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Ciricugno A, Oldrati V, Cattaneo Z, Leggio M, Urgesi C, Olivito G. Cerebellar Neurostimulation for Boosting Social and Affective Functions: Implications for the Rehabilitation of Hereditary Ataxia Patients. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1651-1677. [PMID: 38270782 PMCID: PMC11269351 DOI: 10.1007/s12311-023-01652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
Beyond motor deficits, spinocerebellar ataxia (SCA) patients also suffer cognitive decline and show socio-affective difficulties, negatively impacting on their social functioning. The possibility to modulate cerebello-cerebral networks involved in social cognition through cerebellar neurostimulation has opened up potential therapeutic applications for ameliorating social and affective difficulties. The present review offers an overview of the research on cerebellar neurostimulation for the modulation of socio-affective functions in both healthy individuals and different clinical populations, published in the time period 2000-2022. A total of 25 records reporting either transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) studies were found. The investigated clinical populations comprised different pathological conditions, including but not limited to SCA syndromes. The reviewed evidence supports that cerebellar neurostimulation is effective in improving social abilities in healthy individuals and reducing social and affective symptoms in different neurological and psychiatric populations associated with cerebellar damage or with impairments in functions that involve the cerebellum. These findings encourage to further explore the rehabilitative effects of cerebellar neurostimulation on socio-affective deficits experienced by patients with cerebellar abnormalities, as SCA patients. Nevertheless, conclusions remain tentative at this stage due to the heterogeneity characterizing stimulation protocols, study methodologies and patients' samples.
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Affiliation(s)
- Andrea Ciricugno
- IRCCS Mondino Foundation, 27100, Pavia, Italy.
- Department of Brain and Behavioral Science, University of Pavia, 27100, Pavia, Italy.
| | - Viola Oldrati
- Scientific Institute, IRCCS Eugenio Medea, 23842, Bosisio Parini, Italy
| | - Zaira Cattaneo
- IRCCS Mondino Foundation, 27100, Pavia, Italy
- Department of Human and Social Sciences, University of Bergamo, 24129, Bergamo, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185, Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
| | - Cosimo Urgesi
- Scientific Institute, IRCCS Eugenio Medea, 23842, Bosisio Parini, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100, Udine, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185, Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179, Rome, Italy
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Olivito G, Siciliano L, Leggio M, Van Overwalle F. Effective connectivity analysis of resting-state mentalizing brain networks in spinocerebellar ataxia type 2: A dynamic causal modeling study. Neuroimage Clin 2024; 43:103627. [PMID: 38843759 PMCID: PMC11190556 DOI: 10.1016/j.nicl.2024.103627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 05/31/2024] [Accepted: 05/31/2024] [Indexed: 06/24/2024]
Abstract
Neuroimaging studies on healthy subjects described the causal effective connectivity of cerebellar-cerebral social mentalizing networks, revealing the presence of closed-loops. These studies estimated effective connectivity by applying Dynamic Causal Modeling on task-related fMRI data of healthy subjects performing mentalizing tasks. Thus far, few studies have applied Dynamic Causal Modeling to resting-state fMRI (rsfMRI) data to test the effective connectivity within the cerebellar-cerebral mentalizing network in the absence of experimental manipulations, and no study applied Dynamic Causal Modeling on fMRI data of patients with cerebellar disorders typically showing social cognition deficits. Thus, in this research we applied spectral Dynamic Causal Modeling, to rsfMRI data of 13 patients affected by spinocerebellar ataxia type 2 (SCA2) and of 23 matched healthy subjects. Specifically, effective connectivity was tested between acknowledged mentalizing regions of interest: bilateral cerebellar Crus II, dorsal and ventral medial prefrontal cortex, bilateral temporo-parietal junctions and precuneus. SCA2 and healthy subjects shared some similarities in cerebellar-cerebral mentalizing effective connectivity at rest, confirming the presence of closed-loops between cerebellar and cerebral mentalizing regions in both groups. However, relative to healthy subjects, SCA2 patients showed effective connectivity variations mostly in cerebellar-cerebral closed loops, namely weakened inhibitory connectivity from the cerebellum to the cerebral cortex, but stronger inhibitory connectivity from the cerebral cortex to the cerebellum. The present study demonstrated that effective connectivity changes affect a function-specific mentalizing network in SCA2 patients, allowing to deepen the direction and strength of the causal effective connectivity mechanisms driven by the cerebellar damage associated with SCA2.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, Italy; Ataxia Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy.
