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Manto M. The underpinnings of cerebellar ataxias. Clin Neurophysiol Pract 2022; 7:372-387. [PMID: 36504687 PMCID: PMC9731828 DOI: 10.1016/j.cnp.2022.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/07/2022] [Accepted: 11/06/2022] [Indexed: 11/18/2022] Open
Abstract
The human cerebellum contains more than 60% of all neurons of the brain. Anatomically, the cerebellum is divided into 10 lobules (I-X). The cerebellar cortex is arranged into three layers: the molecular layer (external), the Purkinje cell layer and the granular layer (internal). Purkinje neurons and interneurons are inhibitory, except for granule cells. The layer of Purkinje neurons inhibit cerebellar nuclei, the sole output of the cerebellar circuitry, as well as vestibular nuclei. The cerebellum is arranged into a series of olivo-cortico-nuclear modules arranged longitudinally in the rostro-caudal plane. The cerebro-cerebellar connectivity is organized into multiple loops running in parallel. From the clinical standpoint, it is now considered that cerebellar symptoms can be gathered into 3 cerebellar syndromes: a cerebellar motor syndrome (CMS), a vestibulocerebellar syndrome (VCS) and a cerebellar cognitive affective syndrome/Schmahmann syndrome (CCAS/SS). CMS remains a cornerstone of modern clinical ataxiology, and relevant lesions involve lobules I-V, VI and VIII. The core feature of cerebellar symptoms is dysmetria, covering motor dysmetria (errors in the metrics of motion) and dysmetria of thought. The cerebellar circuitry plays a key-role in the generation and maintenance of internal models which correspond to neural representations reproducing the dynamic properties of the body. These models allow predictive computations for motor, cognitive, social, and affective operations. Cerebellar circuitry is endowed with noticeable plasticity properties.
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2
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Beuriat PA, Cristofori I, Gordon B, Grafman J. The shifting role of the cerebellum in executive, emotional and social processing across the lifespan. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2022; 18:6. [PMID: 35484543 PMCID: PMC9047369 DOI: 10.1186/s12993-022-00193-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022]
Abstract
The cerebellum's anatomical and functional organization and network interactions between the cerebellum and the cerebral cortex and subcortical structures are dynamic across the lifespan. Executive, emotional and social (EES) functions have likewise evolved during human development from contributing to primitive behaviors during infancy and childhood to being able to modulate complex actions in adults. In this review, we address how the importance of the cerebellum in the processing of EES functions might change across development. This evolution is driven by the macroscopic and microscopic modifications of the cerebellum that are occurring during development including its increasing connectivity with distant supra-tentorial cortical and sub-cortical regions. As a result of anatomical and functional changes, neuroimaging and clinical data indicate that the importance of the role of the cerebellum in human EES-related networks shifts from being crucial in newborns and young children to being only supportive later in life. In early life, given the immaturity of cortically mediated EES functions, EES functions and motor control and perception are more closely interrelated. At that time, the cerebellum due to its important role in motor control and sequencing makes EES functions more reliant on these computational properties that compute spatial distance, motor intent, and assist in the execution of sequences of behavior related to their developing EES expression. As the cortical brain matures, EES functions and decisions become less dependent upon these aspects of motor behavior and more dependent upon high-order cognitive and social conceptual processes. At that time, the cerebellum assumes a supportive role in these EES-related behaviors by computing their motor and sequential features. We suspect that this evolving role of the cerebellum has complicated the interpretation of its contribution to EES computational demands.
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Affiliation(s)
- Pierre-Aurélien Beuriat
- Cognitive Neuroscience Laboratory, Brain Injury Research, Shirley Ryan AbilityLab, Chicago, IL, USA. .,Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Department of Pediatric Neurosurgery, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon, France. .,Rockfeller School of Medicine, Claude Bernard University, Lyon, France.
