The assessment of cognitive functions in patients with isolated cerebellar infarctions: A follow-up study

Erdal, Yuksel; Perk, Seyma; Keskinkılıç, Cahit; Bayramoğlu, Banu; Mahmutoğlu, Abdullah Soydan; Emre, Ufuk

doi:10.1016/j.neulet.2021.136252

Cited by 12 publications

(14 citation statements)

References 33 publications

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“…In the current study, we applied the ACE-III scale to explore cognitive function in patients with cerebellar disorders and found that the incidence of cognitive impairment is 48.9%, which was higher than in previous studies (Kalashnikova et al, 2005;Erdal et al, 2021). The possible explanation is that the most common cognitive screening tools previously applied were the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment scale (MoCA), which were mainly focused on detecting the dysfunction of episodic memory and were not suitable for the cerebellar disease.…”

Section: Discussionmentioning

confidence: 57%

RETRACTED: Characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location

Liu

Liu²,

Zhang³

2022

Front. Aging Neurosci.

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Objective: This study aimed to explore the characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location.Methods: Forty-five patients with isolated cerebellar infarction were collected in the Department of Neurology, Beijing Tiantan Hospital. Thirty healthy controls were recruited matched by age and education. Global cognitive function was evaluated by using Addenbrooke’s Cognitive Examination version III (ACE-III). An extensive neuropsychological assessment battery was also tested to evaluate the characteristics of each cognitive domain. 3D slicer software was used to draw the lesion, and evaluate the lesions’ volume, side, and location. Group analysis was used to compare the differences in cognitive performance between patients and healthy controls, and patients with left and right cerebellar hemisphere infarction. Spearman analysis was used to explore the correlation between cognitive function and lesion volume. We also subdivided each patient’s lesions according to the cerebellar atlas to identify the specific cerebellar location related to cognitive decline.Results: Patients with cerebellar infarction had a lower ACE-III score compared with the healthy group (87.9 ± 6.2 vs. 93.7 ± 2.9, p < 0.001), and 22 (48.9%) patients were diagnosed with cognitive impairment. The z-transformed score of attention and executive function in the patients’ group was −0.9 ± 1.4 and −0.8 ± 1.0 respectively, with 19 (43.2%) and 23 (56.4%) patients impaired. Compared with healthy controls, the relative risk ratio with 95% confidence interval (CI) for impairment in attention and executive function were 3.24 (1.22–8.57) and 3.39 (1.45–7.89). However, only 10 (22.1%) patients showed impairment in more than two cognitive domains. Compared with the left lesion group, patients with right cerebellar infarction showed significantly impaired executive function (−1.1 ± 0.3 vs. −0.5 ± 0.2, p = 0.01). And the cerebellar posterior lobe regions, especially lobules VI, VIII, and IX, were explored to have lower cognitive performance. Furthermore, lesion volume was identified to be associated with the ACE-III score (r = −0.37, p = 0.04).Conclusion: We identified that cerebellar involvement in cognition, especially in attention processing and executive function. Cerebellar right-sided lateralization of cognition and functional topography were also revealed in the current study.

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Section: Discussionmentioning

confidence: 57%

RETRACTED: Characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location

Liu

Liu²,

Zhang³

2022

Front. Aging Neurosci.

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“…A few studies conducted on the subacute or chronic period have not detected any significant deficit in cerebellar cognition [6]. Furthermore, cognitive disorders in cerebellar infarctions may recover in time, which means that the prognosis is good [45,46].Traditional neuropsychological tests, which may detect well-defined cognitive profiles caused by supratentorial cerebral damage, are sometimes inadequately sensitive to identify "subclinical" abnormalities that might occur as a result of cerebellar diseases [47].The use of specific tests to detect CCAS may be critical in understanding cognitive changes following cerebellar disorders. The CCAS scale, which was developed in 2018, is an easily applicable bedside test to detect CCAS in clinical practice [48].The scale is a 10-item battery including significantly abnormal cognitive tests between patients and healthy controls: semantic fluency, phonemic fluency, category switching, verbal memory, digit span forward and backward, cube drawing, similarities, and Go/No-Go test.…”

Section: Neuropsychiatric Featuresmentioning

confidence: 99%

Cognitive Dysfunction following Cerebellar Stroke: Insights Gained from Neuropsychological and Neuroimaging Research