| | - Frank Van Overwalle
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Belgium
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Urbini N, Siciliano L, Olivito G, Leggio M. Unveiling the role of cerebellar alterations in the autonomic nervous system: a systematic review of autonomic dysfunction in spinocerebellar ataxias. J Neurol 2023; 270:5756-5772. [PMID: 37749264 PMCID: PMC10632228 DOI: 10.1007/s00415-023-11993-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Autonomic dysfunctions are prevalent in several cerebellar disorders, but they have not been systematically investigated in spinocerebellar ataxias (SCAs). Studies investigating autonomic deficits in SCAs are fragmented, with each one focusing on different autonomic dysfunctions and different SCA subtypes. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic review of the literature to assess the presence of autonomic dysfunctions in various SCAs. PubMed served as the primary database, and the Rayyan web application was employed for study screening. RESULTS We identified 46 articles investigating at least one autonomic function in patients with SCA. The results were analyzed and categorized based on the genetic subtype of SCA, thereby characterizing the specific autonomic deficits associated with each subtype. CONCLUSION This review confirms the presence of autonomic dysfunctions in various genetic subtypes of SCA, underscoring the cerebellum's role in the autonomic nervous system (ANS). It also emphasizes the importance of investigating these functions in clinical practice.
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Affiliation(s)
- Nicole Urbini
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy.
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy.
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185, Rome, Italy
- Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179, Rome, Italy
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Conrad J, Huppert A, Ruehl RM, Wuehr M, Schniepp R, Zu Eulenburg P. Disability in cerebellar ataxia syndromes is linked to cortical degeneration. J Neurol 2023; 270:5449-5460. [PMID: 37480400 PMCID: PMC10576698 DOI: 10.1007/s00415-023-11859-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE We aimed to relate clinical measures of disability in chronic cerebellar degeneration to structural whole-brain changes using voxel-based and surface-based morphometry (vbm and sbm). We were particularly interested in remote effects of cerebellar degeneration in the cerebral cortex. METHODS We recruited 30 patients with cerebellar degeneration of different aetiologies (downbeat nystagmus syndrome, DBN n = 14, spinocerebellar ataxia, SCA n = 9, sporadic adult late-onset ataxia, SAOA n = 7). All patients were thoroughly characterised in the motor, cognitive, vestibular and ocular-motor domains. Vbm and sbm were used to evaluate structural differences between cerebellar degeneration patients and a group of healthy age- and gender-matched volunteers. Linear regression models were used to correlate functional measures of disease progression and postural stability with whole brain volumetry. RESULTS Patients with SCA and SAOA showed widespread volume loss in the cerebellar hemispheres and less prominently in the vermis. Patients with DBN showed a distinct pattern of grey matter volume (GMV) loss that was restricted to the vestibular and ocular-motor representations in lobules IX, X and V-VII. Falls were associated with brainstem white matter volume. VBM and SBM linear regression models revealed associations between severity of ataxic symptoms, cognitive performance and preferred gait velocity. This included extra-cerebellar (sub-)cortical hubs of the motor and locomotion network (putamen, caudate, thalamus, primary motor cortex, prefrontal cortex) and multisensory areas involved in spatial navigation and cognition. CONCLUSION Functional disability in multiple domains was associated with structural changes in the cerebral cortex.
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Affiliation(s)
- Julian Conrad
- German Center for Vertigo and Balance Disorders and Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
- German Center for Vertigo and Balance Disorders (DSGZ), LMU Munich, Munich, Germany.
