Cognitive and affective disturbances following focal cerebellar damage in adults: A neuropsychological and SPECT study

被引:120
作者
Baillieux, Hanne [1 ]
De Smet, Hyo Jung [1 ]
Dobbeleir, Andre [2 ,3 ]
Paquier, Philippe F. [1 ,4 ,5 ]
De Deyn, Peter P. [6 ,7 ]
Marien, Peter [1 ,6 ,7 ]
机构
[1] Vrije Univ Brussel, Dept Linguist, Brussels, Belgium
[2] ZNA AZ Middelheim, Dept Nucl Med, Antwerp, Belgium
[3] Univ Ziekenhuis Gent, Ghent, Belgium
[4] Hop Univ Erasme ULB, Dept Neurol, Brussels, Belgium
[5] Univ Antwerp, Unit Neurosci, Antwerp, Belgium
[6] ZNA AZ Middelheim, Dept Neurol, Antwerp, Belgium
[7] Univ Antwerp, Inst Born Bunge, Lab Neurochem & Behav, Antwerp, Belgium
关键词
Cerebellum; Adults; Cognition; Cognitive-affective syndrome; SPECT; APRAXIC AGRAPHIA; VASCULAR TERRITORIES; TUMOR RESECTION; LANGUAGE; STROKE; INFARCTION; LESIONS; DYSFUNCTION; HEMORRHAGE; DISORDERS;
D O I
10.1016/j.cortex.2009.09.002
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
The traditional view on cerebellar functioning has recently been challenged by results from neuroanatomical, neuroimaging and clinical studies. In this contribution, eighteen patients with primary cerebellar lesions (vascular: n = 13; neoplastic: n = 5) were systematically investigated by means of an extensive neuropsychological test battery. Fifteen patients (83%) presented with a broad variety of cognitive and linguistic deficits following cerebellar damage. Disturbances of attention (72%), executive functioning (50%) and memory (50%) were most commonly found. Analyses of our results tend to support the hypothesis of a lateralization of cognitive modulation within the cerebellum, the right cerebellar hemisphere being associated with logical reasoning and language processing and the left cerebellum mediating right-hemispheric functions including attentional and visuo-spatial skills. In addition, nine patients (50%) presented with frontal-like behavioural and affective alterations. In an attempt to determine the working-mechanism underlying cerebellar-induced cognitive and affective disturbances, all patients were investigated by means of quantified Tc-99m-ethylenecysteine dimer (ECD) single photon emission computerized tomography (SPECT) studies. From a semiological point of view, damage to the cerebellum can cause a broad spectrum of clinically significant cognitive and affective disturbances. From a pathophysiological point of view, quantified SPECT data, reflecting the phenomenon of cerebello-cerebral diaschisis, support the functional impact of the cerebellar lesion on cortical functioning through disruption of cerebello-cerebral connections. (C) 2009 Elsevier Srl. All rights reserved.
引用
收藏
页码:869 / 879
页数:11
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