Dysmetria and errors in predictions: the role of internal forward model
Open accessAbstract
The terminology of cerebellar dysmetria embraces a ubiquitous symptom in motor deficits, oculomotor symptoms, and cognitive/emotional symptoms occurring in cerebellar ataxias. Patients with episodic ataxia exhibit recurrent episodes of ataxia, including motor dysmetria. Despite the consensus that cerebellar dysmetria is a cardinal symptom, there is still no agreement on its pathophysiological mechanisms to date since its first clinical description by Babinski. We argue that impairment in the predictive computation for voluntary movements explains a range of characteristics accompanied by dysmetria. Within this framework, the cerebellum acquires and maintains an internal forward model, which predicts current and future states of the body by integrating an estimate of the previous state and a given efference copy of motor commands. Two of our recent studies experimentally support the internal-forward-model hypothesis of the cerebellar circuitry. First, the cerebellar outputs (firing rates of dentate nucleus cells) contain predictive information for the future cerebellar inputs (firing rates of mossy fibers). Second, a component of movement kinematics is predictive for target motions in control subjects. In cerebellar patients, the predictive component lags behind a target motion and is compensated with a feedback component. Furthermore, a clinical analysis has examined kinematic and electromyography (EMG) features using a task of elbow flexion goal-directed movements, which mimics the finger-to-nose test. Consistent with the hypothesis of the internal forward model, the predictive activations in the triceps muscles are impaired, and the impaired predictive activations result in hypermetria (overshoot). Dysmetria stems from deficits in the predictive computation of the internal forward model in the cerebellum. Errors in this fundamental mechanism result in undershoot (hypometria) and overshoot during voluntary motor actions. The predictive computation of the forward model affords error-based motor learning, coordination of multiple degrees of freedom, and adequate timing of muscle activities. Both the timing and synergy theory fit with the internal forward model, microzones being the elemental computational unit, and the anatomical organization of converging inputs to the Purkinje neurons providing them the unique property of a perceptron in the brain. We propose that motor dysmetria observed in attacks of ataxia occurs as a result of impaired predictive computation of the internal forward model in the cerebellum.
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The connectivity of the cerebellum is organized in a series of parallel loops with the cerebral cortex, the striatum, and the spinal cord, making the cerebellum a key sensorimotor interface: each region receives inputs from a specific region of the central nervous system and sends back projections to these same regions.
“The connectivity of the cerebellum is organized in a series of parallel loops with the cerebral cortex, the striatum, and the spinal cord, which makes the cerebellum a key sensorimotor interface: each region of the cerebellum receives inputs from a specific region of the central nervous system, and sends back projections to these same regions (Sokolov et al., 2017; Diedrichsen et al., 2019; Cabar”
From The Forward Model: A Unifying Theory for the Role of the Cerebellum in Motor Control and Sense of Agency (2021) · cites this paper as Cabaraux et al., 2020
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Experimental — accuracy not yet measuredSome deficits observed in cerebellar patients could be explained by an impaired forward model resulting in increased dependence on delayed visual feedback.
“Altogether, this suggests that some of the deficits observed in cerebellar patients could be explained by an impaired forward model resulting in increased dependence on delayed visual feedback (Kakei et al., 2019; Cabaraux et al., 2020; Tanaka et al., 2020; Zimmet et al., 2020).”
From The Forward Model: A Unifying Theory for the Role of the Cerebellum in Motor Control and Sense of Agency (2021) · cites this paper as Cabaraux et al., 2020
Patients with cerebellar lesions are impaired for on-line movement correction, with dysmetria and intention tremor as hallmarks of cerebellar ataxia.
“Patients with cerebellar lesions are impaired for on-line movement correction: overshooting or undershooting the target (dysmetria) and oscillatory corrections (intention tremor) are the hallmarks of cerebellar ataxia, which can be broadly defined as inaccuracy and incoordination in limb movements and instability in posture, gait and ocular saccades (Holmes, 1939; Cabaraux et al., 2020).”
