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Andringa A, Meskers C, van de Port I, Zandvliet S, Scholte L, de Groot J, Kwakkel G, van Wegen E. Quantifying neural and non-neural components of wrist hyper-resistance after stroke: Comparing two instrumented assessment methods. Med Eng Phys 2021; 98:57-64. [PMID: 34848039 DOI: 10.1016/j.medengphy.2021.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022]
Abstract
Patients with poor upper limb motor recovery after stroke are likely to develop increased resistance to passive wrist extension, i.e., wrist hyper-resistance. Quantification of the underlying neural and non-neural elastic components is of clinical interest. This cross-sectional study compared two methods: a commercially available device (NeuroFlexor®) with an experimental EMG-based device (Wristalyzer) in 43 patients with chronic stroke. Spearman's rank correlation coefficients (r) between components, modified Ashworth scale (MAS) and range of passive wrist extension (PRoM) were calculated with 95% confidence intervals. Neural as well as elastic components assessed by both devices were associated (r = 0.61, 95%CI: 0.38-0.77 and r = 0.53, 95%CI: 0.28-0.72, respectively). The neural component assessed by the NeuroFlexor® associated significantly with the elastic components of NeuroFlexor® (r = 0.46, 95%CI: 0.18-0.67) and Wristalyzer (r = 0.36, 95%CI: 0.06-0.59). The neural component assessed by the Wristalyzer was not associated with the elastic components of both devices. Neural and elastic components of both devices associated similarly with the MAS (r = 0.58, 95%CI: 0.34-0.75 vs. 0.49, 95%CI: 0.22-0.69 and r = 0.51, 95%CI: 0.25-0.70 vs. 0.30, 95%CI: 0.00-0.55); elastic components associated with PRoM (r = -0.44, 95%CI: -0.65- -0.16 vs. -0.74, 95%CI: -0.85- -0.57 for NeuroFlexor® and Wristalyzer respectively). Results demonstrate that both methods perform similarly regarding the quantification of neural and elastic wrist hyper-resistance components and have an added value when compared to clinical assessment with the MAS alone. The added value of EMG in the discrimination between neural and non-neural components requires further investigation.
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Affiliation(s)
- Aukje Andringa
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Carel Meskers
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA; Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, the Netherlands.
| | | | - Sarah Zandvliet
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Larissa Scholte
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, the Netherlands
| | - Jurriaan de Groot
- Department of Rehabilitation Medicine, Leiden University Medical Centre, Leiden, the Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA; Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, the Netherlands
| | - Erwin van Wegen
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
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Bareš M, Apps R, Avanzino L, Breska A, D'Angelo E, Filip P, Gerwig M, Ivry RB, Lawrenson CL, Louis ED, Lusk NA, Manto M, Meck WH, Mitoma H, Petter EA. Consensus paper: Decoding the Contributions of the Cerebellum as a Time Machine. From Neurons to Clinical Applications. CEREBELLUM (LONDON, ENGLAND) 2019; 18:266-286. [PMID: 30259343 DOI: 10.1007/s12311-018-0979-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Time perception is an essential element of conscious and subconscious experience, coordinating our perception and interaction with the surrounding environment. In recent years, major technological advances in the field of neuroscience have helped foster new insights into the processing of temporal information, including extending our knowledge of the role of the cerebellum as one of the key nodes in the brain for this function. This consensus paper provides a state-of-the-art picture from the experts in the field of the cerebellar research on a variety of crucial issues related to temporal processing, drawing on recent anatomical, neurophysiological, behavioral, and clinical research.The cerebellar granular layer appears especially well-suited for timing operations required to confer millisecond precision for cerebellar computations. This may be most evident in the manner the cerebellum controls the duration of the timing of agonist-antagonist EMG bursts associated with fast goal-directed voluntary movements. In concert with adaptive processes, interactions within the cerebellar cortex are sufficient to support sub-second timing. However, supra-second timing seems to require cortical and basal ganglia networks, perhaps operating in concert with cerebellum. Additionally, sensory information such as an unexpected stimulus can be forwarded to the cerebellum via the climbing fiber system, providing a temporally constrained mechanism to adjust ongoing behavior and modify future processing. Patients with cerebellar disorders exhibit impairments on a range of tasks that require precise timing, and recent evidence suggest that timing problems observed in other neurological conditions such as Parkinson's disease, essential tremor, and dystonia may reflect disrupted interactions between the basal ganglia and cerebellum.The complex concepts emerging from this consensus paper should provide a foundation for further discussion, helping identify basic research questions required to understand how the brain represents and utilizes time, as well as delineating ways in which this knowledge can help improve the lives of those with neurological conditions that disrupt this most elemental sense. The panel of experts agrees that timing control in the brain is a complex concept in whom cerebellar circuitry is deeply involved. The concept of a timing machine has now expanded to clinical disorders.
