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Wang Z, Diedrichsen J, Saltoun K, Steele C, Arnold-Anteraper SR, Yeo BTT, Schmahmann JD, Bzdok D. Structural covariation between cerebellum and neocortex intrinsic structural covariation links cerebellum subregions to the cerebral cortex. J Neurophysiol 2024; 132:849-869. [PMID: 39052236 PMCID: PMC11427046 DOI: 10.1152/jn.00164.2024] [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: 04/15/2024] [Revised: 07/17/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
The human cerebellum is increasingly recognized to be involved in nonmotor and higher-order cognitive functions. Yet, its ties with the entire cerebral cortex have not been holistically studied in a whole brain exploration with a unified analytical framework. Here, we characterized dissociable cortical-cerebellar structural covariation patterns based on regional gray matter volume (GMV) across the brain in n = 38,527 UK Biobank participants. Our results invigorate previous observations in that important shares of cortical-cerebellar structural covariation are described as 1) a dissociation between the higher-level cognitive system and lower-level sensorimotor system and 2) an anticorrelation between the visual-attention system and advanced associative networks within the cerebellum. We also discovered a novel pattern of ipsilateral, rather than contralateral, cerebral-cerebellar associations. Furthermore, phenome-wide association assays revealed key phenotypes, including cognitive phenotypes, lifestyle, physical properties, and blood assays, associated with each decomposed covariation pattern, helping to understand their real-world implications. This systems neuroscience view paves the way for future studies to explore the implications of these structural covariations, potentially illuminating new pathways in our understanding of neurological and cognitive disorders.NEW & NOTEWORTHY Cerebellum's association with the entire cerebral cortex has not been holistically studied in a unified way. Here, we conjointly characterize the population-level cortical-cerebellar structural covariation patterns leveraging ∼40,000 UK Biobank participants whole brain structural scans and ∼1,000 phenotypes. We revitalize the previous hypothesis of an anticorrelation between the visual-attention system and advanced associative networks within the cerebellum. We also discovered a novel ipsilateral cerebral-cerebellar associations. Phenome-wide association (PheWAS) revealed real-world implications of the structural covariation patterns.
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Affiliation(s)
- Zilong Wang
- McConnell Brain Imaging Centre, Department of Biomedical Engineering, Faculty of Medicine, School of Computer Science, The Neuro-Montreal Neurological Institute (MNI), McGill University, Montreal, Quebec, Canada
- Mila-Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Jörn Diedrichsen
- Western Institute for Neuroscience, Western University, London, Ontario, Canada
- Department of Computer Science, Western University, London, Ontario, Canada
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, Canada
| | - Karin Saltoun
- McConnell Brain Imaging Centre, Department of Biomedical Engineering, Faculty of Medicine, School of Computer Science, The Neuro-Montreal Neurological Institute (MNI), McGill University, Montreal, Quebec, Canada
- Mila-Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Christopher Steele
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sheeba Rani Arnold-Anteraper
- Advanced Imaging Research Center, UTSW, Dallas, Texas, United States
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, Illinois, United States
| | - B T Thomas Yeo
- Department of Electrical & Computer Engineering, Centre for Translational MR Research, Centre for Sleep & Cognition, N.1 Institute for Health and Institute for Digital Medicine, National University of Singapore, Singapore, Singapore
| | - Jeremy D Schmahmann
- Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Danilo Bzdok
- McConnell Brain Imaging Centre, Department of Biomedical Engineering, Faculty of Medicine, School of Computer Science, The Neuro-Montreal Neurological Institute (MNI), McGill University, Montreal, Quebec, Canada
- Mila-Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
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Moussa-Tooks AB, Beermann A, Manzanarez Felix K, Coleman M, Bouix S, Holt D, Lewandowski KE, Öngür D, Breier A, Shenton ME, Heckers S, Walther S, Brady RO, Ward HB. Isolation of Distinct Networks Driving Action and Cognition in Psychomotor Processes. Biol Psychiatry 2024; 96:390-400. [PMID: 38452884 PMCID: PMC11414019 DOI: 10.1016/j.biopsych.2024.02.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/02/2024] [Accepted: 02/23/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Psychomotor disturbances are observed across psychiatric disorders and often manifest as psychomotor slowing, agitation, disorganized behavior, or catatonia. Psychomotor function includes both cognitive and motor components, but the neural circuits driving these subprocesses and how they relate to symptoms have remained elusive for centuries. METHODS We analyzed data from the HCP-EP (Human Connectome Project for Early Psychosis), a multisite study of 125 participants with early psychosis and 58 healthy participants with resting-state functional magnetic resonance imaging and clinical characterization. Psychomotor function was assessed using the 9-hole pegboard task, a timed motor task that engages mechanical and psychomotor components of action, and tasks assessing processing speed and task switching. We used multivariate pattern analysis of whole-connectome data to identify brain correlates of psychomotor function. RESULTS We identified discrete brain circuits driving the cognitive and motor components of psychomotor function. In our combined sample of participants with psychosis (n = 89) and healthy control participants (n = 52), the strongest correlates of psychomotor function (pegboard performance) (p < .005) were between a midline cerebellar region and left frontal region and presupplementary motor area. Psychomotor function was correlated with both cerebellar-frontal connectivity (r = 0.33) and cerebellar-presupplementary motor area connectivity (r = 0.27). However, the cognitive component of psychomotor performance (task switching) was correlated only with cerebellar-frontal connectivity (r = 0.19), whereas the motor component (processing speed) was correlated only with cerebellar-presupplementary motor area connectivity (r = 0.15), suggesting distinct circuits driving unique subprocesses of psychomotor function. CONCLUSIONS We identified cerebellar-cortical circuits that drive distinct subprocesses of psychomotor function. Future studies should probe relationships between cerebellar connectivity and psychomotor performance using neuromodulation.
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Affiliation(s)
- Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Psychological and Brain Sciences and Program in Neuroscience, Indiana University Bloomington, Bloomington, Indiana
| | - Adam Beermann
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - Michael Coleman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Brigham & Women's Hospital, Boston, Massachusetts
| | - Sylvain Bouix
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Québec, Canada
| | - Daphne Holt
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Kathryn E Lewandowski
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Belmont, Massachusetts
| | - Dost Öngür
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Belmont, Massachusetts
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
| | - Martha E Shenton
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Brigham & Women's Hospital, Boston, Massachusetts; Department of Radiology, Harvard Medical School and Brigham & Women's Hospital, Boston, Massachusetts
| | - Stephan Heckers
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Sebastian Walther
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Roscoe O Brady
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Belmont, Massachusetts
| | - Heather Burrell Ward
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.
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Asaridou SS, Cler GJ, Wiedemann A, Krishnan S, Smith HJ, Willis HE, Healy MP, Watkins KE. Microstructural Properties of the Cerebellar Peduncles in Children With Developmental Language Disorder. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2024; 5:774-794. [PMID: 39175782 PMCID: PMC11338306 DOI: 10.1162/nol_a_00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 03/13/2024] [Indexed: 08/24/2024]
Abstract
Children with developmental language disorder (DLD) struggle to learn their native language for no apparent reason. While research on the neurobiological underpinnings of the disorder has focused on the role of corticostriatal systems, little is known about the role of the cerebellum in DLD. Corticocerebellar circuits might be involved in the disorder as they contribute to complex sensorimotor skill learning, including the acquisition of spoken language. Here, we used diffusion-weighted imaging data from 77 typically developing and 54 children with DLD and performed probabilistic tractography to identify the cerebellum's white matter tracts: the inferior, middle, and superior cerebellar peduncles. Children with DLD showed lower fractional anisotropy (FA) in the inferior cerebellar peduncles (ICP), fiber tracts that carry motor and sensory input via the inferior olive to the cerebellum. Lower FA in DLD was driven by lower axial diffusivity. Probing this further with more sophisticated modeling of diffusion data, we found higher orientation dispersion but no difference in neurite density in the ICP of children with DLD. Reduced FA is therefore unlikely to be reflecting microstructural differences in myelination, rather the organization of axons in these pathways is disrupted. ICP microstructure was not associated with language or motor coordination performance in our sample. We also found no differences in the middle and superior peduncles, the main pathways connecting the cerebellum with the cortex. To conclude, it is not corticocerebellar but atypical olivocerebellar white matter connections that characterize DLD and suggest the involvement of the olivocerebellar system in speech and language acquisition and development.
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Affiliation(s)
- Salomi S. Asaridou
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Gabriel J. Cler
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Anna Wiedemann
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Saloni Krishnan
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Surrey, UK
| | - Harriet J. Smith
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Hanna E. Willis
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Máiréad P. Healy
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kate E. Watkins
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
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Lee HS, Kim S, Kim H, Baik SM, Kim DH, Chang WH. No Additional Effects of Sequential Facilitatory Cerebral and Cerebellar rTMS in Subacute Stroke Patients. J Pers Med 2024; 14:687. [PMID: 39063941 PMCID: PMC11278256 DOI: 10.3390/jpm14070687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
The aim of this study was to investigate the additional effects of cerebellar rTMS on the motor recovery of facilitatory rTMS over affected primary motor cortex (M1) in subacute stroke patients. Twenty-eight subacute stroke patients were recruited in this single-blind, randomized, controlled trial. The Cr-Cbll group received Cr-Cbll rTMS stimulation consisting of high-frequency rTMS over affected M1 (10 min), motor training (10 min), and high-frequency rTMS over contralesional Cbll (10 min). The Cr-sham group received sham rTMS instead of high-frequency rTMS over the cerebellum. Ten daily sessions were performed for 2 weeks. A Fugl-Meyer Assessment (FMA) was measured before (T0), immediately after (T1), and 2 months after the intervention (T2). A total of 20 participants (10 in the Cr-Cbll group and 10 in the Cr-sham group) completed the intervention. There was no significant difference in clinical characteristics between the two groups at T0. FMA was significantly improved after the intervention in both Cr-Cbll and Cr-sham groups (p < 0.05). However, there was no significant interaction in FMA between time and group. In conclusion, these results could not demonstrate that rTMS over the contralesional cerebellum has additional effects to facilitatory rTMS over the affected M1 for improving motor function in subacute stroke patients.
