Ackermann H, Daum I
Neurologische Klinik, Universität Tübingen.
Fortschr Neurol Psychiatr. 1995 Jan;63(1):30-7. doi: 10.1055/s-2007-996600.
It is a classical topic of clinical neurology that cerebellar dysfunctions give rise to motor deficits but spare the sensory and mental domains. Since the last century, however, cognitive decline occasionally has been attributed to diseases and lesions of the cerebellum. In recent years this assumption has gained in importance. The recent literature puts forward four arguments in favour of this suggestion: a) The neocerebellum has large reciprocal fibre connections with the association areas of the cerebral cortex. b) Functional imaging studies revealed activation of circumscript cerebellar regions during cognitive tasks. c) Patients with cerebellar malformations and diseases, respectively, may present with psychopathological signs and neuropsychological deficits. d) Atrophy of the cerebellum has been reported in schizophrenic and autistic syndromes. The present review aims at a critical evaluation of the relevant clinical and neuropsychological literature. So far there is no convincing evidence that lesions and diseases restricted to the cerebellum give rise to dementia or to impaired verbal and visual memory functions. With respect to specific perceptual tasks such as the discrimination of time intervals, problem solving, and visuospatial functions, no definite conclusion is possible so far. Some studies revealed cerebellar atrophy in schizophrenic and autistic patients. However, the functional relevance of these findings must be questioned since cytoarchitectonic alterations in extracerebellar areas, e.g. the basal forebrain, are present in these disorders as well.
小脑功能障碍会导致运动缺陷,但不影响感觉和精神领域,这是临床神经学的一个经典话题。然而,自上个世纪以来,认知能力下降偶尔被归因于小脑的疾病和病变。近年来,这一假设变得越来越重要。最近的文献提出了支持这一观点的四个论据:a)新小脑与大脑皮层的联合区域有大量相互的纤维连接。b)功能成像研究显示,在认知任务期间,特定的小脑区域会被激活。c)患有小脑畸形和疾病的患者可能会出现精神病理学症状和神经心理学缺陷。d)在精神分裂症和自闭症综合征中,已有小脑萎缩的报道。本综述旨在对相关的临床和神经心理学文献进行批判性评估。到目前为止,尚无令人信服的证据表明局限于小脑的病变和疾病会导致痴呆或言语和视觉记忆功能受损。对于特定的感知任务,如时间间隔辨别、问题解决和视觉空间功能,目前还无法得出明确的结论。一些研究发现精神分裂症和自闭症患者存在小脑萎缩。然而,由于这些疾病中也存在小脑外区域(如基底前脑)的细胞结构改变,这些发现的功能相关性值得质疑。