De Benedictis Alessandro, Rossi-Espagnet Maria Camilla, de Palma Luca, Carai Andrea, Marras Carlo Efisio
Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Front Neurol. 2022 Feb 4;13:806298. doi: 10.3389/fneur.2022.806298. eCollection 2022.
In the past, the cerebellum was considered to be substantially involved in sensory-motor coordination. However, a growing number of neuroanatomical, neuroimaging, clinical and lesion studies have now provided converging evidence on the implication of the cerebellum in a variety of cognitive, affective, social, and behavioral processes as well. These findings suggest a complex anatomo-functional organization of the cerebellum, involving a dense network of cortical territories and reciprocal connections with many supra-tentorial association areas. The final architecture of cerebellar networks results from a complex, highly protracted, and continuous development from childhood to adulthood, leading to integration between short-distance connections and long-range extra-cerebellar circuits. In this review, we summarize the current evidence on the anatomo-functional organization of the cerebellar connectome. We will focus on the maturation process of afferent and efferent neuronal circuitry, and the involvement of these networks in different aspects of neurocognitive processing. The final section will be devoted to identifying possible implications of this knowledge in neurosurgical practice, especially in the case of posterior fossa tumor resection, and to discuss reliable strategies to improve the quality of approaches while reducing postsurgical morbidity.
过去,小脑被认为主要参与感觉运动协调。然而,现在越来越多的神经解剖学、神经影像学、临床和损伤研究都提供了一致的证据,表明小脑也参与了各种认知、情感、社会和行为过程。这些发现提示小脑具有复杂的解剖功能组织,涉及密集的皮质区域网络以及与许多幕上联合区域的相互连接。小脑网络的最终结构源于从儿童期到成年期复杂、高度漫长且持续的发育过程,导致短距离连接与长距离小脑外回路之间的整合。在这篇综述中,我们总结了关于小脑连接组解剖功能组织的当前证据。我们将聚焦于传入和传出神经元回路的成熟过程,以及这些网络在神经认知加工不同方面的参与情况。最后一部分将致力于确定这些知识在神经外科实践中的可能意义,特别是在后颅窝肿瘤切除的情况下,并讨论在降低术后发病率的同时提高手术入路质量的可靠策略。
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