| | - Irene Cristofori
- Institute of Cognitive, Neuroscience Marc Jeannerod, CNRS/UMR 5229, 69500, Bron, France.,Université Claude Bernard, Lyon 1, 69100, Villeurbanne, France
| | - Barry Gordon
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
| | - Jordan Grafman
- Cognitive Neuroscience Laboratory, Brain Injury Research, Shirley Ryan AbilityLab, Chicago, IL, USA.,Departments of Neurology, Psychiatry and Cognitive Neurology & Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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3
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Dellatolas G, Câmara-Costa H. The role of cerebellum in the child neuropsychological functioning. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:265-304. [PMID: 32958180 DOI: 10.1016/b978-0-444-64150-2.00023-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This chapter proposes a review of neuropsychologic and behavior findings in pediatric pathologies of the cerebellum, including cerebellar malformations, pediatric ataxias, cerebellar tumors, and other acquired cerebellar injuries during childhood. The chapter also contains reviews of the cerebellar mutism/posterior fossa syndrome, reported cognitive associations with the development of the cerebellum in typically developing children and subjects born preterm, and the role of the cerebellum in neurodevelopmental disorders such as autism spectrum disorders and developmental dyslexia. Cognitive findings in pediatric cerebellar disorders are considered in the context of known cerebellocerebral connections, internal cellular organization of the cerebellum, the idea of a universal cerebellar transform and computational internal models, and the role of the cerebellum in specific cognitive and motor functions, such as working memory, language, timing, or control of eye movements. The chapter closes with a discussion of the strengths and weaknesses of the cognitive affective syndrome as it has been described in children and some conclusions and perspectives.
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Affiliation(s)
- Georges Dellatolas
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France.
| | - Hugo Câmara-Costa
- GRC 24, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France; Centre d'Etudes en Santé des Populations, INSERM U1018, Paris, France
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4
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Steiner KM, Jansen S, Adeishvili N, Hulst T, Ernst TM, Müller O, Wondzinski E, Göricke SL, Siebler M, Uengoer M, Timmann D. Extinction of cognitive associations is preserved in patients with cerebellar disease. Neurobiol Learn Mem 2020; 169:107185. [PMID: 32061996 DOI: 10.1016/j.nlm.2020.107185] [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: 05/01/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 10/25/2022]
Abstract
In the present study extinction and renewal of cognitive associations were assessed in two experiments in participants with focal and degenerative cerebellar disease. Using a predictive learning task, participants had to learn by trial and error the relationships between food items and the occurrence of stomach trouble in a hypothetical patient. In the first experiment, focus was on renewal effects. Participants with chronic cerebellar stroke (n = 14; mean age 50.9 ± 12 years), participants with degenerative cerebellar disease (n = 16; mean age 58 ± 12 years), age-, sex-, and education matched controls (n = 20; mean age 53.7 ± 10.8 years) and young controls (n = 19; mean age 23.2 ± 2.7 years) were tested. Acquisition and extinction of food-stomach trouble associations took part in two different contexts (represented by restaurants). In a subsequent test phase, food stimuli were presented in both contexts and no feedback was given. This allowed testing for renewal of the initially acquired associations in the acquisition context. Acquisition and extinction learning were not significantly different between groups. Significant renewal effects were present in young controls only. In the second experiment, focus was on extinction. To control for age effects, 19 young participants with chronic surgical lesions of the cerebellum (mean age 25.6 ± 6.1 years), and 24 age-, sex- and education-matched healthy controls were tested. Acquisition and extinction of food-stomach trouble associations took part in the same context. In the extinction phase, the relationship with stomach trouble was reversed in some of the food items. Acquisition and extinction learning were not significantly different between groups. The main finding of the present study was preserved extinction of learned cognitive associations in participants with chronic cerebellar disease. Findings agree with previous observations in the literature that cognitive abnormalities are frequently absent or weak in adults with cerebellar disease. This does not exclude a contribution of the cerebellum to extinction of learned associations. For example, findings may be different in more challenging cognitive tasks, and in participants with acute cerebellar disease with no time for compensation.
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Affiliation(s)
- Katharina M Steiner
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany.
| | - Sarah Jansen
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Nino Adeishvili
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Thomas Hulst
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Thomas M Ernst
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Oliver Müller
- Department of Neurosurgery, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Elke Wondzinski
- Department of Neurology, MediClin Fachklinik Rhein/Ruhr, Essen, Germany
| | - Sophia L Göricke
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen University Hospital, University of Duisburg-Essen, Germany
| | - Mario Siebler
- Department of Neurology, MediClin Fachklinik Rhein/Ruhr, Essen, Germany
| | - Metin Uengoer
- Department of Psychology, Philipps-Universität Marburg, Germany
| | - Dagmar Timmann
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
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5
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Language Cerebro-cerebellar Reorganization in Children After Surgery of Right Cerebellar Astrocytoma: a fMRI Study. THE CEREBELLUM 2020; 18:791-806. [PMID: 31111430 DOI: 10.1007/s12311-019-01039-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Language processing depends on an integrated circuit involving the left supratentorial language areas and the right posterior lateral cerebellar hemisphere (lobule VI, lobule VII, Crus I, and Crus II). Reorganization of the language system after lesions of the cerebral language areas includes also cerebellar relocation. This is the first study assessing functional language reorganization after lesions concerning primarily the cerebellum, using a fMRI paradigm of phonological covert word production task in six children operated for right cerebellar astrocytoma and in 15 typically developing children. We found right cerebellar and left frontal activations in healthy controls and high variability of reorganizational patterns in patients with early right cerebellar lesion. Also lesions not located in the areas typically involved in language tasks (Crus I and Crus II) can cause reorganization between the two hemispheres or hemispheric language reinforcement of the original lateralization. We discuss the role of several variables in determining the reorganizational pattern such as the site, extension, and timing of surgery. No variables revealed as predictors, suggesting that co-occurring influence of other biological and/or pathological factors are not yet demonstrated. Lesions in the postero-lateral cerebellum seem related to less efficient language performances, as an indicator of the system's functioning.