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Affiliation(s)
- Martin Bareš
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
- Department of Neurology, School of Medicine, University of Minnesota, Minneapolis, USA.
| | - Richard Apps
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Laura Avanzino
- Department of Experimental Medicine, Section of Human Physiology and Centro Polifunzionale di Scienze Motorie, University of Genoa, Genoa, Italy
- Centre for Parkinson's Disease and Movement Disorders, Ospedale Policlinico San Martino, Genoa, Italy
| | - Assaf Breska
- Department of Psychology and Helen Wills Neuroscience Institute, University of California, Berkeley, USA
| | - Egidio D'Angelo
- Neurophysiology Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Brain Connectivity Center, Fondazione Istituto Neurologico Nazionale Casimiro Mondino (IRCCS), Pavia, Italy
| | - Pavel Filip
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marcus Gerwig
- Department of Neurology, University of Duisburg-Essen, Duisburg, Germany
| | - Richard B Ivry
- Department of Psychology and Helen Wills Neuroscience Institute, University of California, Berkeley, USA
| | - Charlotte L Lawrenson
- School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK
| | - Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Nicholas A Lusk
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Mario Manto
- Department of Neurology, CHU-Charleroi, Charleroi, Belgium -Service des Neurosciences, UMons, Mons, Belgium
| | - Warren H Meck
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Hiroshi Mitoma
- Medical Education Promotion Center, Tokyo Medical University, Tokyo, Japan
| | - Elijah A Petter
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
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Bodranghien F, Oulad Ben Taib N, Van Maldergem L, Manto M. A Postural Tremor Highly Responsive to Transcranial Cerebello-Cerebral DCS in ARCA3. Front Neurol 2017; 8:71. [PMID: 28316589 PMCID: PMC5334604 DOI: 10.3389/fneur.2017.00071] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/16/2017] [Indexed: 11/24/2022] Open
Abstract
Background and objectives Cerebellar ataxias are disabling disorders that impact the quality of life of patients. In many cases, an effective treatment is missing. Despite the increasing knowledge on the pathogenesis of cerebellar disorders including genetic aspects, there is currently a gap in the therapeutical management of cerebellar deficits. Cerebellar ataxia associated with ANO10 mutation (ARCA3) presents a disabling cerebellar syndrome. The aim of this study is to report a patient with a marked postural tremor responding to transcranial cerebello-cerebral direct current stimulation (tCCDCS). Methods We applied tCCDCS using anodal stimulation over the cerebellum with a return electrode on the contralateral motor cortex. We performed a clinical rating, accelerometry studies, and recordings of voluntary movements at baseline, after sham, and after active tCCDCS. Results A dramatic response of postural tremor was observed after tCCDCS, with a major drop of the power spectral density to 26.12% of basal values. Discussion The postural tremor of cerebellar ataxia associated with ANO10 mutation was highly responsive to tCCDCS in our patient. This case illustrates that tCCDCS is a novel therapeutic option in the treatment of cerebellar deficits and might represent a promising tool to reduce tremor in ARCA3.
