three warning stimuli, prestimulus cerebellar and cingulate activity were predictive. The cerebellar results may reflect a number of possible factors, including a role in timing, response readiness, prediction and attention.

A spatially unbiased atlas template of the human cerebellum

This article presents a new high-resolution atlas template of the human, cerebellum and brainstem, based on the anatomy of 20 young healthy individuals. The atlas is spatially unbiased, i.e., the location of each structure is equal to the expected location of that structure across individuals in MNI space, a result that is cross-validated with an independent sample of 16 individuals. At the same time, the new template preserves the anatomical detail of cerebellar structures through a nonlinear atlas generation algorithm. In comparison to current whole-brain templates, it allows for an improved voxel-by-voxel normalization for functional MRI and lesion analysis. Alignment to the template requires that the cerebellum and brainstem are isolated from the surrounding tissue, a process for which an automated algorithm has been developed. Compared to normalization to the MNI whole-brain template, the new method strongly improves the alignment of individual fissures, reducing their spatial spread by 60%, and improves the overlap of the deep cerebellar nuclei. Applied to functional MRI data, the new normalization technique leads to a 5-15% increase in peak t values and in the activated volume in the cerebellar cortex for movement vs. rest contrasts. This indicates that the new template significantly improves the overlap of functionally equivalent cerebellar regions across individuals. The template and software are freely available as an SPM-toolbox, which also allows users to relate the new template to the annotated volumetric (Schmahmann, J.D., Doyon, J., Toga, A., Petrides, M., Evans, A. (2000). MRI atlas of the human cerebellum. San Diego: Academic Press) and surface-based (Van Essen, D.C. (2002a) Surface-based atlases of cerebellar cortex in the human, macaque, and mouse. Ann. N. Y. Acad. Sci. 978:468-479.) atlas of one individual, the "colin27"-brain.

Towards an understanding of cognitive function in Friedreich ataxia

There is limited documentation regarding cognitive function in individuals with Friedreich ataxia (FRDA), possibly because FRDA is widely held to predominantly affect the spinal cord, peripheral sensory nerves and cerebellum and not to affect cognition. Traditionally, the cerebellum has been thought to coordinate voluntary movement and motor tone, posture and gait. However, recent studies have implicated the cerebellum in a range of cognitive functions including executive function, visuospatial organisation and memory. We review the available data on cognitive function and neuroimaging in FRDA and the role of the cerebellum in cognitive function. We conclude with recommendations for future research including correlating cognitive function in individuals with FRDA with possible determinants of disease severity, such as age of onset and the causative genetic mutation.

Deficits in predictive smooth pursuit after mild traumatic brain injury

Given that even mild traumatic brain injury (TBI) may produce extensive diffuse axonal injury (DAI), we hypothesized that mild TBI patients would show deficits in predictive smooth pursuit eye movements (SPEM), associated with impaired cognitive functions, as these processes are dependent on common white matter connectivity between multiple cerebral and cerebellar regions. The ability to predict target trajectories during SPEM was investigated in 21 mild TBI patients using a periodic sinusoidal paradigm. Compared to 26 control subjects, TBI patients demonstrated decreased target prediction. TBI patients also showed increased eye position error and variability of eye position, which correlated with decreased target prediction. In all subjects, average target prediction, eye position error and eye position variability correlated with scores related to attention and executive function on the California Verbal Learning Test (CVLT-II). However, there were no differences between TBI and control groups in average eye gain or intra-individual eye gain variability, or in performance on the Wechsler Abbreviated Scale of Intelligence (WASI), suggesting that the observed deficits did not result from general oculomotor impairment or reduced IQ. The correlation between SPEM performance and CVLT-II scores suggests that predictive SPEM may be a sensitive assay of cognitive functioning, including attention and executive function. This is the first report to our knowledge that TBI patients show impaired predictive SPEM and eye position variability, and that these impairments correlate with cognitive deficits.

Declarative and procedural learning in children and adolescents with posterior fossa tumours

Background

This quasi-experimental study was designed to assess two important learning types – procedural and declarative – in children and adolescents affected by posterior fossa tumours (astrocytoma vs. medulloblastoma), given that memory has an important impact on the child's academic achievement and personal development.