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Affiliation(s)
- Ho Seok Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Sungwon Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Heegoo Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Seung-min Baik
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Dae Hyun Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
- Department of Health Sciences and Technology, Department of Medical Device Management & Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul 06355, Republic of Korea
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Asaridou SS, Cler GJ, Wiedemann A, Krishnan S, Smith HJ, Willis HE, Healy MP, Watkins KE. Microstructural Properties of the Cerebellar Peduncles in Children with Developmental Language Disorder. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.13.548858. [PMID: 37503009 PMCID: PMC10370025 DOI: 10.1101/2023.07.13.548858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Children with developmental language disorder (DLD) struggle to learn their native language for no apparent reason. While research on the neurobiological underpinnings of the disorder has focused on the role of cortico-striatal systems, little is known about the role of the cerebellum in DLD. Cortico-cerebellar circuits might be involved in the disorder as they contribute to complex sensorimotor skill learning, including the acquisition of spoken language. Here, we used diffusion-weighted imaging data from 77 typically developing and 54 children with DLD and performed probabilistic tractography to identify the cerebellum's white matter tracts: the inferior, middle, and superior cerebellar peduncles. Children with DLD showed lower fractional anisotropy (FA) in the inferior cerebellar peduncles (ICP), fiber tracts that carry motor and sensory input via the inferior olive to the cerebellum. Lower FA in DLD was driven by lower axial diffusivity. Probing this further with more sophisticated modeling of diffusion data, we found higher orientation dispersion but no difference in neurite density in the ICP of DLD. Reduced FA is therefore unlikely to be reflecting microstructural differences in myelination in this tract, rather the organization of axons in these pathways is disrupted. ICP microstructure was not associated with language or motor coordination performance in our sample. We also found no differences in the middle and superior peduncles, the main pathways connecting the cerebellum with the cortex. To conclude, it is not cortico-cerebellar but atypical olivocerebellar white matter connections that characterize DLD and suggest the involvement of the olivocerebellar system in speech acquisition and development.
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Affiliation(s)
- Salomi S. Asaridou
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Gabriel J. Cler
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Speech & Hearing Sciences, University of Washington, Seattle, USA
| | - Anna Wiedemann
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Saloni Krishnan
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Surrey, UK
| | - Harriet J. Smith
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Hanna E. Willis
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - Máiréad P. Healy
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Kate E. Watkins
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
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Matsugi A, Mori N, Hosomi K, Saitoh Y. Cerebellar repetitive transcranial magnetic stimulation modulates the motor learning of visually guided voluntary postural control task. Neurosci Lett 2022; 788:136859. [PMID: 36038031 DOI: 10.1016/j.neulet.2022.136859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 10/15/2022]
Abstract
We investigated whether vermal cerebellar low-frequency repetitive transcranial magnetic stimulation (crTMS) affects motor learning of visually guided postural tracking training (VTT) using foot center of pressure (COP) as well as the stability and sensory contribution of upright standing. Twenty-one healthy volunteers participated (10 in the sham-crTMS group and 11 in the active-crTMS group). For VTT, participants stood on the force plate 1.5 m from the monitor on which the COP and target moved in a circle. Participants tracked the target with their own COP for 1 min, and 10 VTT sessions were conducted. The tracking error (TE) was compared between trials. Active- or sham-crTMS sessions were conducted prior to VTT. At baseline (before crTMS), pre-VTT (after crTMS), and post-VTT, the COP trajectory during upright static standing under four conditions (eyes, open/closed; surface, hard/rubber) was recorded. Comparison of the length of the COP trajectory or path and sensory-contribution-rate showed no significant difference between baseline and pre- and post-VTT. There was a significant decrease in TE in the sham-crTMS but not in the active-crTMS group. VTT and crTMS did not immediately affect the stability and sensory contribution of upright standing; however, crTMS immediately affected motor learning. The vermal cerebellum may contribute to motor learning of voluntary postural control.
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Affiliation(s)
- Akiyoshi Matsugi
- Faculty of Rehabilitation, Shijonawate Gakuen University, Hojo 5-11-10, Daitou City, Osaka 574-0011, Japan.
| | - Nobuhiko Mori
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka 565-0871, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka 565-0871, Japan
| | - Youichi Saitoh
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Machikaneyama 1-3, Toyonaka City, Osaka 560-8531, Japan; Tokuyukai Rehabilitation Clinic, Shinsenri-nishimachi 2-24-18, Toyonaka City, Osaka 560-0083, Japan
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Matsugi A, Nishishita S, Yoshida N, Tanaka H, Douchi S, Bando K, Tsujimoto K, Honda T, Kikuchi Y, Shimizu Y, Odagaki M, Nakano H, Okada Y, Mori N, Hosomi K, Saitoh Y. Impact of Repetitive Transcranial Magnetic Stimulation to the Cerebellum on Performance of a Ballistic Targeting Movement. CEREBELLUM (LONDON, ENGLAND) 2022:10.1007/s12311-022-01438-9. [PMID: 35781778 DOI: 10.1007/s12311-022-01438-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) of the cerebellum on changes in motor performance during a series of repetitive ballistic-targeting tasks. Twenty-two healthy young adults (n = 12 in the active-rTMS group and n = 10 in the sham rTMS group) participated in this study. The participants sat on a chair in front of a monitor and fixed their right forearms to a manipulandum. They manipulated the handle with the flexion/extension of the wrist to move the bar on the monitor. Immediately after a beep sound was played, the participant moved the bar as quickly as possible to the target line. After the first 10 repetitions of the ballistic-targeting task, active or sham rTMS (1 Hz, 900 pulses) was applied to the right cerebellum. Subsequently, five sets of 100 repetitions of this task were conducted. Participants in the sham rTMS group showed improved reaction time, movement time, maximum velocity of movement, and targeting error after repetition. However, improvements were inhibited in the active-rTMS group. Low-frequency cerebellar rTMS may disrupt motor learning during repetitive ballistic-targeting tasks. This supports the hypothesis that the cerebellum contributes to motor learning and motor-error correction in ballistic-targeting movements.
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Affiliation(s)
- Akiyoshi Matsugi
- Faculty of Rehabilitation, Shijonawate Gakuen University, Hojo 5-11-10, Daitou city, Osaka, 574-0011, Japan.
| | - Satoru Nishishita
- Institute of Rehabilitation Science, Tokuyukai Medical Corporation, 3-11-1 Sakuranocho, Toyonaka City, Osaka, 560-0054, Japan.,Kansai Rehabilitation Hospital, 3-11-1 Sakuranocho, Toyonaka City, Osaka, 560-0054, Japan
| | - Naoki Yoshida
- Okayama Healthcare Professional University, Okayama, Japan
| | - Hiroaki Tanaka
- Department of Physical Medicine and Rehabilitation, Kansai Medical University Hirakata Hospital, Shinmachi 2-3-1, Hirakata City, Osaka, 573-1191, Japan.,Department of Physical Medicine and Rehabilitation, Kansai Medical University, Shinmachi 2-5-1, Hirakata City, Osaka, 573-1010, Japan
| | - Shinya Douchi
- Department of Rehabilitation, National Hospital Organization Kinki-chuo Chest Medical Center, 1180 Nagasone-Town, Kita-ku, Sakai, Osaka, 591-8025, Japan
| | - Kyota Bando
- National Center of Neurology and Psychiatry, National Center Hospital, Kodaira, 187-0031, Japan
| | - Kengo Tsujimoto
- National Center of Neurology and Psychiatry, National Center Hospital, Kodaira, 187-0031, Japan
| | - Takeru Honda
- Basic Technology Research Center, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan
| | - Yutaka Kikuchi
- Department of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohtamachi366, Isesaki City, Gunma, 372-0006, Japan
| | - Yuto Shimizu
- Department of Rehabilitation for Intractable Neurological Disorders, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohtamachi366, Isesaki City, Gunma, 372-0006, Japan
| | - Masato Odagaki
- Maebashi Institute of Technology, Maebashi, Gunma Prefecture, Japan
| | - Hideki Nakano
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan
| | - Yohei Okada
- Neurorehabilitation Research Center of Kio University, Nara, Koryo-cho, Kitakatsuragi-gun, 635-0832, Japan
| | - Nobuhiko Mori
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| | - Koichi Hosomi
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka, 565-0871, Japan
| | - Youichi Saitoh
- Department of Mechanical Science and Bioengineering, Osaka University Graduate School of Engineering Science, Machikaneyama 1-3, Toyonaka City, Osaka, 560-8531, Japan.,Tokuyukai Rehabilitation Clinic, Shinsenrinishimachi 2-24-18, Toyonaka City, Osaka, 560-0083, Japan
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León Ruiz M, Sospedra M, Arce Arce S, Tejeiro-Martínez J, Benito-León J. Current evidence on the potential therapeutic applications of transcranial magnetic stimulation in multiple sclerosis: a systematic review of the literature. NEUROLOGÍA (ENGLISH EDITION) 2022; 37:199-215. [PMID: 35465914 DOI: 10.1016/j.nrleng.2020.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/29/2018] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION A growing number of studies have evaluated the effects of transcranial magnetic stimulation (TMS) for the symptomatic treatment of multiple sclerosis (MS). METHODS We performed a PubMed search for articles, recent books, and recommendations from the most relevant clinical practice guidelines and scientific societies regarding the use of TMS as symptomatic treatment in MS. CONCLUSIONS Excitatory electromagnetic pulses applied to the affected cerebral hemisphere allow us to optimise functional brain activity, including the transmission of nerve impulses through the demyelinated corticospinal pathway. Various studies into TMS have safely shown statistically significant improvements in spasticity, fatigue, lower urinary tract dysfunction, manual dexterity, gait, and cognitive deficits related to working memory in patients with MS; however, the exact level of evidence has not been defined as the results have not been replicated in a sufficient number of controlled studies. Further well-designed, randomised, controlled clinical trials involving a greater number of patients are warranted to attain a higher level of evidence in order to recommend the appropriate use of TMS in MS patients across the board. TMS acts as an adjuvant with other symptomatic and immunomodulatory treatments. Additional studies should specifically investigate the effect of conventional repetitive TMS on fatigue in these patients, something that has yet to see the light of day.
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Affiliation(s)
- M León Ruiz
- Servicio de Neurología, Clínica San Vicente, Madrid, Spain; Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
| | - M Sospedra
- Sección de Neuroinmunología y de Investigación en Esclerosis Múltiple, Departamento de Neurología, Hospital Universitario de Zúrich, Zurich, Switzerland
| | - S Arce Arce
- Servicio de Psiquiatría, Clínica San Vicente, Madrid, Spain; Departamento de Dirección Médica, Clínica San Vicente, Madrid, Spain
| | - J Tejeiro-Martínez
- Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | - J Benito-León
- Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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León Ruiz M, Sospedra M, Arce Arce S, Tejeiro-Martínez J, Benito-León J. Current evidence on the potential therapeutic applications of transcranial magnetic stimulation in multiple sclerosis: A systematic review of the literature. Neurologia 2022; 37:199-215. [PMID: 29898858 DOI: 10.1016/j.nrl.2018.03.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/03/2018] [Accepted: 03/29/2018] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION A growing number of studies have evaluated the effects of transcranial magnetic stimulation (TMS) for the symptomatic treatment of multiple sclerosis (MS). METHODS We performed a PubMed search for articles, recent books, and recommendations from the most relevant clinical practice guidelines and scientific societies regarding the use of TMS as symptomatic treatment in MS. CONCLUSIONS Excitatory electromagnetic pulses applied to the affected cerebral hemisphere allow us to optimise functional brain activity, including the transmission of nerve impulses through the demyelinated corticospinal pathway. Various studies into TMS have safely shown statistically significant improvements in spasticity, fatigue, lower urinary tract dysfunction, manual dexterity, gait, and cognitive deficits related to working memory in patients with MS; however, the exact level of evidence has not been defined as the results have not been replicated in a sufficient number of controlled studies. Further well-designed, randomised, controlled clinical trials involving a greater number of patients are warranted to attain a higher level of evidence in order to recommend the appropriate use of TMS in MS patients across the board. TMS acts as an adjuvant with other symptomatic and immunomodulatory treatments. Additional studies should specifically investigate the effect of conventional repetitive TMS on fatigue in these patients, something that has yet to see the light of day.
