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The cerebellar cognitive affective syndrome

J D Schmahmann¹, J C Sherman

¹Department of Neurology, Massachusetts General Hospital, Boston 02114, USA.

Brain : a Journal of Neurology

|May 13, 1998

Summary

The cerebellum influences higher-order cognitive and emotional functions. Lesions in specific cerebellar regions cause a distinct set of deficits, now termed the cerebellar cognitive affective syndrome.

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Area of Science:

Neuroscience
Cognitive Psychology
Neurology

Background:

Neuroimaging suggests cerebellar involvement in higher-order functions.
Clinical evidence for this role is limited.
The cerebellum's contribution to cognition and emotion requires further investigation.

Purpose of the Study:

To investigate the cognitive and affective consequences of cerebellar disease.
To define a clinical syndrome associated with cerebellar lesions.
To characterize the nature and severity of mental function changes in patients with cerebellar disease.

Main Methods:

Neurological examinations
Bedside mental state tests
Neuropsychological studies
Anatomical neuroimaging in 20 patients with cerebellar disease.

Main Results:

Posterior lobe and vermis lesions caused prominent behavioral changes.
Deficits included impaired executive functions, spatial cognition, personality changes, and language problems.
Anterior lobe lesions resulted in minor cognitive and spatial deficits.
A new clinical entity, the 'cerebellar cognitive affective syndrome,' was identified.

Conclusions:

The cerebellum modulates neural circuits involved in cognition and emotion.
Cerebellar cognitive affective syndrome encompasses deficits in executive function, spatial cognition, personality, and language.
Cerebellar lesions can significantly impact higher-order mental functions.

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