Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: 2. Biomechanical characteristics

This study addresses cerebellar involvement in classically conditioned nociceptive lower limb withdrawal reflexes in standing humans. A preceding study compared electromyographic activities in leg muscles of eight patients with cerebellar disease (CBL) and eight age-matched controls (CTRL). The present study extends and completes that investigation by recording biomechanical signals from a strain-gauge-equipped platform during paired auditory conditioning stimuli (CS) and unconditioned stimuli (US) trials and during US-alone trials. The withdrawal reflex performance-lifting the stimulated limb (decreasing the vertical force from that leg, i.e. 'unloading') and transferring body weight to the supporting limb (increasing the vertical force from that leg, i.e. 'loading')-was quantified by the corresponding forces exerted onto the platform. The force changes were not simultaneous but occurred as a sequence of multiple force peaks at different times depending on the specific limb task (loading or unloading). Motor learning, expressed by the occurrence of conditioned responses (CR), is characterized by this sequence beginning already within the CSUS window. Loading and unloading were delayed and prolonged in CBL, resulting in incomplete rebalancing during the analysis period. Trajectory loops of the center of vertical pressure-derived from vertical forces-were also incomplete in CBL within the recording period. However, exposing CBL to a CS resulted in motor improvement reflected by shortening the time of rebalancing and by optimizing the trajectory loop. In summary, associative responses in CBL are not absent although they are less frequent and of smaller amplitude than in CTRL.

Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: I. electrophysiological characteristics

The aim of this study was to demonstrate the involvement of the human cerebellum in the classically conditioned lower limb withdrawal reflex in standing subjects. Electromyographic activity was recorded from the main muscle groups of both legs of eight patients with cerebellar disease (CBL) and eight control subjects (CTRL). The unconditioned stimulus (US) consisted of electrical stimulation of the tibial nerve at the medial malleolus. The conditioning stimulus (CS) was an auditory signal given via headphones. Experiments started with 70 paired conditioning stimulus-unconditioned stimulus(CSUS) trials followed by 50 US-alone trials. The general reaction consisted of lifting and flexing the stimulated (stepping) leg with accompanying activation of the contralateral (supporting) leg. In CTRL, the ipsilateral (side of stimulation) flexor and contralateral extensor muscles were activated characteristically. In CBL, the magnitudes of ipsilateral flexor and contralateral extensor muscle activation were reduced comparably. In CTRL, the conditioning process increased the incidence of conditioned responses (CR), following a typical learning curve, while CBL showed a clearly lower CR incidence with a marginal increase, albeit, at a shorter latency. Conditioning processes also modified temporal parameters by shortening unconditioned response (UR) onset latencies and UR times to peak and, more importantly in CBL, also the sequence of activation of muscles, which became similar to that of CTRL. The expression of this reflex in standing subjects showed characteristic differences in the groups tested with the underlying associative processes not being restricted exclusively to the CR but also modifying parameters of the innate UR.

Trace eyeblink conditioning in patients with cerebellar degeneration: comparison of short and long trace intervals

To elucidate whether the cerebellar cortex may contribute to trace eyeblink conditioning in humans, eight patients with degenerative cerebellar disorders (four with sporadic adult onset ataxia, three with autosomal dominant cerebellar ataxia type III and one with spinocerebellar ataxia type 6) and eight age- and sex-matched healthy control subjects were investigated. Individual high resolution three-dimensional MRI data sets were acquired. As revealed by volumetric measurements of the cerebellum using ECCET software, patients showed cerebellar atrophy to various degrees. No abnormalities were observed in the control subjects. Eyeblink conditioning was performed twice using a tone of 40 ms as conditioned stimulus, followed by a short (400 ms) and a long (1,000 ms) trace interval and an air-puff of 100 ms as unconditioned stimulus. Using the short trace interval, eyeblink conditioning was significantly impaired in cerebellar patients compared to controls, even in those who fulfilled criteria of awareness. Using the long trace interval no significant group differences could be observed. The present findings of impaired trace eyeblink acquisition in patients with cortical cerebellar degeneration suggest that the cerebellar cortex in humans, in addition to the interposed nucleus, is involved in trace eyeblink conditioning, if the trace interval is relatively short. Using a long trace interval, the cerebellum appears to be less important.

The involvement of the human cerebellum in eyeblink conditioning

Besides its known importance for motor coordination, the cerebellum plays a major role in associative learning. The form of cerebellum-dependent associative learning, which has been examined in greatest detail, is classical conditioning of eyeblink responses. The much advanced knowledge of anatomical correlates, as well as cellular and molecular mechanisms involved in eyeblink conditioning in animal models are of particular importance because there is general acceptance that findings in humans parallel the animal data. The aim of the present review is to give an update of findings in humans. Emphasis is put on human lesion studies, which take advantage of the advances of high-resolution structural magnetic resonance imaging (MRI). In addition, findings of functional brain imaging in healthy human subjects are reviewed. The former helped to localize areas involved in eyeblink conditioning within the cerebellum, the latter was in particular helpful in delineating extracerebellar neural substrates, which may contribute to eyeblink conditioning. Human lesion studies support the importance of cortical areas of the ipsilateral superior cerebellum both in the acquisition and timing of conditioned eyeblink responses (CR). Furthermore, the ipsilateral cerebellar cortex seems to be also important in extinction of CRs. Cortical areas, which are important for CR acquisition, overlap with areas related to the control of the unconditioned eyeblink response. Likewise, cortical lesions are followed by increased amplitudes of unconditioned eyeblinks. These findings are in good accordance with the animal literature. Knowledge about contributions of the cerebellar nuclei in humans, however, is sparse. Due to methodological limitations both of human lesion and functional MRI studies, at present no clear conclusions can be drawn on the relative contributions of the cerebellar cortex and nuclei.

