Abstract
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.
Highlights
In the past, the cerebellum was considered to be substantially involved in sensory-motor coordination through a loop circuit between the cerebellar cortex and the motor cortex, passing through the basilar pontine nuclei and the thalamus [1, 2].growing evidence coming from neuroanatomic, neuroimaging, physiology, and pathology studies has led to a reassessment of the classic view of a selective cerebro-cerebellar connection system in favor of a more complex organization involving distinct, parallel, and segregated networks constituted by loop-shaped connections between different neuronal subgroups
Growing evidence coming from neuroanatomic, neuroimaging, physiology, and pathology studies has led to a reassessment of the classic view of a selective cerebro-cerebellar connection system in favor of a more complex organization involving distinct, parallel, and segregated networks constituted by loop-shaped connections between different neuronal subgroups
This structural complexity may explain the role of the cerebellum in motor function, and in a variety of cognitive, affective, social, and behavioral processes as well [3]
Summary
The cerebellum was considered to be substantially involved in sensory-motor coordination through a loop circuit between the cerebellar cortex and the motor cortex, passing through the basilar pontine nuclei (descending way) and the thalamus (ascending way) [1, 2].growing evidence coming from neuroanatomic, neuroimaging, physiology, and pathology studies has led to a reassessment of the classic view of a selective cerebro-cerebellar connection system in favor of a more complex organization involving distinct, parallel, and segregated networks constituted by loop-shaped connections between different neuronal subgroups. Analysis of resting-state fMRI data in unilateral or bilateral malformation patients showed an impairment of the executivecontrol network involving areas strongly connected with the cerebellum through the fronto-pontine fibers [115, 116] Lesion studies concerning both children and adult cases reported several different types of motor and non-motor language deficits after cerebellar damage, ranging from pure motor speech disorders (e.g., ataxic dysarthria) or linguistic processing impairments (e.g., mutism, conduction-like aphasia, phonemic, semantic, syntactic, lexical deficits, agrammatism, dysprosody), to high-level metalinguistic disturbances (e.g., sentence construction, word definitions, figurative language, word associations, lexical-semantic manipulation) [117,118,119,120,121,122,123,124,125,126,127,128]. Functional connectivity analyses demonstrated that, as for motor function, a topographical organization exists for cognitive and language processing, with representation of the muscles of articulation located in medial lobule VI, whereas conceptual elements of language are mostly represented within the right posterior-lateral regions of lobules VI and VII [3, 61, 71, 128]
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