The Cognitive Face of Cerebellum; Implications for Extended Research

Document Type : Review Article


Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences


For years, the role of cerebellum was believed to be limited to motor functions. Only since almost two decades ago, a new concept about cerebellum and its contribution to non-motor functions including cognition and emotion started to emerged. During the recent years, numerous studies have focused on the cerebellar non-motor functions with their results providing supportive evidence on this view. The connections between cerebellum and cortical and subcortical areas such as frontoparietal cortices and the limbic system provide additional evidence for the involvement of cerebellum in higher cognitive functions. This review has been an effort to discuss the studies assessing different aspects of cognitive and affective disorders following cerebellar damage, as well as the cerebellar activity during cognitive tasks using novel approaches including fMRI and PET scans. 


  1. Desmond JE, Gabrieli JD, Wagner AD, Ginier BL, Glover GH. Lobular patterns of cerebellar activation in verbal working-memory and finger-tapping tasks as revealed by functional MRI. J Neurosci. 1997 Dec 15;17(24):9675-85.
  2. Timmann D, Daum I. Cerebellar contributions to cognitive functions: a progress report after two decades of research. Cerebellum. 2007;6(3):159-62.
  3. Schmahmann JD. The role of the cerebellum in cognition and emotion: personal reflections since 1982 on the dysmetria of thought hypothesis, and its historical evolution from theory to therapy. Neuropsychol Rev. 2010 Sep;20(3):236-60.
  4. Ravizza SM, McCormick CA, Schlerf JE, Justus T, Ivry RB, Fiez JA. Cerebellar damage produces selective deficits in verbal working memory. Brain. 2006 Feb;129(Pt 2):306-20.
  5. Reeber SL, Otis TS, Sillitoe RV. New roles for the cerebellum in health and disease. Front Syst Neurosci. 2013;7:83. PubMed PMID: 24294192.
  6. Bastian AJ. Moving, sensing and learning with cerebellar damage. Curr Opin Neurobiol. 2011 Aug;21(4):596-601. PubMed PMID: 21733673.
  7. Schmahmann JD. Disorders of the cerebellum: ataxia, dysmetria of thought, and the cerebellar cognitive affective syndrome. J Neuropsychiatry Clin Neurosci. 2004 Summer;16(3):367-78.
  8. Beaton A, Marien P. Language, cognition and the cerebellum: grappling with an enigma. Cortex. 2010 Jul-Aug;46(7):811-20.
  9. Marien P, Ackermann H, Adamaszek M, Barwood CH, Beaton A, Desmond J, et al. Consensus paper: Language and the cerebellum: an ongoing enigma. Cerebellum. 2014 Jun;13(3):386-410. PubMed PMID: 24318484.
  10. Durisko C, Fiez JA. Functional activation in the cerebellum during working memory and simple speech tasks. Cortex. 2010 Jul-Aug;46(7):896-906. PubMed PMID: 19853247.
  11. Schlosser RG, Wagner G, Sauer H. Assessing the working memory network: studies with functional magnetic resonance imaging and structural equation modeling. Neuroscience. 2006 Apr 28;139(1):91-103.
  12. Marvel CL, Desmond JE. Functional topography of the cerebellum in verbal working memory. Neuropsychol Rev. 2010 Sep;20(3):271-9. PubMed PMID: 20563894.
  13. Hokkanen LS, Kauranen V, Roine RO, Salonen O, Kotila M. Subtle cognitive deficits after cerebellar infarcts. Eur J Neurol. 2006 Feb;13(2):161-70.
  14. Hautzel H, Mottaghy FM, Specht K, Muller HW, Krause BJ. Evidence of a modality-dependent role of the cerebellum in working memory? An fMRI study comparing verbal and abstract n-back tasks. Neuroimage. 2009 Oct 1;47(4):2073-82.
  15. Posthuma D, Baare WF, Hulshoff Pol HE, Kahn RS, Boomsma DI, De Geus EJ. Genetic correlations between brain volumes and the WAIS-III dimensions of verbal comprehension, working memory, perceptual organization, and processing speed. Twin Res. 2003 Apr;6(2):131-9.
  16. Gottwald B, Wilde B, Mihajlovic Z, Mehdorn HM. Evidence for distinct cognitive deficits after focal cerebellar lesions. J Neurol Neurosurg Psychiatry. 2004 Nov;75(11):1524-31. PubMed PMID: 15489381.
  17. Gottwald B, Mihajlovic Z, Wilde B, Mehdorn HM. Does the cerebellum contribute to specific aspects of attention? Neuropsychologia. 2003;41(11):1452-60.
  18. Schweizer TA, Alexander MP, Cusimano M, Stuss DT. Fast and efficient visuotemporal attention requires the cerebellum. Neuropsychologia. 2007 Oct 1;45(13):3068-74.