- Division for Neurodegenerative Diseases, Department of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, 68167, Mannheim, Germany.
| | - Anna Huppert
- German Center for Vertigo and Balance Disorders and Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - Ria Maxine Ruehl
- German Center for Vertigo and Balance Disorders and Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- German Center for Vertigo and Balance Disorders (DSGZ), LMU Munich, Munich, Germany
| | - Max Wuehr
- German Center for Vertigo and Balance Disorders (DSGZ), LMU Munich, Munich, Germany
| | - Roman Schniepp
- German Center for Vertigo and Balance Disorders and Department of Neurology, Munich University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- German Center for Vertigo and Balance Disorders (DSGZ), LMU Munich, Munich, Germany
| | - Peter Zu Eulenburg
- German Center for Vertigo and Balance Disorders (DSGZ), LMU Munich, Munich, Germany
- Institute for Neuroradiology LMU Munich, Munich, Germany
- Graduate School of Systemic Neurosciences-GSN, LMU Munich, Munich, Germany
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Siciliano L, Olivito G, Urbini N, Silveri MC, Leggio M. The rising role of cognitive reserve and associated compensatory brain networks in spinocerebellar ataxia type 2. J Neurol 2023; 270:5071-5084. [PMID: 37421466 PMCID: PMC10511586 DOI: 10.1007/s00415-023-11855-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/10/2023]
Abstract
Pre-existing or enhanced cognitive abilities influence symptom onset and severity in neurodegenerative diseases, which improve an individual's ability to deal with neurodegeneration. This process is named cognitive reserve (CR), and it has acquired high visibility in the field of neurodegeneration. However, the investigation of CR has been neglected in the context of cerebellar neurodegenerative disorders. The present study assessed CR and its impact on cognitive abilities in spinocerebellar ataxia type 2 (SCA2), which is a rare cerebellar neurodegenerative disease. We investigated the existence of CR networks in terms of compensatory mechanisms and neural reserve driven by increased cerebello-cerebral functional connectivity. The CR of 12 SCA2 patients was assessed using the Cognitive Reserve Index Questionnaire (CRIq), which was developed for appraising life-span CR. Patients underwent several neuropsychological tests to evaluate cognitive functioning and a functional MRI examination. Network based statistics analysis was used to assess functional brain networks. The results revealed significant correlations of CRIq measures with cognitive domains and patterns of increased connectivity in specific cerebellar and cerebral regions, which likely indicated CR networks. This study showed that CR may influence disease-related cognitive deficits, and it was related to the effective use of specific cerebello-cerebral networks that reflect a CR biomarker.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Nicole Urbini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | | | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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Olivito G, Siciliano L, Clausi S, Lupo M, Baiocco R, Gragnani A, Saettoni M, Delle Chiaie R, Laghi F, Leggio M. The Cerebellum Gets Social: Evidence from an Exploratory Study of Cerebellar, Neurodevelopmental, and Psychiatric Disorders. Biomedicines 2023; 11:309. [PMID: 36830846 PMCID: PMC9953169 DOI: 10.3390/biomedicines11020309] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Social prediction is a key feature of social cognition (SC), a function in which the modulating role of the cerebellum is recognized. Accordingly, cerebellar alterations are reported in cerebellar pathologies, neurodevelopmental disorders, and psychiatric conditions that show SC deficits. Nevertheless, to date, no study has directly compared populations representative of these three conditions with respect to SC and cerebellar alterations. Therefore, the present exploratory study aimed to compare the SC profiles of individuals with cerebellar neurodegenerative disorders (CB), autism (ASD), bipolar disorder type 2 (BD2), or healthy subjects (HS) using a battery of social tests requiring different degrees of prediction processing. The patterns of cerebellar gray matter (GM) alterations were compared among the groups using voxel-based morphometry. Compared to HS, the clinical groups showed common SC deficits in tasks involving a moderate to high level of prediction. The behavioral results of the clinical groups are consistent with the presence of overlapping GM reduction in cerebellar right Crus II, an area notably involved in complex social processing and prediction. Although exploratory and preliminary, these results deepen the cerebellar role in social prediction and highlight the transdiagnostic value of the cerebellum in social functioning and prediction in pathologies of different aetiologies, forecasting novel possibilities for shared interventions.