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6
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Brissenden JA, Somers DC. Cortico-cerebellar networks for visual attention and working memory. Curr Opin Psychol 2019; 29:239-247. [PMID: 31202085 PMCID: PMC7256875 DOI: 10.1016/j.copsyc.2019.05.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/03/2019] [Accepted: 05/14/2019] [Indexed: 01/22/2023]
Abstract
Cerebellar cortex, which is cytoarchitectonically homogenous, can be functionally differentiated by connectivity differences across the cerebral cortex. The cerebral cortical dorsal attention network exhibits strong, selective connectivity with a set of cerebellar circuits, including lobule VIIb/VIIIa. Recent findings demonstrate that lobule VIIb/VIIIa exhibits functional properties characteristic of the cortical dorsal attention network: task-specific activation; working memory load-dependent responses; and the representation of visuospatial location. Moreover, functional cortico-cerebellar subnetworks exhibit topographic specialization for different aspects of visual attentional processing. Thus, cerebellar lobule VIIb/VIIIa, rather than simply supporting motor functions, appears to be an integral part of the brain's visual attentional circuitry. More generally, these findings suggest that parallel cortico-cerebellar networks may play highly specific functional roles in a broad range of cognitive processes.
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Affiliation(s)
- James A Brissenden
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA 02215, United States
| | - David C Somers
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA 02215, United States.
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7
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El-Shamayleh Y, Kojima Y, Soetedjo R, Horwitz GD. Selective Optogenetic Control of Purkinje Cells in Monkey Cerebellum. Neuron 2017. [PMID: 28648497 DOI: 10.1016/j.neuron.2017.06.002] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purkinje cells of the primate cerebellum play critical but poorly understood roles in the execution of coordinated, accurate movements. Elucidating these roles has been hampered by a lack of techniques for manipulating spiking activity in these cells selectively-a problem common to most cell types in non-transgenic animals. To overcome this obstacle, we constructed AAV vectors carrying the channelrhodopsin-2 (ChR2) gene under the control of a 1 kb L7/Pcp2 promoter. We injected these vectors into the cerebellar cortex of rhesus macaques and tested vector efficacy in three ways. Immunohistochemical analyses confirmed selective ChR2 expression in Purkinje cells. Neurophysiological recordings confirmed robust optogenetic activation. Optical stimulation of the oculomotor vermis caused saccade dysmetria. Our results demonstrate the utility of AAV-L7-ChR2 for revealing the contributions of Purkinje cells to circuit function and behavior, and they attest to the feasibility of promoter-based, targeted, genetic manipulations in primates.
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Affiliation(s)
- Yasmine El-Shamayleh
- Department of Physiology & Biophysics, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA; Washington National Primate Research Center, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA
| | - Yoshiko Kojima
- Department of Physiology & Biophysics, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA; Washington National Primate Research Center, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA
| | - Robijanto Soetedjo
- Department of Physiology & Biophysics, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA; Washington National Primate Research Center, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA
| | - Gregory D Horwitz
- Department of Physiology & Biophysics, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA; Washington National Primate Research Center, University of Washington, 1959 NE Pacific St., HSB I-728, UW Mailbox 357290, Seattle, WA 98195, USA.
