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Cognitive Deficit And Contralateral Frontal Hypoperfusion In Patients With Cerebellar Lesions

Publication at First Faculty of Medicine, Faculty of Arts |
2012

Abstract

The cerebellum is considered to be mainly involved in motor circuits, particularly movement coordination and muscle tone regulation. However, recent findings show that its functions also include cognition and emotions.

The aim of our study was to contribute to this discussion by investigating neuropsychological deficits in patients with cerebellar lesions. Methods: We included 16 subjects with a structural lesion limited to the cerebellum, five women and eight men, with mean age of 51.4 years (range 22-79 years).

Etiology involved ischemia in eight patients and tumour surgery in the other eight. The control group was composed of 16 subjects, five women and eight men, mean age 57.7 (range 29-79 years).

All subjects underwent a structured interview, neurological assessment of ataxia, comprehensive neuropsychological assessment of cognitive, executive and affective functions and single-photon emission computed tomography (SPECT). Results: Patients with cerebellar damage scored significantly lower on neuropsychological measurement of executive function (planning, strategy, abstraction, flexibility, inhibition) and also on memory, visuospatial and attention measures.

Affective changes, although clearly present in the clinical picture of the research sample, were not confirmed. SPECT revealed hypoperfusion in the affected cerebellar hemisphere associated with hypoperfusion in the contralateral frontal lobe, suggesting mutual functional relationship between these regions.

Conclusion: Our quantitative study of neuropsychological deficits in patients with cerebellar lesions provides a comprehensive account of deficits associated with this type of insult: executive alteration is the most pronounced followed by visuospatial and construction impairment, whereas attention, learning and memory are less impaired.