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Affiliation(s)
- Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Silvia Clausi
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Klinikos Center for Psychodiagnostics and Psychotherapy, Viale delle Milizie 38, 00192 Roma, Italy
| | - Michela Lupo
- Servizio di Tutela della Salute Mentale e Riabilitazione dell’Età Evolutiva ASL, Roma 2, 00145 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Roberto Delle Chiaie
- Department of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Roma, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
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Modulating mental state recognition by anodal tDCS over the cerebellum. Sci Rep 2022; 12:22616. [PMID: 36585436 PMCID: PMC9803656 DOI: 10.1038/s41598-022-26914-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
Increasing evidence from neuroimaging and clinical studies has demonstrated cerebellar involvement in social cognition components, including the mentalizing process. The aim of this study was to apply transcranial direct current stimulation (tDCS) to modulate cerebellar excitability to investigate the role the cerebellum plays in mental state recognition. Forty-eight healthy subjects were randomly assigned to different groups in which anodal, cathodal, or sham tDCS (2 mA for 20 min) was delivered centering the electrode on the vermis to stimulate the posterior portion of the cerebellum. The ability to attribute mental states to others was tested before and after tDCS using a digital version of the 'Reading the Mind in the Eyes test', which includes visual perceptive and motor stimuli as control conditions. Correct response and reaction times (RTs) were recorded. The results revealed a significant reduction in RTs between the baseline and post-stimulation sessions after cerebellar anodal tDCS only for mental state stimuli (Wilcoxon test p = 0.00055), whereas no significant effect was found in the cathodal or sham conditions or for visual perceptive and motor stimuli. Overall, our study suggests that cerebellar anodal tDCS might selectively improve mental state recognition and constitute an effective strategy to positively modulate the mentalizing process.
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Pu M, Ma Q, Haihambo N, Li M, Baeken C, Baetens K, Deroost N, Heleven E, Van Overwalle F. Dynamic causal modeling of cerebello-cerebral connectivity when sequencing trait-implying actions. Cereb Cortex 2022; 33:6366-6381. [PMID: 36573440 DOI: 10.1093/cercor/bhac510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/28/2022] Open
Abstract
Abstract
Prior studies suggest that the cerebellum contributes to the prediction of action sequences as well as the detection of social violations. In this dynamic causal modeling study, we explored the effective connectivity of the cerebellum with the cerebrum in processing social action sequences. A first model aimed to explore functional cerebello-cerebral connectivity when learning trait/stereotype-implying action sequences. We found many significant bidirectional connectivities between mentalizing areas of the cerebellum and the cerebrum including the temporo-parietal junction (TPJ) and medial prefrontal cortex (mPFC). Within the cerebrum, we found significant connectivity between the right TPJ and the mPFC, and between the TPJ bilaterally. A second model aimed to investigate cerebello-cerebral connectivity when conflicting information arises. We found many significant closed loops between the cerebellum and cerebral mentalizing (e.g. dorsal mPFC) and executive control areas (e.g. medial and lateral prefrontal cortices). Additional closed loops were found within the cerebral mentalizing and executive networks. The current results confirm prior research on effective connectivity linking the cerebellum with mentalizing areas in the cerebrum for predicting social sequences, and extend it to cerebral executive areas for social violations. Overall, this study emphasizes the critical role of cerebello-cerebral connectivity in understanding social sequences.
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Affiliation(s)
- Min Pu
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Qianying Ma
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Naem Haihambo
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Meijia Li
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Chris Baeken
- Ghent University Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent Experimental Psychiatry (GHEP) lab, , 9000, Ghent , Belgium
- University Hospital (UZBrussel) Department of Psychiatry, , 1090, Brussels , Belgium
- Eindhoven University of Technology , Department of Electrical Engineering, 5612, Eindhoven, Th e Netherlands
| | - Kris Baetens
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Natacha Deroost
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Elien Heleven
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
| | - Frank Van Overwalle
- Vrije Universiteit Brussel Faculty of Psychology and Center for Neuroscience, , 1050, Brussels , Belgium
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Siciliano L, Olivito G, Leggio M. The cerebellum gains weight: A systematic review of alterations in cerebellar volume and cerebro-cerebellar functional alterations in individuals with eating disorders. Neurosci Biobehav Rev 2022; 141:104863. [PMID: 36089105 DOI: 10.1016/j.neubiorev.2022.104863] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/10/2022] [Accepted: 09/04/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Brain imaging studies on eating disorders (EDs) often reported volumetric and functional changes involving the cerebellum. Nevertheless, few studies performed in-depth examinations and suggested a cerebellar role in the EDs' pathophysiology. METHODS A systematic literature search on volumetric changes and functional alterations involving the cerebellum in individuals with EDs was conducted using PubMed, PsychInfo and Web of Science. This review was conducted according to the Preferred Reporting Items for Systematic Reviews (PRISMA) statement and Rayyan web application for screening studies. RESULTS Twenty-four papers reporting cerebellar alterations in individuals with EDs were included in the study: 9 assessing brain volumetric changes, 9 investigating task-based functional brain activation and 6 investigating brain functional connectivity at rest. Most studies focused on anorectic-type EDs (n.22), while fewer involved bulimic-type EDs (n.9) and eating disorders not otherwise specified (n.2), revealing subtypes-specific patterns of altered cerebellar volume and functionality. CONCLUSIONS This review proposes critical arguments to consider the cerebellum as a key structure in the pathophysiology of EDs that requires further forthcoming exploration.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179 Rome, Italy.