Comparison of the electrically evoked leg withdrawal reflex in cerebellar patients and healthy controls

The aim of this study was to analyze the contribution of the cerebellum in the performance of the lower limb withdrawal reflexes. This has been accomplished by comparing the electrically evoked responses in cerebellar patients (CBL) with those in sex- and age-matched healthy control subjects (CTRL). The stimulus was applied to the subjects' medial plantar nerve in four blocks of ten trials each with switching the stimulus from one leg to the other after each block. Responses of the main muscle groups (tibial muscle: TA; gastrocnemius muscle: GA; rectus femoris muscle: RF; biceps femoris muscle: BI) of both legs were recorded during each stimulus. The group of CBL patients consisted of both focally lesioned patients (CBLf) and patients presenting a diffuse degenerative pathology (CBLd). (1) For the withdrawal reflex in CTRL subjects, responses were observed in distal and proximal muscles of the ipsilateral side and corresponding concomitant responses on the side contralateral to the stimulation, whereas in CBL patients responses were restricted primarily to distal muscles, particularly the TA of the ipsilateral, i.e. the stimulated, side. (2) The sequence of activation of the different distal and proximal muscles ipsilateral to the stimulation, derived from latencies and times-to-peak, was for the CTRL group: TA-GA-BI-RF. This sequence was found also in the CBLf patients on their unaffected side. However, on their affected side CBLf patients showed very early GA activation, almost simultaneously with TA and RF activations and before BI activation. RF activation before BI activation was also found in CBLd. In the latter group, GA was activated after RF but before BI with all responses typically delayed. (3) The general pattern of the electrically evoked lower limb reflex consisted of an early, excitatory F1 component and a later, excitatory F2 component of larger amplitude observed in the CTRL subjects and the CBLd patients. In contrast to this pattern CBLf patients exhibited large F1 components followed by small F2 components. (4) The characteristic differences in the withdrawal reflex responses of cerebellar patients depended on the type of the lesion, providing evidence for an important involvement of the cerebellum in the control of the performance of withdrawal reflexes.

Trace eyeblink conditioning in human subjects with cerebellar lesions

Trace eyeblink conditioning was investigated in 31 patients with focal cerebellar lesions and 19 age-matched controls. Twelve patients presented with lesions including the territory of the superior cerebellar artery (SCA). In 19 patients lesions were restricted to the territory of the posterior inferior cerebellar artery (PICA). A 3D magnetic resonance imaging was used to determine the extent of the cortical lesion and possible involvement of cerebellar nuclei. Eyeblink conditioning was performed using a 40 ms tone as conditioned stimulus (CS) followed by a stimulus free trace-interval of 400 ms and a 100 ms air-puff as unconditioned stimulus (US). In SCA patients with lesions including parts of the cerebellar interposed nucleus trace eyeblink conditioning was significantly impaired. Pure cortical lesions of the superior cerebellum were not sufficient to reduce acquisition of trace conditioned eyeblink responses. PICA patients were not impaired in trace eyeblink conditioning. Consistent with animal studies the findings of the present human lesion study suggest that, in addition to forebrain areas, the interposed nucleus is of importance in trace eyeblink conditioning. Although cortical cerebellar areas appear less important in trace compared with delay eyeblink conditioning, the present data strengthen the view that cerebellar structures contribute to different forms of eyeblink conditioning paradigms.

Eyeblink conditioning in patients with hereditary ataxia: a one-year follow-up study

Delay eyeblink conditioning was examined in patients with genetically-defined heredoataxias and age-matched control subjects. 24 patients with spinocerebellar ataxia type 6 (SCA6), type 3 (SCA3), and Friedreich's ataxia (FRDA) participated. SCA6 affects primarily the cerebellum, whereas extracerebellar involvement is common in SCA3 and FRDA. Testing was performed in three sessions six months apart. Severity of ataxia was defined based on the International Ataxia Cooperative Rating Scale (ICARS). As expected, cerebellar patients were significantly impaired in eyeblink conditioning compared to controls. Signs of retention and further learning across sessions were present in controls, but not in the cerebellar patients. In addition, findings of disturbed timing of conditioned responses were observed. Both onsets and peaks of the conditioned responses (CRs) occurred significantly earlier in cerebellar patients. Shortened CR responses were most prominent in patients with primarily cerebellar cortical disease (SCA6). In the group of all cerebellar patients, the SCA3 and the FRDA group correlations between learning deficits and clinical findings were weak. Moderate-to-strong correlations were found in the SCA6 patients. There was no significant change, however, in clinical ataxia scores and CR incidence across the three sessions. In summary, impaired learning of conditioned eyeblink responses is a stable finding across multiple sessions in patients with degenerative cerebellar disorders. Eyeblink conditioning may be a useful measure of cerebellar impairment in patients with hereditary ataxias that primarily affect the cerebellum (such as SCA6). In other heredoataxias (such as SCA3 and FRDA), extracerebellar involvement not assessed by ICARS likely contributes to eyeblink conditioning abnormalities.

Use of sequence information in associative learning in control subjects and cerebellar patients

Previous studies of our group have shown that cerebellar patients are impaired in their ability to associate a color and a numeral or two colors with a button push. The aim of the present study was to examine whether control subjects make use of sequence information in visuomotor associative learning tasks and if this ability is impaired in cerebellar patients. A group of eight patients with degenerative cerebellar disease and eight age, sex and IQ matched controls were tested. Subjects had to learn the association between pairs of colored squares and a button push. Two colored squares were shown one after the other in a fixed or random order on a computer screen. Control subjects but not cerebellar patients took advantage of the fixed order information of colored squares in order to improve associative learning. Differences between groups could not be explained by differences in verbal and visuospatial short-term memory, color discrimination, affective state or motor disturbances. Results suggest that impaired sequencing of sensory stimuli may contribute to disorders in visuomotor associative learning in cerebellar patients.