Methods

We had three groups: two clinical (eighteen subjects) and one control (twelve subjects). The learning types in these groups were assessed by two experimental tasks evaluating procedural-implicit and declarative memory. A Serial Reaction-Time Task was used to measure procedural sequence learning, and the Spanish version [1] of the California Verbal Learning Test-Children's Version- CVLT- [2] to measure declarative-explicit learning. The learning capacity was assessed considering only the blocks that represent learning, and were compared with MANOVA in clinical and normal subjects. The Raven, simple reaction-time, finger-tapping test, and grooved pegboard tests were used to assess the overall functioning of subjects. The results were compared with those from a control group of the same age, and with Spanish norm-referenced tools where available

Results

The results indicate the absence of procedural-implicit learning in both clinical groups, whereas declarative-explicit learning is maintained in both groups.

Conclusion

The clinical groups showed a conservation of declarative learning and a clear impairment of procedural learning. The results support the role of the cerebellum in the early phase of procedural learning.

The cerebellum's involvement in the judgment of spatial orientation: a functional magnetic resonance imaging study

A functional magnetic resonance imaging (fMRI) study was conducted to integrate the clinical observations of the impaired judgment of spatial orientation of cerebellar patients with recent theoretical discoveries about the role of the cerebellum in cognitive functions. Ten normal healthy male right-handed Chinese postgraduates consented to participate in this study. The experimental task employed was a modified version of Benton's Judgment of Line Orientation Test, administered in a blocked fMRI study. The findings indicated activation of the cerebellar regions, the Hemisphere Lobules IV, VI and Crus I, while the subjects were performing the experimental task of the judgment of the orientation of lines. Furthermore, cortical regions were activated, including the bilateral precuneus (BA 7), the extrastriate regions (BA 19), and the bilateral prefrontal regions (BA 9, 10, 44, 46). The imaging data confirmed that the activity of the cerebellum is associated with judging spatial orientation. The theoretical and clinical implications of the findings are discussed.

Cerebellar damage produces selective deficits in verbal working memory

The cerebellum is often active in imaging studies of verbal working memory, consistent with a putative role in articulatory rehearsal. While patients with cerebellar damage occasionally exhibit a mild impairment on standard neuropsychological tests of working memory, these tests are not diagnostic for exploring these processes in detail. The current study was designed to determine whether damage to the cerebellum is associated with impairments on a range of verbal working memory tasks, and if so, under what circumstances. Moreover, we assessed the hypothesis that these impairments are related to impaired rehearsal mechanisms. Patients with damage to the cerebellum (n = 15) exhibited a selective deficit in verbal working memory: spatial forward and backward spans were normal, but forward and backward verbal spans were lower than controls. While the differences were significant, digit spans were relatively preserved, especially in comparison to the dramatic reductions typically observed in classic 'short-term memory' patients with perisylvian brain damage. The patients tended to be more impaired on a verbal version compared to a spatial version of a working memory task with a long delay and this impairment was correlated with overall symptom and dysarthria severity. These results are consistent with a contribution of the cerebellum to rehearsal and suggest that inclusion of a delay before recall is especially detrimental in individuals with cerebellar damage. However, when we examined markers of rehearsal (i.e. word-length and articulatory suppression effects) in an immediate serial recall task, we found that qualitative aspects of the patients' rehearsal strategies were unaffected. We propose that the cerebellum may contribute to verbal working memory during the initial phonological encoding and/or by strengthening memory traces rather than by fundamentally subserving covert articulatory rehearsal.

Support for the homeobox transcription factor gene ENGRAILED 2 as an autism spectrum disorder susceptibility locus