  19. Courchesne E, Townsend J, Akshoomoff NA, Saitoh O, Yeung-Courchesne R, Lincoln AJ, et al. Impairment in shifting attention in autistic and cerebellar patients. Behav Neurosci. 1994 Oct;108(5):848-65.
  20. Baldacara L, Borgio JG, Lacerda AL, Jackowski AP. Cerebellum and psychiatric disorders. Rev Bras Psiquiatr. 2008 Sep;30(3):281-9.
  21. Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry. 2006 Apr;163(4):716-23.
  22. Perlov E, Tebarzt van Elst L, Buechert M, Maier S, Matthies S, Ebert D, et al. H(1)-MR-spectroscopy of cerebellum in adult attention deficit/hyperactivity disorder. J Psychiatr Res. 2010 Oct;44(14):938-43.
  23. Castellanos FX, Lee PP, Sharp W, Jeffries NO, Greenstein DK, Clasen LS, et al. Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA. 2002 Oct 9;288(14):1740-8.
  24. Berquin PC, Giedd JN, Jacobsen LK, Hamburger SD, Krain AL, Rapoport JL, et al. Cerebellum in attention-deficit hyperactivity disorder: a morphometric MRI study. Neurology. 1998 Apr;50(4):1087-93.
  25. Ravizza SM, Ivry RB. Comparison of the basal ganglia and cerebellum in shifting attention. J Cogn Neurosci. 2001 Apr 1;13(3):285-97.
  26. De Smet HJ, Baillieux H, De Deyn PP, Marien P, Paquier P. The cerebellum and language: the story so far. Folia Phoniatr Logop. 2007;59(4):165-70.
  27. Leggio MG, Silveri MC, Petrosini L, Molinari M. Phonological grouping is specifically affected in cerebellar patients: a verbal fluency study. J Neurol Neurosurg Psychiatry. 2000 Jul;69(1):102-6. P
  28. Marien P, Engelborghs S, Pickut BA, De Deyn PP. Aphasia following cerebellar damage: fact or fallacy? Journal of Neurolinguistics. 2000 7/15/;13(2–3):145-71.
  29. Walter N, Joanette Y. The unnoticed contributions of the cerebellum to language. Folia Phoniatr Logop. 2007;59(4):171-6.
  30. Justus T. The cerebellum and English grammatical morphology: evidence from production, comprehension, and grammaticality judgments. J Cogn Neurosci. 2004 Sep;16(7):1115-30.
  31. Fabbro F, Moretti R, Bava A. Language impairments in patients with cerebellar lesions. Journal of Neurolinguistics. 2000 7/15/;13(2–3):173-88.
  32. Desmond JE, Fiez JA. Neuroimaging studies of the cerebellum: language, learning and memory. Trends Cogn Sci. 1998 Sep 1;2(9):355-62.
  33. Booth JR, Wood L, Lu D, Houk JC, Bitan T. The role of the basal ganglia and cerebellum in language processing. Brain Res. 2007 Feb 16;1133(1):136-44.
  34. Verly M, Verhoeven J, Zink I, Mantini D, Peeters R, Deprez S, et al. Altered functional connectivity of the language network in ASD: role of classical language areas and cerebellum. Neuroimage Clin. 2014;4:374-82.
  35. Stoodley CJ, Schmahmann JD. Functional topography in the human cerebellum: a meta-analysis of neuroimaging studies. Neuroimage. 2009 Jan 15;44(2):489-501.
  36. Pliatsikas C, Johnstone T, Marinis T. Grey matter volume in the cerebellum is related to the processing of grammatical rules in a second language: a structural voxel-based morphometry study. Cerebellum. 2014 Feb;13(1):55-63.
  37. Villanueva R. The cerebellum and neuropsychiatric disorders. Psychiatry Res. 2012 Aug 15;198(3):527-32.
  38. Baumann O, Mattingley JB. Functional topography of primary emotion processing in the human cerebellum. Neuroimage. 2012 Jul 16;61(4):805-11.
  39. Wolf U, Rapopot MK, Schweizer TA. Evaluating the Affective Component of the Cerebellar Cognitive Affective Syndrome. J Neuropsychiatry Clin Neurosci. 2009 2009;21(3):9.
  40. Petrosini L, Cutuli D, Picerni E, Laricchiuta D. Cerebellum and personality traits. Cerebellum. 2015 Feb;14(1):43-6.
  41. Turner BM, Paradiso S, Marvel CL, Pierson R, Boles Ponto LL, Hichwa RD, et al. The cerebellum and emotional experience. Neuropsychologia. 2007 Mar 25;45(6):1331-41.
