A Clinical Study Of The Relationship Between The Cerebellum And Cognition

Objective To explore the relationship between the cerebellum and cognition, and provide related basis of the diagnosis, treatment, recovery and prognosis of cerebellum in the future, this study will discuss the cognitive function of different cerebellar location mainly using head magnetic resonance imaging, neuropsychological and neuropsychiatrial assessment on the patients with cerebellar hemisphere or vermis lesions.Methods21patients with different cerebellar lesions (cerebellar infarction, cerebellar hemorrhage, cerebellar space-occupying lesions) in Department of Neurology and Neurosurgery in our hospital from March2013to March2014were selected as the Case group, and21random patients without any neurological diseases and other physical diseases were selected as the Control group. The case group can complete all tests of cognitive function after onset in a stable condition within10-30days. The Montreal Cognitive Assessment(MoCA) was used for the general assessment of the cognition, the Rey Auditory Vocabulary Learning Test(AVLT), Digit Span Test(DST), Clinical Memory Scale(CMS) for the assessment of memory function, the Symbol Digital Mode Test(SDMT), The Line Bisection Test(TLBT) and Trail Making Test(TMT) for the assessment of the visuospatial function, the Wisconsin Card Sorting Test(WCST) for the assessment of executive function, the Chinese Aphasia Examination Scale(CAES) for the assessment of linguistic function and the Hamilton Depression Scale(HAMD) and Neuropsychiatric Inventory(NPI) for the assessment of emotional function on the case group and control group. The3.0T MRI was applied for patients with cerebellar left or right hemisphere lesion, and using MRIcron software overlap all the clear T1imaging lesions of the edge on the standard template layer. And various parameters will be statistical analyzed by the SPSS17.0software.Results(1)Compaired with the control group, the case group of cerebellum scored significantly lower in MOCA, AVLT, DST, directional memory, associative learning, the image free recall, the meaningless picture recognition, character features memories, total memory quotient, SDMT, TLBT, CC, RCP, RFP, language understanding and naming, but scored significantly higher in TMT, RE, RP, nRPE, HAMD and NPI(P<0.01, P<0.05).(2)In the case group of cerebelum, compaired among the case group of left hemisphere, the case group of right hemisphere and the case group of vermis, the case group of left hemisphere scored higher in associative learning than the case group of right hemisphere(P<0.05); the case group of left hemisphere scored lower in TLBT, RCP and RFP, but scored higher in RF than the case group of right hemisphere and the case group of vermis(P<0.01, P <0.05); the case group of right hemisphere scored higher in RP and nRPE, but scored lower in language and naming than the case group of left hemisphere and the case group of vermis(P <0.01, P<0.05); the case group of vermis scored higher in HAMD and NPI than the case group of left hemisphere and the case group of right hemisphere(P<0.01).Conclusions (1)The cerebellum involves in the forming process of some cognition, and part of the cognitive function such as memory, visuospatial processes, executive function, linguistic function and emotional function will decline to varying degrees after the damage of cerebellum.(2)The memory, visuospatial processes, executive function, linguistic function and emotional function will be impaired to varying degrees when the cerebellum has unilateral or vermis lesions.(3)Cognitive impairment characterized by different locations of the cerebellar lesions-the visuospatial processes, the abstract generalization ability and the concept formation ability will severely impaired when the left hemisphere of cerebellum has lesions, the attentional ability and the cognitive ability of transfer will badly impaired when the right hemisphere of cerebellum has lesions, the emotional function will impaired when the vermis of cerebellum has lesions.(4)In patients with right-handed, the linguistic function will severely impaired when the right hemisphere of cerebellum has lesions.