Our previous research involving 167 nuclear families from the Autism Genetic Resource Exchange (AGRE) demonstrated that two intronic SNPs, rs1861972 and rs1861973, in the homeodomain transcription factor gene ENGRAILED 2 (EN2) are significantly associated with autism spectrum disorder (ASD). In this study, significant replication of association for rs1861972 and rs1861973 is reported for two additional data sets: an independent set of 222 AGRE families (rs1861972-rs1861973 haplotype, P=.0016) and a separate sample of 129 National Institutes of Mental Health families (rs1861972-rs1861973 haplotype, P=.0431). Association analysis of the haplotype in the combined sample of both AGRE data sets (389 families) produced a P value of .0000033, whereas combining all three data sets (518 families) produced a P value of .00000035. Population-attributable risk calculations for the associated haplotype, performed using the entire sample of 518 families, determined that the risk allele contributes to as many as 40% of ASD cases in the general population. Linkage disequilibrium (LD) mapping with the use of polymorphisms distributed throughout the gene has shown that only intronic SNPs are in strong LD with rs1861972 and rs1861973. Resequencing and association analysis of all intronic SNPs have identified alleles associated with ASD, which makes them candidates for future functional analysis. Finally, to begin defining the function of EN2 during development, mouse En2 was ectopically expressed in cortical precursors. Fewer En2-transfected cells than controls displayed a differentiated phenotype. Together, these data provide further genetic evidence that EN2 might act as an ASD susceptibility locus, and they suggest that a risk allele that perturbs the spatial/temporal expression of EN2 could significantly alter normal brain development.

Magnetic resonance imaging of cerebellar-prefrontal and cerebellar-parietal functional connectivity

Recent studies of the cerebellum indicated its involvement in a diverse array of functions, and analyses of non-human primate neuroanatomy have revealed connections between cerebellum and cerebral cortex that might support cerebellar contributions to a wider range of functions than traditionally thought. These include cortico-ponto-cerebellar projections originating throughout cerebral cortex, in addition to projections from the dentate nucleus of the cerebellum to prefrontal and posterior parietal cortices via the thalamus. Such projections likely serve as important substrates for cerebellar involvement in human cognition, assuming their analogues are prominent in the human brain. These connections can be examined from a functional perspective through the use of functional connectivity MRI (FCMRI), a technique that allows the in vivo examination of coherence in MR signal among functionally related brain regions. Using this approach, low-frequency fluctuations in MR signal in the dentate nucleus correlated with signal fluctuations in cerebellar, thalamic, limbic, striatal, and cerebrocortical regions including parietal and frontal sites, with prominent coherence in dorsolateral prefrontal cortex. These findings indicate that FCMRI is a useful tool for examining functional relationships between the cerebellum and other brain regions, and they support the findings from non-human primate studies showing anatomic projections from cerebellum to regions of cerebral cortex with known involvement in higher cognitive functions. To our knowledge, this represents the first demonstration of functional coherence between the dentate nucleus and parietal and prefrontal cortices in the human brain, suggesting the presence of cerebellar-parietal and cerebellar-prefrontal functional connectivity.

Hemispheric differences in hemodynamics elicited by auditory oddball stimuli

Evidence from neuroimaging studies suggests that the right hemisphere of the human brain might be more specialized for attention than the left hemisphere. However, differences between right and left hemisphere in the magnitude of hemodynamic activity (i.e., 'functional asymmetry') rarely have been explicitly examined in previous neuroimaging studies of attention. This study used a new voxel-based comparison method to examine hemispheric differences in the amplitude of the hemodynamic response in response to infrequent target, infrequent novel, and frequent standard stimuli during an event-related fMRI auditory oddball task in 100 healthy adult participants. Processing of low probability task-relevant target stimuli, or 'oddballs', and low probability task-irrelevant novel stimuli is believed to engage in orienting and attentional processes. It was hypothesized that greater right-hemisphere activation compared to left would be observed to infrequent target and novel stimuli. Consistent with predictions, greater right hemisphere than left frontal, temporal, and parietal lobe activity was observed for target detection and novelty processing. Moreover, asymmetry effects did not differ with respect to age or gender of the participants. The results (1) support the proposal that the right hemisphere is differentially engaged in processing salient stimuli and (2) demonstrate the successful use of a new voxel-based laterality analysis technique for fMRI data.

