Hernáez-Goñi P, Tirapu-Ustárroz J, Iglesias-Fernández L, Luna-Lario P
Clinica Ubarmin, Elcano, Navarra, España.
Rev Neurol. 2010 Nov 16;51(10):597-609.
In recent decades there has been a significant increase in the number of articles that have drawn attention to the possible importance of the role of the cerebellum in non-motor functions. Schmahmann and Sherman, for example, have described the cognitive, behavioural and emotional pattern of what has been called cerebellar cognitive affective syndrome. A central aspect of this disorder is the dysregulation of affect that occurs when lesions involve what has been called the limbic cerebellum (mainly the vermis).
A non-systematic review of the most important literature on the role of the cerebellum in emotional and behavioural regulation was carried out. Two lines of analysis were followed. The first of them was the study of the psycho-pathological symptoms or neuropsychiatric disorders presented by patients suffering from different cerebellar pathologies ranging from congenital pathologies such as agenesis of the cerebellum, dysplasia or hypoplasia to other acquired diseases like tumours in the posterior fossa, cerebellitis or superficial siderosis. In such cases it has been seen that when the cerebellar vermis is compromised, patients display disorders affecting their behaviour and emotions, and psychiatric pathologies are more frequent. In the second line, we analysed the role played by the cerebellum in different psycho-pathological disorders in which the structure of the cerebellum was found to be altered. Although not universal, these alterations were consistent, since they involve the cerebellar vermis.
Although the body of evidence continues to grow, a critical review of the scientific literature leads us to reflect on evolution in the study of the cerebral substrate underlying the cognitive functions and the evolution undergone by this study.
近几十年来,关注小脑在非运动功能中可能发挥的重要作用的文章数量显著增加。例如,施马曼和谢尔曼描述了所谓的小脑认知情感综合征的认知、行为和情感模式。这种疾病的一个核心方面是当病变累及所谓的边缘小脑(主要是蚓部)时出现的情感调节障碍。
对关于小脑在情绪和行为调节中作用的最重要文献进行了非系统综述。遵循了两条分析思路。第一条是研究患有不同小脑疾病的患者所呈现的心理病理症状或神经精神障碍,这些疾病范围从先天性疾病如小脑发育不全、发育异常或发育不良到其他后天性疾病如后颅窝肿瘤、小脑炎或浅表性铁沉积症。在这些病例中可以看到,当小脑蚓部受损时,患者会出现影响其行为和情绪的障碍,并且精神疾病更为常见。在第二条思路中,我们分析了小脑在不同心理病理障碍中所起的作用,在这些障碍中发现小脑结构发生了改变。虽然并非普遍现象,但这些改变是一致的,因为它们都涉及小脑蚓部。
尽管证据不断增加,但对科学文献的批判性回顾促使我们思考认知功能潜在脑基质研究的演变以及该研究经历的发展过程。