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8
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Igelström KM, Webb TW, Graziano MSA. Functional Connectivity Between the Temporoparietal Cortex and Cerebellum in Autism Spectrum Disorder. Cereb Cortex 2017; 27:2617-2627. [PMID: 27073219 DOI: 10.1093/cercor/bhw079] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The neural basis of autism spectrum disorder (ASD) is not yet understood. ASD is marked by social deficits and is strongly associated with cerebellar abnormalities. We studied the organization and cerebellar connectivity of the temporoparietal junction (TPJ), an area that plays a crucial role in social cognition. We applied localized independent component analysis to resting-state fMRI data from autistic and neurotypical adolescents to yield an unbiased parcellation of the bilateral TPJ into 11 independent components (ICs). A comparison between neurotypical and autistic adolescents showed that the organization of the TPJ was not significantly altered in ASD. Second, we used the time courses of the TPJ ICs as spatially unbiased "seeds" for a functional connectivity analysis applied to voxels within the cerebellum. We found that the cerebellum contained a fine-grained, lateralized map of the TPJ. The connectivity of the TPJ subdivisions with cerebellar zones showed one striking difference in ASD. The right dorsal TPJ showed markedly less connectivity with the left Crus II. Disturbed cerebellar input to this key region for cognition and multimodal integration may contribute to social deficits in ASD. The findings might also suggest that the right TPJ and/or left Crus II are potential targets for noninvasive brain stimulation therapies.
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Affiliation(s)
- Kajsa M Igelström
- Princeton Neuroscience Institute.,Department of Psychology, Princeton University, Princeton, NJ 08544, USA
| | - Taylor W Webb
- Princeton Neuroscience Institute.,Department of Psychology, Princeton University, Princeton, NJ 08544, USA
| | - Michael S A Graziano
- Princeton Neuroscience Institute.,Department of Psychology, Princeton University, Princeton, NJ 08544, USA
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9
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Stoodley CJ, Limperopoulos C. Structure-function relationships in the developing cerebellum: Evidence from early-life cerebellar injury and neurodevelopmental disorders. Semin Fetal Neonatal Med 2016; 21:356-64. [PMID: 27184461 PMCID: PMC5282860 DOI: 10.1016/j.siny.2016.04.010] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The increasing appreciation of the role of the cerebellum in motor and non-motor functions is crucial to understanding the outcomes of acquired cerebellar injury and developmental lesions in high-risk fetal and neonatal populations, children with cerebellar damage (e.g. posterior fossa tumors), and neurodevelopmental disorders (e.g. autism). We review available data regarding the relationship between the topography of cerebellar injury or abnormality and functional outcomes. We report emerging structure-function relationships with specific symptoms: cerebellar regions that interconnect with sensorimotor cortices are associated with motor impairments when damaged; disruption to posterolateral cerebellar regions that form circuits with association cortices impact long-term cognitive outcomes; and midline posterior vermal damage is associated with behavioral dysregulation and an autism-like phenotype. We also explore the impact of age and the potential role for critical periods on cerebellar structure and child function. These findings suggest that the cerebellum plays a critical role in motor, cognitive, and social-behavioral development, possibly via modulatory effects on the developing cerebral cortex.
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Affiliation(s)
- Catherine J Stoodley
- Department of Psychology and Center for Behavioral Neuroscience, American University, Washington DC, USA.
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10
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Yang Z, Wu P, Weng X, Bandettini PA. Cerebellum engages in automation of verb-generation skill. J Integr Neurosci 2014; 13:1-17. [PMID: 24738536 DOI: 10.1142/s0219635214500010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Numerous studies have shown cerebellar involvement in item-specific association, a form of explicit learning. However, very few have demonstrated cerebellar participation in automation of non-motor cognitive tasks. Applying fMRI to a repeated verb-generation task, we sought to distinguish cerebellar involvement in learning of item-specific noun-verb association and automation of verb generation skill. The same set of nouns was repeated in six verb-generation blocks so that subjects practiced generating verbs for the nouns. The practice was followed by a novel block with a different set of nouns. The cerebellar vermis (IV/V) and the right cerebellar lobule VI showed decreased activation following practice; activation in the right cerebellar Crus I was significantly lower in the novel challenge than in the initial verb-generation task. Furthermore, activation in this region during well-practiced blocks strongly correlated with improvement of behavioral performance in both the well-practiced and the novel blocks, suggesting its role in the learning of general mental skills not specific to the practiced noun-verb pairs. Therefore, the cerebellum processes both explicit verbal associative learning and automation of cognitive tasks. Different cerebellar regions predominate in this processing: lobule VI during the acquisition of item-specific association, and Crus I during automation of verb-generation skills through practice.