Impaired temporal prediction and eye–hand coordination in patients with cerebellar lesions

This study investigated the effect of cerebellar lesions on temporal prediction and coordination in eye and hand movements. Nine patients with cerebellar lesions were compared to controls while they made saccades with and without simultaneous pointing movements towards a target that was either temporally predictable or non-predictable. The direction and amplitude of the target step was always predictable. Patients made much more early and late saccades than controls, but an equal amount of visually triggered saccades. This suggests that inappropriate saccades could be suppressed during the preparation of a goal-directed saccade. Hand movement frequency did not differ between both groups. Thus, cerebellar lesions can induce inappropriate saccades more easily than inappropriate hand movements. Controls, but not patients, generated visually triggered saccades of shorter latencies when the target was temporally predictable. Thus, the patients could not use information about target timing to synchronise visually triggered saccades with the target. They could, however, use this information to improve the suppression of inappropriate saccades. Regarding coordination, patients showed impairments in synchronising saccades with hand movements. Nevertheless, hand movements led to an enhancement of anticipatory saccades in patients as in controls. Moreover, hand movements and temporal predictability affected saccadic accuracy in both groups similarly. These results suggest that cerebellar lesions do not generally prevent access to temporal information on the rhythm of a target sequence or the timing of a planned hand movement. More specifically, the cerebellum seems to be crucial for synchronizing saccades with such learned or planned temporal events.

Functional MRI localizing in the cerebellum

Mapping of cerebellar function by functional MRI now enables us not only to re-establish older anatomic findings of somatotopic representations but to gain new insights in the function of the cerebellum and its intimate relations of cerebral regions to serving sensorimotor function, sensory discrimination, and cognitive processing. Consequently, it will change our understanding of neurologic and psychologic failures in patients with inborn errors or neurodegenerative diseases or after neurosurgical procedures.

Cerebellar agenesis II: motor and language functions

In a former study of a patient with cerebellar agenesis (HK) mild motor deficits, problems in delay eyeblink conditioning and mild to moderate deficits in IQ, planning behavior, visuospatial abilities, visual memory, and attention were found. The present study reports additional findings in the same patient. In the motor domain, impairments in fine motor manipulations, trace eyeblink conditioning and motor imagination in a functional magnetic resonance (fMRI) study were found. Based on fMRI findings; however, cortical areas involved in a tapping task did not significantly differ from a healthy control group. In the cognitive domain, deficits in speech comprehension as well as verbal learning and declarative memory were present. No significant affective symptoms were observed. Although problems in executive, visuospatial and language tasks are in agreement with the so-called cerebellar cognitive affective syndrome-other possibilities remain. Non-motor impairments in HK might also be a consequence of lacking motor abilities in development and motor deficits may interfere with the performance of parts of the cognitive tasks. In addition, lack of promotion and learning opportunities in childhood may contribute and mental retardation based on extracerebellar dysfunction cannot be excluded.

Children with low motor ability have lower visual-motor integration ability but unaffected perceptual skills

The purpose of this study was to examine perceptual, visual-motor abilities and intellectual skills in children with low, average and above average motor abilities. The participants were 144 children (aged 6-10 years) attending elementary school. Three groups of children were identified on the basis of their performance at the TGMD (Test of Gross Motor Development; [Ulrich, D.A. (1985). TGMD, Test of Gross Motor Development. Austin, Texas: PRO-ED. Edizione Italiana a cura di D. Ianes, TEST TGM. Test di valutazione delle abilita grosso-motorie. 1994, Trento: Edizioni Centro Studi Erickson]). Each child received an intelligence test (K-BIT; [Kaufman, A.S., & Kaufman, N.L. (1990). K-BIT. Kaufman Brief Intelligence Test. Circle Pines, MN: American Guidance Service]) and was evaluated for perceptual and visual-motor integration abilities (DTVP; [Hammill, D.D., Pearson, N.A., & Voress, J.K. (1993). Developmental Test of Visual Perception (2nd ed.). Austin, Texas: PRO-ED. Edizione Italiana a cura di D. Ianes, TEST TPV. Test di percezione visiva e integrazione visuo-motoria. Trento: Edizioni Centro Studi Erickson]). Results highlight a significant difference in visual-motor integration between children with high and low gross-motor abilities, in the absence of significant differences in perceptual skills or intellectual ability. The findings are discussed with reference to the concept of atypical brain development [Gilger, J.W., & Kaplan, B.J. (2001). Atypical brain development: A conceptual framework for understanding developmental learning disabilities. Developmental Neuropsychology, 20, 465].