From The Forward Model: A Unifying Theory for the Role of the Cerebellum in Motor Control and Sense of Agency (2021) · cites this paper as Cabaraux et al., 2020
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More, H. L., Weber, D. J., Hutchinson, J. R., Aung, S., Collins, D. F., & Donelan, J. M. (2009) · Comparative Biochemistry and Physiology Part A Molecular & Integrative Physiology · doi:10.1016/j.cbpa.2009.04.510 · Cited by 17 · see citing works
Shift from hypermetria to hypometria in an aberrant recovery following cerebellar infarction
Manto, M.-U., Hildebrand, J. G., & Jacquy, J. (1998) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(98)00048-3 · Cited by 12 · see citing works
Self-citationScaling of sensorimotor control in terrestrial mammals
More, H. L., Donelan, M., Weber, D. J., Hutchinson, J. R., Aung, S., & Collins, D. F. (2009) · Comparative Biochemistry and Physiology Part A Molecular & Integrative Physiology · doi:10.1016/j.cbpa.2009.04.217 · Cited by 9 · see citing works
Manto, M. U., & Habas, C. (2013) · Springer eBooks · doi:10.1007/978-2-8178-0447-7 · Cited by 8 · see citing works
Self-citation
Flagged first, then by citations
1 of the 100 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- [44]Manto M. Habas C. Le Cervelet, de L’anatomie et la Physiologie à la Clinique Humaine Springer-Verlag Paris, France 2013
- [54]Ito M. The Cerebellum Brain for an Implicit Self FT Press Upper Saddle River, NJ, USA 2012
Cited by
Sorted by citations
Welniarz, Q., Worbe, Y., & Gallea, C. (2021) · Frontiers in Systems Neuroscience · doi:10.3389/fnsys.2021.644059 · Cited by 125 · see citing works
Cabaraux, P., Agrawal, S. K., Cai, H., Calabrò, R. S., Casali, C., Damm, L., Doss, S., Habas, C., Horn, A. K. E., Ilg, W., et al. (2022) · The Cerebellum · doi:10.1007/s12311-022-01373-9 · Cited by 54 · see citing works
Self-citationConsensus Paper: Cerebellum and Reward
Manto, M. U., Adamaszek, M., Apps, R., Carlson, E. S., Guarque‐Chabrera, J., Heleven, E., Kakei, S., Khodakhah, K., Kuo, S., Lin, C.-Y. R., et al. (2024) · The Cerebellum · doi:10.1007/s12311-024-01702-0 · Cited by 50 · see citing works
Self-citationCastiglia, S. F., Trabassi, D., Tatarelli, A., Ranavolo, A., Varrecchia, T., Fiori, L., Lenola, D. D., Cioffi, E., Raju, M., Coppola, G., et al. (2022) · The Cerebellum · doi:10.1007/s12311-021-01361-5 · Cited by 30 · see citing works
Neurophysiology of cerebellar ataxias and gait disorders
Manto, M. U., Serrao, M., Castiglia, S. F., Timmann, D., Tzvi, E., Pan, M., Kuo, S., & Ugawa, Y. (2023) · Clinical Neurophysiology Practice · doi:10.1016/j.cnp.2023.07.002 · Cited by 25 · see citing works
Self-citationThe Potential Role of Dopamine in Mediating Motor Function and Interpersonal Synchrony
Probolovski, H. Z. G., & Dahan, A. (2021) · Biomedicines · doi:10.3390/biomedicines9040382 · Cited by 15 · see citing works
Advances in the Pathogenesis of Auto-antibody-Induced Cerebellar Synaptopathies
Mitoma, H., & Manto, M. U. (2022) · The Cerebellum · doi:10.1007/s12311-021-01359-z · Cited by 18 · see citing works
Self-citationUdi, O. A., Oyem, J. C., Ebeye, O. A., Chris-Ozoko, L. E., Igbigbi, P. S., & Olannye, D. U. (2022) · Clinical Nutrition Open Science · doi:10.1016/j.nutos.2022.06.001 · Cited by 17 · see citing works
Castiglia, S. F., Trabassi, D., Conte, C., Gioiosa, V., Sebastianelli, G., Abagnale, C., Ranavolo, A., Lorenzo, C. D., Coppola, G., Casali, C., et al. (2024) · The Cerebellum · doi:10.1007/s12311-024-01663-4 · Cited by 15 · see citing works