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Affiliation(s)
- M León Ruiz
- Servicio de Neurología, Clínica San Vicente, Madrid, España; Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
| | - M Sospedra
- Sección de Neuroinmunología y de Investigación en Esclerosis Múltiple, Departamento de Neurología, Hospital Universitario de Zúrich, Zúrich, Suiza
| | - S Arce Arce
- Servicio de Psiquiatría, Clínica San Vicente, Madrid, España; Departamento de Dirección Médica, Clínica San Vicente, Madrid, España
| | - J Tejeiro-Martínez
- Servicio de Neurología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España
| | - J Benito-León
- Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, España
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10
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Tacyildiz AE, Bilgin B, Gungor A, Ucer M, Karadag A, Tanriover N. Dentate Nucleus: Connectivity-Based Anatomic Parcellation Based on Superior Cerebellar Peduncle Projections. World Neurosurg 2021; 152:e408-e428. [PMID: 34062299 DOI: 10.1016/j.wneu.2021.05.102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Projections from the dentate nucleus (DN) follow a certain organized course to upper levels. Crossing and noncrossing fibers of the dentatorubrothalamic (DRT) tract terminate in the red nucleus and thalamus and have various connections throughout the cerebral cortex. We aimed to establish the microsurgical anatomy of the DN in relation to its efferent connections to complement the increased recognition of its surgical importance and also to provide an insight into the network-associated symptoms related to lesions and microsurgery in and around the region. METHODS The cerebellum, DN, and superior cerebellar peduncle (SCP) en route to red nucleus were examined through fiber dissections from the anterior, posterior, and lateral sides to define the connections of the DN and its relationships with adjacent neural structures. RESULTS The DN was anatomically divided into 4 areas based on its relation to the SCP; the lateral major, lateral anterosuperior, posteromedial, and anteromedial compartments. Most of the fibers originating from the lateral compartments were involved in the decussation of the SCP. The ventral fibers originating from the lateral anterosuperior compartment were exclusively involved in the decussation. The fibers from the posteromedial compartment ascended ipsilaterally and decussated, whereas most anteromedial fibers ascended ipsilaterally and did not participate in the decussation. CONCLUSIONS Clarifying the anatomofunctional organization of the DN in relation to the SCP could improve microneurosurgical results by reducing the complication rates during infratentorial surgery in and around the nucleus. The proposed compartmentalization would be a major step forward in this effort.
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Affiliation(s)
- Abdullah Emre Tacyildiz
- Department of Neurosurgery, Karabuk Research and Training Hospital, Health Science University, Karabuk, Turkey; Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Berra Bilgin
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey; Department of Neurosurgery, Tepecik Research and Training Hospital, Health Science University, Izmir, Turkey
| | - Abuzer Gungor
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey; Department of Neurosurgery, Umraniye Research and Training Hospital, Health Science University, Istanbul, Turkey
| | - Melih Ucer
- Department of Neurosurgery, Kanuni Sultan Suleyman Research and Training Hospital, Health Science University, Istanbul, Turkey
| | - Ali Karadag
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey; Department of Neurosurgery, Tepecik Research and Training Hospital, Health Science University, Izmir, Turkey
| | - Necmettin Tanriover
- Microsurgical Neuroanatomy Laboratory, Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey; Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
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11
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Tsuboi T, Wong JK, Eisinger RS, Okromelidze L, Burns MR, Ramirez-Zamora A, Almeida L, Wagle Shukla A, Foote KD, Okun MS, Grewal SS, Middlebrooks EH. Comparative connectivity correlates of dystonic and essential tremor deep brain stimulation. Brain 2021; 144:1774-1786. [PMID: 33889943 DOI: 10.1093/brain/awab074] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/25/2021] [Accepted: 02/15/2021] [Indexed: 11/14/2022] Open
Abstract
The pathophysiology of dystonic tremor and essential tremor remains partially understood. In patients with medication-refractory dystonic tremor or essential tremor, deep brain stimulation (DBS) targeting the thalamus or posterior subthalamic area has evolved into a promising treatment option. However, the optimal DBS targets for these disorders remains unknown. This retrospective study explored the optimal targets for DBS in essential tremor and dystonic tremor using a combination of volumes of tissue activated estimation and functional and structural connectivity analyses. We included 20 patients with dystonic tremor who underwent unilateral thalamic DBS, along with a matched cohort of 20 patients with essential tremor DBS. Tremor severity was assessed preoperatively and approximately 6 months after DBS implantation using the Fahn-Tolosa-Marin Tremor Rating Scale. The tremor-suppressing effects of DBS were estimated using the percentage improvement in the unilateral tremor-rating scale score contralateral to the side of implantation. The optimal stimulation region, based on the cluster centre of gravity for peak contralateral motor score improvement, for essential tremor was located in the ventral intermediate nucleus region and for dystonic tremor in the ventralis oralis posterior nucleus region along the ventral intermediate nucleus/ventralis oralis posterior nucleus border (4 mm anterior and 3 mm superior to that for essential tremor). Both disorders showed similar functional connectivity patterns: a positive correlation between tremor improvement and involvement of the primary sensorimotor, secondary motor and associative prefrontal regions. Tremor improvement, however, was tightly correlated with the primary sensorimotor regions in essential tremor, whereas in dystonic tremor, the correlation was tighter with the premotor and prefrontal regions. The dentato-rubro-thalamic tract, comprising the decussating and non-decussating fibres, significantly correlated with tremor improvement in both dystonic and essential tremor. In contrast, the pallidothalamic tracts, which primarily project to the ventralis oralis posterior nucleus region, significantly correlated with tremor improvement only in dystonic tremor. Our findings support the hypothesis that the pathophysiology underpinning dystonic tremor involves both the cerebello-thalamo-cortical network and the basal ganglia-thalamo-cortical network. Further our data suggest that the pathophysiology of essential tremor is primarily attributable to the abnormalities within the cerebello-thalamo-cortical network. We conclude that the ventral intermediate nucleus/ventralis oralis posterior nucleus border and ventral intermediate nucleus region may be a reasonable DBS target for patients with medication-refractory dystonic tremor and essential tremor, respectively. Uncovering the pathophysiology of these disorders may in the future aid in further improving DBS outcomes.
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Affiliation(s)
- Takashi Tsuboi
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA.,Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Joshua K Wong
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Robert S Eisinger
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | | | - Mathew R Burns
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Adolfo Ramirez-Zamora
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Leonardo Almeida
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Aparna Wagle Shukla
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Kelly D Foote
- Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | | | - Erik H Middlebrooks
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA.,Department of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
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12
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Course induced dexterity development and cerebellar grey matter growth of dentistry students: a randomised trial. Sci Rep 2021; 11:6188. [PMID: 33731734 PMCID: PMC7969763 DOI: 10.1038/s41598-021-84549-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/01/2021] [Indexed: 11/08/2022] Open
Abstract
This study primarily focuses on the assessment of dentistry students’ improvement of manual skills resulting from their participation in courses. We aimed to prove that systematic manual skills development significantly improves dexterity. We hypothesized that the dexterity training regimen improves manual dexterity demonstrated by the HAM-Man (Hamburg Assessment Test for Medicine-Manual Dexterity) test scores and CGM (cerebellar grey matter) growth. Thirty volunteers were randomly divided into two equal groups (study and control). Firstly, volunteers were examined by the HAM-Man test and baseline MRI scans. Afterwards, a manual skills development course was launched for the “study group”. Secondly, all the manual skills of the students were evaluated longitudinally, by the HAM-Man test. Simultaneously, the follow-up MRI scans were taken to observe morphologic changes in the cerebellum. The Wilcoxon signed-rank test and Student Paired t-test were used for statistical analyses. Value p < 0.05 was considered significant. After the training, significant growth of CGM as well as improvement on manual skill assessment tests, were found in the study group. Training courses are suitable for preparing students with low levels of dexterity for performing demanding tasks. The improvement is demonstrable by a wire bending test and by bilateral CGM enlargement as well.
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13
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Darch HT, Cerminara NL, Gilchrist ID, Apps R. Pre-movement changes in sensorimotor beta oscillations predict motor adaptation drive. Sci Rep 2020; 10:17946. [PMID: 33087847 PMCID: PMC7578788 DOI: 10.1038/s41598-020-74833-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/28/2020] [Indexed: 11/09/2022] Open
Abstract
Beta frequency oscillations in scalp electroencephalography (EEG) recordings over the primary motor cortex have been associated with the preparation and execution of voluntary movements. Here, we test whether changes in beta frequency are related to the preparation of adapted movements in human, and whether such effects generalise to other species (cat). Eleven healthy adult humans performed a joystick visuomotor adaptation task. Beta (15-25 Hz) scalp EEG signals recorded over the motor cortex during a pre-movement preparatory phase were, on average, significantly reduced in amplitude during early adaptation trials compared to baseline, late adaptation, or aftereffect trials. The changes in beta were not related to measurements of reaction time or reach duration. We also recorded local field potential (LFP) activity within the primary motor cortex of three cats during a prism visuomotor adaptation task. Analysis of these signals revealed similar reductions in motor cortical LFP beta frequencies during early adaptation. This effect was present when controlling for any influence of the reaction time and reach duration. Overall, the results are consistent with a reduction in pre-movement beta oscillations predicting an increase in adaptive drive in upcoming task performance when motor errors are largest in magnitude and the rate of adaptation is greatest.
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Affiliation(s)
- Henry T Darch
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Nadia L Cerminara
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK
| | - Iain D Gilchrist
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK.
| | - Richard Apps
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.
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14
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An Implicit Plan Still Overrides an Explicit Strategy During Visuomotor Adaptation Following Repetitive Transcranial Magnetic Stimulation of the Cerebellum. EXPERIMENTAL RESULTS 2020. [DOI: 10.1017/exp.2020.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AbstractMotor adaptation is a process by which the brain gradually reduces error induced by a predictable change in the environment, e.g., pointing while wearing prism glasses. It is thought to occur via largely implicit processes, though explicit strategies are also thought to contribute. Research suggests a role of the cerebellum in the implicit aspects of motor adaptation. Using non-invasive brain stimulation, we sought to investigate the involvement of the cerebellum in implicit motor adaptation in healthy participants. Inhibition of the cerebellum was attained through repetitive transcranial magnetic stimulation (rTMS), after which participants performed a visuomotor-rotation task while using an explicit strategy. Adaptation and aftereffects of the TMS group showed no difference in behaviour compared to a Sham stimulation group, therefore this study did not provide any further evidence of a specific role of the cerebellum in implicit motor adaptation. However, our behavioral findings replicate those in the seminal study by Mazzoni and Krakauer (2006).
