Clinical neuropsychological and functional neuroimaging features in patients with cerebellar infarction

Abstract

Objective To investigate the neuropsychological and functional neuroimaging features in patients with cerebellar infarction (CI). Methods We analyzed 59 CI patients（27 left CI, 32 right CI）and 26 healthy control subjects who received standard and experimental cognitive testing and neuroimaging study. We compared the cognitive manifestations between the groups with Student’s t test. Results Patients with CI（left/right）achieved significantly lower scores in auditory verbal learning test (AVLT) of memory test (12.27±1.37 vs 9.33±1.90/10.25±2.20, t=6.46, 4.26, P<0.05), Associative Learning of Clinical Memory Scale (22.77±3.07 vs 18.67±1.98/16.84±3.55, t=5.74, 6.69, P<0.05), symbol digit modalities test (SDMT) of visuospatial test(42.54±6.32 vs 20.85±9.57/34.84±16.10, t=9.68,2.47, P<0.05), and errors responses (RE) of Wisconsin card sorting test for executive function (16.77±2.64 vs 52.22±16.29/54.47±16.27, t=11.15, 12.89, P<0.05). Patients with left CI had significantly lower scores in correct responses percentage (RCP; 58.71±10.93 vs 78.43±5.26，t=-8.41, P<0.05）and significantly higher scores in the trials to compete first category (RF; 23.59±9.79 vs 14.12±3.75，t=4.68, P<0.05）. Those finding suggests left CI would cause impairment on abstract conceptualization and concept formation; The patients with right CI had significantly lower scores in total memory quotient（86.69±7.56 vs 112.02±9.70，t=-11.17, P<0.05）, higher scores in perseverative responses (RP; 44.59±17.50 vs 8.23±3.46，t=11.47, P<0.05）and nonperseverative responses errors percentage (nRPE; 44.00±20.67 vs 10.58±2.35, t=9.07, P<0.05）. It means right CI would cause serious deficits on memory, cognitive shift and attention. The fibers between cerebellum and frontal, parietal lobe were reduced in CI patients, compared with healthy control. Conclusions These results suggest that cerebellum participated in the formation of part of cognitive function by connection with cerebrum. After CI, that the fibers contacted with the prefrontal and parietal reduced is the possible mechanisms for cognitive impairment. Key words: Brain infarction; Neuropsychological tests; Magnetic resonance imaging