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Cited by 718Neurological disorders and treatmentsVestibular and auditory disordersNeural and Behavioral Psychology Studies

The neuropsychiatry of the cerebellum — insights from the clinic

Schmahmann, Jeremy D., Weilburg, Jeffrey B., Sherman, Janet C.·2007·The Cerebellum
DOI 10.1080/14734220701490995
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Abstract

A central aspect of the cerebellar cognitive affective syndrome is the dysregulation of affect that occurs when lesions involve the 'limbic cerebellum' (vermis and fastigial nucleus). In this case series we describe neuropsychiatric disturbances in adults and children with congenital lesions including cerebellar agenesis, dysplasia, and hypoplasia, and acquired conditions including cerebellar stroke, tumor, cerebellitis, trauma, and neurodegenerative disorders. The behaviors that we witnessed and that were described by patients and families included distractibility and hyperactivity, impulsiveness, disinhibition, anxiety, ritualistic and stereotypical behaviors, illogical thought and lack of empathy, as well as aggression and irritability. Ruminative and obsessive behaviors, dysphoria and depression, tactile defensiveness and sensory overload, apathy, childlike behavior, and inability to appreciate social boundaries and assign ulterior motives were also evident. We grouped these disparate neurobehavioral profiles into five major domains, characterized broadly as disorders of attentional control, emotional control, and social skill set as well as autism spectrum disorders, and psychosis spectrum disorders. Drawing on our dysmetria of thought hypothesis, we conceptualized the symptom complexes within each putative domain as reflecting either exaggeration (overshoot, hypermetria) or diminution (hypotonia, or hypometria) of responses to the internal or external environment. Some patients fluctuated between these two states. We consider the implications of these neurobehavioral observations for the care of patients with ataxia, discuss the broader role of the cerebellum in the pathogenesis of these neuropsychiatric symptoms, and revisit the possibility of using cerebellar stimulation to treat psychiatric disorders by enhancing cerebellar modulation of cognition and emotion.

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  • Cerebellar involvement cannot be excluded from a number of behaviors often associated with autism that are common pharmacological treatment targets, including hyperactivity, aggression, irritability, and mood symptoms.

    “Casting a broader net, cerebellar involvement cannot be excluded from a number of behaviors often associated with autism that are very common pharmacological treatment targets -- including hyperactivity, aggression, irritability, and mood symptoms [258].”

    From Consensus Paper: Pathological Role of the Cerebellum in Autism (2012) · cites this paper as [258]

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Authors
Schmahmann, J. D., Weilburg, J. B., & Sherman, J. C.
Affiliations
Harvard University (US)
Corresponding author
Schmahmann, Jeremy D.
ORCID
Venue
The Cerebellum
Publisher
Springer Science and Business Media LLC
Published
2007-09
Volume
6
Issue
3
Pages
254-267
ISSN
  • 1473-4222 (ISSN-L)
  • 1473-4230
DOI
10.1080/14734220701490995
OpenAlex
W2138526638
Cited by
718
References
114
Citations by year
2026: 19 · 2025: 29 · 2024: 32 · 2023: 28 · 2022: 53 · 2021: 52 · 2020: 53 · 2019: 37 · 2018: 58 · 2017: 41 · 2016: 34 · 2015: 37 · 2014: 42 · 2013: 44 · 2012: 45
FWCI
20.29
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Cerebellum (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (R01MH067980, MH067980)
Topics
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
cerebellar cognitive affective syndrome, cerebellar agenesis, cerebellar dysplasia, cerebellar hypoplasia, cerebellar infarction, cerebellar tumor, cerebellitis, neurodegenerative diseases, distractibility, hyperactivity, impulsivity, disinhibition, anxiety, aggression, irritability, autism spectrum disorder, psychosis spectrum disorders, ataxia, cerebellar stimulation, social cognition, emotion regulation
MeSH terms
Mental Disorders, Cerebellar Diseases, Cerebellum, Cognition Disorders, Humans

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