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15
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Matsugi A, Douchi S, Hasada R, Mori N, Okada Y, Yoshida N, Nishishita S, Hosomi K, Saitoh Y. Cerebellar Repetitive Transcranial Magnetic Stimulation and Noisy Galvanic Vestibular Stimulation Change Vestibulospinal Function. Front Neurosci 2020; 14:388. [PMID: 32410952 PMCID: PMC7198759 DOI: 10.3389/fnins.2020.00388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/30/2020] [Indexed: 12/30/2022] Open
Abstract
Background The cerebellum strongly contributes to vestibulospinal function, and the modulation of vestibulospinal function is important for rehabilitation. As transcranial magnetic stimulation (TMS) and electrical stimulation may induce functional changes in neural systems, we investigated whether cerebellar repetitive TMS (crTMS) and noisy galvanic vestibular stimulation (nGVS) could modulate vestibulospinal response excitability. We also sought to determine whether crTMS could influence the effect of nGVS. Methods Fifty-nine healthy adults were recruited; 28 were randomly allocated to a real-crTMS group and 31 to a sham-crTMS group. The crTMS was conducted using 900 pulses at 1 Hz, while the participants were in a static position. After the crTMS, each participant was allocated to either a real-nGVS group or sham-nGVS group, and nGVS was delivered (15 min., 1 mA; 0.1–640 Hz) while patients were in a static position. The H-reflex ratio (with/without bilateral bipolar square wave pulse GVS), which reflects vestibulospinal excitability, was measured at pre-crTMS, post-crTMS, and post-nGVS. Results We found that crTMS alone and nGVS alone have no effect on H-reflex ratio but that the effect of nGVS was obtained after crTMS. Conclusion crTMS and nGVS appear to act as neuromodulators of vestibulospinal function.
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Affiliation(s)
- Akiyoshi Matsugi
- Faculty of Rehabilitation, Shijonawate Gakuen University, Daito, Japan
| | - Shinya Douchi
- Department of Rehabilitation, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Rikiya Hasada
- Department of Rehabilitation, Nagahara Hospital, Higasiosaka, Japan
| | - Nobuhiko Mori
- Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yohei Okada
- Faculty of Health Sciences, Kio University, Koryo, Japan.,Neurorehabilitation Research Center, Kio University, Koryo, Japan
| | - Naoki Yoshida
- Institute of Rehabilitation Science, Tokuyukai Medical Corporation, Toyonaka, Japan.,Kansai Rehabilitation Hospital, Toyonaka, Japan
| | - Satoru Nishishita
- Institute of Rehabilitation Science, Tokuyukai Medical Corporation, Toyonaka, Japan.,Kansai Rehabilitation Hospital, Toyonaka, Japan
| | - Koichi Hosomi
- Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Youichi Saitoh
- Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan.,Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka, Japan
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16
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Samuelsson JG, Sundaram P, Khan S, Sereno MI, Hämäläinen MS. Detectability of cerebellar activity with magnetoencephalography and electroencephalography. Hum Brain Mapp 2020; 41:2357-2372. [PMID: 32115870 PMCID: PMC7244390 DOI: 10.1002/hbm.24951] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/15/2019] [Accepted: 02/01/2020] [Indexed: 12/31/2022] Open
Abstract
Electrophysiological signals from the cerebellum have traditionally been viewed as inaccessible to magnetoencephalography (MEG) and electroencephalography (EEG). Here, we challenge this position by investigating the ability of MEG and EEG to detect cerebellar activity using a model that employs a high‐resolution tessellation of the cerebellar cortex. The tessellation was constructed from repetitive high‐field (9.4T) structural magnetic resonance imaging (MRI) of an ex vivo human cerebellum. A boundary‐element forward model was then used to simulate the M/EEG signals resulting from neural activity in the cerebellar cortex. Despite significant signal cancelation due to the highly convoluted cerebellar cortex, we found that the cerebellar signal was on average only 30–60% weaker than the cortical signal. We also made detailed M/EEG sensitivity maps and found that MEG and EEG have highly complementary sensitivity distributions over the cerebellar cortex. Based on previous fMRI studies combined with our M/EEG sensitivity maps, we discuss experimental paradigms that are likely to offer high M/EEG sensitivity to cerebellar activity. Taken together, these results show that cerebellar activity should be clearly detectable by current M/EEG systems with an appropriate experimental setup.
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Affiliation(s)
- John G Samuelsson
- Harvard-MIT Division of Health Sciences and Technology (HST), Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Padmavathi Sundaram
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sheraz Khan
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Martin I Sereno
- Department of Psychology and Neuroimaging Center, San Diego State University, San Diego, California, USA.,Experimental Psychology, University College London, London, UK
| | - Matti S Hämäläinen
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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17
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Boggs DL, Cortes-Briones JA, Surti T, Luddy C, Ranganathan M, Cahill JD, Sewell AR, D'Souza DC, Skosnik PD. The dose-dependent psychomotor effects of intravenous delta-9-tetrahydrocannabinol (Δ 9-THC) in humans. J Psychopharmacol 2018; 32:1308-1318. [PMID: 30255720 DOI: 10.1177/0269881118799953] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Binding studies have demonstrated that levels of the cannabinoid receptor type-1 are highest in the basal ganglia and cerebellum, two areas critical for motor control. However, no studies have systematically examined the dose-related effects of intravenous delta-9-tetrahydrocannabinol, the primary cannabinoid receptor type-1 partial agonist in cannabis, on broad domains of psychomotor function in humans. AIMS Therefore, three domains of psychomotor function were assessed in former cannabis users (cannabis abstinent for a minimum of three months; n=23) in a three test-day, within-subject, double-blind, randomized, cross-over, and counterbalanced study during which they received intravenous delta-9-tetrahydrocannabinol (placebo, 0.015 mg/kg, and 0.03 mg/kg). METHODS Gross motor function was assessed via the Cambridge Neuropsychological Test Automated Battery Motor Screening Task, fine motor control via the Lafayette Instrument Grooved Pegboard task, and motor timing via a Paced Finger-Tapping Task. In addition, the Cambridge Neuropsychological Test Automated Battery Rapid Visual Processing Task was utilized to determine whether delta-9-tetrahydrocannabinol-induced motor deficits were confounded by disruptions in sustained attention. RESULTS/OUTCOMES Delta-9-tetrahydrocannabinol resulted in robust dose-dependent deficits in fine motor control (Grooved Pegboard Task) and motor timing (Paced Finger-Tapping Task), while gross motor performance (Motor Screening Task) and sustained attention (Rapid Visual Processing Task) were unimpaired. Interestingly, despite the observed dose-dependent increases in motor impairment and blood levels of delta-9-tetrahydrocannabinol, subjects reported similar levels of intoxication in the two drug conditions. CONCLUSIONS/INTERPRETATION These data suggest that while several domains of motor function are disrupted by delta-9-tetrahydrocannabinol, subjective feelings of intoxication are dissociable from cannabinoid-induced psychomotor effects. Results are discussed in terms of the potential neural mechanisms of delta-9-tetrahydrocannabinol in motor structures.
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Affiliation(s)
- Douglas L Boggs
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Jose A Cortes-Briones
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Toral Surti
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Christina Luddy
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Mohini Ranganathan
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - John D Cahill
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Andrew R Sewell
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Deepak C D'Souza
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Patrick D Skosnik
- 1 Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA.,2 Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA
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18
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Abstract
Transcranial magnetic and electric stimulation of the brain are novel and highly promising techniques currently employed in both research and clinical practice. Improving or rehabilitating brain functions by modulating excitability with these noninvasive tools is an exciting new area in neuroscience. Since the cerebellum is closely connected with the cerebral regions subserving motor, associative, and affective functions, the cerebello-thalamo-cortical pathways are an interesting target for these new techniques. Targeting the cerebellum represents a novel way to modulate the excitability of remote cortical regions and their functions. This review brings together the studies that have applied cerebellar stimulation, magnetic and electric, and presents an overview of the current knowledge and unsolved issues. Some recommendations for future research are implemented as well.
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19
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Non-invasive Cerebellar Stimulation: a Promising Approach for Stroke Recovery? THE CEREBELLUM 2017; 17:359-371. [DOI: 10.1007/s12311-017-0906-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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20
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Gheysen F, Lasne G, Pélégrini-Issac M, Albouy G, Meunier S, Benali H, Doyon J, Popa T. Taking the brakes off the learning curve. Hum Brain Mapp 2016; 38:1676-1691. [PMID: 28009072 DOI: 10.1002/hbm.23489] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/14/2016] [Accepted: 12/01/2016] [Indexed: 11/07/2022] Open
Abstract
Motor learning is characterized by patterns of cerebello-striato-cortical activations shifting in time, yet the early dynamic and function of these activations remains unclear. Five groups of subjects underwent either continuous or intermittent theta-burst stimulation of one cerebellar hemisphere, or no stimulation just before learning a new motor sequence during fMRI scanning. We identified three phases during initial learning: one rapid, one slow, and one quasi-asymptotic performance phase. These phases were not changed by left cerebellar stimulation. Right cerebellar inhibition, however, accelerated learning and enhanced brain activation in critical motor learning-related areas during the first phase, continuing with reduced brain activation but high-performance in late phase. Right cerebellar excitation did not affect the early learning process, but slowed learning significantly in late phase, along with increased brain activation. We conclude that the right cerebellum is a key factor coordinating other neuronal loops in the early acquisition of an explicit motor sequential skill. Hum Brain Mapp 38:1676-1691, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Freja Gheysen
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.,Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Gabriel Lasne
- Sorbonne Universités, UPMC Univ Paris 06, Inserm U1146, CNRS UMR7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Mélanie Pélégrini-Issac
- Sorbonne Universités, UPMC Univ Paris 06, Inserm U1146, CNRS UMR7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Genevieve Albouy
- Functional Neuroimaging Unit, University of Montreal Geriatric Institute, Montreal, Quebec, Canada.,Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Movement Control and Neuroplasticity Research Group, Kinesiology Department, KU Leuven, Leuven, Belgium
| | - Sabine Meunier
- Institut du Cerveau et de la Moelle Épinière (ICM), UPMC Univ Paris 06 UMR S975, Inserm U1127, CNRS UMR 7225, Paris, France
| | - Habib Benali
- Sorbonne Universités, UPMC Univ Paris 06, Inserm U1146, CNRS UMR7371, Laboratoire d'Imagerie Biomédicale, Paris, France
| | - Julien Doyon
- Functional Neuroimaging Unit, University of Montreal Geriatric Institute, Montreal, Quebec, Canada.,Department of Psychology, University of Montreal, Montreal, Quebec, Canada
| | - Traian Popa
- Institut du Cerveau et de la Moelle Épinière (ICM), UPMC Univ Paris 06 UMR S975, Inserm U1127, CNRS UMR 7225, Paris, France
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Argyropoulos GPD. The cerebellum, internal models and prediction in 'non-motor' aspects of language: A critical review. BRAIN AND LANGUAGE 2016; 161:4-17. [PMID: 26320734 DOI: 10.1016/j.bandl.2015.08.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/25/2015] [Accepted: 08/06/2015] [Indexed: 06/04/2023]
Abstract
The emergence of studies on cerebellar contributions in 'non-motor' aspects of predictive language processing has long been awaited by researchers investigating the neural foundations of language and cognition. Despite (i) progress in research implicating the cerebellum in language processing, (ii) the widely-accepted nature of the uniform, multi-modal computation that the cerebellum implements in the form of internal models, as well as (iii) the long tradition of psycholinguistic studies addressing prediction mechanisms, research directly addressing cerebellar contributions to 'non-motor' predictive language processing has only surfaced in the last five years. This paper provides the first review of this novel field, along with a critical assessment of the studies conducted so far. While encouraging, the evidence for cerebellar involvement in 'non-motor' aspects of predictive language processing remains inconclusive under further scrutiny. Future directions are finally discussed with respect to outstanding questions in this novel field of research.
