Contralateral cerebellar damage impairs imperative planning but not updating of aimed arm movements in humans

The specific motor control processes supported by the cerebellum and impaired with cerebellar damage remain unclear. The cerebellum has been implicated in both planning and updating of accurate movements. Previously, we used a statistical model to parcel aiming performance that was constrained by a timed-response paradigm into contributions attributed to a specified plan and feedforward updating. Here, we apply this procedure to determine the putative role of the cerebellum in planning and updating goal-directed aiming by comparing the performance of subjects with unilateral cerebellar stroke to controls. Subjects rapidly moved to targets in predictable or unpredictable conditions and cerebellar subjects used the contralesional limb to control for ipsilesional motor execution deficits. Displacement-derived movement velocity was used in the statistical model to determine the effect of planning and updating on accuracy. Compared to controls, the cerebellar group demonstrated errors in final position that were primarily determined by planning deficits. This finding is manifest in four ways: Cerebellar subjects (1) were less accurate than controls in both predictable and unpredictable conditions; (2) they showed minimal benefit from increased preparation time for target amplitude specification; (3) with ample time to plan direction, wrong direction response frequency was greater; and (4) final position was minimally determined by the plan. Because these deficits were found contralesional to the moving limb, the cerebellum's role in planning is not lateralized to one hemisphere but rather our findings suggest that cerebellar output affects motor planning for both upper limbs. Indeed, a lesion analysis showed that the dentate nucleus, an area implicated in planning motor strategies and the primary cerebellar output nucleus, was the only common region affected by our patient group with contralateral cerebellar strokes.