Brain development in autism: early overgrowth followed by premature arrest of growth

Due to the relatively late age of clinical diagnosis of autism, the early brain pathology of children with autism has remained largely unstudied. The increased use of retrospective measures such as head circumference, along with a surge of MRI studies of toddlers with autism, have opened a whole new area of research and discovery. Recent studies have now shown that abnormal brain overgrowth occurs during the first 2 years of life in children with autism. By 2-4 years of age, the most deviant overgrowth is in cerebral, cerebellar, and limbic structures that underlie higher-order cognitive, social, emotional, and language functions. Excessive growth is followed by abnormally slow or arrested growth. Deviant brain growth in autism occurs at the very time when the formation of cerebral circuitry is at its most exuberant and vulnerable stage, and it may signal disruption of this process of circuit formation. The resulting aberrant connectivity and dysfunction may lead to the development of autistic behaviors. To discover the causes, neural substrates, early-warning signs and effective treatments of autism, future research should focus on elucidating the neurobiological defects that underlie brain growth abnormalities in autism that appear during these critical first years of life.

Attentional modulation in human primary olfactory cortex

Central to the concept of attention is the fact that identical stimuli can be processed in different ways. In olfaction, attention may designate the identical flow of air through the nose as either respiration or olfactory exploration. Here we have used functional magnetic resonance imaging (fMRI) to probe this attentional mechanism in primary olfactory cortex (POC). We report a dissociation in POC that revealed attention-dependent and attention-independent subregions. Whereas a temporal subregion comprising temporal piriform cortex (PirT) responded equally across conditions, a frontal subregion comprising frontal piriform cortex (PirF) and the olfactory tubercle responded preferentially to attended sniffs as opposed to unattended sniffs. In addition, a task-specific anticipatory response occurred in the attention-dependent region only. This dissociation was consistent across two experimental designs: one focusing on sniffs of clean air, the other focusing on odor-laden sniffs. Our findings highlight the role of attention at the earliest cortical levels of olfactory processing.

Three autism candidate genes: a synthesis of human genetic analysis with other disciplines

Autism is a particularly complex disorder when considered from virtually any methodological framework, including the perspective of human genetics. We first present a review of the genetic analysis principles relevant for discussing autism genetics research. From this body of work we highlight results from three candidate genes, REELIN (RELN), SEROTONIN TRANSPORTER (5HTT), and ENGRAILED 2 (EN2) and discuss the relevant neuroscience, molecular genetics, and statistical results that suggest involvement of these genes in autism susceptibility. As will be shown, the statistical results from genetic analysis, when considered alone, are in apparent conflict across research groups. We use these three candidate genes to illustrate different problems in synthesizing results from non-overlapping research groups examining the same problem. However, when basic genetic principles and results from other scientific disciplines are incorporated into a unified theoretical framework, at least some of the difficulties with interpreting results can be understood and potentially overcome as more data becomes available to the field of autism research. Integrating results from several scientific frameworks provides new hypotheses and alternative data collection strategies for future work.

Evidence for distinct cognitive deficits after focal cerebellar lesions

OBJECTIVES

Anatomical evidence and lesion studies, as well as functional magnetic resonance imaging (fMRI) studies, indicate that the cerebellum contributes to higher cognitive functions. Cerebellar posterior lateral regions seem to be relevant for cognition, while vermal lesions seem to be associated with changes in affect. However, the results remain controversial. Deficits of patients are sometimes still attributed to motor impairment.

METHODS

We present data from a detailed neuropsychological examination of 21 patients with cerebellar lesions due to tumour or haematoma, and 21 controls matched for age, sex, and years of education.

RESULTS

Patients showed deficits in executive function, and in attentional processes such as working memory and divided attention. Further analysis revealed that patients with right-sided lesions were in general more impaired than those with left-sided lesions.

CONCLUSIONS

Those hypotheses that suggest that lesions of the right cerebellar hemisphere lead to verbal deficits, while those of the left lead to non-verbal deficits, have in part been confirmed. The generally greater impairment of those patients with a right-sided lesion has been interpreted as resulting from the connection of the right cerebellum to the left cerebral hemisphere, which is dominant for language functions and crucial for right hand movements. Motor impairment was correlated with less than half of the cognitive measures, with no stronger tendency for correlation with cognitive tests that require motor responses discernible. The results are discussed on the basis of an assumption that the cerebellum has a predicting and preparing function, indicating that cerebellar lesions lead to a "dysmetria of thought."