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Affiliation(s)
- Georgios P D Argyropoulos
- Developmental Neurosciences Programme, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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22
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Naro A, Leo A, Russo M, Cannavò A, Milardi D, Bramanti P, Calabrò RS. Does Transcranial Alternating Current Stimulation Induce Cerebellum Plasticity? Feasibility, Safety and Efficacy of a Novel Electrophysiological Approach. Brain Stimul 2016; 9:388-395. [PMID: 26946958 DOI: 10.1016/j.brs.2016.02.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cerebellum-brain functional connectivity can be shaped through different non-invasive neurostimulation approaches. In this study, we propose a novel approach to perturb the cerebellum-brain functional connectivity by means of transcranial alternating current stimulation (tACS). METHODS Twenty-five healthy individuals underwent a cerebellar tACS protocol employing different frequencies (10, 50, and 300 Hz) and a sham-tACS over the right cerebellar hemisphere. We measured their after-effects on the motor evoked potential (MEP) amplitude, the cerebellum-brain inhibition (CBI), the long-latency intracortical inhibition (LICI), from the primary motor cortex of both the hemispheres. In addition, we assessed the functional adaptation to a right hand sequential tapping motor task. RESULTS None of the participants had any side-effect. Following 50 Hz-tACS, we observed a clear contralateral CBI weakening, paralleled by a MEP increase with a better adaptation to frequency variations during the sequential tapping. The 300 Hz-tACS induced a contralateral CBI strengthening, without significant MEP and kinematic after-effects. The 10 Hz-tACS conditioning was instead ineffective. CONCLUSIONS We may argue that tACS protocols could have interfered with the activity of CBI-sustaining Purkinje cell, affecting motor adaptation. Our safe approach seems promising in studying the cerebellum-brain functional connectivity, with possible implications in neurorehabilitative settings.
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Affiliation(s)
- Antonino Naro
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | - Antonino Leo
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy
| | | | | | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Italy
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Meola A, Comert A, Yeh FC, Sivakanthan S, Fernandez-Miranda JC. The nondecussating pathway of the dentatorubrothalamic tract in humans: human connectome-based tractographic study and microdissection validation. J Neurosurg 2015; 124:1406-12. [PMID: 26452117 DOI: 10.3171/2015.4.jns142741] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The dentatorubrothalamic tract (DRTT) is the major efferent cerebellar pathway arising from the dentate nucleus (DN) and decussating to the contralateral red nucleus (RN) and thalamus. Surprisingly, hemispheric cerebellar output influences bilateral limb movements. In animals, uncrossed projections from the DN to the ipsilateral RN and thalamus may explain this phenomenon. The aim of this study was to clarify the anatomy of the dentatorubrothalamic connections in humans. METHODS The authors applied advanced deterministic fiber tractography to a template of 488 subjects from the Human Connectome Project (Q1-Q3 release, WU-Minn HCP consortium) and validated the results with microsurgical dissection of cadaveric brains prepared according to Klingler's method. RESULTS The authors identified the "classic" decussating DRTT and a corresponding nondecussating path (the nondecussating DRTT, nd-DRTT). Within each of these 2 tracts some fibers stop at the level of the RN, forming the dentatorubro tract and the nondecussating dentatorubro tract. The left nd-DRTT encompasses 21.7% of the tracts and 24.9% of the volume of the left superior cerebellar peduncle, and the right nd-DRTT encompasses 20.2% of the tracts and 28.4% of the volume of the right superior cerebellar peduncle. CONCLUSIONS The connections of the DN with the RN and thalamus are bilateral, not ipsilateral only. This affords a potential anatomical substrate for bilateral limb motor effects originating in a single cerebellar hemisphere under physiological conditions, and for bilateral limb motor impairment in hemispheric cerebellar lesions such as ischemic stroke and hemorrhage, and after resection of hemispheric tumors and arteriovenous malformations. Furthermore, when a lesion is located on the course of the dentatorubrothalamic system, a careful preoperative tractographic analysis of the relationship of the DRTT, nd-DRTT, and the lesion should be performed in order to tailor the surgical approach properly and spare all bundles.
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Affiliation(s)
- Antonio Meola
- Department of Neurosurgery, University of Pittsburgh Medical Center;,Department of Neurosurgery, University of Pisa, Italy; and
| | - Ayhan Comert
- Department of Neurosurgery, University of Pittsburgh Medical Center;,Department of Anatomy, Ankara University School of Medicine, Ankara, Turkey
| | - Fang-Cheng Yeh
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania
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Koppelmans V, Hirsiger S, Mérillat S, Jäncke L, Seidler RD. Cerebellar gray and white matter volume and their relation with age and manual motor performance in healthy older adults. Hum Brain Mapp 2015; 36:2352-63. [PMID: 25704867 DOI: 10.1002/hbm.22775] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 02/04/2015] [Accepted: 02/06/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Functional neuroimaging and voxel-based morphometry studies have confirmed the important role of the cerebellum in motor behavior. However, little is known about the relationship between cerebellar gray (GMv) and white matter (WMv) volume and manual motor performance in aging individuals. This study aims to quantify the relationship between cerebellar tissue volume and manual motor performance. EXPERIMENTAL DESIGN To gain more insight into cerebellar function and how it relates to the role of the primary motor cortex (M1), we related cerebellar GMv, WMv, and M1v to manual motor performance in 217 healthy older individuals. Left and right cerebellar GMv and WMv, and M1v were obtained using FreeSurfer. The following motor measures were obtained: grip force, tapping speed, bimanual visuomotor coordination, and manual dexterity. PRINCIPAL OBSERVATIONS Significant positive relationships were observed between cerebellar GMv and WMv and grip strength, right cerebellar WMv and right-hand tapping speed, right cerebellar WMv and dexterity, M1v and grip strength, and right M1v and left-hand dexterity, though effect sizes were small. CONCLUSIONS Our results show that cerebellar GMv and WMv are differently associated with manual motor performance. These associations partly overlap with the brain-behavior associations between M1 and manual motor performance. Not all observed associations were lateralized (i.e., ipsilateral cerebellar and contralateral M1v associations with motor performance), which could point to age-related neural dedifferentiation. The current study provides new insights in the role of the cerebellum in manual motor performance. In consideration of the small effect sizes replication studies are needed to validate these results.
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The molecular evidence of neural plasticity induced by cerebellar repetitive transcranial magnetic stimulation in the rat brain: A preliminary report. Neurosci Lett 2014; 575:47-52. [DOI: 10.1016/j.neulet.2014.05.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022]
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26
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Vella A, Della Nave R, Vetrugno R, Diciotti S, Boschi S, Banci Bonamici F, Mascalchi M. Cerebellar hyperperfusion in semantic dementia. Neurocase 2014; 20:175-82. [PMID: 23414345 DOI: 10.1080/13554794.2012.741255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Despite evidence of a cerebellar contribution to language, possible functional changes of the cerebellum in patients with language impairment secondary to cerebral neurodegeneration has not been investigated so far. We examined with resting perfusion single photon emission tomography one patient with semantic dementia and the data were compared with a normal subject database. Region of interest and Statistical Parametric Mapping 2 analysis showed in the patient hypoperfusion of the left temporal and parietal lobe and hyperperfusion in the superior vermis and cerebellar hemispheres (lobules IV, V, and VI). The cerebellum shows increased flow of possible compensatory significance in patients with language disturbance associated to cerebral degenerative changes.
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Affiliation(s)
- Alessandra Vella
- a Nuclear Medicine, "Le Scotte" Hospital, University of Siena , Siena , Italy
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Li Voti P, Conte A, Rocchi L, Bologna M, Khan N, Leodori G, Berardelli A. Cerebellar continuous theta-burst stimulation affects motor learning of voluntary arm movements in humans. Eur J Neurosci 2013; 39:124-31. [DOI: 10.1111/ejn.12391] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 09/02/2013] [Accepted: 09/16/2013] [Indexed: 11/26/2022]
Affiliation(s)
| | - Antonella Conte
- IRCCS Neuromed Institute; Pozzilli IS Italy
- Department of Neurology and Psychiatry; “Sapienza” University of Rome; Viale dell'Università, 30 00185 Rome Italy
| | - Lorenzo Rocchi
- Department of Neurology and Psychiatry; “Sapienza” University of Rome; Viale dell'Università, 30 00185 Rome Italy
| | | | - Nashaba Khan
- Department of Neurology and Psychiatry; “Sapienza” University of Rome; Viale dell'Università, 30 00185 Rome Italy
| | - Giorgio Leodori
- Department of Neurology and Psychiatry; “Sapienza” University of Rome; Viale dell'Università, 30 00185 Rome Italy
| | - Alfredo Berardelli
- IRCCS Neuromed Institute; Pozzilli IS Italy
- Department of Neurology and Psychiatry; “Sapienza” University of Rome; Viale dell'Università, 30 00185 Rome Italy
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Duffield T, Trontel H, Bigler ED, Froehlich A, Prigge MB, Travers B, Green RR, Cariello AN, Cooperrider J, Nielsen J, Alexander A, Anderson J, Fletcher PT, Lange N, Zielinski B, Lainhart J. Neuropsychological investigation of motor impairments in autism. J Clin Exp Neuropsychol 2013; 35:867-81. [PMID: 23985036 PMCID: PMC3907511 DOI: 10.1080/13803395.2013.827156] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
It is unclear how standardized neuropsychological measures of motor function relate to brain volumes of motor regions in autism spectrum disorder (ASD). An all-male sample composed of 59 ASD and 30 controls (ages 5-33 years) completed three measures of motor function: strength of grip (SOG), finger tapping test (FTT), and grooved pegboard test (GPT). Likewise, all participants underwent magnetic resonance imaging with region of interest (ROI) volumes obtained to include the following regions: motor cortex (precentral gyrus), somatosensory cortex (postcentral gyrus), thalamus, basal ganglia, cerebellum, and caudal middle frontal gyrus. These traditional neuropsychological measures of motor function are assumed to differ in motor complexity, with GPT requiring the most followed by FTT and SOG. Performance by ASD participants on the GPT and FTT differed significantly from that of controls, with the largest effect size differences observed on the more complex GPT task. Differences on the SOG task between the two groups were nonsignificant. Since more complex motor tasks tap more complex networks, poorer GPT performance by those with ASD may reflect less efficient motor networks. There was no gross pathology observed in classic motor areas of the brain in ASD, as ROI volumes did not differ, but FTT was negatively related to motor cortex volume in ASD. The results suggest a hierarchical motor disruption in ASD, with difficulties evident only in more complex tasks as well as a potential anomalous size-function relation in motor cortex in ASD.