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Affiliation(s)
| | - Nordeyn Oulad Ben Taib
- Service de Neurochirurgie, ULB-Erasme, Bruxelles, Belgium; Service de Neurochirurgie, CHU-StPierre, Bruxelles, Belgium
| | - Lionel Van Maldergem
- Centre de génétique humaine, Université de Franche-Comté, Besançon, France; Metabolic Unit, Université de Liège, Liège, Belgium
| | - Mario Manto
- Unité d'Etude du Mouvement-GRIM, FNRS, ULB-Erasme, Bruxelles, Belgium; Service des Neurosciences, UMons, Mons, Belgium
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Bodranghien F, Bastian A, Casali C, Hallett M, Louis ED, Manto M, Mariën P, Nowak DA, Schmahmann JD, Serrao M, Steiner KM, Strupp M, Tilikete C, Timmann D, van Dun K. Consensus Paper: Revisiting the Symptoms and Signs of Cerebellar Syndrome. CEREBELLUM (LONDON, ENGLAND) 2016; 15:369-91. [PMID: 26105056 PMCID: PMC5565264 DOI: 10.1007/s12311-015-0687-3] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The cerebellum is involved in sensorimotor operations, cognitive tasks and affective processes. Here, we revisit the concept of the cerebellar syndrome in the light of recent advances in our understanding of cerebellar operations. The key symptoms and signs of cerebellar dysfunction, often grouped under the generic term of ataxia, are discussed. Vertigo, dizziness, and imbalance are associated with lesions of the vestibulo-cerebellar, vestibulo-spinal, or cerebellar ocular motor systems. The cerebellum plays a major role in the online to long-term control of eye movements (control of calibration, reduction of eye instability, maintenance of ocular alignment). Ocular instability, nystagmus, saccadic intrusions, impaired smooth pursuit, impaired vestibulo-ocular reflex (VOR), and ocular misalignment are at the core of oculomotor cerebellar deficits. As a motor speech disorder, ataxic dysarthria is highly suggestive of cerebellar pathology. Regarding motor control of limbs, hypotonia, a- or dysdiadochokinesia, dysmetria, grasping deficits and various tremor phenomenologies are observed in cerebellar disorders to varying degrees. There is clear evidence that the cerebellum participates in force perception and proprioceptive sense during active movements. Gait is staggering with a wide base, and tandem gait is very often impaired in cerebellar disorders. In terms of cognitive and affective operations, impairments are found in executive functions, visual-spatial processing, linguistic function, and affective regulation (Schmahmann's syndrome). Nonmotor linguistic deficits including disruption of articulatory and graphomotor planning, language dynamics, verbal fluency, phonological, and semantic word retrieval, expressive and receptive syntax, and various aspects of reading and writing may be impaired after cerebellar damage. The cerebellum is organized into (a) a primary sensorimotor region in the anterior lobe and adjacent part of lobule VI, (b) a second sensorimotor region in lobule VIII, and (c) cognitive and limbic regions located in the posterior lobe (lobule VI, lobule VIIA which includes crus I and crus II, and lobule VIIB). The limbic cerebellum is mainly represented in the posterior vermis. The cortico-ponto-cerebellar and cerebello-thalamo-cortical loops establish close functional connections between the cerebellum and the supratentorial motor, paralimbic and association cortices, and cerebellar symptoms are associated with a disruption of these loops.
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Affiliation(s)
- Florian Bodranghien
- FNRS ULB-Erasme, Unité d'Etude du Mouvement, 808 Route de Lennik, 1070, Brussels, Belgium
| | - Amy Bastian
- Kennedy Krieger Institute, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - Carlo Casali
- Department of Medical and Surgical Sciences and Biotechnologies, Rome Sapienza University, Rome, Italy
| | - Mark Hallett
- Human Motor Control Section, NINDS, Bethesda, MD, USA
| | - Elan D Louis
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Mario Manto
- FNRS ULB-Erasme, Unité d'Etude du Mouvement, 808 Route de Lennik, 1070, Brussels, Belgium.