Do Children With Focal Cerebellar Lesions Show Deficits in Shifting Attention?

More recent findings suggest a possible role of the cerebellum in nonmotor functions. Disability of individuals with cerebellar damage in rapidly shifting attention is one frequently used example to support cerebellar involvement in mental skills. The original proposal was based on findings in five children with chronic surgical lesions of the cerebellum and a young adult with a degenerative disorder. The aim of the present study was to repeat Akshoomoff and Courchesne's initial findings in a larger group of children with focal cerebellar lesions. Ten children with cerebellar lesions and 10 age- and sex-matched controls were tested. Neocerebellar areas were affected in all children with cerebellar damage except one based on detailed analysis of MRI scans. Subjects had to perform a focus and a shift attention task. Two visual and two auditory stimuli were presented in a pseudorandom order. An ellipse and a high-pitched tone were presented less frequently than a circle and a low-pitched tone. Rare stimuli were presented at five different time intervals. In the focus tasks, subjects had to react to the same rare stimulus of one of the two modalities. In the shift task, subjects had to switch between the two rare stimuli. Motor deficits based on reaction times were small in cerebellar children compared with controls. The ability of target detection did not significantly differ in the children with cerebellar lesions compared with the control children in both the focus and the shift attention task. In particular, children with cerebellar damage showed no significant impairment in rapid (<2 s) shifts of attention. The present findings indicate that the cerebellum may be less critical in attention related processes than suggested previously.

Beyond common resources: the cortical basis for resolving task interference

Recent studies have suggested that declining inhibitory control observed during simultaneous increases in working memory (WM) demands may be due to sharing common neural resources, although it is relatively unclear how these processes are successfully combined at a neural level. Event-related functional MRI was used to examine task performance that required inhibition of varying numbers of items held in WM. Common activation regions for WM and inhibition were observed and this functional overlap may constitute the cortical basis for task interference. However, maintaining successful inhibitory control under increasing WM demands tended not to increase activation in these overlapping regions as might be expected if these common areas reflect common resources essential for task performance. Instead, increased activation was observed predominantly in unique, inhibition-specific regions including dorsolateral prefrontal cortex. The finding that successfully maintaining weaker stimulus--response relationships in the face of competition from stronger, prepotent responses requires greater activity in these regions reveals the means by which the brain resolves task interference and supports theories of how top-down attentional control is implemented.

Annotation: Deconstructing the attention deficit in fragile X syndrome: a developmental neuropsychological approach

BACKGROUND

Fragile X syndrome is one of the world's leading hereditary causes of developmental delay in males. The past decade has witnessed an explosion of research that has begun to unravel the condition at its various levels: from the genetic and brain levels to the cognitive level, and then to the environmental and behavioural levels. Our aim in this review is to attempt to integrate some of the extensive body of knowledge to move the research a step closer to understanding how the dynamics of atypical development can influence the specific cognitive and behavioural end-states frequently observed in children and adolescents with fragile X syndrome.

METHODS

We conducted a review of the current neuropsychological and neuropsychiatric approaches that have attempted to delineate the pattern of 'spared' and 'impaired' functions associated with the phenotype.

RESULTS

The profile of findings suggests that fragile X syndrome should not be viewed merely as a catalogue of spared and impaired cognitive functions or modules. Instead, there appears to be a process of almost gradual modularisation whereby cognitive mechanisms become domain specific as a function of development itself (Karmiloff-Smith, 1992). The results of a decade of intense research point towards an early weakness in one or more components of executive control rather than single, static higher-level deficits (e.g., spatial cognition, speech processing). This weakness affects both the development of more complex functions and current performance.

CONCLUSIONS

The prevailing tendency to interpret developmental disorders in terms of fixed damage to distinct modular functions needs to be reconsidered. We offer this review as an example of an alternative approach, attempting to identify an initial deficit and its consequences for the course of development. Through better definition of the cognitive and behavioural phenotype, in combination with current progress in brain imaging techniques and molecular studies, the next decade should continue to hold exciting promise for fragile X syndrome and other neurodevelopmental disorders.