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Affiliation(s)
- Zhi Yang
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing, 100101, P. R. China , Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1148, USA
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11
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Cerebellar granule cells are generated postnatally in humans. Brain Struct Funct 2013; 219:1271-86. [PMID: 23716277 DOI: 10.1007/s00429-013-0565-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 04/22/2013] [Indexed: 12/22/2022]
Abstract
How many cerebellar granule cells are generated pre- or postnatally in human is unknown. Using a rigorous design-based stereologic approach we investigated postmortem cerebella from 14 children who died between the first postnatal day (P1) and 11 months of age (M11). We found a statistically significant (p < 0.05) age-related increase in the total number of granule cells from 5.9 × 10(9) at M1 to 37.6 × 10(9) at M10/11 per cerebellar half but not in the total number of Purkinje cells (12.1 × 10(6) at M1 vs. 13.9 × 10(6) at M10/11 per cerebellar half). Accordingly, approximately 85 % of the cerebellar granule cells are generated postnatally in human, and the number of granule cells per Purkinje cell in the human cerebellum increases from 485 at M1 to 2,700 at M10/11, approximately. These data indicate that the human cerebellum has a much higher functional plasticity during the first year of life than previously thought, and may respond very sensitively to internal and external influences during this time. This has important implications for several neuropsychiatric conditions in which cerebellar involvement has been demonstrated.
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12
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Rochefort C, Lefort JM, Rondi-Reig L. The cerebellum: a new key structure in the navigation system. Front Neural Circuits 2013; 7:35. [PMID: 23493515 PMCID: PMC3595517 DOI: 10.3389/fncir.2013.00035] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 02/22/2013] [Indexed: 12/03/2022] Open
Abstract
Early investigations of cerebellar function focused on motor learning, in particular on eyeblink conditioning and adaptation of the vestibulo-ocular reflex, and led to the general view that cerebellar long-term depression (LTD) at parallel fiber (PF)–Purkinje cell (PC) synapses is the neural correlate of cerebellar motor learning. Thereafter, while the full complexity of cerebellar plasticities was being unraveled, cerebellar involvement in more cognitive tasks—including spatial navigation—was further investigated. However, cerebellar implication in spatial navigation remains a matter of debate because motor deficits frequently associated with cerebellar damage often prevent the dissociation between its role in spatial cognition from its implication in motor function. Here, we review recent findings from behavioral and electrophysiological analyses of cerebellar mutant mouse models, which show that the cerebellum might participate in the construction of hippocampal spatial representation map (i.e., place cells) and thereby in goal-directed navigation. These recent advances in cerebellar research point toward a model in which computation from the cerebellum could be required for spatial representation and would involve the integration of multi-source self-motion information to: (1) transform the reference frame of vestibular signals and (2) distinguish between self- and externally-generated vestibular signals. We eventually present herein anatomical and functional connectivity data supporting a cerebello-hippocampal interaction. Whilst a direct cerebello-hippocampal projection has been suggested, recent investigations rather favor a multi-synaptic pathway involving posterior parietal and retrosplenial cortices, two regions critically involved in spatial navigation.
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13
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Thürling M, Hautzel H, Küper M, Stefanescu M, Maderwald S, Ladd M, Timmann D. Involvement of the cerebellar cortex and nuclei in verbal and visuospatial working memory: A 7T fMRI study. Neuroimage 2012; 62:1537-50. [DOI: 10.1016/j.neuroimage.2012.05.037] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/29/2012] [Accepted: 05/16/2012] [Indexed: 11/27/2022] Open
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14
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Bellebaum C, Daum I, Suchan B. Mechanisms of cerebellar contributions to cognition in humans. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2012; 3:171-184. [DOI: 10.1002/wcs.1161] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christian Bellebaum
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Ruhr‐University of Bochum, Bochum, Germany
| | - Irene Daum
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Ruhr‐University of Bochum, Bochum, Germany
| | - Boris Suchan
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Ruhr‐University of Bochum, Bochum, Germany
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15
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Abstract
This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'The trainee consistently demonstrates a knowledge of management approaches for specific impairments including spasticity, ataxia.'
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Affiliation(s)
- Jon Marsden
- School of Health Professions, Peninsula Allied Health Centre, Derriford Road, University of Plymouth, PL6 8BH, UK.