Classically conditioned postural reflex in cerebellar patients

The aim of the current study was to compare postural responses to repetitive platform-evoked perturbations in cerebellar patients with those of healthy subjects using a classical conditioning paradigm. The perturbations consisted of tilting of the platform (unconditioned stimulus: US) at random time intervals, preceded by an auditory signal that represented the conditioning stimulus (CS). Physiological reactions were recorded biomechanically by measuring the vertical ground forces, yielding the center of vertical pressure (CVP), and electrophysiologically by EMG measurements of the main muscle groups of both legs. The recording session consisted of a control section with US-alone trials, a testing section with paired stimuli and a brief final section with US-alone trials. Healthy control subjects were divided into those establishing conditioned responses (CR) in all muscles tested (strategy I) and those with CR in the gastrocnemius muscles only (strategy II), suggesting an associative motor-related process is involved. Patients with a diffuse, non-localized disease were almost unable to establish CR. This was also true for a patient with a focal surgical lesion with no CR on the affected side but who, simultaneously, showed an essentially normal CR incidence on the intact side. During US-alone trials healthy controls exhibited a remarkable decay of the UR amplitude due to a non-associative motor-related process such as habituation. The decay was most prominent in the paired trials section. In contrast, patients showed no significant differences in the UR amplitude throughout the entire recording session. Analysis of the CVP supported the electrophysiological findings, showing CR in the controls only. The differences between the responses of control subjects and those of the cerebellar patients imply strongly that the cerebellum is involved critically in controlling associative and non-associative motor-related processes.

Amplitude changes of unconditioned eyeblink responses in patients with cerebellar lesions

Timing and amplitude parameters of unconditioned eyeblink responses were investigated in 24 patients with unilateral cerebellar lesions following infarcts within the territory of the superior cerebellar artery (SCA, n=12) and of the posterior inferior cerebellar artery (PICA, n=12). The extent of cortical cerebellar lesions, i.e., which lobules were affected and possible involvement of cerebellar nuclei, was determined by three-dimensional magnetic resonance imaging (3D MRI). Amplitude parameters of eyeblink responses were normalized and expressed as percentage of the unaffected side in patients and the second tested side in age-matched controls. Normalized peak amplitudes, burst area and burst duration were significantly increased in SCA patients with lesions restricted to cortical areas. Burst onset and time to peak were not significantly different compared with controls. Temporal and amplitude parameters of eyeblink responses were unchanged in SCA patients with additional involvement of cerebellar nuclei and in patients with lesions of the PICA territory. Consistent with animal lesion and recording studies and a recent human functional magnetic resonance imaging (fMRI) study, the present data suggest that cortical areas of the superior cerebellum are of importance in eyeblink control in humans. These areas partly overlap with areas known to be critical in eyeblink conditioning.

Cerebellar responses evoked by nociceptive leg withdrawal reflex as revealed by event-related FMRI

The aim of the present study was to examine nociceptive leg withdrawal reflex-related areas in the human cerebellum using event-related functional brain imaging (fMRI). Knowledge about cerebellar areas involved in unconditioned limb withdrawal reflex control has some relevance in understanding data of limb withdrawal reflex conditioning studies. Sixteen healthy adult subjects participated. Nociceptive leg withdrawal reflexes were evoked by electrical stimulation of the left tibial nerve behind the medial malleolus. An event-related fMRI paradigm was applied with a total of 30 stimuli being delivered pseudorandomly during 500 consecutive MR scans. Surface electromyographic (EMG) recordings were performed from the left anterior tibial muscle. Only trials with significant reflex EMG activity were used as active events in fMRI statistical analysis. The specified contrasts compared the active event condition with rest. Leg withdrawal reflex-related areas were located within the vermis, paravermis, and lateral posterior cerebellar hemispheres bilaterally. Vermal and paravermal areas in lobules III/IV in the anterior lobe and in lobule VIII in the posterior lobe agree with the cerebellar representation of climbing and mossy fiber hindlimb afferents and voluntary leg movements. They are likely related to efferent modulation of the leg withdrawal reflex and/or sensory processing of afferent inputs from the reflex and/or the noxious stimulus. Additional activation within vermal lobule VI and hemispheral lobules VI/Crus I may be related to other pain-related processes (e.g., facial grimacing, fear, and startlelike reactions).

Comparison of eyeblink conditioning in patients with superior and posterior inferior cerebellar lesions

The aim of the present study was to compare eyeblink conditioning in cerebellar patients with lesions including the territory of the superior cerebellar artery (SCA) and in patients with lesions restricted to the territory of the posterior inferior cerebellar artery (PICA). The cerebellar areas known to be most critical in eyeblink conditioning based on animal data (i.e. Larsell lobule H VI and interposed nucleus) are commonly supplied by the SCA. Eyeblink conditioning was expected to be impaired in SCA, but not in PICA patients. A total of 27 cerebellar patients and 25 age-matched controls were tested. Cerebellar lesions were primarily unilateral (n = 20). Most patients suffered from ischaemic infarctions of the SCA (n = 11) or the PICA (n = 13). The other patients presented with cerebellar tumours (n = 2) and cerebellar agenesis (n = 1). The extent of the cortical lesion (i.e. which lobuli were affected) and possible involvement of the cerebellar nuclei was determined by 3D-MRI. As expected, the ability to acquire classically conditioned eyeblink responses was significantly reduced in the group of all cerebellar patients compared with the controls. In the patients with unilateral cerebellar lesions, conditioning deficits were present ipsilaterally. In SCA patients with lesions including hemispheral lobules VI and Crus I, eyeblink conditioning was significantly reduced on the affected side compared with the unaffected side. No significant difference between the affected and unaffected sides was present in patients with lesions restricted to the common PICA territory (i.e. Crus II and below). Conditioning deficits were neither significantly different in SCA patients with pure cortical lesions compared with SCA patients with additional nuclear impairment nor in SCA patients with unilateral lesions compared with SCA patients with bilateral lesions. To summarize, unilateral cortical lesions of the superior cerebellum appear to be sufficient to reduce eyeblink conditioning in humans significantly.

Classical conditioning of postural reflexes

Unexpected external perturbations of body equilibrium elicit compensatory postural reflexes. The reflex patterns change only minimally, even after repetitive perturbations. This study addressed the question of whether classical conditioning can alter the reflex patterns. In the first session 27 healthy subjects were tested when standing on an unexpectedly tilting platform. Electromyographic (EMG) activity from different leg muscles and the vertical ground forces, from which the centre of vertical pressure (CVP) was computed, were recorded. In a subsequent session subjects were tested using the classical conditioning paradigm with the tilting platform as the unconditioned stimulus (US) and a prior auditory signal as the conditioning stimulus (CS). The decay of the unconditioned response (UR) observed in the first session was similar and small in all subjects. During conditioning, 22% of the subjects established conditioned responses (CR) in all muscles recorded (strategy 1). UR amplitudes of the anterior tibialis (TA) decayed more than in the first session. The resulting CVP excursions were similar to those observed in US-alone trials. The remaining subjects exhibited CR only in the gastrocnemius muscle but developed a substantial decay of UR, resulting in very small CVP excursions (strategy 2). Our data suggest that processing of US-preceding conditioning stimulus leads to different strategies in the control of postural adjustment with assumed underlying associative and non-associative plastic processes.

