Alan Albert, Ennabe Michelle, Alsarafandi Muath, Malik Noor, Laws Edward R, Weinand Martin
Global Neurosurgical Alliance, Tucson, Arizona, United States.
College of Medicine, The University of Arizona College of Medicine - Tucson, Arizona, United States.
Surg Neurol Int. 2024 Apr 26;15:141. doi: 10.25259/SNI_226_2024. eCollection 2024.
Emerging research expands our understanding of the cerebellum beyond motor control to include cognitive, emotional, and autonomic functions. This review examines the cerebellum's complex role, spotlighting Schmahmann's syndrome, or cerebellar cognitive affective syndrome (CCAS), which impairs executive functions, language, and spatial processing. It emphasizes advancements in diagnosing CCAS and the imperative of developing superior diagnostic tools for managing cerebellar pathologies effectively.
A comprehensive literature search was performed using databases such as PubMed, OVID Embase, and OVID Medline. Using the keywords "cerebellar cognitive, affective syndrome" and "Schmahmann syndrome," the search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines for systemic review, in which the selection process narrowed down an initial set of 54 articles to 12, focusing on the impact of the CCAS scale on diagnosing and understanding Schmahmann's syndrome.
The review's analysis confirms the cerebellum's roles in motor and cognitive functions and underscores the CCAS scale as a significant advancement in detecting cerebellar deficits, surpassing traditional assessments such as the mini-mental state examination and Montreal cognitive assessment.
This review emphasizes the importance of understanding the cerebellum's involvement in cognition and emotion and the crucial role of the CCAS scale for identifying cerebellar impairments. It calls for better diagnostic tools to assess CCAS accurately and suggests enhancing the CCAS Scale to reflect cultural and educational diversity. This will improve the diagnosis and treatment of cerebellar disorders, promoting a comprehensive neurological perspective on the cerebellum's functions.
新兴研究拓展了我们对小脑的认识，其作用不再局限于运动控制，还包括认知、情感和自主神经功能。本综述探讨了小脑的复杂作用，重点关注施马曼综合征，即小脑认知情感综合征（CCAS），该综合征会损害执行功能、语言和空间处理能力。综述强调了CCAS诊断方面的进展以及开发更优诊断工具对于有效管理小脑病变的必要性。
使用PubMed、OVID Embase和OVID Medline等数据库进行了全面的文献检索。按照系统评价和Meta分析的首选报告项目（PRISMA）2020系统评价指南，以“小脑认知情感综合征”和“施马曼综合征”为关键词进行检索，筛选过程将最初的54篇文章缩减至12篇，重点关注CCAS量表对施马曼综合征诊断和理解的影响。
综述分析证实了小脑在运动和认知功能中的作用，并强调CCAS量表是检测小脑功能缺陷的一项重大进展，优于简易精神状态检查和蒙特利尔认知评估等传统评估方法。
本综述强调了理解小脑在认知和情感方面作用的重要性，以及CCAS量表在识别小脑损伤方面的关键作用。综述呼吁使用更好的诊断工具来准确评估CCAS，并建议改进CCAS量表以反映文化和教育多样性。这将改善小脑疾病的诊断和治疗，促进从全面的神经学角度看待小脑功能。
