ABSTRACT
The aim of the present study was to examine if the most frequent cognitive disorders after cortical damage with a well-known cerebral lateralization, namely aphasia, neglect and extinction, are present in an unselected series of continuously admitted patients with acute cerebellar stroke. Twenty-two adults with acute cerebellar stroke were compared with 22 age- and education-matched healthy control subjects. High-resolution magnetic resonance images showed infarctions of the left cerebellar hemisphere in 12 and of the right hemisphere in ten patients. Standard aphasia tests revealed no statistically significant difference comparing patients with right- and left-sided ischemia and controls, whereas patients with left-sided ischemia showed mild deficits in a verb generation task. Neglect and extinction tasks revealed no significant differences between groups. Our findings support previous observations in the literature that cerebellar patients frequently perform within the normal range in standard neuropsychological tests. This does not exclude, however, that abnormalities may be present in more sophisticated testing of language and visuospatial functions.
Subject(s)
Aphasia/etiology , Cerebellum/pathology , Perceptual Disorders/etiology , Stroke/complications , Stroke/pathology , Verbal Behavior/physiology , Adult , Aged , Brain Mapping , Female , Functional Laterality , Humans , Language , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Psychomotor Performance/physiology , Reaction Time/physiology , Young AdultABSTRACT
Structural changes of the cerebellum have been reported in attention-deficit/hyperactivity disorder (ADHD) in several studies. The cerebellum is a structure essential for motor coordination and motor learning. Beside behavioral deficits, children with ADHD often show slight motor abnormalities. In the present study, handwriting was examined in both children with ADHD and children with cerebellar lesions. By writing the same sentence several times, letter height increased in the ADHD and cerebellar groups but not in controls. Comparable disorders of handwriting in cerebellar and ADHD children support previous studies, which suggest a contribution of cerebellar dysfunction to motor abnormalities in ADHD. However, an involvement of non-cerebellar dysfunctions in ADHD cannot be excluded.
Subject(s)
Attention Deficit Disorder with Hyperactivity/pathology , Attention Deficit Disorder with Hyperactivity/physiopathology , Cerebellar Diseases/pathology , Cerebellar Diseases/physiopathology , Handwriting , Adolescent , Child , Female , Humans , MaleABSTRACT
The aim of the present study was to examine if clinically significant signs of aphasia, neglect or extinction, which have a well-known cerebral lateralization, are present in children and adolescents with acute focal lesions following tumour surgery in the cerebellum. Eight children and adolescents with cerebellar tumours were tested within days after tumour surgery. None of the children had received radiation or chemotherapy at the time of testing. Eleven age- and education-matched control subjects with major orthopedic surgery participated. High-resolution magnetic resonance images showed lesions of the right cerebellar hemisphere in three and of the left hemisphere in five children. Standard aphasia tests revealed no statistically significant difference comparing children with right- and left-sided lesions and controls. Mild signs of language disturbance, however, were present in single subjects with right-sided cerebellar lesions. Neglect and extinction tasks revealed minor abnormalities, which lacked consistent lateralization and were best explained by more unspecific attentional deficits and motor disorders in acute post-surgical stage. Acute right-sided cerebellar lesions can be followed by mild signs of language disturbances in single subjects. Clinically significant signs of neglect and extinction, however, are not observed in children and adolescents with acute surgical cerebellar lesions.
Subject(s)
Aphasia/etiology , Cerebellar Neoplasms/surgery , Extinction, Psychological , Perceptual Disorders/etiology , Postoperative Complications/diagnosis , Acute Disease , Adolescent , Aphasia/diagnosis , Cerebellar Neoplasms/pathology , Child , Cognition , Female , Functional Laterality , Humans , Language Disorders/diagnosis , Language Disorders/etiology , Magnetic Resonance Imaging , Male , Movement Disorders/diagnosis , Movement Disorders/etiology , Perceptual Disorders/diagnosis , SpeechABSTRACT
A possible role of the human cerebellum in the generation of verbs corresponding to presented nouns has been suggested. Previous functional brain imaging studies have compared generation of verbs with the reading of nouns as a measure of verb generation. In the present fMRI study involving healthy human subjects, the effects of speech articulation and motor imagery associated with verb production were investigated in greater detail. Generation of verbs to visually presented nouns was compared to a condition in which subjects read those same verbs that had been individually generated by each subject. Activation in lobule HVI/Crus I of the right cerebellar hemisphere was found as a measure of verb generation. In contrast, reading of verbs as a measure of speech articulation evoked cerebellar activations in both left and right paravermal lobule VI. These results suggest an involvement of the right lateral cerebellar hemisphere in linguistic functions during verb generation. Alternatively, effects of inner speech could also possibly explain the results.
Subject(s)
Cerebellum/physiology , Language , Speech/physiology , Adolescent , Adult , Cues , Female , Humans , Linear Models , Magnetic Resonance Imaging , Male , Models, Neurological , Models, Statistical , Oxygen/blood , Reading , Stereotaxic TechniquesABSTRACT
The aim of the present study was to investigate if clinically relevant affective or behavioral changes as described in adults in the cerebellar affective syndrome by Schmahmann and Sherman [The cerebellar cognitive affective syndrome, Brain 121 (1998) 561-579] are likely to occur as a long-term sequelae of cerebellar vermis lesions in children. Site and extent of the vermal lesion were defined on the basis of individual 3D-MRI scans and lesion data were correlated with behavioral and affective changes. Affect and behavior were assessed in children after cerebellar tumor surgery by means of experimenter ratings based on the description of the cerebellar affective syndrome and free ratings by the patients and their parents. Twelve children and adolescents with a former cerebellar astrocytoma surgery without subsequent radiation or chemotherapy participated. Detailed analysis of individual 3D-MR images revealed that lesions affected the vermis in nine children. Experimenter ratings according to Schmahmann revealed no relevant problems in patients. In five out of nine patients with vermal affection somewhat increased thoughtful, anxious or aggressive behavior was reported by patients and parents. In conclusion, minor behavioral and affective changes were present in a subset of children with chronic vermal lesions.
