Neurophysiology of the cerebellum and clinical correlations: a review

The cerebellum is a complex structure tightly connected to the cerebral cortex, brainstem, and spinal cord. It plays an important role in movement coordination and motor planning. Lately, it has been also recognized as a key component in cognitive circuits. The specific motor functions of the cerebellum include the control of the initiation, execution, and velocity of movements, as well as the maintenance of balance, motor coordination, and muscle tonus. Cerebellar lesions typically result in ataxia but can also lead to other manifestations, such as abnormal eye movements, severe vertigo, or impaired motor learning. Additionally, the cerebellum plays a key role in cognitive processes, with dysfunction leading to conditions such as the cerebellar cognitive affective syndrome (CCAS). Functional distinctions are evident between the cerebellar vermis, hemispheres, and flocculonodular lobe, each contributing to different motor and cognitive domains. In the current review, we address the current understanding of cerebellar anatomy and physiology, highlighting the most relevant correlations between lesion location and clinical symptomatology for practicing neurologists.