| | - Peter Mariën
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital, Antwerp, Belgium
| | - Dennis A Nowak
- Helios Klinik Kipfenberg, Kindingerstrasse 13, D-85110, Kipfenberg, Germany
- Neurologische Universitätsklinik, Philipps-Universität Marburg, Baldingerstraße, D-35043, Marburg, Germany
| | - Jeremy D Schmahmann
- Ataxia Unit, Cognitive Behavioural Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Rome Sapienza University, Rome, Italy
- Rehabilitation Centre, Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Katharina Marie Steiner
- Department of Neurology, University Clinic Essen, Hufelandstrasse 55, 45147, Essen, Germany
- Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | | | - Caroline Tilikete
- CRNL INSERM U1028 CNRS UMR5292, Team ImpAct, Bron, F-69676, France
- Lyon I University, Lyon, F-69373, France
- Hospices Civils de Lyon, Neuro-Ophthalmology and Neurology D, Hôpital Neurologique Pierre Wertheimer, Bron, F-69677, France
| | - Dagmar Timmann
- Department of Neurology, University Clinic Essen, Hufelandstrasse 55, 45147, Essen, Germany
- Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Kim van Dun
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital, Antwerp, Belgium
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Grimaldi G, Oulad Ben Taib N, Manto M, Bodranghien F. Marked reduction of cerebellar deficits in upper limbs following transcranial cerebello-cerebral DC stimulation: tremor reduction and re-programming of the timing of antagonist commands. Front Syst Neurosci 2014; 8:9. [PMID: 24523678 PMCID: PMC3906576 DOI: 10.3389/fnsys.2014.00009] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/14/2014] [Indexed: 11/13/2022] Open
Abstract
Cerebellar ataxias represent a very heterogeneous group of disabling disorders for which we lack effective symptomatic therapies in most cases. There is currently an intense interest in the use of non-invasive transcranial DC stimulation (tDCS) to modulate the activity of the cerebellum in ataxic disorders. We performed a detailed laboratory assessment of the effects of transcranial cerebello-cerebral DC stimulation (tCCDCS, including a sham procedure) on upper limb tremor and dysmetria in 2 patients presenting a dominant spinocerebellar ataxia (SCA) type 2, one of the most common SCAs encountered during practice. Both patients had a very similar triplet expansion size in the ATXN2 gene (respectively, 39 and 40 triplets). tCCDCS reduced both postural tremor and action tremor, as confirmed by spectral analysis. Quadratical PSD (power spectral density) of postural tremor dropped to 38.63 and 41.42% of baseline values in patient 1 and 2, respectively. The integral of the subband 4-20 Hz dropped to 46.9 and 62.3% of baseline values, respectively. Remarkably, tCCDCS canceled hypermetria and reduced dramatically the onset latency of the antagonist EMG activity associated with fast goal-directed movements toward 3 aimed targets (0.2, 0.3, and 0.4 rad). Following tCCDCS, the latency dropped from 108-98 to 63-57 ms in patient 1, and from 74-87 to 41-46 ms in patient 2 (mean control values ± SD: 36 ± 8 to 45 ± 11 ms), corresponding to a major drop of z scores for the 2 patients from 7.12 ± 0.69 to 1.28 ± 1.27 (sham procedure: 6.79 ± 0.71). This is the first demonstration that tCCDCS improves upper limb tremor and hypermetria in SCA type 2. In particular, this is the first report of a favorable effect on the onset latency of the antagonist EMG activity, a neurophysiological marker of the defect in programming of timing of motor commands. Our results indicate that tCCDCS should be considered in the symptomatic management of upper limb motor deficits in cerebellar ataxias. Future studies addressing a tDCS-based neuromodulation to improve motor control of upper limbs are required (a) in a large group of cerebellar disorders, and (b) in different subgroups of ataxic patients. The anatomical location of the cerebellum below the skull is particularly well suited for such studies.
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Affiliation(s)
| | - Nordeyn Oulad Ben Taib
- Unité d'Etude du Mouvement, ULB Neurologie Bruxelles, Belgium ; Service de Neurochirurgie, CHU Saint-Pierre Bruxelles, Belgium
| | - Mario Manto
- Unité d'Etude du Mouvement, ULB Neurologie Bruxelles, Belgium ; Fonds de la Recherche Scientifique-ULB Bruxelles, Belgium
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Grimaldi G, Manto M. Anodal transcranial direct current stimulation (tDCS) decreases the amplitudes of long-latency stretch reflexes in cerebellar ataxia. Ann Biomed Eng 2013; 41:2437-47. [PMID: 23780473 DOI: 10.1007/s10439-013-0846-y] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 06/12/2013] [Indexed: 10/26/2022]
Abstract
Recent studies suggest that the neuromodulation of the cerebellum using transcranial direct current stimulation (tDCS) could represent a new therapeutic strategy for the management of cerebellar disorders. Anodal tDCS of the cerebellum increases the excitability of the cerebellar cortex. We tested the effects of anodal tDCS applied over the cerebellum in ataxic patients. We studied (a) stretch reflexes (SR) in upper limb (SLSR: short-latency stretch reflexes; LLSR: long-latency stretch reflexes), (b) a coordination functional task in upper limbs based on mechanical counters (MCT: mechanical counter test), and (c) computerized posturography. tDCS did not change the amplitude of SLSR, but reduced significantly the amplitudes of LLSR. tDCS did not improve the MCT scores and did not modify posture. We suggest that anodal tDCS of the cerebellum reduces the amplitudes of LLSR by increasing the inhibitory effect exerted by the cerebellar cortex upon cerebellar nuclei. The absence of effect upon upper limb coordination and posture suggests that the cerebello-cerebral networks subserving these functions are less responsive to anodal tDCS of the cerebellum. Anodal tDCS of the cerebellum represents a novel experimental tool to investigate the effects of the cerebellar cortex on the modulation of the amplitudes of LLSR.
