Neuropsychological disorders induced by cerebellar damage

Motor coordination disorders caused by cerebellar dysfunction are well known. However, the less known cerebellar neuropsychological disorders also merit attention, since they occur more frequently than one might imagine.

We describe a 66-year-old patient with severe cerebellar damage caused by hemorrhagic stroke and associated with cognitive impairments (including impaired executive function, reasoning and judgment). A review of the literature on these neuropsychological disorders revealed a set of clinical, anatomical and functional imaging arguments that prompted us to broaden our vision of the cerebellum's role by acknowledging the presence of a cognitive component as well as the well-known motility component. In fact, there is good evidence of altered executive function (including mental flexibility, scheduling capacities and verbal working memory) in cerebellar patients. Visuospatial capacities are also affected, with disorders of visual memory and construction abilities having been reported. In terms of language, we noted reports of hypospontaneity and agrammatism with syntax problems. Memory (especially verbal memory), learning (both associative and procedural), judgment and reasoning also seem to be affected. In terms of emotion, various types of abnormal behavior and psychiatric disorders have been described and range from depression to true psychoses. Even though these data are controversial and must be confirmed, they prompt us to reconsider and deepen our understanding of the cerebellum's role and the functioning and improve our approach to (and management of) patients with cerebellar damage.