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179 Rome, Italy.
| | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina 306-354, 00179 Rome, Italy.
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Siciliano L, Olivito G, Urbini N, Silveri MC, Leggio M. “Mens Sana in Corpore Sano”: The Emerging Link of Motor Reserve with Motor and Cognitive Abilities and Compensatory Brain Networks in SCA2 Patients. Biomedicines 2022; 10:biomedicines10092166. [PMID: 36140267 PMCID: PMC9496032 DOI: 10.3390/biomedicines10092166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
The ability to resiliently cope with neuropathological lesions is a key scientific concern. Accordingly, this study aims to investigate whether motor reserve (MR), likely to be boosted by exercise engagement in a lifetime, affects motor symptom severity, cognitive functioning, and functional brain networks in spinocerebellar ataxia type 2 (SCA2)—a cerebellar neurodegenerative disease. The MR of 12 SCA2 patients was assessed using the Motor Reserve Index Questionnaire (MRIq), developed ad hoc for estimating lifespan MR. The International Cooperative Ataxia Rating Scale was used to assess clinical motor features, and neuropsychological tests were used to evaluate cognitive functioning. Patients underwent an MRI examination, and network-based statistics (NBS) analysis was carried out to detect patterns of functional connectivity (FC). Significant correlations were found between MRIq measures and the severity of motor symptoms, educational and intellectual levels, executive function, and processing speed. NBS analysis revealed a higher FC within subnetworks consisting of specific cerebellar and cerebral areas. FC patterns were positively correlated with MRIq measures, likely indicating the identification of an MR network. The identified network might reflect a biomarker likely to underlie MR, influenced by education and cognitive functioning, and impacting the severity of motor symptoms.
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Affiliation(s)
- Libera Siciliano
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Nicole Urbini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | | | - Maria Leggio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Correspondence:
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11
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Clausi S, Siciliano L, Olivito G, Leggio M. Cerebellum and Emotion in Social Behavior. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1378:235-253. [PMID: 35902475 DOI: 10.1007/978-3-030-99550-8_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Accumulating evidence suggests that the cerebellum plays a crucial role not only in the motor and cognitive domains but also in emotions and social behavior. In the present chapter, after a general introduction on the significance of the emotional components of social behavior, we describe recent efforts to understand the contributions of the cerebellum in social cognition focusing on the emotional and affective aspects. Specifically, starting from the description of the cerebello-cortical networks subtending the social-affective domains, we illustrate the most recent findings on the social cerebellum and the possible functional mechanisms by which the cerebellum modulate social-affective behavior. Finally, we discuss the possible consequences of cerebellar dysfunction in the social-affective domain, focusing on those neurological and psychopathological conditions in which emotional and social behavior difficulties have been described as being associated with cerebellar structural or functional alterations.
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Affiliation(s)
- Silvia Clausi
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy. .,Psychology Department, Sapienza University, Rome, Italy.
