Cognitive deficits in Cerebellar Stroke Study

The cerebellum plays an important role in coordinating and timing of motor
behaviour. Lesions in the cerebellum therefore cause a number of deficits such
as ataxia, dysarthria and disturbed eye-movements. Although these common
neurological deficits caused by cerebellar lesions are well described in
literature, cognitive and neuropsychological impacts were for a long
insufficiently highlighted. In the last two decades this has changed and
several studies published on cognitive deficits after focal cerebellar damage.
Moreover some studies suggest a role of the cerebellum in various
neuropsychiatric diseases such as Attention Deficit-Hyperactivity Disorder
(ADHD), Autism en Schizophrenia.

These cognitive and neuropsychiatric aspects of the cerebellum are caused by
the connections with (pre)frontal cortex and limbic cortex. There are two known
pathways in the cerebellum: The afferent pathways that project from the cortex
via the pontine nuclei to the cerebellum and the efferent pathways from the
deep cerebellar nuclei via the thalamus to the cerebral cortex. These
cerebello-thalamo-cortical trajects end mostly in motor and non-motor areas of
the prefrontal cortex. Within the cerebellum further divisions demonstrate
prominent language and verbal memory tasks in right cerebellar hemisphere,
while visuo-spatial tasks are located in left cerebellar hemisphere. However
neuropsychiatric deficits are associated with lesions in the medial part of the
cerebellum.

Cognitive repercussions that appear after cerebellar stroke are usually
neglected in clinical settings because of the prominent motor deficits.
Although studies with small patient groups and heterogeneous groups show
cognitive deficits, it has not affected treatment and clinical care after
cerebellar stroke. Because of limited research it remains unclear whether
cerebellar stroke patients show cognitive deficits and in which domain of the
cerebellum is involved.

To assess the outcome and pattern of frontal cognitive deficits between
patients with cerebellar stroke compared to frontal stroke after three months
of acute ischemic stroke with several validated neuropsychological tests and
questionnaire

Observational, prospectvie, single centre study

No risk, Patients are seen at 3 months policlinical visit for neuropsyhological
tests during 45 minutes.