Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J Int Med Res. 2024 Mar;52(3):3000605241235848. doi: 10.1177/03000605241235848.
Cognitive impairment in focal cerebellar disorders has been widely recognized and is described as cerebellar cognitive affective syndrome (CCAS). However, the relationship between CCAS and crossed cerebello-cerebral diaschisis (CCD) has rarely been discussed. The present report describes the uncommon phenomenon of CCD in two cases with isolated cerebellar infarction, and discuss its contribution to cognitive impairment. Cognitive performance was examined using the CCAS scale and a battery of neuropsychological assessments. Moreover, the relative distribution of cerebral and cerebellar blood flow was measured using three-dimensional arterial spin labeling imaging. Case 1 showed deficits in general cognition and had impaired language, episodic memory, and executive function. Case 2 showed deficits in general cognition at baseline, and cognitive deterioration of visuospatial abilities, language, episodic memory, and executive function was observed at the 3-month follow-up. Both cases met the diagnosis criteria of CCAS. Reduced cerebral blood flow was observed in the cerebral hemisphere contralateral to the cerebellar infarction at baseline in Case 1, and at the 3-month follow-up in Case 2. The present report describes cognitive decline after isolated cerebellar infarction in combination with contralateral cerebral hypoperfusion, as measured using quantitative arterial spin labeling. One possible mechanism involves the functional depression of cerebello-cerebral pathways.
局灶性小脑疾病引起的认知障碍已得到广泛认可，并被描述为小脑认知情感综合征（CCAS）。然而，CCAS 与交叉小脑-大脑失联络（CCD）之间的关系很少被讨论。本报告描述了两例孤立性小脑梗死患者中罕见的 CCD 现象，并讨论了其对认知障碍的影响。使用 CCAS 量表和一系列神经心理学评估来检查认知表现。此外，使用三维动脉自旋标记成像测量脑和小脑血流的相对分布。病例 1 表现为一般认知功能障碍，语言、情景记忆和执行功能受损。病例 2 基线时表现为一般认知功能障碍，在 3 个月随访时观察到视空间能力、语言、情景记忆和执行功能的认知恶化。两个病例均符合 CCAS 的诊断标准。病例 1 在基线时观察到小脑梗死对侧大脑半球的脑血流减少，而病例 2 在 3 个月随访时观察到。本报告描述了孤立性小脑梗死合并对侧大脑低灌注后出现的认知下降，这是使用定量动脉自旋标记测量的。一种可能的机制涉及到小脑-大脑通路的功能抑制。