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Affiliation(s)
- Tyler Duffield
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Haley Trontel
- Department of Psychology, University of Montana, Missoula, Montana
| | - Erin D. Bigler
- Department of Psychology, Brigham Young University, Provo, Utah
- Neuroscience Center, Brigham Young University, Provo, Utah
- Department of Psychiatry, University of Utah, Salt Lake City, Utah
- The Brain Institute of Utah, University of Utah, Salt Lake City, Utah
| | - Alyson Froehlich
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Molly B. Prigge
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, Utah
- Interdepartmental Neuroscience Program, University of Utah, Salt Lake City, Utah
| | - Brittany Travers
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
| | - Ryan R. Green
- Department of Psychology, Brigham Young University, Provo, Utah
| | - Annahir N. Cariello
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Jason Cooperrider
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, Utah
- Interdepartmental Neuroscience Program, University of Utah, Salt Lake City, Utah
| | - Jared Nielsen
- Department of Psychiatry, School of Medicine, University of Utah, Salt Lake City, Utah
- Interdepartmental Neuroscience Program, University of Utah, Salt Lake City, Utah
| | - Andrew Alexander
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin
| | - Jeffrey Anderson
- Department of Radiology, University of Utah, Salt Lake City, Utah
| | - P. Thomas Fletcher
- The Brain Institute of Utah, University of Utah, Salt Lake City, Utah
- School of Computing, University of Utah, Salt Lake City, Utah
| | - Nicholas Lange
- Departments of Psychiatry and Biostatistics, Harvard University, Boston, Massachusetts
- Neurostatistics Laboratory, McLean Hospital, Belmont, Massachusetts
| | - Brandon Zielinski
- Department of Pediatrics and Neurology, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Janet Lainhart
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin, Madison, Wisconsin
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Lu MK, Tsai CH, Ziemann U. Cerebellum to motor cortex paired associative stimulation induces bidirectional STDP-like plasticity in human motor cortex. Front Hum Neurosci 2012; 6:260. [PMID: 23049508 PMCID: PMC3446544 DOI: 10.3389/fnhum.2012.00260] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 08/31/2012] [Indexed: 11/25/2022] Open
Abstract
The cerebellum is crucially important for motor control and adaptation. Recent non-invasive brain stimulation studies have indicated the possibility to alter the excitability of the cerebellum and its projections to the contralateral motor cortex, with behavioral consequences on motor control and adaptation. Here we sought to induce bidirectional spike-timing dependent plasticity (STDP)-like modifications of motor cortex (M1) excitability by application of paired associative stimulation (PAS) in healthy subjects. Conditioning stimulation over the right lateral cerebellum (CB) preceded focal transcranial magnetic stimulation (TMS) of the left M1 hand area at an interstimulus interval of 2 ms (CB→M1 PAS2 ms), 6 ms (CB→M1 PAS6 ms) or 10 ms (CB→M1 PAS10 ms) or randomly alternating intervals of 2 and 10 ms (CB→M1 PASControl). Effects of PAS on M1 excitability were assessed by the motor-evoked potential (MEP) amplitude, short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and cerebellar-motor cortex inhibition (CBI) in the first dorsal interosseous muscle of the right hand. CB→M1 PAS2 ms resulted in MEP potentiation, CB→M1 PAS6 ms and CB→M1 PAS10 ms in MEP depression, and CB→M1 PASControl in no change. The MEP changes lasted for 30–60 min after PAS. SICI and CBI decreased non-specifically after all PAS protocols, while ICF remained unaltered. The physiological mechanisms underlying these MEP changes are carefully discussed. Findings support the notion of bidirectional STDP-like plasticity in M1 mediated by associative stimulation of the cerebello-dentato-thalamo-cortical pathway and M1. Future studies may investigate the behavioral significance of this plasticity.
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Affiliation(s)
- Ming-Kuei Lu
- Department of Neurology, Goethe-University Frankfurt/Main, Germany ; Neuroscience Laboratory, Department of Neurology, China Medical University Hospital Taichung, Taiwan ; Institute of Medical Science and School of Medicine, China Medical University Taichung, Taiwan
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Irannejad S, Savage R. Is a cerebellar deficit the underlying cause of reading disabilities? ANNALS OF DYSLEXIA 2012; 62:22-52. [PMID: 22160801 DOI: 10.1007/s11881-011-0060-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 09/22/2011] [Indexed: 05/31/2023]
Abstract
This study investigated whether children with dyslexia differed in their performance on reading, phonological, rapid naming, motor, and cerebellar-related tasks and automaticity measures compared to reading age (RA)-matched and chronological age (CA)-matched control groups. Participants were 51 children attending mainstream English elementary schools in Quebec. All participants completed measures of IQ, word and nonword reading fluency, elision, nonword decoding, rapid naming, bead threading, peg moving, toe tapping, postural stability, and muscle tone. Results from both group contrasts and analyses at the individual case level did not provide support for claims of motor-cerebellar involvement in either typical or atypical reading acquisition. Results were more consistent with a phonological core process account of both typical reading and reading difficulty. Phonological deficits for children with dyslexia compared to RA-matched controls were, however, only evident in group contrasts. Findings thus also have important implications for identifying at-risk readers among their same-aged peers.
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Affiliation(s)
- Shahrzad Irannejad
- Office of Students with Disabilities, McGill University, Montreal, Quebec, H3A 1Y2, Canada.
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31
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Kühn S, Romanowski A, Schilling C, Banaschewski T, Barbot A, Barker GJ, Brühl R, Büchel C, Conrod PJ, Czech K, Dalley JW, Flor H, Garavan H, Häke I, Ittermann B, Ivanov N, Mann K, Lathrop M, Loth E, Lüdemann K, Mallik C, Martinot JL, Palafox C, Poline JB, Reuter J, Rietschel M, Robbins TW, Smolka MN, Nees F, Walaszek B, Schumann G, Heinz A, Gallinat J. Manual dexterity correlating with right lobule VI volume in right-handed 14-year-olds. Neuroimage 2012; 59:1615-21. [DOI: 10.1016/j.neuroimage.2011.08.100] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 11/29/2022] Open
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Hoffland BS, Bologna M, Kassavetis P, Teo JTH, Rothwell JC, Yeo CH, van de Warrenburg BP, Edwards MJ. Cerebellar theta burst stimulation impairs eyeblink classical conditioning. J Physiol 2011; 590:887-97. [PMID: 22199171 DOI: 10.1113/jphysiol.2011.218537] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Theta burst stimulation (TBS) protocols of repetitive transcranial magnetic stimulation (rTMS) have after-effects on excitability of motor areas thought to be due to LTP- and LTD-like processes at cortical synapses. The present experiments ask whether, despite the low intensities of stimulation used and the anatomy of the posterior fossa, TBS can also influence the cerebellum. Acquisition and retention of eyeblink classical conditioning (EBCC) was examined in 30 healthy volunteers after continuous theta burst stimulation (cTBS) over the right cerebellar hemisphere. In subjects who received cerebellar cTBS, conditioned responses were fewer and their onsets were earlier (in the last half of the acquisition blocks) than those from control subjects. There was, however, no effect of cerebellar cTBS on the re-acquisition of EBCC in another session of EBCC 7–10 days later. There was also no effect of cerebellar cTBS on the re-acquisition of EBCC in subjects not naïve to EBCC when the stimulation was delivered immediately before a re-acquisition session. Control experiments verified that suppressive effects of cTBS on EBCC were not due to changes in motor cortical excitability or sensory disturbance caused by cTBS. Based on previous EBCC studies in various cerebellar pathologies, our data are compatible with the hypothesis that cerebellar cTBS has a focal cerebellar cortical effect, and are broadly in line with data from studies of EBCC in various animal models. These results confirm that cerebellar TBS has measurable effects on the function of the cerebellum, and indicate it is a useful non-invasive technique with which to explore cerebellar physiology and function in humans.
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Affiliation(s)
- Britt S Hoffland
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, UCL, Queen Square, London WC1N 3BG, UK
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Metabolic Changes of Cerebrum by Repetitive Transcranial Magnetic Stimulation over Lateral Cerebellum: A Study with FDG PET. THE CEREBELLUM 2011; 11:739-48. [DOI: 10.1007/s12311-011-0333-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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34
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Is the Cerebellum a Potential Target for Stimulation in Parkinson's Disease? Results of 1-Hz rTMS on Upper Limb Motor Tasks. THE CEREBELLUM 2011; 10:804-11. [DOI: 10.1007/s12311-011-0290-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Cerebellar Theta-Burst Stimulation Selectively Enhances Lexical Associative Priming. THE CEREBELLUM 2011; 10:540-50. [DOI: 10.1007/s12311-011-0269-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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36
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Jenkinson N, Miall RC. Disruption of saccadic adaptation with repetitive transcranial magnetic stimulation of the posterior cerebellum in humans. THE CEREBELLUM 2011; 9:548-55. [PMID: 20665254 PMCID: PMC2996540 DOI: 10.1007/s12311-010-0193-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Saccadic eye movements are driven by motor commands that are continuously modified so that errors created by eye muscle fatigue, injury, or—in humans—wearing spectacles can be corrected. It is possible to rapidly adapt saccades in the laboratory by introducing a discrepancy between the intended and actual saccadic target. Neurophysiological and lesion studies in the non-human primate as well as neuroimaging and patient studies in humans have demonstrated that the oculomotor vermis (lobules VI and VII of the posterior cerebellum) is critical for saccadic adaptation. We studied the effect of transiently disrupting the function of posterior cerebellum with repetitive transcranial magnetic stimulation (rTMS) on the ability of healthy human subjects to adapt saccadic eye movements. rTMS significantly impaired the adaptation of the amplitude of saccades, without modulating saccadic amplitude or variability in baseline conditions. Moreover, increasing the intensity of rTMS produced a larger impairment in the ability to adapt saccadic size. These results provide direct evidence for the role of the posterior cerebellum in man and further evidence that TMS can modulate cerebellar function.
