The cerebellar role in Executive Functions:new insights from behavioral and structural neuroimaging data

“Executive functions” (EFs) are a set of cognitive processes that allow to select and monitor behaviours to achieve specific goals. Although it has been proposed that the cerebellum is involved in EFs by means of specific anatomical connections with the lateral prefrontal cortex, its specific role in these processes needs to be clarified. Aim of the present study was to investigate the EFs in subject with cerebellar pathology to characterize their profile of executive impairment. Twenty-three patients with cerebellar atrophy (CA), 18 patients with focal cerebellar damage (FCD), and 43 matched healthy controls (CT) were enrolled in the study and underwent an extensive evaluation of the EFs. A one-way Anova and Tukey’s post hoc test were performed. Moreover a principal components analysis with 3 factors (Planning, Set shifting and Cognitive Inhibition) was executed to identify possible shared process among impaired EFs tasks. Finally, in order to investigate the link between executive impairment and the pattern of cerebellar structural alterations, T1 weighted scans were also collected for voxel-based morphometry analysis and cerebellar lesion characterization. The neuropsychological assessment evidenced that CA was significantly impaired in planning tasks while FCD was significantly impaired in set shifting tasks. By using the neuroimaging analysis, the damaged cerebellar regions have been identified in CA and FCD. The structural alteration patterns have been related to the executive impairment patterns. The hypothesis that, in presence of a cerebellar pathology, different profiles of EFs alteration depend on cerebellar damage localization will be discussed.