MRI atlas of the human cerebellar nuclei

The differential role of the cerebellar cortex and nuclei has rarely been addressed in human lesion and functional brain imaging studies. One important reason is the difficulty of defining the localization of the cerebellar nuclei and extent of possible lesions based on CT or MR scans. The present MRI investigation was specifically designed to study the anatomy of the deep cerebellar nuclei. In both basal ganglia and cerebellar nuclei of healthy human subjects the amount of iron is high compared to the rest of the brain. Clusters of iron are paramagnetic and, therefore, tend to cause local inhomogenities in a magnetic field. The iron-induced susceptibility artefacts were used to visualize the cerebellar nuclei as hypointensities on MR images. A three-dimensional atlas of the dentate (D), interposed (I), and fastigial (F) nuclei is presented in standard proportional stereotaxic space coordinates based on findings in a healthy 26-year-old female. A three-dimensional axial volume of the cerebellum was acquired using a T1-weighted fast low-angle shot (FLASH) sequence on a Siemens Sonata 1.5 Tesla MR. To increase the signal to noise ratio the sequence was acquired 5 times and averaged. Each volume was registered, resampled to 1.00 x 1.00 x 1.00-mm3 voxel size and spatially normalized into a standard proportional stereotaxic space (the MNI-space) using SPM99. Localization of cerebellar nuclei were confirmed by comparison with postmortem MRI and histological microsections of another brain.

Motor deficits cannot explain impaired cognitive associative learning in cerebellar patients

There is a strong evidence that the cerebellum is involved in associative motor learning. The exact role of the cerebellum in motor learning, and whether it is involved in cognitive learning processes too, are still controversially discussed topics. A common problem of assessing cognitive capabilities of cerebellar patients is the existence of additional motor demands in all cognitive tests. Even if the patients are able to cope well with the motor requirements of the task, their performance could still involve compensating strategies which cost them more attentional resources than the normal controls. To investigate such interaction effects of cognitive and motor demands in cerebellar patients, we conducted a cognitive associative learning paradigm and varied systematically the motor demands and the cognitive requirements of the task. Nine patients with isolated cerebellar disease and nine matched healthy controls had to learn the association between pairs of color squares, presented centrally on a computer monitor together with a left or right answer button. In the simple motor condition, the answer button had to be pressed once and in the difficult condition three times. We measured the decision times and evaluated the correctly named associations after the test was completed. The cerebellar subjects showed a learning deficit, compared to the normal controls. However, this deficit was independent of the motor difficulty of the task. The cerebellum seems to contribute to motor-independent processes, which are generally involved in associative learning.

Changes in conditioned postural responses. Comparison between cerebellar patients and healthy subjects

Postural responses elicited by external perturbation change characteristically during classical conditioning. This is assumed to be controlled by the cerebellum. In this study conditioning of postural responses in cerebellar patients was compared with that of healthy subjects. Subjects were tested when standing on a platform. Perturbations consisted of platform tilts (unconditioned stimulus, US), preceded by an auditory signal (conditioned stimulus, CS). The recording session consisted of US-alone and paired CS-US trials. In healthy subjects, unconditioned response (UR) amplitude decayed significantly with time in the recording session, especially strongly during paired trials. Amplitudes of cerebellar patients, however, decayed modestly and continuously, independently of the presence (paired trials) or otherwise of a CS. In addition, only healthy subjects established conditioned responses. Our data suggest that the prior auditory information is used to prepare postural responses. Deficits in cerebellar patients suggest a possible role of the cerebellum in controlling this plastic motor-related process.

Fear conditioned changes of heart rate in patients with medial cerebellar lesions

Fear conditioned changes of heart rate and skin conductance responses were investigated in patients with medial cerebellar lesions. A classical conditioning paradigm with a tone as the conditioned stimulus (CS) and an electrical shock as the unconditioned stimulus (US) was tested on five patients with medial cerebellar lesions due to surgery for astrocytoma and five controls. The CS preceded the US by 5900 ms and coterminated with the US. Changes in heart rate and skin conductance responses were obtained as measures for autonomic fear responses. Effects of conditioning were quantified by comparison of the habituation and extinction phases. Controls, but not cerebellar patients, showed a significant decrease of heart rate during fear conditioning. However, there were no significant fear conditioned changes in electrodermal responses in either group. In summary, the medial cerebellum seems to be involved in fear-conditioned bradycardia in humans.

Involvement of the human medial cerebellum in long-term habituation of the acoustic startle response

Animal studies have shown an involvement of the cerebellar vermis in long-term habituation of the acoustic startle response, but not in short-term habituation. The aim of the present study was to investigate whether short-term and long-term habituation of the acoustic startle response are impaired in patients with medial cerebellar lesions. Five patients with midline cerebellar lesions due to surgery for astrocytoma and ten healthy, age- and sex-matched subjects were studied. Subjects received 40 acoustic startle stimuli each day on five successive days. Peak amplitudes of the startle response recorded at the orbicularis oculi and the sternomastoid muscles were obtained. Data were analyzed for response decrement within the training session of one day (short-term habituation) and for a decrease in the startle response across the five training days (long-term habituation). Short- and long-term habituation of the startle response recorded at the sternomastoid muscles could be achieved in controls and in cerebellar patients. However, long-term habituation of the blink component of the acoustic startle response recorded at the orbicularis oculi muscles was significantly impaired in patients with cerebellar lesions compared with control subjects, whereas short-term habituation was preserved in both groups. The present findings suggest that the medial cerebellum is involved in long-term habituation of the blink component of the startle response in humans.