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Affiliation(s)
- Ned Jenkinson
- Nuffield Department of Surgery, University of Oxford, Oxford, UK.
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Hiraoka K, Horino K, Yagura A, Matsugi A. Cerebellar TMS evokes a long latency motor response in the hand during a visually guided manual tracking task. THE CEREBELLUM 2011; 9:454-60. [PMID: 20549404 DOI: 10.1007/s12311-010-0187-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous studies showed that transcranial magnetic stimulation (TMS) to the cerebellum evokes a long latency motor response in the soleus muscle during a postural task. The cerebellum is activated not only during postural tasks but also during motor tasks for which eye-hand coordination is required. The purpose of this study was to investigate whether TMS over the cerebellum evokes long latency motor responses in the hand during a visually guided manual tracking task. Eight healthy humans tracked an oscillatory moving target with the right index finger or pointed the finger at a stationary target, and TMS was delivered to the scalp over the cerebellum during the motor tasks. Trials with sham TMS were inserted between the trials with cerebellar TMS. The trajectory of finger movement fluctuated 92 ms after cerebellar TMS with a 24% probability during tracking of a moving target. The fluctuation was preceded by an electromyographic burst in the first dorsal interosseous muscle starting at 65 ms after TMS. The probability of fluctuation evoked by cerebellar TMS was significantly larger than that evoked by sham TMS during tracking of a moving target. This significant difference was absent in trials during which subjects pointed their index finger at a stationary target. These findings indicate that cerebellar TMS evokes a long latency motor response during a visually guided manual tracking task. The long latency motor response may be related to cerebellar activity associated with eye-hand coordination or to the detection of and correction for visuomotor errors.
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Affiliation(s)
- Koichi Hiraoka
- School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino 3-7-30, Habikino City, Osaka 583-8555, Japan.
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Minks E, Kopickova M, Marecek R, Streitova H, Bares M. TRANSCRANIAL MAGNETIC STIMULATION OF THE CEREBELLUM. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2010; 154:133-9. [DOI: 10.5507/bp.2010.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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39
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Fisher KM, Lai HM, Baker MR, Baker SN. Corticospinal activation confounds cerebellar effects of posterior fossa stimuli. Clin Neurophysiol 2009; 120:2109-2113. [PMID: 19836995 PMCID: PMC2852652 DOI: 10.1016/j.clinph.2009.08.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Revised: 08/26/2009] [Accepted: 08/28/2009] [Indexed: 11/20/2022]
Abstract
Objective To investigate the efficacy of magnetic stimulation over the posterior fossa (PF) as a non-invasive assessment of cerebellar function in man. Methods We replicated a previously reported conditioning-test paradigm in 11 healthy subjects. Transcranial magnetic stimulation (TMS) at varying intensities was applied to the PF and motor cortex with a 3, 5 or 7 ms interstimulus interval (ISI), chosen randomly for each trial. Surface electromyogram (EMG) activity was recorded from two intrinsic hand muscles and two forearm muscles. Responses were averaged and rectified, and MEP amplitudes were compared to assess whether suppression of the motor output occurred as a result of the PF conditioning pulse. Results Cortical MEPs were suppressed following conditioning-test ISIs of 5 or 7 ms. No suppression occurred with an ISI of 3 ms. PF stimuli alone also produced EMG responses, suggesting direct activation of the corticospinal tract (CST). Conclusions CST collaterals are known to contact cortical inhibitory interneurones; antidromic CST activation could therefore contribute to the observed suppression of cortical MEPs. Significance PF stimulation probably activates multiple pathways; even at low intensities it should not be regarded as a selective assessment of cerebellar function unless stringent controls can confirm the absence of confounding activity in other pathways.
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Affiliation(s)
- Karen M Fisher
- Institute of Neuroscience, Henry Wellcome Building, Medical School, Newcastle University, Newcastle-upon-Tyne NE2 4HH, UK
| | - H Ming Lai
- Department of Neurophysiology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK
| | - Mark R Baker
- Institute of Neuroscience, Henry Wellcome Building, Medical School, Newcastle University, Newcastle-upon-Tyne NE2 4HH, UK
| | - Stuart N Baker
- Institute of Neuroscience, Henry Wellcome Building, Medical School, Newcastle University, Newcastle-upon-Tyne NE2 4HH, UK.
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40
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Popa T, Russo M, Meunier S. Long-lasting inhibition of cerebellar output. Brain Stimul 2009; 3:161-9. [PMID: 20633445 DOI: 10.1016/j.brs.2009.10.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Revised: 09/28/2009] [Accepted: 10/06/2009] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE The cerebellar influence on the motor cortex output is exerted mostly though the cerebellothalamocortical pathway (CTC). One way to explore this pathway is by the means of transcranial magnetic stimulation (TMS). A single-pulse conditioning magnetic stimulation delivered over the lateral cerebellum was shown to diminish the excitability of the contralateral motor cortex 5 milliseconds later (cerebellocortical inhibition [CBI]), most likely through transynaptic activation of cerebellar Purkinje cells, which in turn inhibit the tonic activity of the CTC. Repetitive TMS (rTMS) delivered over the lateral cerebellum was shown to induce a long-lasting change of the cortical excitability, as well, but the mechanism and time course of this effect are still debated. METHODS We tested the time course of the effects of rTMS on the CBI in five paradigms: (1) 1 Hz rTMS, (2) continuous theta burst stimulation (cTBS), and (3) intermittent TBS (iTBS) over the right cerebellum, (4) 1 Hz rTMS over the cervical nerve roots, and (5) 1 Hz rTMS over the left cerebellum. Surface electromyography was recorded from the right first dorsal interosseous (FDI) and adductor digiti minimi. A double-cone coil was used for single-pulse cerebellar stimulation, whereas a figure-of-eight coil was used for the rTMS. The stimulus intensity was set at 90% of the M1 resting motor threshold for 1 Hz rTMS, and at 80% of the M1 active motor threshold for TBS. Both types of cerebellar stimulation were performed under magnetic resonance image (MRI)-guided neuronavigation centered over the right VIII B lobule, and stimulation intensities were adjusted for cerebellar cortex depth. A figure-of-eight coil was used for left motor cortex stimulation. RESULTS There was significant CBI suppression to the left motor cortex up to 30 minutes after the 900 stimuli of 1 Hz rTMS over either cerebellar hemisphere, and after 600 stimuli of cTBS over the right cerebellum, but not after 600 stimuli of iTBS over the right cerebellum, or after 900 of 1 Hz rTMS stimuli delivered over the cervical nerve roots. The 1 Hz rTMS over the left cerebellum significantly reduced the CBI in the right FDI 10 minutes after the end of the intervention. The amplitudes of the unconditioned cortical motor-evoked potentials were not significantly changed. CONCLUSIONS Our findings suggest that repetitive cerebellar stimulation operate at a cerebellar level, rather then at a cortical level.
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Affiliation(s)
- T Popa
- ER6 University of Pierre et Marie Curie (University of Paris 06), Service de Réadaptation Fonctionnelle, Hôpital de la Salpêtrière, Paris, France.
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41
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Ugawa Y. [Basic mechanism of magnetic human cerebellar stimulation and its clinical application]. Rinsho Shinkeigaku 2009; 49:621-628. [PMID: 19999142 DOI: 10.5692/clinicalneurol.49.621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
I here summarize the history of cerebellar stimulation experiments in humans and give some caution to use this stimulation method. In clinical evaluation, we consider the cerebellum as a kind of computer to get information from the peripheral structures and also higher motor cortical centers including the primary motor cortex (M1) and send a cerebellar command to M1 after computation of much information. We study functions of the cerebello-afferent and cerebello-efferent connections using cerebellar stimulation and differentiate these pathways dysfunction. We first activated the cerebellum using electrical stimulation. The most effective position, effective current direction and the interval of conditioning and test stimuli suggested that the observed effect might be produced by some cerebellar structures activation. Studies of cerebellar ataxia patients and other disorders supported the idea that the suppression is produced by the inhibition of dentato-thalamo-cortical pathway by Purkinje cell activation. In patients with a lesion at cerebellar hemisphere, dentate nucleus, superior cerebellar peduncle, motor thalamus, the suppression effect was not evoked. In contrast, the suppression was normally elicited in patients with a lesion at pontine nucleus, middle cerebellar peduncle even though they had clinically definite ataxia. Normal suppression was evoked in patients with non-cerebellar ataxia (sensory ataxia due to paraneoplastic syndrome, tabes dorsalis, ataxic sensory neuropathy). Based on these results, we concluded that the cerebellar electrical stimulation method was useful to differentiate cerebellar ataxia due to cerebellar efferent pathways lesions from other cerebellar ataxia and non-cerebellar ataxia. We demonstrated that magnetic stimulation over the cerebellum using a double-cone coil can produce the same effect as those elicited by electrical cerebellar stimulation. These all results supported the proposal that the magnetic stimulation over the cerebellum can enable us to differentiate the cerebellar efferent ataxia from other cerebellar ataxia and non-cerebellar ataxia. A recent paper has cautioned us to conclude the observed phenomenon to be produced by cerebellar activation after exclusion of several other factors as stated in the original paper. The most serious factor to exclude is the antidromic activation of the corticospinal tracts by the cerebellar stimulation conditioning stimulus. To exclude this possibility, it is important how to measure the threshold of the corticospinal tracts. We recommend that we should use rectified EMG recordings when determining it. In summary, I conclude that the cerebellar magnetic stimulation is a good tool for physiological differentiation of cerebellar ataxia mechanisms in ataxic patients. At a current stage, I recommend a conservative method mentioned in the editorial paper for magnetic cerebellar stimulation.
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Affiliation(s)
- Yoshikazu Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University
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Koch G, Mori F, Marconi B, Codecà C, Pecchioli C, Salerno S, Torriero S, Lo Gerfo E, Mir P, Oliveri M, Caltagirone C. Changes in intracortical circuits of the human motor cortex following theta burst stimulation of the lateral cerebellum. Clin Neurophysiol 2008; 119:2559-69. [PMID: 18824403 DOI: 10.1016/j.clinph.2008.08.008] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 08/09/2008] [Accepted: 08/18/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The cerebellum takes part in several motor functions through its influence on the motor cortex (M1). Here, we applied the theta burst stimulation (TBS) protocol, a novel form of repetitive Transcranial Magnetic Stimulation (rTMS) over the lateral cerebellum. The aim of this study was to test whether TBS of the lateral cerebellum could be able to modulate the excitability of the contralateral M1 in healthy subjects. METHODS Motor-evoked potentials (MEPs) amplitude, short intracortical inhibition (SICI), long intracortical inhibition (LICI) and short intracortical facilitation (SICF) were tested in the M1 before and after cerebellar continuous TBS (cTBS) or intermittent TBS (iTBS). RESULTS We found that cTBS induced a reduction of SICI and an increase of LICI. On the other hand, cerebellar iTBS reduced LICI. MEPs amplitude also differently vary following cerebellar stimulation with cTBS or iTBS, resulting in a decrease by the former and an increase by the latter. CONCLUSIONS Although the interpretation of these data remains highly speculative, these findings reveal that the cerebellar cortex undergoes bidirectional plastic changes that modulate different intracortical circuits within the contralateral primary motor cortex. SIGNIFICANCE Long-lasting modifications of these pathways could be useful to treat various pathological conditions characterized by an altered cortical excitability.