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Affiliation(s)
- Giuliana Grimaldi
- Unité d'Etude du Mouvement (UEM), ULB-Erasme, ULB Neurologie 808 Route de Lennik, 1070, Bruxelles, Belgium
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Abstract
The cerebellum is a key-piece for information processing and is involved in numerous motor and nonmotor activities, thanks to the anatomical characteristics of the circuitry, the enormous computational capabilities and the high connectivity to other brain areas. Despite its uniform cytoarchitecture, cerebellar circuitry is segregated into functional zones. This functional parcellation is driven by the connectivity and the anatomo-functional heterogeneity of the numerous extra-cerebellar structures linked to the cerebellum, principally brain cortices, precerebellar nuclei and spinal cord. Major insights into cerebellar functions have been gained with a detailed analysis of the cerebellar outputs, with the evidence that fundamental aspects of cerebrocerebellar operations are the closed-loop circuit and the predictions of future states. Cerebellar diseases result in disturbances of accuracy of movements and lack of coordination. The cerebellar syndrome includes combinations of oculomotor disturbances, dysarthria and other speech deficits, ataxia of limbs, ataxia of stance and gait, as well as often more subtle cognitive/behavioral impairments. Our understanding of the corresponding anatomo-functional maps for the human cerebellum is continuously improving. We summarize the topography of the clinical deficits observed in cerebellar patients and the growing evidence of a regional subdivision into motor, sensory, sensorimotor, cognitive and affective domains. The recently described topographic dichotomy motor versus nonmotor cerebellum based upon anatomical, functional and neuropsychological studies is also discussed.
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Affiliation(s)
- Giuliana Grimaldi
- Service de Neurologie, Unité d'Etude du Mouvement, ULB Erasme, 808 Route de Lennik, Brussels, Belgium.
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Manto M, Bower JM, Conforto AB, Delgado-García JM, da Guarda SNF, Gerwig M, Habas C, Hagura N, Ivry RB, Mariën P, Molinari M, Naito E, Nowak DA, Oulad Ben Taib N, Pelisson D, Tesche CD, Tilikete C, Timmann D. Consensus paper: roles of the cerebellum in motor control--the diversity of ideas on cerebellar involvement in movement. CEREBELLUM (LONDON, ENGLAND) 2012; 11:457-87. [PMID: 22161499 PMCID: PMC4347949 DOI: 10.1007/s12311-011-0331-9] [Citation(s) in RCA: 539] [Impact Index Per Article: 44.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Considerable progress has been made in developing models of cerebellar function in sensorimotor control, as well as in identifying key problems that are the focus of current investigation. In this consensus paper, we discuss the literature on the role of the cerebellar circuitry in motor control, bringing together a range of different viewpoints. The following topics are covered: oculomotor control, classical conditioning (evidence in animals and in humans), cerebellar control of motor speech, control of grip forces, control of voluntary limb movements, timing, sensorimotor synchronization, control of corticomotor excitability, control of movement-related sensory data acquisition, cerebro-cerebellar interaction in visuokinesthetic perception of hand movement, functional neuroimaging studies, and magnetoencephalographic mapping of cortico-cerebellar dynamics. While the field has yet to reach a consensus on the precise role played by the cerebellum in movement control, the literature has witnessed the emergence of broad proposals that address cerebellar function at multiple levels of analysis. This paper highlights the diversity of current opinion, providing a framework for debate and discussion on the role of this quintessential vertebrate structure.
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Affiliation(s)
- Mario Manto
- Unité d'Etude du Mouvement, FNRS, ULB Erasme, 808 Route de Lennik, Brussels, Belgium.
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