| | - Libera Siciliano
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Giusy Olivito
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
| | - Maria Leggio
- Ataxia Laboratory, Santa Lucia Foundation IRCCS, Rome, Italy.,Psychology Department, Sapienza University, Rome, Italy
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Van Overwalle F, Baeken C, Campanella S, Crunelle CL, Heleven E, Kornreich C, Leggio M, Noël X, Vanderhasselt MA, Baetens K. The Role of the Posterior Cerebellum in Dysfunctional Social Sequencing. THE CEREBELLUM 2021; 21:1123-1134. [PMID: 34637054 DOI: 10.1007/s12311-021-01330-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 01/19/2023]
Abstract
Recent advances in social neuroscience have highlighted the critical role of the cerebellum in social cognition, and especially the posterior cerebellum. Studies have supported the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people's actions will be executed and what our most likely responses are to these actions. This mechanism allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand other's social behaviors and mental states (e.g., beliefs, intentions, traits). In this paper, we argue that the central role of the posterior cerebellum in identifying and automatizing social action sequencing provides a fruitful starting point for investigating social dysfunctions in a variety of clinical pathologies, such as autism, obsessive-compulsive and bipolar disorder, depression, and addiction. Our key hypothesis is that dysfunctions of the posterior cerebellum lead to under- or overuse of inflexible social routines and lack of plasticity for learning new, more adaptive, social automatisms. We briefly review past research supporting this view and propose a program of research to test our hypothesis. This approach might alleviate a variety of mental problems of individuals who suffer from inflexible automatizations that stand in the way of adjustable and intuitive social behavior, by increasing posterior cerebellar plasticity using noninvasive neurostimulation or neuro-guided training programs.
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Affiliation(s)
- Frank Van Overwalle
- Department of Psychology & Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium.
| | - Chris Baeken
- Department of Psychology & Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium.,Department of Psychiatry, Vrije Universiteit Brussel & Universitair Ziekenhuis Brussel, Brussel, Belgium.,Department of Psychiatry, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium.,Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Salvatore Campanella
- Laboratoire de Psychologie Médicale Et d'Addictologie, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium.,UNI Neuroscience Institute, Université Libre de Bruxelles, Bruxelles, Belgium.,Faculty of Psychology, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Cleo L Crunelle
- Department of Psychiatry, Vrije Universiteit Brussel & Universitair Ziekenhuis Brussel, Brussel, Belgium
| | - Elien Heleven
- Department of Psychology & Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale Et d'Addictologie, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium.,UNI Neuroscience Institute, Université Libre de Bruxelles, Bruxelles, Belgium.,Faculty of Psychology, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Maria Leggio
- Department of Psychology & Ataxia Laboratory, Fondazione Santa Lucia IRCCS, Sapienza University of Roma, Rome, Italy
| | - Xavier Noël
- Laboratoire de Psychologie Médicale Et d'Addictologie, Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium.,UNI Neuroscience Institute, Université Libre de Bruxelles, Bruxelles, Belgium.,Faculty of Psychology, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | - Kris Baetens
- Department of Psychology & Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium.,Brussels University Consultation Center, Vrije Universiteit Brussel, Brussel, Belgium
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13
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Identification of the Prodromal Symptoms and Pre-Ataxic Stage in Cerebellar Disorders: The Next Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910057. [PMID: 34639359 PMCID: PMC8507858 DOI: 10.3390/ijerph181910057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 02/02/2023]
Abstract
Cerebellar ataxias (CAs) manifest with a combination of motor incoordination, cognitive, affective and recently identified social symptoms. Novel therapies aim to stop the progression of the subgroup of the degenerative ataxias, or even to cure the disease with a functional and anatomical restoration of the cerebellar circuitry in the near future. The goal of stopping the progression of the disease is particularly relevant if applied at a very early stage of the disease, when the cerebellar reserve is only slightly impaired. Therefore, the search of the prodromal phase or pre-ataxic stage of CAs represents a very important challenge for the scientific community. The identification of pre-manifest individuals and the recruitment of individuals at risk has become a key-challenge to address neuroprotective therapies. The feasibility is high due to the recent progress in the biological and morphological biomarkers of CAs.
