Restoring cognitive functions using non-invasive brain stimulation techniques in patients with cerebellar disorders
Open accessAbstract
Numerous studies have highlighted the possibility of modulating the excitability of cerebro-cerebellar circuits bi-directionally using transcranial electrical brain stimulation, in a manner akin to that observed using magnetic stimulation protocols. It has been proposed that cerebellar stimulation activates Purkinje cells in the cerebellar cortex, leading to inhibition of the dentate nucleus, which exerts a tonic facilitatory drive onto motor and cognitive regions of cortex through a synaptic relay in the ventral-lateral thalamus. Some cerebellar deficits present with cognitive impairments if damage to non-motor regions of the cerebellum disrupts the coupling with cerebral cortical areas for thinking and reasoning. Indeed, white matter changes in the dentato-rubral tract correlate with cognitive assessments in patients with Friedreich ataxia, suggesting that this pathway is one component of the anatomical substrate supporting a cerebellar contribution to cognition. An understanding of the physiology of the cerebro-cerebellar pathway previously helped us to constrain our interpretation of results from two recent studies in which we showed cognitive enhancements in healthy participants during tests of arithmetic after electrical stimulation of the cerebellum, but only when task demands were high. Others studies have also shown how excitation of the prefrontal cortex can enhance performance in a variety of working memory tasks. Thus, future efforts might be guided toward neuro-enhancement in certain patient populations, using what is commonly termed "non-invasive brain stimulation" as a cognitive rehabilitation tool to modulate cerebro-cerebellar circuits, or for stimulation over the cerebral cortex to compensate for decreased cerebellar drive to this region. This article will address these possibilities with a review of the relevant literature covering ataxias and cerebellar cognitive affective disorders, which are characterized by thalamo-cortical disturbances.
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Because the dorsolateral prefrontal cortex is laterally located and often close to the area of stimulation, working memory may be a cognitive function expected to benefit from non-invasive brain stimulation.
“As the dorsolateral prefrontal cortex (DLPFC) is laterally located and often close to the area of stimulation, working memory may be a cognitive function expected to benefit from NIBS (Brunoni & Vanderhasselt, 2014; Miniussi & Rossini, 2011; Pope & Chris Miall, 2014; Tracy et al., 2015).”
From Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis (2020) · cites this paper as Pope & Chris Miall, 2014
The Introduction section “tDCS after-effects and the cerebellum” says prefrontal stimulation can enhance performance on working-memory tasks, supporting the proposed benefit. It does not say that the DLPFC is often close to the stimulation area or give proximity as the reason for that benefit. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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Sydnor, M. J., Johnson, M. A., Lammers, B., Murter, J. L., Lindquist, M. A., & Sebastian, R. (2026) · medRxiv · doi:10.64898/2026.06.08.26354856
- Authors
- Pope, P. A., & Miall, R. C.
- Affiliations
- University of Birmingham (GB)
- Corresponding author
- Pope, Paul A.
- ORCID
- Miall, R. Chris
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2014-04-02
- Volume
- 5
- Pages
- 33-33
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC3980102
- OpenAlex
- W2110244051
- Cited by
- 46
- References
- 50
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 1 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 2
- FWCI
- 0.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (WT087554)
- Medical Research Council (MR/J012610/1, MR/K00414X/1)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- transcranial electrical stimulation, cerebellar ataxia, Friedreich's ataxia, Purkinje cells, dentate nucleus, cognitive rehabilitation, cognitive enhancement, working memory, prefrontal cortex, non-invasive brain stimulation
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