Liu

Chen

et al. 2022

Neural Plasticity

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Although the cerebellum has been consistently noted in the process of cognition, the pathophysiology of this link is still under exploration. Cerebellar stroke, in which the lesions are focal and limited, provides an appropriate clinical model disease for studying the role of the cerebellum in the cognitive process. This review article targeting the cerebellar stroke population (1) describes a cognitive impairment profile, (2) identifies the cerebellar structural alterations linked to cognition, and (3) reveals possible mechanisms of cerebellar cognition using functional neuroimaging. The data indicates the disruption of the cerebro-cerebellar loop in cerebellar stroke and its contribution to cognitive dysfunctions. And the characteristic of cognitive deficits are mild, span a broad spectrum, dominated by executive impairment. The consideration of these findings could contribute to deeper and more sophisticated insights into the cognitive function of the cerebellum and might provide a novel approach to cognitive rehabilitation. The goal of this review is to spread awareness of cognitive impairments in cerebellar disorders.

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“…The higher rate of cerebellar right-sided posterior lesions in our cohort may also contribute to a more severe cognitive clinical pattern due to the loss of cross-connections between the dominant hemisphere and the right cerebellum ( 14 , 41 ). Yet, this association between the right cerebellar lesion and worse cognitive outcomes is inconstant and needs further investigation in larger groups of subjects ( 35 ). Compared with patients with cerebellar degenerative diseases or chronic cerebellar stroke, patients with acute cerebellar vascular lesions failed more items [5 compared with 3 in Naeije et al ( 20 ), Maas et al ( 37 ) and Chirino-Pérez et al ( 39 )] and had a worse CCAS-S total raw score [68/120 against 72/120 in Benussi et al ( 42 ) and 88/120 in Chirino-Pérez et al ( 39 )].…”

Section: Discussionmentioning

confidence: 99%

“…In degenerative disorders, this diaschisis is gradual and allows compensatory mechanisms as highlighted in degenerative cerebellar ataxias ( 43 – 46 ). At the acute vascular cerebellar lesion stage, both cognitive impairments and CCD on functional brain imaging are maximal ( 35 , 47 – 49 ), while compensatory strategies through plasticity or recovery have not yet developed. Over time, cognitive impairments related to cerebellar vascular impairment partially improve, suggesting that the acute disconnection from the cerebellum might recover or be compensated ( 32 , 39 ).…”

Section: Discussionmentioning

confidence: 99%

Cerebellar cognitive affective syndrome after acute cerebellar stroke

2022

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IntroductionThe cerebellum modulates both motor and cognitive behaviors, and a cerebellar cognitive affective syndrome (CCAS) was described after a cerebellar stroke in 1998. Yet, a CCAS is seldom sought for, due to a lack of practical screening scales. Therefore, we aimed at assessing both the prevalence of CCAS after cerebellar acute vascular lesion and the yield of the CCAS-Scale (CCAS-S) in an acute stroke setting.Materials and methodsAll patients admitted between January 2020 and January 2022 with acute onset of a cerebellar ischemic or haemorrhagic first stroke at the CUB-Hôpital Erasme and who could be evaluated by the CCAS-S within a week of symptom onset were included.ResultsCerebellar acute vascular lesion occurred in 25/1,580 patients. All patients could complete the CCAS-S. A definite CCAS was evidenced in 21/25 patients. Patients failed 5.2 ± 2.12 items out of 8 and had a mean raw score of 68.2 ± 21.3 (normal values 82–120). Most failed items of the CCAS-S were related to verbal fluency, attention, and working memory.ConclusionA definite CCAS is present in almost all patients with acute cerebellar vascular lesions. CCAS is efficiently assessed by CCAS-S at bedside tests in acute stroke settings. The magnitude of CCAS likely reflects a cerebello-cortical diaschisis.

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The assessment of cognitive functions in patients with isolated cerebellar infarctions: A follow-up study

Cited by 12 publications

References 33 publications

RETRACTED: Characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location

RETRACTED: Characteristics of cognitive function in patients with cerebellar infarction and its association with lesion location

Cognitive Dysfunction following Cerebellar Stroke: Insights Gained from Neuropsychological and Neuroimaging Research

Cerebellar cognitive affective syndrome after acute cerebellar stroke

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