Shared internal models for feedforward and feedback control of arm dynamics in non‐human primates
Maeda, R. S., Kersten, R., & Pruszynski, J. A. (2020) · European Journal of Neuroscience · doi:10.1111/ejn.15056 · Cited by 13 · see citing works
Mitoma, H., Kakei, S., Tanaka, H., & Manto, M. U. (2023) · Biology · doi:10.3390/biology12111435 · Cited by 11 · see citing works
Self-citationCerebellar long-term depression and auto-immune target of auto-antibodies: the concept of LTDpathies
Mitoma, H., Honnorat, J., Yamaguchi, K., & Manto, M. U. (2021) · Molecular Biomedicine · doi:10.1186/s43556-020-00024-x · Cited by 10 · see citing works
Self-citationShoaib, Z., Chang, W. K., Lee, J., Lee, S. H., Phillips, Z., V, Lee, S. H., Paik, N., Hwang, H., & Kim, W. (2023) · The Cerebellum · doi:10.1007/s12311-023-01511-x · Cited by 10 · see citing works
Cerebellum: From the identification of the cerebellar motor syndrome to the internal models
Manto, M. U., & Mitoma, H. (2023) · Handbook of clinical neurology · doi:10.1016/b978-0-323-98817-9.00024-7 · Cited by 7 · see citing works
Self-citationAdvances in cerebellar disorders: pre-clinical models, therapeutic targets, and challenges
Manto, M. U., Cendelín, J., Strupp, M., & Mitoma, H. (2023) · Expert Opinion on Therapeutic Targets · doi:10.1080/14728222.2023.2263911 · Cited by 6 · see citing works
Self-citationCheviet, A., Masselink, J., Koun, É., Salemme, R., Lappe, M., Tilikete, C., & Pélisson, D. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab455 · Cited by 6 · see citing works
The Three Cornerstones of Cerebellar Ataxia: Closing the Loop of 200 Years of Cerebellar Research
Cabaraux, P., Gandini, J., & Manto, M. U. (2021) · Contemporary clinical neuroscience · doi:10.1007/978-3-030-75817-2_23 · Cited by 5 · see citing works
Self-citationCundari, M., Vestberg, S., HANSSON, A., Kennberg, J., Gustafsson, P., & Rasmussen, A. (2025) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617725000189 · Cited by 4 · see citing works
Tatarelli, A., Babič, J., Casali, C., Castiglia, S. F., Chini, G., Ciancia, R., Cioffi, E., Fiori, L., Michieli, M., Montante, B., et al. (2024) · Applied Sciences · doi:10.3390/app14156537 · Cited by 4 · see citing works
The Neurophysiology of the Cerebellum in Emotion
Adamaszek, M., & Kirkby, K. C. (2022) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-99550-8_7 · Cited by 4 · see citing works
Neural Predictive Computation in the Cerebellum
Tanaka, H., Ishikawa, T., & Kakei, S. (2021) · Contemporary clinical neuroscience · doi:10.1007/978-3-030-75817-2_18 · Cited by 4 · see citing works
Self-citationCurrent and Future Perspectives of the Cerebellum in Affective Neuroscience
Adamaszek, M., Manto, M. U., & Schutter, D. J. L. G. (2022) · Advances in experimental medicine and biology · doi:10.1007/978-3-030-99550-8_19 · Cited by 3 · see citing works
Self-citationGraciani, Z., de Moraes, Í. A. P., Alberissi, C. A. D. O., Prado‐Rico, J. M., da Silva, T. D., Martinez, J. P., de Araújo, L. V., Pontes, R. G., Fernandes, S. M. D. S., Barbosa, R. C. C., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0312705 · Cited by 2 · see citing works
Valè, N., Righetti, A., Martini, E., Boldo, M., Bombieri, N., & Smania, N. (2024) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2024.3518416 · Cited by 2 · see citing works
Speech, Kinematics and Gait Analysis of Degenerative Cerebellar Ataxia Syndromes