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Affiliation(s)
- Giacomo Koch
- Laboratorio di Neurologia Clinica e Comportamentale, Fondazione Santa Lucia IRCCS, Via Ardeatina, 306, 00179 Rome, Italy.
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Koch G, Rossi S, Prosperetti C, Codecà C, Monteleone F, Petrosini L, Bernardi G, Centonze D. Improvement of hand dexterity following motor cortex rTMS in multiple sclerosis patients with cerebellar impairment. Mult Scler 2008; 14:995-8. [DOI: 10.1177/1352458508088710] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We tested the effects of 5-Hz repetitive transcranial magnetic stimulation (rTMS) over the motor cortex in multiple sclerosis (MS) subjects with cerebellar symptoms. rTMS improved hand dexterity in cerebellar patients ( n = 8) but not in healthy subjects ( n = 7), as detected by a significant transient reduction of the time required to complete the nine-hole pegboard task. rTMS of the motor cortex may be a useful approach to treat cerebellar impairment in MS patients.
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Affiliation(s)
- G Koch
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - S Rossi
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - C Prosperetti
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - C Codecà
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - F Monteleone
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - L Petrosini
- Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy; Dipartimento di Psicologia, Università La Sapienza, Rome, Italy
| | - G Bernardi
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
| | - D Centonze
- Clinica Neurologica, Dipartimento di Neuroscienze, Università Tor Vergata, Rome, Italy; Centro Europeo per la Ricerca sul Cervello (CERC)/Fondazione Santa Lucia, Rome, Italy
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Miall RC, Christensen LOD, Cain O, Stanley J. Disruption of state estimation in the human lateral cerebellum. PLoS Biol 2007; 5:e316. [PMID: 18044990 PMCID: PMC2229864 DOI: 10.1371/journal.pbio.0050316] [Citation(s) in RCA: 195] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Accepted: 09/28/2007] [Indexed: 11/30/2022] Open
Abstract
The cerebellum has been proposed to be a crucial component in the state estimation process that combines information from motor efferent and sensory afferent signals to produce a representation of the current state of the motor system. Such a state estimate of the moving human arm would be expected to be used when the arm is rapidly and skillfully reaching to a target. We now report the effects of transcranial magnetic stimulation (TMS) over the ipsilateral cerebellum as healthy humans were made to interrupt a slow voluntary movement to rapidly reach towards a visually defined target. Errors in the initial direction and in the final finger position of this reach-to-target movement were significantly higher for cerebellar stimulation than they were in control conditions. The average directional errors in the cerebellar TMS condition were consistent with the reaching movements being planned and initiated from an estimated hand position that was 138 ms out of date. We suggest that these results demonstrate that the cerebellum is responsible for estimating the hand position over this time interval and that TMS disrupts this state estimate. Motor control depends on the brain's awareness of the current state of the body. Knowing the current position and movement of the arm, for example, allows one to reach rapidly and accurately towards a target. However, sensory information reaches the brain only after a short delay, and the arm may already be in motion. Therefore, it has been proposed that the brain must calculate a “state estimate”—by combining sensory information about the last known position of the arm with predictions of its responses to recent movement commands—which it uses to accurately plan and control a reaching movement. To test this idea, we used transcranial magnetic stimulation to briefly disrupt several separate areas in the brain as participants reached to a target. We show that stimulation over the cerebellum caused reaching errors consistent with movements planned on the arm's position about 140 ms previously, whereas stimulation of other brain areas did not disrupt reaching direction. These results add weight to the hypothesis that the cerebellum predicts the state of the motor system. This hypothesis can explain the loss of movement control experienced by cerebellar patients and supports computational theories that the cerebellum is a predictive model of the motor system. Transcranial magnetic stimulation of the human cerebellum causes errors in reaching movements that are consistent with a temporary disruption in estimating the arm's current state.
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Affiliation(s)
- R Chris Miall
- School of Psychology, University of Birmingham, Birmingham, United Kingdom.
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Oliveri M, Torriero S, Koch G, Salerno S, Petrosini L, Caltagirone C. The role of transcranial magnetic stimulation in the study of cerebellar cognitive function. THE CEREBELLUM 2007; 6:95-101. [PMID: 17366271 DOI: 10.1080/14734220701213421] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Transcranial magnetic stimulation (TMS) allows non-invasive stimulation of brain structures. This technique can be used either for stimulating the motor cortex, recording motor evoked potentials from peripheral muscles, or for modulating the excitability of other non-motor areas in order to establish their necessity for a given task. TMS of the cerebellum can give interesting insights on the cerebellar functions. Paired-TMS techniques, delivering stimuli over the cerebellum followed at various interstimulus intervals by stimuli over the motor cortex, allow studying the pattern of connectivity between the cerebellum and the contralateral motor cortex in physiological as well as in pathological conditions. Repetitive TMS, delivering trains of stimuli at different frequencies, allows interfering with the function of cerebellar circuits during the execution of cognitive tasks. This application complements neuropsychological and neuroimaging studies in the study of the cerebellar involvement in a number of cognitive operations, ranging from procedural memory, working memory and learning through observation.
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Affiliation(s)
- Massimiliano Oliveri
- Dipartimento di Psicologia, Università di Palermo, Via Ardeatina 306, 00179 Rome, Italy.
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Lee KH, Egleston PN, Brown WH, Gregory AN, Barker AT, Woodruff PWR. The role of the cerebellum in subsecond time perception: evidence from repetitive transcranial magnetic stimulation. J Cogn Neurosci 2007; 19:147-57. [PMID: 17214571 DOI: 10.1162/jocn.2007.19.1.147] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In three experiments, we investigated the role of the cerebellum in sub- and suprasecond time perception by using repetitive transcranial magnetic stimulation (rTMS). In Experiment 1, subjects underwent four 8-min 1-Hz rTMS sessions in a within-subject design. rTMS sites were the medial cerebellum (real and sham rTMS), left lateral cerebellum, and right lateral cerebellum. Following each rTMS session, subjects completed a subsecond temporal bisection task (stimuli in the range 400-800 msec). Compared with sham rTMS, rTMS applied over the right lateral or medial cerebellum induced a leftward shift of the psychophysical function (perceived lengthening of time). In Experiment 2, a separate sample of subjects underwent the identical rTMS procedure and completed a suprasecond bisection task (stimuli in the 1000-2000 msec range). In this experiment, rTMS to the cerebellar sites did not produce any significant changes compared with sham rTMS. Experiment 3 employed a within-subject design to replicate findings from Experiments 1 and 2. Subjects underwent four rTMS conditions (sub- and suprabisection tasks following medial cerebellar and sham rTMS). rTMS induced a significant leftward shift of psychophysical function in the subsecond bisection, but not in the suprasecond bisection. In this study, we have demonstrated that transient cerebellar stimulation can differently affect the ability to estimate time intervals below and above a duration of 1 sec. The results of this study provide direct evidence for the role of the cerebellum in processing subsecond time intervals. This study further suggests that the perception of sub- and suprasecond intervals is likely to depend upon distinct neural systems.
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Gowen E, Miall RC. The cerebellum and motor dysfunction in neuropsychiatric disorders. CEREBELLUM (LONDON, ENGLAND) 2007; 6:268-79. [PMID: 17786823 PMCID: PMC6010149 DOI: 10.1080/14734220601184821] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The cerebellum is densely interconnected with sensory-motor areas of the cerebral cortex, and in man, the great expansion of the association areas of cerebral cortex is also paralleled by an expansion of the lateral cerebellar hemispheres. It is therefore likely that these circuits contribute to non-motor cognitive functions, but this is still a controversial issue. One approach is to examine evidence from neuropsychiatric disorders of cerebellar involvement. In this review, we narrow this search to test whether there is evidence of motor dysfunction associated with neuropsychiatric disorders consistent with disruption of cerebellar motor function. While we do find such evidence, especially in autism, schizophrenia and dyslexia, we caution that the restricted set of motor symptoms does not suggest global cerebellar dysfunction. Moreover, these symptoms may also reflect involvement of other, extra-cerebellar circuits and detailed examination of specific sub groups of individuals within each disorder may help to relate such motor symptoms to cerebellar morphology.
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Affiliation(s)
- E Gowen
- Faculty of Life Sciences, University of Manchester, UK.
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48
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Pollok B, Butz M, Gross J, Südmeyer M, Timmermann L, Schnitzler A. Coupling between cerebellar hemispheres: behavioural, anatomic, and functional data. THE CEREBELLUM 2006; 5:212-9. [PMID: 16997753 DOI: 10.1080/14734220600621294] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
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.
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Affiliation(s)
- Bettina Pollok
- Department of Neurology, Heinrich Heine University, Duesseldorf, Germany.
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49
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Manto M, Nowak DA, Schutter DJLG. Coupling between cerebellar hemispheres and sensory processing. THE CEREBELLUM 2006; 5:187-8. [PMID: 16997748 DOI: 10.1080/14734220600925075] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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50
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Gowen E, Miall RC. Behavioural aspects of cerebellar function in adults with Asperger syndrome. CEREBELLUM (LONDON, ENGLAND) 2005; 4:279-89. [PMID: 16321884 DOI: 10.1080/14734220500355332] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aside from social deficits, Asperger and autistic individuals also exhibit motor control abnormalities such as impaired gait, balance, manual dexterity and grip. One brain area that has consistently been reported on autopsy and imaging studies to be abnormal in such individuals is the cerebellum. As the cerebellum controls sensorimotor coordination and lesions here typically cause hypotonia, dysmetria and dyscoordination, we performed a series of quantitative tests aimed at investigating cerebellar function in Asperger individuals. Tests examining visually guided movement (rapid pointing), speeded complex movement (finger tapping, rapid hand turning), muscle tone (catching dropped weight), prediction, coordination and timing (balance, grip force and interval timing) were conducted on 12 Asperger subjects and 12 age and IQ matched controls. In comparison to control subjects, Asperger subject's demonstrated: (i) decreased pointing accuracy and rate, (ii) increased postural instability, and (iii) decreased timing accuracy. IQ was found to co-vary with some parameters of each of these tasks and no further impairments were found on the remaining tests. We suggest that these specific deficits reflect impairment in the ability to integrate sensory input with appropriate motor commands and are consistent with cerebellar dysfunction in Asperger syndrome.
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Affiliation(s)
- Emma Gowen
- Behavioural Brain Sciences, School of Psychology, University of Birmingham, UK.
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