A possible role of the human cerebellum in conditioning of the jaw-opening reflex

The role of the human cerebellum in classical conditioning of the jaw-opening reflex was investigated using positron emission tomography (PET) in healthy subjects. The jaw-opening reflex was elicited by electrical stimulation of the right corner of the mouth (unconditioned stimulus, US). The conditioned stimulus was a tone preceding the US and coterminating with the US. Changes of regional cerebral blood flow (rCBF) were correlated with the rate of conditioning per PET scan. Conditioning effects were present in one third of all subjects. In these subjects, a significant increase of rCBF in the ipsilateral, intermediate cerebellum was shown during ongoing conditioning. Thus, the intermediate cerebellum appears to be involved in classical conditioning of the jaw-opening reflex in humans.

Fear conditioned potentiation of the acoustic blink reflex in patients with cerebellar lesions

OBJECTIVE

To investigate whether the human cerebellum takes part in fear conditioned potentiation of the acoustic blink reflex.

METHODS

A group of 10 cerebellar patients (eight patients with lesions involving the medial cerebellum, two patients with circumscribed lesions of the cerebellar hemispheres) was compared with a group of 16 age and sex matched healthy control subjects. The fear conditioned potentiation paradigm consisted of three phases. During the first, habituation phase subjects received 20 successive acoustic blink stimuli. In the subsequent fear conditioning phase, subjects passed through 20 paired presentations of the unconditioned fear stimulus (US; an electric shock) and the conditioned stimulus (CS; a light). Thereafter, subjects underwent the potentiation phase, which consisted of a pseudorandom order of 12 trials of the acoustic blink stimulus alone, 12 acoustic blink stimuli paired with the conditioned stimulus, and six conditioned stimuli paired with the unconditioned stimulus. The EMG of the acoustic blink reflex was recorded at the orbicularis oculi muscles. The potentiation effect was determined as the difference in normalised peak amplitude of the blink reflex evoked by pairs of CS and acoustic blink stimuli and evoked by the acoustic stimulus alone.

RESULTS

In the habituation phase, short term habituation of the acoustic blink reflex was preserved in all cerebellar patients. However, in the potentiation phase, the potentiation effect of the blink reflex was significantly reduced in patients with medial cerebellar lesions compared with the controls (mean (SD) potentiation effect (%), patients: -6.4 (15.3), controls: 21.6 (35.6)), but was within normal limits in the two patients with lateral lesions.

CONCLUSIONS

The present findings suggest that the human medial cerebellum is involved in associative learning of non-specific aversive reactions-that is, the fear conditioned potentiation of the acoustic blink reflex.

Classically conditioned withdrawal reflex in cerebellar patients. 1. Impaired conditioned responses

The role of the cerebellum in the classically conditioned, human lower-limb-withdrawal reflex was studied in ten patients with pure cerebellar diseases (CBL), ten patients showing additional extracerebellar symptoms (CBL+), and in 11 sex- and age-matched normal controls (CTRL). Where conditioning was successful, the electrically evoked, unconditioned response was preceded by a tone-conditioned response (CR). CR incidence was variable, with best results in the CTRL, significantly less in CBL, and lowest in CBL+. Although CRs could be established in subjects in all groups, a continuous increase in the CR incidence in the course of the recording session was observed primarily in CTRL. In CBL and CBL+, such a characteristic reflex acquisition was rather the exception. CR onsets in CBL were within the range of those in CTRL, but CR amplitude was significantly lower in CBL. Cerebellar patients with circumscribed lesions behaved differently in our motor-learning paradigm, depending on the lesion site. Patients suffering from pathology of the posterior inferior cerebellum showed a mean CR incidence within the lower range of CTRL. In contrast, if the anterior and superior cerebellum was affected, few or even no CRs were observed. Our findings thus provide evidence that the human cerebellum is required for the acquisition and the retention of this specific conditioned limb-withdrawal reflex. In particular, anterior and superior parts of the cerebellum appear to be involved. Thus, an expansion of the current concept of clinically based, functional compartmentalization is suggested, such that anterior and superior cerebellar regions must be intact to establish plastic changes required for the acquisition of the conditioned withdrawal response.

Classically conditioned withdrawal reflex in cerebellar patients. 2. Impaired unconditioned responses

The study addresses the issue of the role of the cerebellum in human withdrawal-reflex conditioning by comparing data from patients with pure cerebellar diseases (CBL, n = 10) and from cerebellar patients showing additional extracerebellar symptoms (CBL+, n = 10) with those from 11 control subjects (CTRL). During recording sessions, the standard delay-conditioning paradigm with paired-trials was used with tone as the conditioned stimulus (CS). Parameters of the conditioned muscle responses are analyzed in an accompanying paper. Here, we focus on the unconditioned muscle response. A train of current pulses (unconditioned stimulus, US) evoked a lower-limb withdrawal reflex (unconditioned response, UR), which was recorded electromyographically from leg muscles. During the recording sessions with CTRL subjects, UR amplitudes decayed from initially 100% to approximately 50% at the end of the session. This type of decay was clearly less pronounced in the CBL group and minimal in the CBL+ group. Furthermore, the CBL group exhibited UR onsets that were delayed by 20 ms compared with those from CTRL subjects. Although the ranges of measurements characterizing the URs of a given cerebellar patient tested in the paired-trial paradigm overlapped with those of control subjects, the statistically significant differences observed at the group level suggest deficits in the performance of the reflex responses. The delayed URs in patients and the different type of decay of UR amplitudes in repetitively evoked withdrawal reflexes constitute evidence that the cerebellum is critically involved in the control of these UR parameters.

Inactivation of interposed nuclei in the cat: classically conditioned withdrawal reflexes, voluntary limb movements and the action primitive hypothesis

The cerebellar interposed nuclei are considered critical components of circuits controlling the classical conditioning of eyeblink responses in several mammalian species. The main purpose of the present experiments was to examine whether the interposed nuclei are also involved in the control of classically conditioned withdrawal responses in other skeletomuscular effector systems. To achieve this objective, a unique learning paradigm was developed to examine classically conditioned withdrawal responses in three effector systems (the eyelid, forelimb and hindlimb) in individual cats. Trained animals were injected with muscimol in the cerebellar interposed nuclei, and the effects on the three conditioned responses (CRs) were examined. Although the effects of muscimol were less dramatic than previously reported in the rabbit eyeblink preparation, the inactivation of the cerebellar nuclei affected the performance of CRs in all three effector systems. In additional experiments, animals were injected with muscimol at the sites affecting classically conditioned withdrawal responses to determine the effects of these injections on reaching and locomotion behaviors. These tests demonstrated that the same regions of the cerebellar interposed nuclei which control withdrawal reflexes are also involved in the control of limb flexion and precision placement of the paw during both locomotion and reaching tasks. The obtained data indicate that the interposed nuclei are involved in the control of ipsilateral action primitives and that inactivating the interposed nuclei affects several modes of action of these functional units.