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14
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Rodríguez-Labrada R, Batista-Izquierdo A, González-Melix Z, Reynado-Cejas L, Vázquez-Mojena Y, Sanz YA, Canales-Ochoa N, González-Zaldívar Y, Dogan I, Reetz K, Velázquez-Pérez L. Cognitive Decline Is Closely Associated with Ataxia Severity in Spinocerebellar Ataxia Type 2: a Validation Study of the Schmahmann Syndrome Scale. THE CEREBELLUM 2021; 21:391-403. [PMID: 34313938 DOI: 10.1007/s12311-021-01305-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 01/10/2023]
Abstract
The cerebellar cognitive affective syndrome scale (CCAS-S) was designed to detect specific cognitive dysfunctions in cerebellar patients but is scarcely validated in spinocerebellar ataxias (SCA). The objective of this study is to determine the usefulness of the CCAS-S in a Cuban cohort of SCA2 patients and the relationship of its scores with disease severity. The original scale underwent a forward and backward translation into Spanish language, followed by a pilot study to evaluate its comprehensibility. Reliability, discriminant, and convergent validity assessments were conducted in 64 SCA2 patients and 64 healthy controls matched for sex, age, and education. Fifty patients completed the Montreal Cognitive Assessment (MoCA) test. The CCAS-S showed an acceptable internal consistency (Cronbach's alpha = 0.74) while its total raw score and the number of failed tests showed excellent (ICC = 0.94) and good (ICC = 0.89) test-retest reliability, respectively. Based on original cut-offs, the sensitivity of CCAS-S to detect possible/probable/definite CCAS was notably high (100%/100%/91%), but specificities were low (6%/30/64%) because the decreased specificity observed in four items. CCAS-S performance was significantly influenced by ataxia severity in patients and by education in both groups. CCAS-S scores correlated with MoCA scores, but showed higher sensitivity than MoCA to detect cognitive impairments in patients. The CCAS-S is particularly useful to detect cognitive impairments in SCA2 but some transcultural and/or age and education-dependent adaptations could be necessary to improve its diagnostic properties. Furthermore, this scale confirmed the parallelism between cognitive and motor deficits in SCA2, giving better insights into the disease pathophysiology and identifying novel outcomes for clinical trials.
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Affiliation(s)
- Roberto Rodríguez-Labrada
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.
- Cuban Center for Neurosciences, 190st between 25st and 27st, Cubanacan, Playa, 11300, Havana, Cuba.
| | | | | | | | - Yaimeé Vázquez-Mojena
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
- Cuban Center for Neurosciences, 190st between 25st and 27st, Cubanacan, Playa, 11300, Havana, Cuba
| | | | - Nalia Canales-Ochoa
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba
| | | | - Imis Dogan
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology, RWTH Aachen University, Aachen, Germany
- JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Juelich Research Center GmbH and RWTH Aachen University, Aachen, Germany
| | - Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Holguín, Cuba.
- Cuban Academy of Sciences, Cuba st 460, Between Teniente Rey St and Compostela St, Habana Vieja, 19100, Havana, Cuba.
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15
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Lupo M, Olivito G, Gragnani A, Saettoni M, Siciliano L, Pancheri C, Panfili M, Bozzali M, Delle Chiaie R, Leggio M. Comparison of Cerebellar Grey Matter Alterations in Bipolar and Cerebellar Patients: Evidence from Voxel-Based Analysis. Int J Mol Sci 2021; 22:ijms22073511. [PMID: 33805296 PMCID: PMC8036397 DOI: 10.3390/ijms22073511] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/26/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to compare the patterns of cerebellar alterations associated with bipolar disease with those induced by the presence of cerebellar neurodegenerative pathologies to clarify the potential cerebellar contribution to bipolar affective disturbance. Twenty-nine patients affected by bipolar disorder, 32 subjects affected by cerebellar neurodegenerative pathologies, and 37 age-matched healthy subjects underwent a 3T MRI protocol. A voxel-based morphometry analysis was used to show similarities and differences in cerebellar grey matter (GM) loss between the groups. We found a pattern of GM cerebellar alterations in both bipolar and cerebellar groups that involved the anterior and posterior cerebellar regions (p = 0.05). The direct comparison between bipolar and cerebellar patients demonstrated a significant difference in GM loss in cerebellar neurodegenerative patients in the bilateral anterior and posterior motor cerebellar regions, such as lobules I-IV, V, VI, VIIIa, VIIIb, IX, VIIb and vermis VI, while a pattern of overlapping GM loss was evident in right lobule V, right crus I and bilateral crus II. Our findings showed, for the first time, common and different alteration patterns of specific cerebellar lobules in bipolar and neurodegenerative cerebellar patients, which allowed us to hypothesize a cerebellar role in the cognitive and mood dysregulation symptoms that characterize bipolar disorder.
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Affiliation(s)
- Michela Lupo
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Correspondence: ; Tel.: +39-065-150-1115
| | - Giusy Olivito
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Gragnani
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy; (A.G.); (M.S.)