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16
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Thürling M, Küper M, Stefanescu R, Maderwald S, Gizewski ER, Ladd ME, Timmann D. Activation of the dentate nucleus in a verb generation task: A 7T MRI study. Neuroimage 2011; 57:1184-91. [PMID: 21640191 DOI: 10.1016/j.neuroimage.2011.05.045] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 05/12/2011] [Accepted: 05/16/2011] [Indexed: 11/18/2022] Open
Abstract
There is increasing evidence of a topographic organization within the human cerebellar cortex for motor and non-motor functions. Likewise, a subdivision of the dentate nucleus in a more dorsal and rostral motor domain and a more ventral and caudal non-motor domain has been proposed by Dum and Strick (2003) based on anatomical studies in monkey. In humans, however, very little is known about topographic organization within the dentate nucleus. Activation of the dentate nucleus in a verb generation task was examined in young and healthy subjects using ultra-highfield 7T functional magnetic resonance imaging (fMRI) with its increase in signal-to-noise ratio. Data of 17 subjects were included in statistical analysis. Subjects were asked to (i) read words (nouns) aloud presented on a screen, (ii) silently read the same nouns, (iii) silently generate the appropriate verbs to the same nouns and (iv) to silently repeat the names of the months. A block design was used. For image processing, a recently developed region of interest (ROI) driven normalization method of the dentate nuclei was applied. Activation related to motor speech (contrast aloud reading minus silent reading) was strongest in the rostral parts of the dentate nucleus. Dorsorostral activations were present bilaterally. Activation related to verb generation (contrast verb generation minus silent reading) was found in the ventrocaudal parts of the dentate nucleus on the right. The present findings are in good accordance with the anatomical data in monkeys and suggest that the human dentate nucleus can be subdivided into a rostral and more dorsal motor domain and a ventrocaudal non-motor domain.
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Affiliation(s)
- M Thürling
- Department of Neurology, University of Duisburg-Essen, Essen, Germany
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17
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Peterburs J, Bellebaum C, Koch B, Schwarz M, Daum I. Working memory and verbal fluency deficits following cerebellar lesions: relation to interindividual differences in patient variables. THE CEREBELLUM 2011; 9:375-83. [PMID: 20387024 DOI: 10.1007/s12311-010-0171-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Findings concerning cognitive impairment in patients with focal cerebellar lesions tend to be inconsistent and usually reflect a mild deficit. Patient variables such as lesion age and the age at lesion onset might affect functional reorganization and contribute to the variability of the findings. To assess this issue, 14 patients with focal vascular cerebellar lesions and 14 matched healthy control subjects performed a verbal working memory and a verbal long-term memory task as well as verbal fluency tasks. Patients showed deficits in working memory and verbal fluency, while recall of complex narrative material was intact. Verbal fluency performance correlated significantly with age in the patient group, with more severe impairments in older patients, suggesting that age at lesion onset is a critical variable for cognitive outcome. In controls, no significant correlations with age were observed. Taken together, our findings support the idea of cerebellar involvement in nonmotor functions and indicate the relevance of interindividual differences in regard to clinical parameters after focal cerebellar damage.
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Affiliation(s)
- Jutta Peterburs
- Institute of Cognitive Neuroscience, Department of Neuropsychology, Faculty of Psychology, Ruhr University Bochum, Universitaetsstrasse 150, 44780 Bochum, Germany.
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Abstract
An eight-month-old male Caucasian infant presented with ataxia and titubations, which had been noticed shortly after birth. He was born to healthy non-consanguineous parents after an unremarkable pregnancy. There was no maternal use of drugs, alcohol or tobacco. A prenatal ultrasound at 36 weeks conceptual age (performed at the request of the parents since the 20 week ultrasound had not been performed) revealed an enlarged posterior fossa, no cerebellar tissue, a normal corpus callosum and no evidence of hydrocephalus. He was delivered via spontaneous vaginal delivery at 37 weeks gestation without complications. Birth weight was 3630g and the neonatal course was unremarkable. Developmentally, at eight months-of-age he could not sit. A formal developmental assessment at 19 months-of-age revealed gross and fine motor delay. He was pulling to stand and was cruising but was not walking independently. He was able to stack two cubes. He was very social, highly imitative and used over 50 words. His words were clear and there was no dysarthria. His receptive and expressive language skills were deemed to be at the 18-21 month level. Family history was non-contributory. Physical examination at 19 months-of-age revealed weight and height between the 10-25 percentiles and head circumference at the 25th percentile. Head titubation was present throughout the examination. Extraocular movements were full, with bilateral intermittent esotropia. Upon fixing of the head, horizontal nystagmus and saccadic intrusions on smooth pursuit exam were noted. Fundoscopic examination was normal. He had mild truncal hypotonia, with appropriate strength for his age.