Non-motor associative learning in patients with isolated degenerative cerebellar disease

In recent decades it has become clear that the cerebellum is involved in associative motor learning, but its exact role in motor learning as such is still controversial. Recently, a contribution of the cerebellum to different cognitive abilities has also been considered, but it remains unclear whether the cerebellum contributes to cognitive associative learning. We compared nine patients with an isolated cerebellar degenerative disease in a cognitive associative learning task with 10 controls. Patients and controls were matched for age, sex, handedness, level of education, intelligence and capabilities of visual memory. The subjects were asked to learn the association between six pairs of colours and numerals by trial and error. Additionally, a simple reaction time and a visual scanning test were conducted in order to control for the influence of motor performance deficits in cerebellar patients. In comparison with the controls, it took the patients significantly longer to learn the correct associations between colours and numerals, and they were impaired in recognizing them later on. Two patients showed no associative learning effect at all. Neither the simple reaction time nor the visual scanning time correlated substantially with the results of associative learning. Therefore, motor-associated disabilities are unlikely to be the reason for the learning deficit in cerebellar patients. Our results suggest that the cerebellum might contribute to motor-independent processes that are generally involved in associative learning.

Involvement of the human cerebellum during habituation of the acoustic startle response: a PET study

The present study investigated the involvement of the human cerebellum in the habituation of the acoustic startle response using PET. The startle response was elicited in seven young, healthy subjects by a tone presented via headphones. Startle responses were recorded from the right sternocleidomastoid muscle. Regional cerebral blood flow (rCBF) was assessed in nine scans and one startle stimulus was applied during each scan. The reduction of size of the sternocleidomastoid muscle response was correlated with changes in rCBF during the ongoing process of startle response habituation. A significant decrease of rCBF was found in the medial cerebellum. These data are consistent with an involvement of the medial parts of the human cerebellum in non-associative learning as proposed by previous animal studies.

Spatial distribution of field potential profiles in the cat cerebellar cortex evoked by peripheral and central inputs

The present study was designed to characterize the spread of excitation within the frontal plane of the cat cerebellar cortex following different types of stimuli. In particular, experiments were performed to determine whether the spread of excitation evoked by mossy fibre inputs proceeds primarily along the parallel fibres ("beam-like" spread) or whether these inputs activate non-propagated foci ("patches") in the cerebellar cortex. Field potentials were recorded within a frontal plane as a medial to lateral array at different depths in parallel tracks. The recordings were made following electrical stimulation of different forelimb nerves and functionally related areas of the sensorimotor cortex as well as during passive paw movements. The resulting spatial grid of responses provides discrete spatio-temporal information reflecting the activation of specific cerebellar afferents and the neuronal interactions they evoke. The method employed demonstrates the spatial distribution of the temporal sequence of excitability changes throughout all the cerebellar cortical layers. In general, the characteristics of the responses in the intermediate cerebellar cortex depended on the source of the signals. Activity patterns evoked by peripheral nerve stimulation showed more clustered foci compared with those following electrical stimulation of functionally related areas of the sensorimotor cortex. The centrally evoked profiles were generally more homogeneous. The largest number of foci were observed following passive movements around the wrist joint. The spread of excitation in the vertical direction was evaluated by the spatial shift of the line of reversal of the N3/P2-potential (zero-isopotential line). Lines of reversal for peripherally-evoked activity patterns were approximately 90 microns closer to the molecular layer than those evoked by central stimulation in animals in which recordings have been performed in lobule Vc. The opposite was found for recordings in lobule Vb, where potential reversals following peripheral stimulation were located 40 microns deeper than those evoked following central stimulation. Cortical inputs resulted in a more proximal activation of lobule Vc Purkinje cell dendrites than in lobule Vb. This type of input processing thus seems to be lobule dependent. A beam-like spread of excitation could not be demonstrated. For both climbing fibre and mossy fibre afferent systems multiple foci were found in the frontal plane. The foci due to mossy fibre activation arose from the granular layer and expanded vertically to the molecular layer. For the climbing fibre system the foci were restricted to the molecular layer, where they merged to form a superficial band of activation. Although the data presented in this paper favour a focal distribution of activity, they do not exclude beam-like propagation along the parallel fibres, because of the difficulty of detecting this pattern in response to the stimuli. The "beam"- and "patch"-like hypotheses need not be mutually exclusive. Each could contribute to a specific stage of the temporal-spatial processing in the cerebellar cortex in a functional and task-specific manner.

A reliable method for sustaining a pre-defined pre-innervation level

Numerous experimental approaches are based on evaluating electromyographically recorded muscle activity. Some experiments require a certain level of pre-innervation in a muscle or muscle group whereas others must avoid this. Measured parameters, such as the time to onset of the muscle response to an electrical stimulus, etc., depend critically on the level of pre-innervation. The pre-innervation level is most commonly estimated from parameters such as the force generated by this muscle or the upright posture of a human subject. These methods, however, are indirect and may yield erroneous results. This paper describes an inexpensive method developed for a wide range of applications in muscle-tonus-based experiments, in which the tonus is precisely controlled. A simple electronic circuit is presented by which the level of muscle pre-innervation is directly recorded, monitored and - depending on the experimental approach - also fed back to the subject. Physiological experiments on the flexion reflex in healthy human subjects document the reliability of our electronic device.

