The neuropsychiatry of the cerebellum – insights from the clinic Export

@article{citeulike:1901513, abstract = {A central aspect of the cerebellar cognitive affective syndrome is the dysregulation of affect that occurs when lesions involve the \‘limbic cerebellum\’ (vermis and fastigial nucleus). In this case series we describe neuropsychiatric disturbances in adults and children with congenital lesions including cerebellar agenesis, dysplasia, and hypoplasia, and acquired conditions including cerebellar stroke, tumor, cerebellitis, trauma, and neurodegenerative disorders. The behaviors that we witnessed and that were described by patients and families included distractibility and hyperactivity, impulsiveness, disinhibition, anxiety, ritualistic and stereotypical behaviors, illogical thought and lack of empathy, as well as aggression and irritability. Ruminative and obsessive behaviors, dysphoria and depression, tactile defensiveness and sensory overload, apathy, childlike behavior, and inability to appreciate social boundaries and assign ulterior motives were also evident. We grouped these disparate neurobehavioral profiles into five major domains, characterized broadly as disorders of attentional control, emotional control, and social skill set as well as autism spectrum disorders, and psychosis spectrum disorders. Drawing on our dysmetria of thought hypothesis, we conceptualized the symptom complexes within each putative domain as reflecting either exaggeration (overshoot, hypermetria) or diminution (hypotonia, or hypometria) of responses to the internal or external environment. Some patients fluctuated between these two states. We consider the implications of these neurobehavioral observations for the care of patients with ataxia, discuss the broader role of the cerebellum in the pathogenesis of these neuropsychiatric symptoms, and revisit the possibility of using cerebellar stimulation to treat psychiatric disorders by enhancing cerebellar modulation of cognition and emotion.}, author = {Schmahmann, Jeremy D. and Weilburg, Jeffrey B. and Sherman, Janet C.}, citeulike-article-id = {1901513}, citeulike-linkout-0 = {http://dx.doi.org/10.1080/14734220701490995}, doi = {10.1080/14734220701490995}, journal = {The Cerebellum}, keywords = {cerebellar, cerebellum}, number = {3}, pages = {254--267}, posted-at = {2008-08-19 08:32:20}, priority = {2}, publisher = {Informa Healthcare}, title = {The neuropsychiatry of the cerebellum \– insights from the clinic}, url = {http://dx.doi.org/10.1080/14734220701490995}, volume = {6}, year = {2007} }

TY - JOUR ID - citeulike:1901513 L3 - citeulike-article-id:1901513 N2 - A central aspect of the cerebellar cognitive affective syndrome is the dysregulation of affect that occurs when lesions involve the ‘limbic cerebellum’ (vermis and fastigial nucleus). In this case series we describe neuropsychiatric disturbances in adults and children with congenital lesions including cerebellar agenesis, dysplasia, and hypoplasia, and acquired conditions including cerebellar stroke, tumor, cerebellitis, trauma, and neurodegenerative disorders. The behaviors that we witnessed and that were described by patients and families included distractibility and hyperactivity, impulsiveness, disinhibition, anxiety, ritualistic and stereotypical behaviors, illogical thought and lack of empathy, as well as aggression and irritability. Ruminative and obsessive behaviors, dysphoria and depression, tactile defensiveness and sensory overload, apathy, childlike behavior, and inability to appreciate social boundaries and assign ulterior motives were also evident. We grouped these disparate neurobehavioral profiles into five major domains, characterized broadly as disorders of attentional control, emotional control, and social skill set as well as autism spectrum disorders, and psychosis spectrum disorders. Drawing on our dysmetria of thought hypothesis, we conceptualized the symptom complexes within each putative domain as reflecting either exaggeration (overshoot, hypermetria) or diminution (hypotonia, or hypometria) of responses to the internal or external environment. Some patients fluctuated between these two states. We consider the implications of these neurobehavioral observations for the care of patients with ataxia, discuss the broader role of the cerebellum in the pathogenesis of these neuropsychiatric symptoms, and revisit the possibility of using cerebellar stimulation to treat psychiatric disorders by enhancing cerebellar modulation of cognition and emotion. IS - 3 JF - The Cerebellum EP - 267 TI - The neuropsychiatry of the cerebellum – insights from the clinic PB - Informa Healthcare VL - 6 SP - 254 KW - cerebellar KW - cerebellum AU - Schmahmann, Jeremy AU - Weilburg, Jeffrey AU - Sherman, Janet PY - 2007/// UR - http://dx.doi.org/10.1080/14734220701490995 ER -