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Aphasia and Neglect Are Uncommon in Cerebellar Disease: Negative Findings in a Prospective Study in Acute Cerebellar Stroke. THE CEREBELLUM 2010; 9:556-66. [DOI: 10.1007/s12311-010-0197-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stoodley CJ, Schmahmann JD. Evidence for topographic organization in the cerebellum of motor control versus cognitive and affective processing. Cortex 2010; 46:831-44. [PMID: 20152963 PMCID: PMC2873095 DOI: 10.1016/j.cortex.2009.11.008] [Citation(s) in RCA: 952] [Impact Index Per Article: 68.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 09/25/2009] [Accepted: 10/31/2009] [Indexed: 11/18/2022]
Abstract
Patients with cerebellar damage often present with the cerebellar motor syndrome of dysmetria, dysarthria and ataxia, yet cerebellar lesions can also result in the cerebellar cognitive affective syndrome (CCAS), including executive, visual spatial, and linguistic impairments, and affective dysregulation. We have hypothesized that there is topographic organization in the human cerebellum such that the anterior lobe and lobule VIII contain the representation of the sensorimotor cerebellum; lobules VI and VII of the posterior lobe comprise the cognitive cerebellum; and the posterior vermis is the anatomical substrate of the limbic cerebellum. Here we analyze anatomical, functional neuroimaging, and clinical data to test this hypothesis. We find converging lines of evidence supporting regional organization of motor, cognitive, and limbic behaviors in the cerebellum. The cerebellar motor syndrome results when lesions involve the anterior lobe and parts of lobule VI, interrupting cerebellar communication with cerebral and spinal motor systems. Cognitive impairments occur when posterior lobe lesions affect lobules VI and VII (including Crus I, Crus II, and lobule VIIB), disrupting cerebellar modulation of cognitive loops with cerebral association cortices. Neuropsychiatric disorders manifest when vermis lesions deprive cerebro-cerebellar-limbic loops of cerebellar input. We consider this functional topography to be a consequence of the differential arrangement of connections of the cerebellum with the spinal cord, brainstem, and cerebral hemispheres, reflecting cerebellar incorporation into the distributed neural circuits subserving movement, cognition, and emotion. These observations provide testable hypotheses for future investigations.
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Affiliation(s)
- Catherine J Stoodley
- Ataxia Unit, Cognitive/Behavioral Neurology Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 175 Cambridge Street, Boston, MA 02114, USA.
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Fournier del Castillo MC, Maldonado Belmonte MJ, Ruiz-Falcó Rojas ML, López Pino MÁ, Bernabeu Verdú J, Suárez Rodríguez JM. Cerebellum Atrophy and Development of a Peripheral Dysgraphia: A Paediatric Case. THE CEREBELLUM 2010; 9:530-6. [DOI: 10.1007/s12311-010-0188-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Does the cerebellum influence nonmotor behavior? Recent anatomical studies demonstrate that the output of the cerebellum targets multiple nonmotor areas in the prefrontal and posterior parietal cortex, as well as the cortical motor areas. The projections to different cortical areas originate from distinct output channels within the cerebellar nuclei. The cerebral cortical area that is the main target of each output channel is a major source of input to the channel. Thus, a closed-loop circuit represents the major architectural unit of cerebro-cerebellar interactions. The outputs of these loops provide the cerebellum with the anatomical substrate to influence the control of movement and cognition. Neuroimaging and neuropsychological data supply compelling support for this view. The range of tasks associated with cerebellar activation is remarkable and includes tasks designed to assess attention, executive control, language, working memory, learning, pain, emotion, and addiction. These data, along with the revelations about cerebro-cerebellar circuitry, provide a new framework for exploring the contribution of the cerebellum to diverse aspects of behavior.
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Affiliation(s)
- Peter L Strick
- Veterans Affairs Medical Center, Pittsburgh, Pennsylvania 15261, USA.