Conditioned and unconditioned forelimb reflex systems in the cat: involvement of the intermediate cerebellum

Temporary inactivation of the cerebellar interposed nuclei was used to assess the role of the intermediate cerebellum in the performance of forelimb cutaneo-muscular reflexes in the cat. The following types of reflexive responses were evaluated: the classically conditioned and unconditioned forelimb withdrawal responses and the forelimb tactile placing, hopping and magnet responses. The experiments tested the hypothesis that the intermediate cerebellum is involved in the performance of all the above forelimb reflexes. The forelimb withdrawal reflex was classically conditioned in a newly developed paradigm in which animals were first operantly conditioned to stand on four elevated platforms. Trained animals were microinjected with a gamma-aminobutyric acid (GABA) agonist, muscimol, in the interposed nuclei, and the effects of inactivation of the intermediate cerebellar output on the forelimb reflexes were examined. The main findings of these experiments are that unilateral muscimol inactivation of the interposed nuclei in the cat abolished the expression of the classically conditioned limb flexion reflex, suppressed the performance of the unconditioned withdrawal reflex and, in parallel, down-regulated the tactile placing, hopping and magnet postural responses in the ipsilateral forelimb. These observations are inconsistent with concepts indicating exclusive involvement of the intermediate cerebellum in the classically conditioned reflexes elicited by aversive stimuli. On the contrary, they support the hypothesis of a more global involvement of this structure in learned and unlearned defensive flexion reflexes and in automatic postural response systems.

Cerebellar activation during classical conditioning of the human flexion reflex: a PET study

The present study investigated the involvement of the cerebellum in classical conditioning of the cutaneomuscular flexion reflex in four normal volunteers using positron emission tomography (PET). The flexion reflex was elicited by electrical pulses applied to the medial plantar nerve (unconditioned stimulus, US). A tone was presented as the conditioning stimulus, which co-terminated with the US. The incidence of conditioned responses was correlated with changes in rCBI during the acquisition process of flexion reflex conditioning. Blood flow was significantly increased in an area extending from the ipsilateral cerebellum and hippocampus to bilateral frontal regions (p = 0.009). These data provide support for an involvement of the cerebellum as well as hippocampus among other neural systems in classical flexion reflex conditioning.

Classical conditioning of the human flexion reflex

The eyeblink conditioning paradigm is a well established model for studying learning processes in humans and animals. In this study a flexion reflex conditioning paradigm was established using the standard delay paradigm. The flexion reflex was elicited in 10 young, healthy subjects by a train of electrical pulses (100 ms, 100 Hz, 0.65 ms) applied to the medial plantar nerve (unconditioned stimulus, US). A tone (1000 Hz, 550 ms) was presented via headphones as the conditioning stimulus and which coterminated with the US. Responses were recorded from the anterior tibial muscles. Subjects were conditioned within one session of 120 trials of paired stimuli. This was established statistically via the continuous change in characteristic parameters of the responses throughout the experiment. Although the process of limb muscle conditioning takes longer than eyeblink conditioning, this type of flexion-reflex conditioning may possibly serve as a further model for the study of plastic changes within the nervous system. Moreover, the considerable versatility of limb movements offers the advantage of greater possibilities for testing the conditioning result.

Characteristics of posture alterations associated with a stepping movement in cats

The relationship between changes in posture and the performance of a forelimb movement required for a transition between two stance positions was analysed in cats. The task consisted of an operantly conditioned, forelimb stepping movement from one support platform to another located more anterior. The reward was given only after a specific vertical force was applied to the second platform. This ensured that the cat performed a clear transition from its initial stance posture to another requiring a different weight distribution. The strategy adopted by an animal during the conditioned movement was studied by analysing the distribution of the vertical forces as a function of time. Specific quantitative functions were used to describe the weight distribution in the anterior-posterior, right-left and diagonal directions as the task was performed. The temporal parameters characterising this behaviour were not significantly different between animals, except for reaction times. In contrast, spatial parameters reflected in the distribution of vertical forces generated during the performance of the task were characteristic for each animal. As a consequence, a variety of strategies were employed. Nevertheless some general features were found, including the persistence of a diagonal support pattern during the phasic part of the movement, and an initial movement to the side of the forepaw performing the movement. The findings support the view that each animal exhibits a specific strategy for performing this well-learned task, and that the strategy is consistently employed over consecutive trials of the movement.

Cerebellar unit responses of the mossy fibre system to passive movements in the decerebrate cat. I. Responses to static parameters

1) Experiments were designed to detect how static parameters of natural, passive hand movements are encoded and integrated within the cerebellar cortex. For this purpose unit activity was recorded extracellularly from presumed mossy fibres (MF), presumed granule cells (GrC) and from Purkinje cells (PC) discharging with simple spikes (SS) and complex spikes (CS). With respect to the PC, our interest was focussed primarily on the SS activity. The recordings were performed in the intermediate part of the cerebellar anterior lobe of decerebrate cats. The animal's forepaw was passively moved around the wrist joint by an electronically controlled device. The movements were exactly reproducible so that peristimulus time histograms of the unit activity could be constructed. 2) At the input level (MF) and at the first level of integration within the cerebellar cortex (GrC), patterns with similar discharge characteristics were found. Such patterns could, to a limited extent, also be detected at the cerebellar output (SS of PC). However, in most cases of SS discharge, patterns were found with weak correlation between the tonic activity and static parameters of the movements. 3) Absolute paw position, amplitude, and duration of movements were found to be related over wide ranges to the activities of MF and GrC. Absolute position is directly encoded by tonic discharge during the low or high holding phases. Beside this, units were found without a correlation between the tonic discharge and the position of the nonmoving paw. However, in these units it was sometimes observed that the information about the momentary position or the information about the mean position was sometimes conveyed exclusively during the proceeding upward or downward movement. Thus, information about static parameters was transmitted only at times when a dynamic parameter (such as velocity) occurred. This type of position information encoding is termed "indirect mode of transmission". 4) A specific relationship between SS unit activity of PC and the absolute position of the forepaw or amplitude of the movement could be found primarily by using multiple ramps instead of single ramp movements. This was observed even if both types of ramp movements had the same velocity, individual amplitude, and tested range. However, on multiple ramp movements the paw generally remained for a shorter period at a specific position level as compared to the single ramp movements. 5) Apart from this timing phenomenon, a late movement response was observed, which results in a specific type of position information encoding on multiple ramp functions.(ABSTRACT TRUNCATED AT 400 WORDS)