Ganguly, J., Babiker, D., Tamilselvam, Y. K., Soltani, S., Mahdi, Y., Bernaola, M. T., Kulshreshtha, D., Adams, S. G., & Jog, M. (2025) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/cjn.2025.78 · Cited by 2 · see citing works
Cundari, M., Kirchhoff, L., HANSSON, A., Gorcenco, S., Vestberg, S., & Rasmussen, A. (2025) · Neurology Open Access · doi:10.1212/wn9.0000000000000054 · Cited by 2 · see citing works
Cerebellar syndromes: clinical observations leading to the recognition of the three types
Manto, M. U., & Mitoma, H. (2025) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0045-1811727 · Cited by 1 · see citing works
Self-citationElble, R. J. (2026) · Clinical Parkinsonism & Related Disorders · doi:10.1016/j.prdoa.2026.100455 · Cited by 1 · see citing works
Advancements in Cerebellar Modeling and Its Practical Applications: A Comprehensive Review
Huang, S., Xu, T., Chen, J., Huang, J., Wang, Z., Ke, Y., & Yung, W. (2024) · IEEE Access · doi:10.1109/access.2024.3435141 · Cited by 1 · see citing works
Motor-Control Notions in Health and Disease (What Controls Motor Control?)Preprint
Dibaj, P., & Windhorst, U. (2024) · Preprints.org · doi:10.20944/preprints202403.1799.v1 · Cited by 1 · see citing works
Neuroimmune Mechanisms of Cerebellar Ataxias
Mitoma, H., & Manto, M. U. (2023) · Springer eBooks · doi:10.1007/978-3-031-15070-8_94
Self-citationMotor markers of congenital cerebellar hypoplasia
Straulino, E., Devita, M., Sartori, L., Ravelli, A., RUI, M. D., Bendini, M., Pini, L., Spoto, A., Betti, S., Marinuzzi, E., et al. (2025) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2025.109121
Cerebellar clinical syndromes: the triad and rating scales
Manto, M. U., Mitoma, H., Burt, A. L., & Schmahmann, J. D. (2026) · Journal of Neurology · doi:10.1007/s00415-026-13677-5
Self-citationMarchetti, R. (2022) · theses.fr (ABES) · doi:10.70675/e0b6207dz067cz4c77zaac1z78180f13f628
Ceravolo, L., Thomasson, M., Constantin, I. M., Stiennon, E., Chassot, E., Pierce, J. E., Cionca, A., Grandjean, D., Sveikata, L., Assal, F., et al. (2026) · NeuroImage · doi:10.1016/j.neuroimage.2026.121980
Verma, V. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33855-7.00012-7
The Neuroscience of Dance-Making: From Intention to Coordinated Action
Martins, S. A. (2026) · Global perspectives in applied sport and performance psychology. · doi:10.1007/978-3-032-24615-8_3
- Authors
- Cabaraux, P., Gandini, J., Kakei, S., Manto, M., Mitoma, H., & Tanaka, H.
- Affiliations
- HUmani - CHU Charleroi-Chimay (BE)
- Tokyo Metropolitan Institute of Medical Science (JP)
- University of Mons (BE)
- Tokyo Medical University (JP)
- Tokyo City University (JP)
- Corresponding author
- Mitoma, Hiroshi
- Venue
- International Journal of Molecular Sciences
- Publisher
- MDPI AG
- Published
- 2020-09-20
- Volume
- 21
- Issue
- 18
- Pages
- 6900
- ISSN
- 1422-0067 (ISSN-L)
- PMC
- PMC7555030
- OpenAlex
- W3087315882
- Cited by
- 40
- References
- 100
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 1
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Molecular Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- episodic ataxia, cerebellar ataxia, efference copy, dentate nucleus, mossy fibers, hypermetria, hypometria, finger-to-nose test, Purkinje cells, voluntary movement
- MeSH terms
- Cerebellar Ataxia, Cerebellum, Humans, Models, Neurological, Purkinje Cells
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