  42. Schmahmann JD, Sherman JC. The cerebellar cognitive affective syndrome. Brain. 1998 Apr;121 ( Pt 4):561-79.
  43. Parvizi J, Anderson SW, Martin CO, Damasio H, Damasio AR. Pathological laughter and crying: a link to the cerebellum. Brain. 2001 Sep;124(Pt 9):1708-19.
  44. Van Overwalle F, Baetens K, Marien P, Vandekerckhove M. Social cognition and the cerebellum: a meta-analysis of over 350 fMRI studies. Neuroimage. 2014 Feb 1;86:554-72.
  45. Fitzpatrick LE, Crowe SF. Cognitive and emotional deficits in chronic alcoholics: a role for the cerebellum? Cerebellum. 2013 Aug;12(4):520-33.
  46. Schutter DJ, van Honk J. The cerebellum in emotion regulation: a repetitive transcranial magnetic stimulation study. Cerebellum. 2009 Mar;8(1):28-34.
  47. Mothersill O, Knee-Zaska C, Donohoe G. Emotion and Theory of Mind in Schizophrenia-Investigating the Role of the Cerebellum. Cerebellum. 2016 Jun;15(3):357-68.
  48. Powell KB, Voeller KK. Prefrontal executive function syndromes in children. J Child Neurol. 2004 Oct;19(10):785-97.
  49. Schweizer TA, Levine B, Rewilak D, O'Connor C, Turner G, Alexander MP, et al. Rehabilitation of executive functioning after focal damage to the cerebellum. Neurorehabil Neural Repair. 2008 Jan-Feb;22(1):72-7.
  50. Middleton FA, Strick PL. Anatomical evidence for cerebellar and basal ganglia involvement in higher cognitive function. Science. 1994 Oct 21;266 (5184):458.61
  51. Berman KF, Ostrem JL, Randolph C, Gold J, Goldberg TE, Coppola R, et al. Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study. Neuropsychologia. 1995 Aug;33(8):1027-46.
  52. Nagahama Y, Fukuyama H, Yamauchi H, Matsuzaki S, Konishi J, Shibasaki H, et al. Cerebral activation during performance of a card sorting test. Brain. 1996 Oct;119 ( Pt 5):1667-75.
  53. Karatekin C, Lazareff JA, Asarnow RF. Relevance of the cerebellar hemispheres for executive functions. Pediatr Neurol. 2000 Feb;22(2):106-12.
  54. Grafman J, Litvan I, Massaquoi S, Stewart M, Sirigu A, Hallett M. Cognitive planning deficit in patients with cerebellar atrophy. Neurology. 1992 Aug;42(8):1493-6.
  55. Levine B, Robertson IH, Clare L, Carter G, Hong J, Wilson BA, et al. Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. J Int Neuropsychol Soc. 2000 Mar;6(3):299-312.
  56. Wolf U, Rapoport MJ, Schweizer TA. Evaluating the affective component of the cerebellar cognitive affective syndrome. J Neuropsychiatry Clin Neurosci. 2009 Summer;21(3):245-53.
  57. Tomlinson SP, Davis NJ, Bracewell RM. Brain stimulation studies of non-motor cerebellar function: a systematic review. Neurosci Biobehav Rev. 2013 Jun;37(5):766-89.
  58. Tedesco AM, Chiricozzi FR, Clausi S, Lupo M, Molinari M, Leggio MG. The cerebellar cognitive profile. Brain. 2011 Dec;134(Pt 12):3672-86.
  59. Kish SJ, el-Awar M, Schut L, Leach L, Oscar-Berman M, Freedman M. Cognitive deficits in olivopontocerebellar atrophy: implications for the cholinergic hypothesis of Alzheimer's dementia. Ann Neurol. 1988 Aug;24(2):200-6.
  60. Manto M, Marien P. Schmahmann's syndrome - identification of the third cornerstone of clinical ataxiology. Cerebellum Ataxias. 2015;2:2.
  61. Lindberg Bonne N, Evald L, Hansen JK. A case of the cerebellar cognitive affective syndrome in a 12-year-old boy with acute post-infectious cerebellar ataxia. Eur J Paediatr Neurol. 2016 May;20(3):480-2.
  62. Chang C, Siao SW. Cerebellar cognitive affective syndrome: Attention deficit-hyperactivity disorder episode of adolescent with cerebellar atrophy in a psychiatric ward. Kaohsiung J Med Sci. 2016 Jan;32(1):52-4.
  63. Hung PL, Huang SH, Huang CC, Huang SC, Chang YC. Tc-99m HMPAO brain SPECT imaging in children with acute cerebellar ataxia. Clin Nucl Med. 2008 Dec;33(12):841-4.
  64. Mignarri A, Tessa A, Carluccio MA, Rufa A, Storti E, Bonelli G, et al. Cerebellum and neuropsychiatric disorders: insights from ARSACS. Neurol Sci. 2014 Jan;35(1):95-7.