Comparative analysis of cerebellar unit discharge patterns in the decerebrate cat during passive movements

1) The present experiments were undertaken to study how information about the parameters of a passive movement is processed at different neuronal levels of the cat cerebellar cortex. The analysis has been performed by recording extracellularly in the intermediate part of the cerebellar anterior lobe from presumed mossy fibres, presumed granule cells, and Purkinje cells with simple spikes and complex spikes. 2) The discharge patterns obtained during passive movements of the cat's forepaw were characterized by components which could be related to dynamic or static parameters of the movement. With respect to the occurrence of dynamic responses, patterns were classified according to a statistically derived measure in three different types. By using the same statistical measure, discharge patterns were additionally classified into two subgroups according to their response components reflecting static parameters. Within the patterns a clearcut relationship between dynamic and static components was observed. The corresponding distributions are shown and discussed. 3) A very interesting result of the classification of cerebellar discharge patterns is that the distribution of the different types depended on the level of integration within the cerebellar cortex. Patterns of the low scale integrated cerebellar input (mossy fibre-system), as well as those of granule cells (the first cerebellar computational niveau), reflected both static and dynamic movement parameters. At the Purkinje cell level (a level with a high degree of convergence) the discharge patterns are characterized predominantly by dynamic responses. 4) The interrelationship between complex- and simple spikes of Purkinje cells was tested by different methods: a) By analyzing the paired values of the mean complex-(CS) and simple spike (SS) discharge probabilities of 110 Purkinje cells a scatter was obtained, indicating an underlying hyperbolic relation (prob(CS) = a/(prob(SS]b). Thus, a high CS discharge probability is accompanied by a low SS probability and vice versa. b) The timelocked complex- and simple spike responses were studied by comparing the similarity of their responses. All combinations of complex- and simple spike patterns were observed, ranging from a sign correct similarity to a mirror image similarity. The distribution of the measure for similarity shows that the mirror image predominated. c) The individual simple spike discharge probability is characterized by a pause evoked by the occurrence of a complex spike event. The simple spike discharge probabilities during an interval preceding and following a complex spike event were compared.(ABSTRACT TRUNCATED AT 400 WORDS)

Cerebellar feedback signals of a passive hand movement in the awake monkey

From three intact and awake monkeys, 149 Purkinje cells and 44 presumed mossy fibres were recorded in the intermediate part of the cerebellar anterior lobe, and this activity was analyzed with regard to different parameters of a passive hand movement. The tonic discharge rate of the simple spikes (SS) varied according to different joint positions only in a single Purkinje cell, whereas such a position relation was found in nine out of 44 presumed mossy fibres. A phasic increase of the complex spike (CS) discharge rate of Purkinje cells in response to passive wrist movements usually occurred within 100 ms after movement onset. However, in some units a phase of increased CS rate was observed which lasted for the whole movement duration. The amount of this phasic increase in the CS rate depended on the acceleration of movement, but the SS response to movements of different velocity remained unchanged.

A simple method for reliable separation of cerebellar Purkinje cell complex and simple spikes

During the analysis of cerebellar Purkinje cell firing the use of two level discriminators for the separation of complex spike (CS) and simple spike (SS) can produce "wrong SS-events", since the amplitude of the CS wavelets may exceed the discrimination level for the SS. This is also the case, when the initial spike of the CS is negatively deflected. A logic circuit was developed, which ensures reliable separation of the two types of spike by a mutual control of the two channels. The CS wavelet events are obtained via an additional channel.

Simple and complex spike activity of cerebellar Purkinje cells during active and passive movements in the awake monkey

Two Rhesus monkeys (Macaca mulatta) were trained to pursue a target light signal by moving the hand at the wrist joint. Additionally, a d.c. motor could be attached to the lever in order to perform similar passive movements. During performance of the task, single Purkinje cells were recorded from the intermediate part of the cerebellar anterior lobe. Electromyographic activity of the flexor and extensor muscles of the forearm was recorded simultaneously. Passive hand movements evoked changes in the complex spike and simple spike discharge of Purkinje cell. The complex spike responded most sensitively to the beginning of the movement; the activity pattern had phasic character and could be related specifically to the movement direction. The simple spike response was usually weak and hence revealed-less specific relations. During active movements the simple spike frequency change was generally stronger than during passive movements and reached a maximum (or minimum) at the beginning of hand deflexion. The complex spike activity during active movements was characterized by a contrast between the time phases before and after the movement onset. In most of the cases, where a phase of increased activity stopped at the movement onset, the sensory feed-back signal seen during passive movements was cancelled. The possible consequences of the convergence of the complex and simple spike signal for the motor control function of the cerebellum are discussed.

Information about peripheral events conveyed to the cerebellum via the climbing fiber system in the decerebrate cat

Discharges of Purkinje cells (PCs) with simple (SS) and complex spikes (CS) in the c1-zone of lobule Vc of the anterior lobe of the cerebellar cortex were analyzed in the decerebrate cat during a passive movement of the cat forepaw. The CS of the PC responded differentially and/or proportionally to the position of the extremity, amplitude of the movement, velocity and acceleration. Inphase and outphase responses of the climbing fiber (CF) system to sinusoidal movements could depend on the position of the extremity within the operational range. From these results we deduce that peripheral events can be signalled by the CF system. The possible function of the interaction between the two inputs at the PC level is discussed.

Responses of cerebellar units to a passive movement in the decerebrate cat

The responses of mossy fibers (MF), granular cells (GrC) and Purkinje cells (PC) were recorded in the cerebellum of the decerebrate cat during a passive movement about the forepaw wrist joint. Three main discharge patterns containing information about all the static and dynamic parameters of the movement were found. Simultaneous recording of complex spikes (CS) and simple spikes (SS) showed that the activity of PC can be modulated through either MF or CF input channels alone or both together. In the latter case SS and CS discharge most commonly showed an opposite behavior, in which the increase of the frequency of one type of spike was accompanied by a decrease of the frequency of the other type. Both inputs displayed tonic and phasic characteristics and all the qualitative discharge patterns observed. Therefore it was concluded that aside from differences in the discharge frequency, both inputs are able to directly signal peripheral events.