Cerebellar function in autism: functional magnetic resonance image activation during a simple motor task

BACKGROUND

The cerebellum is one of the most consistent sites of neuroanatomic abnormality in autism, yet it is still unclear how such pathology impacts cerebellar function. In normal subjects, we previously demonstrated with functional magnetic resonance imaging (fMRI) a dissociation between cerebellar regions involved in attention and those involved in a simple motor task, with motor activation localized to the anterior cerebellum ipsilateral to the moving hand. The purpose of the present investigation was to examine activation in the cerebella of autistic patients and normal control subjects performing this motor task.

METHODS

We studied eight autistic patients and eight matched normal subjects, using fMRI. An anatomic region-of-interest approach was used, allowing a detailed examination of cerebellar function.

RESULTS

Autistic individuals showed significantly increased motor activation in the ipsilateral anterior cerebellar hemisphere relative to normal subjects, in addition to atypical activation in contralateral and posterior cerebellar regions. Moreover, increased activation was correlated with the degree of cerebellar structural abnormality.

CONCLUSIONS

These findings strongly suggest dysfunction of the autistic cerebellum that is a reflection of cerebellar anatomic abnormality. This neurofunctional deficit might be a key contributor to the development of certain diagnostic features of autism (e.g., impaired communication and social interaction, restricted interests, and stereotyped behaviors).

The autistic brain: birth through adulthood

PURPOSE OF REVIEW

We discuss evidence of brain maldevelopment in the first years of life in autism and new neuroanatomical and functional evidence from later ages of development.

RECENT FINDINGS

Head circumference, an accurate indicator of brain size in children, was reported to jump from normal or below normal size in the first postnatal months in autistic infants to the 84 th percentile by about 1 year of age; this abnormally accelerated growth was concluded by 2 years of age. Infants with extreme head (and therefore brain) growth fell into the severe end of the clinical spectrum and had more extreme neuroanatomical abnormalities. In the frontal and temporal lobes in autism, there have been reports of abnormal increases in gray and white matter at 2 to 4 years; reduced metabolic measures; deviant diffusion tensor imaging results in white matter; underdeveloped cortical minicolumns; and reduced functional activation during socio-emotional, cognitive and attention tasks. Cerebellar abnormalities included abnormal volumes, reduced number and size of Purkinje neurons in the vermis and hemispheres, molecular defects, and reduced functional activation in posterior regions.

SUMMARY

A new neurobiological phenomenon in autism has been described that precedes the onset of clinical behavioral symptoms, and is brief and age-delimited to the first two years of life. The neurobiological defects that precede, trigger, and underlie it may form part of the developmental precursors of some of the anatomical, functional, and behavioral manifestations of autism. Future studies of the first years of life may help elucidate the factors and processes that bring about the unfolding of autistic behavior.

Association of the homeobox transcription factor, ENGRAILED 2, 3, with autism spectrum disorder

Mouse mutants of the homeobox transcription factor Engrailed2 (En2) and autistic individuals display similar cerebellar morphological abnormalities, which include hypoplasia and a decrease in the number of Purkinje cells. Human EN2 maps to 7q36, a chromosomal region that has demonstrated suggestive linkage to autism spectrum disorder (ASD). To investigate EN2 for evidence of association with ASD, four single-nucleotide polymorphisms (SNPs) (rs3735653, rs1861972, rs1861973, rs2361689) that span the majority of the 8.0 kb gene were assessed by the transmission/disequilibrium test. Initially, 138 triads of autistic individuals and their parents were tested. Two intronic SNPs (rs1861972 and rs1861973) demonstrated significant association with autism (rs1861972, P=0.0018; rs1861973, P=0.0003; haplotype, P=0.000005). Flanking exonic SNPs (rs3735653 and rs2361689) did not display association. This analysis was then extended to include 167 small nuclear ASD pedigrees and significant association was again only observed for rs1861972 and rs1861973 under both the narrow and broad diagnostic criteria (narrow: rs1861972 P=0.0290, rs1861973 P=0.0073, haplotype P=0.0009; broad: rs1861972 P=0.0175, rs1861973 P=0.0107, haplotype P=0.0024). These data demonstrate association between a cerebellar patterning gene and ASD, suggesting a role for EN2 as a susceptibility locus and supporting a neurodevelopmental defect hypothesis in the etiology of autism.

