Middle Cerebellar Peduncle Lesions and Their Relation to Affective and Cognitive Impairment in Multiple Sclerosis

Abstract

Background: Cerebellum has long been known to modulate not only motor coordination but also affective and cognitive functions. This study aimed to assess the impact of middle cerebellar peduncle (MCP) lesions on affective and cognitive function in patients with multiple sclerosis (MS). Methods: This was a cross-sectional study conducted on patients with relapsing-remitting MS (RRMS). All patients were subjected to 3-Tesla magnetic resonance imaging (3T MRI), brief international cognitive assessment for MS (BICAMS), and Depression, Anxiety, and Stress Score-21 (DASS-21) upon recruitment. Results: Of the 30 patients recruited, 33.3% and 36.7% had right and left MCP lesions, respectively. Patients with right MCP lesions had significantly worse symbol digit modality test (SDMT) scores (P=0.036), worse California verbal learning test (CVLT) immediate recall scores (P=0.011), and worse CVLT delayed free recall scores (P=0.049), whereas patients with left MCP lesions had lower DASS-21 scores (P<0.005). On multivariate regression analysis, the presence of left MCP lesion was associated with an 8.9-point reduction in DASS-21 scores (CI: -16.985- -0.805, P=0.033), whereas right MCP lesions did not have an independent effect on BICAMS scores after adjustment for age and educational level. Conclusion: Left MCP lesions were associated with significantly lower DASS-21 scores, whereas none of the MCP lesions had an independent impact on cognition.

White matter tracts alterations underpinning reward and conflict processing

“…Although studies suggested that stimulating the superior peduncle increases negative feelings in patients (Nashold and Slaughter 1969), in a more recent study, repetitive transcranial magnetic stimulation of the cerebellum mood enhancement was seen (Ferrucci et al 2012), hence, the results are contradictory. Inconsistent with our nding, a previous study has shown an association between the left middle cerebellum peduncle and anxiety and depression, which indicated a positive correlation between BIS score and this cerebellum peduncle integrity (Hamdy et al 2022). Again, our results on the cerebellum add more details to previous ndings on the association between WM integrity and behavioral and motivational traits due to performing QA analysis.…”

The International Clinical Neuroscience Journal; 2022 in a Glance

“…Sixteen published original articles present new and novel assessments, diagnostic methods, prevention, treatment and approaches of neurological disease, and valuable epidemiological features and findings to be used worldwide. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] The International Clinical Neuroscience Journal is supported by Universal Scientific Education and Research Network (USERN). The goal of (ICNJ) is to continue publishing high quality and novel studies especially in areas of tissue engineering, molecular biology, personalized medicine, degenerative diseases and neuromodulation.…”