THE CEREBELLUM AND COGNITIVE FUNCTION - IMPLICATIONS FOR REHABILITATION

Objective: To characterize the cognitive effects of isolated cerebella r lesions. Design: Review of two inpatient cases. Setting: The rehabil itation unit of a tertiary general hospital. Patients or Other Partici pants: Two patients with acute ischemic strokes who had solitary cereb ellar infarcts. Interventions: Assessment with standard neuropsycholog ical tests. Scores were compared with patients' premorbid levels and s tandardized test norms. A classical conditioning eyeblink paradigm was performed. Main Outcome Measures: Neuropsychological measures of inte llectual and executive functions, learning and memory, visual-spatial abilities, language functioning, fine motor speed, and dexterity. Resu lts: Test findings suggested lesion-associated deficits in higher aspe cts of cognition (visuospatial reasoning, verbal and visual memory, an d intellectual and executive functions). These functions are not usual ly associated with the fundamentally motoric role of the cerebellum. C onclusions: (1) Lesions in the cerebellum can be associated with impai rments in higher cognitive functioning. (2) Such effects may be severe enough for a diagnosis of dementia under current diagnostic criteria. (3) These rehabilitation patients may benefit from comprehensive cogn itive examination to determine if cognitive effects will detract from their participation. (4) Further research is needed to localize which cerebellar areas affect which cognitive abilities. (C) 1996 by the Ame rican Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.