Does the cerebellum contribute to specific aspects of attention?

We present data on attentional and neuropsychological functions of 16 patients with focal cerebellar lesions (13 tumours, 3 haematomas) compared to normative test data, and to 11 control subjects matched for age, gender, and years of education. Patients showed distinct deficits in qualitative aspects of a divided attention task, and in a working memory task. Performance in selective attention was unimpaired. The results support the concept that the cerebellum plays a role not only in motor, but also in higher cognitive functions. They are discussed on the basis of the idea that prediction and preparation are fundamental functions of the cerebellum. Therefore, the results confirm the idea that cerebellar lesions lead to reduced performance in specific attention tasks.

The cerebellum and olfaction in the aging brain: a functional magnetic resonance imaging study

The present study investigated activation of distinct cerebellar regions as a result of olfactory stimulation in healthy young and elderly adults using functional magnetic resonance imaging (fMRI). Ten young and 10 elderly adults were imaged using a 1.5-TMR scanner. The odorant amyl acetate was delivered in 12-s on, 40-s off cycles. Throughout the scan participants responded with a button press at first detection of each stimulus interval followed by a second button press upon odorant extinction. Images were processed with AFNI software. Elderly participants showed significantly decreased cerebellar activation in both the superior semilunar lobule (Crus I) and the inferior semilunar lobule (Crus II), two of three previously identified regions of interest for odor processing, compared to young adults. Interestingly, both groups showed similar levels of activation in the third region of interest, the posterior quadrangular lobule (VI), although the elderly showed more variability than the young did. Previous research identifying this area to be involved in attention may reflect the possibility that elderly adults engaged in olfactory tasks may show more variability than young participants in the degree of attentional demands needed for these tasks as a result of decreased olfactory abilities.

The cerebellum and event timing

Damage to the cerebellum disrupts performance on a range of tasks that require precise timing including the production of skilled movements, eyeblink conditioning, and perceptual tasks such as duration discrimination. We hypothesize that such tasks involve event timing, a form of representation in which the temporal goals are explicitly represented. For example, during finger tapping, the goal to produce evenly paced intervals invokes an explicit temporal representation of the time between successive contact points with the tapping surface. In contrast, timing can be an emergent property in other actions, reflecting temporal consistencies that arise through the control of other movement parameters. One example is continuous circle drawing, a task in which temporal consistency can be achieved by maintaining a constant angular velocity or minimizing higher-order derivatives (e.g., jerk). Temporal consistency on event and emergent timing tasks is not correlated and patients with cerebellar damage show no increase in temporal variability during continuous circle drawing. While the cerebellum likely contributes to performance of a wide range of skilled behaviors, it appears to be especially important when the tasks entail event timing.

The roles of the cerebellum and basal ganglia in timing and error prediction

Recent evidence that the cerebellum and the basal ganglia are activated during the performance of cognitive and attention tasks challenges the prevailing view of their primary function in motor control. The specific roles of the basal ganglia and the cerebellum in cognition, however, have been difficult to identify. At least three functional hypotheses regarding their roles have been proposed. The first hypothesis suggests that their main function is to switch attentional set. The second hypothesis states that they provide error signals regarding stimuli or rewards. The third hypothesis is that they operate as an internal timing system, providing a precise representation of temporal information. Using functional magnetic resonance imaging, we tested these three hypotheses using a task-switching experiment with a 2 x 2 factorial design varying timing (random relative to fixed) and task order (unpredictable relative to predictable). This design allowed us to test whether switching between tasks, timing irregularity and/or task order unpredictability activate the basal ganglia and/or the cerebellum. We show that the cerebellum is primarily activated with timing irregularity while the anterior striatum is activated with task order unpredictability, supporting their distinctive roles in two forms of readjustment. Task order unpredictability alone, independent of reward delivery, is sufficient to induce striatal activation. In addition, activation of the cerebellum and basal ganglia were not specific to switching attention because these regions were both activated during switching between tasks and during the simultaneous maintenance of two tasks without switching between them.