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Cerebellar cognitive affective syndrome

J D Schmahmann1, J C Sherman

  • 1Department of Neurology, Massachusetts General Hospital, Boston, USA.

International Review of Neurobiology
|January 1, 1997
PubMed
Summary

Cerebellar lesions, particularly in the posterior lobe, can cause significant cognitive and behavioral issues, now termed the cerebellar cognitive affective syndrome. These deficits impact executive functions, memory, and emotional affect.

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Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • Uncertainty exists regarding the link between cerebellar lesions and clinically significant behavioral and cognitive disturbances.
  • The cerebellum's role in cognition and emotion has been historically underestimated.

Purpose of the Study:

  • To prospectively evaluate the nature and severity of neurological and mental function changes in patients with cerebellar diseases.
  • To define a new clinical entity associated with cerebellar lesions.

Main Methods:

  • Prospective study of 20 patients with cerebellar diseases over 7 years.
  • Utilized neurological examination, bedside mental state testing, neuropsychological studies, and anatomic neuroimaging.
  • Evaluated changes at presentation and during follow-up.

Main Results:

  • Lesions in the posterior cerebellum and vermis were associated with prominent behavioral changes, including impaired working memory, planning, verbal fluency, abstract reasoning, and affect.
  • Deficits included visual-spatial disorganization, visual memory problems, and sequencing difficulties.
  • Anterior lobe lesions caused only minor executive and visual-spatial function changes.

Conclusions:

  • A new clinical syndrome, the cerebellar cognitive affective syndrome, is defined.
  • This syndrome results from disruption of cerebellar modulation of neural circuits connecting the cerebellum with frontal, parietal, temporal, and limbic cortices.

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