title: Structural cerebellar correlates of cognitive and motor dysfunctions in cerebellar degeneration.
abstract: See King et al. (doi:10.1093/aww348) for a scientific commentary on this article.Detailed mapping of clinical dysfunctions to the cerebellar lobules in disease populations is necessary to establish the functional significance of lobules implicated in cognitive and motor functions in normal subjects. This study constitutes the first quantitative examination of the lobular correlates of a broad range of cognitive and motor phenomena in cerebellar disease. We analysed cross-sectional data from 72 cases with cerebellar disease and 36 controls without cerebellar disease. Cerebellar lobule volumes were derived from a graph-cut based segmentation algorithm. Sparse partial least squares, a variable selection approach, was used to identify lobules associated with motor function, language, executive function, memory, verbal learning, perceptual organization and visuomotor coordination. Motor dysfunctions were chiefly associated with the anterior lobe and posterior lobule HVI. Confrontation naming, noun fluency, recognition, and perceptual organization did not have cerebellar associations. Verb and phonemic fluency, working memory, cognitive flexibility, immediate and delayed recall, verbal learning, and visuomotor coordination were variably associated with HVI, Crus I, Crus II, HVII B and/or HIX. Immediate and delayed recall also showed associations with the anterior lobe. These findings provide preliminary anatomical evidence for a functional topography of the cerebellum first defined in task-based functional magnetic resonance imaging studies of normal subjects and support the hypotheses that (i) cerebellar efferents target frontal lobe neurons involved in forming action representations and new search strategies; (ii) there is greater involvement of the cerebellum when immediate recall tasks involve more complex verbal stimuli (e.g. longer words versus digits); and (iii) it is involved in spontaneous retrieval of long-term memory. More generally, they provide an anatomical background for studies that seek the mechanisms by which cognitive and motor dysfunctions arise from cerebellar degeneration. Beyond replicating these findings, future research should employ experimental tasks to probe the integrity of specific functions in cerebellar disease, and new imaging methods to quantitatively map atrophy across the cerebellum.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Kalyani
authors.initials: K
authors.lastname: Kansal
authors.affiliation: Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA.|Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Ann M
authors.initials: AM
authors.lastname: Fishman
authors.affiliation: Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Haris I
authors.initials: HI
authors.lastname: Sair
authors.affiliation: Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Ying
authors.affiliation: Department of Mathematics and Statistics, Portland State University, Portland, Oregon, USA.
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Jedynak
authors.affiliation: Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Prince
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Chiadi U
authors.initials: CU
authors.lastname: Onyike
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002526:Cerebellar Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000068079:Motor Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
keywords: brain atrophy; cerebellar function; cognitive control; motor control; structural MR imaging