- Associazione Psicologia Cognitiva (APC)/Scuola di Psicoterapia Cognitiva (SPC), 00185 Rome, Italy
| | - Marco Saettoni
- Scuola di Psicoterapia Cognitiva SPC, 58100 Grosseto, Italy; (A.G.); (M.S.)
- Unità Funzionale Salute Mentale Adulti ASL Toscana Nord-Ovest Valle del Serchio, 56121 Pisa, Italy
| | - Libera Siciliano
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, 00185 Rome, Italy;
| | - Corinna Pancheri
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Matteo Panfili
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Marco Bozzali
- Clinical Imaging Science Center, Brighton and Sussex Medical School, Brighton BN1 9RR, UK;
| | - Roberto Delle Chiaie
- Departement of Neuroscience and Mental Health–Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (C.P.); (M.P.); (R.D.C.)
| | - Maria Leggio
- Ataxia Laboratory, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (G.O.); (M.L.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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16
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Impairments in Emotion Recognition and Risk-Taking Behavior After Isolated, Cerebellar Stroke. THE CEREBELLUM 2021; 19:419-425. [PMID: 32108305 PMCID: PMC7198481 DOI: 10.1007/s12311-020-01121-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
An increasing amount of research has shown a cerebellar involvement in higher order cognitive functions, including emotional processing and decision-making. However, it has not been investigated whether impairments in facial emotion recognition, which could be a marker of impaired emotional experiences, are related to risky decision-making in these patients. Therefore, we aimed to investigate facial emotion recognition and risky decision-making in these patients as well as to investigate a relationship between these constructs. Thirteen patients with a discrete, isolated, cerebellar lesion as a consequence of a stroke were included in the study. Emotion recognition was assessed with the Facial Expressions of Emotions—Stimuli and Test (FEEST). Risk-taking behavior was assessed with the Action Selection Test (AST). Furthermore, 106 matched healthy controls performed the FEEST and 20 matched healthy controls performed the AST. Compared with healthy controls, patients were significantly worse in the recognition of emotional expressions and they took significantly more risks. In addition, a worse ability to recognize fearful facial expressions was strongly related to an increase in risky decisions in the AST. Therefore, we suggest that tests of emotion recognition should be incorporated into the neuropsychological assessment after cerebellar stroke to boost detection and treatment of these impairments in these patients.
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17
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The neurobiological underpinning of the social cognition impairments in patients with spinocerebellar ataxia type 2. Cortex 2021; 138:101-112. [PMID: 33677324 DOI: 10.1016/j.cortex.2020.12.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/12/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022]
Abstract
Clinical studies described emotional and social behaviour alterations in patients with cerebellar diseases, proposing a role of specific cerebello-cerebral circuits in social cognition. However, for a long time these difficulties were underestimated, and no studies have addressed the correlation between social cognition deficits and topography of the cerebellar damage. The present study aims to investigate the social cognition impairment and the neuroanatomical alterations in patients with spinocerebellar ataxia type 2 (SCA2) and to analyze their relationship. To this purpose a social cognition battery composed by three tests, and a MRI protocol were administered to 13 SCA2 patients and 26 healthy subjects. The pattern of gray matter (GM) atrophy was analyzed by voxel-based morphometry, and the GM volumes of each altered area were correlated with the behavioral scores to investigate anatomo-functional relationships. In addition, we investigated the relationship between social deficits and damage to the cerebellar peduncles using DTI diffusivity indices. Our patients showed impairment of the immediate perceptual component of the mental state recognition (i.e., to recognize feelings and thoughts from the eyes expression), and difficulties in anger attribution, and in the understanding of false or mistaken beliefs. They showed a pattern of GM reduction in cerebellar regions, including lobules IX and VIIIb and Crus II, all of which are involved in specific components of the mentalizing process. Interestingly, the behavioral performance, in which SCA2 patients showed impairments compared to controls, correlated with the degree of cerebellar GM reduction and with the presence of microstructural abnormalities in the cerebellar peduncles. The present study provides the first characterization of the social cognition deficits in a homogenous cohort SCA2 patients and demonstrates that alterations in specific cerebellar regions should represent the neurobiological underpinning of their social behavior difficulties. Our results offer a new point of view in considering these aspects in the clinical practice.
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