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Rueckriegel SM, Blankenburg F, Henze G, Baqué H, Driever PH. Loss of fine motor function correlates with ataxia and decline of cognition in cerebellar tumor survivors. Pediatr Blood Cancer 2009; 53:424-31. [PMID: 19484752 DOI: 10.1002/pbc.22104] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Motor and cognitive function losses resemble handicaps in pediatric posterior fossa tumor survivors. Several factors determine type and extent of impairment. We quantified loss of fine motor function and its association with ataxia and intelligence in patients with and without adjuvant treatment. PROCEDURE Fine motor function, extent of ataxia and cognitive function were assessed in 25 medulloblastoma (MB) and 16 cerebellar pilocytic astrocytoma (PA) patients at least 1 year after completion of therapy. Kinematic parameters (speed, automation, variability, and pressure) of different movement complexity levels were investigated employing a digitizing graphic tablet. Degree of ataxia was quantified using the International Cooperative Ataxia Rating Scale and cognition was determined using the Wechsler Intelligence Scale. RESULTS Kinematic parameters of low and high complexity tasks as well as ataxia of MB patients were strongly impaired. Fine motor impairment was weaker in PA patients, but still evident in the complex task of writing. Ataxia was significantly more pronounced in medulloblastoma patients. Young age and short recovery time correlated significantly with impaired kinematic parameters. Ataxia was strongly associated with inferior fine motor function. Cognition, especially performance IQ, was associated with dysfunctional kinematic parameters. CONCLUSION The digitizing tablet detected extent of fine motor function loss at varying levels of complexity of pediatric cerebellar tumor survivors. This tool promises to be a potentially effective method for measuring fine motor function in clinical trials and may be helpful in studying mechanisms of neurotoxicity in posterior fossa tumor patients as well as success of rehabilitation.
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Affiliation(s)
- Stefan Mark Rueckriegel
- Pediatric Neurooncology Program, Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Palmer SL, Leigh L. Survivors of pediatric posterior fossa tumors: cognitive outcome, intervention, and risk-based care. Eur J Oncol Nurs 2008; 13:171-8. [PMID: 19019733 DOI: 10.1016/j.ejon.2008.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 09/09/2008] [Accepted: 09/11/2008] [Indexed: 11/15/2022]
Abstract
Adolescent and young adult survivors of posterior fossa tumors face a wide variety of functional challenges following treatment. The concept of survival needs to include plans to regularly monitor and effectively respond to those patients considered at risk for continued morbidities associated with cancer and its treatment. The nature of impairment experienced by survivors is discussed, including predominant patient- and treatment-related risk factors. A model to respond to the cognitive needs of survivors, including risk-based evaluation and intervention, is proposed. It is imperative for the success of the survivor that a team approach is taken to care. This approach must include improving the awareness and education of teachers and other education specialists who interact with this population of survivors. There is also an obligation to put forth effort in developing and validating efficacious intervention programs.
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Affiliation(s)
- Shawna L Palmer
- Department of Behavioral Medicine, St Jude Children's Research Hospital; Memphis, TN 38105-2794, USA.
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Timmann D, Daum I. Cerebellar contributions to cognitive functions: a progress report after two decades of research. CEREBELLUM (LONDON, ENGLAND) 2007; 6:159-62. [PMID: 17786810 DOI: 10.1080/14734220701496448] [Citation(s) in RCA: 168] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Accumulating evidence from both human lesion and functional neuroimaging studies appears to support the hypothesis that the cerebellum contributes to non-motor functions. Along similar lines, cognitive, affective and behavioural changes in psychiatric disorders, such as autism, schizophrenia and dyslexia, have been linked to structural cerebellar abnormalities. The aim of this special issue was to evaluate the current knowledge base after more than 20 years of controversial discussion. The contributions of the special issue cover the most important cognitive domains, i.e., attention, memory and learning, executive control, language and visuospatial function. The available empirical evidence suggests that cognitive changes in patients with cerebellar dysfunction are mild and clearly less severe than the impairments observed after lesions to neocortical areas to which the cerebellum is closely connected via different cerebro-cerebellar loops. Frequently cited early findings, e.g., with respect to a specific cerebellar involvement in attention, have not been replicated or might be confounded by motor or working memory demands of the respective attention task. On the other hand, there is now convincing evidence for a cerebellar involvement in the mediation of a range of cognitive domains, most notably verbal working memory. Verbal working memory problems may partly underlie the compromised performance of cerebellar lesion patients on at least some complex cognitive tasks. Although investigations have moved from anecdotical case reports to hypothesis-driven controlled clinical group studies based on sound methods which are complemented by state-of-the-art functional neuroimaging studies, the empirical evidence available so far does not yet allow a convincing theory of the mechanisms of a cerebellar involvement in cognitive function. Future studies are clearly needed to further elucidate the nature of the processes linked to cerebellar mediation of cognitive processes and their possible link to motor theories of cerebellar function, e.g., its role in prediction and/or timing.
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Affiliation(s)
- Dagmar Timmann
- Department of Neurology, University of Duisburg-Essen, Essen, Germany.
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