Cerebellar syndromes: clinical observations leading to the recognition of the three types.

IF 1.6 4区 医学 Q4 NEUROSCIENCES
Arquivos de neuro-psiquiatria Pub Date : 2025-09-01 Epub Date: 2025-09-19 DOI:10.1055/s-0045-1811727
Mario Manto, Hiroshi Mitoma
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引用次数: 0

Abstract

Cerebellar syndrome is traditionally categorized into three primary types: cerebellar motor syndrome (CMS), vestibulocerebellar syndrome (VCS), and cerebellar cognitive affective syndrome (CCAS) or Schmahmann syndrome (SS). The first type is subdivided into five elemental features: dysmetria, kinetic tremor, asynergia, adiadochokinesis and dyschronometria. The second is characterized by dysmetria of saccades and jerky pursuit, as well as downbeat nystagmus and gaze-evoked nystagmus. And the third type is associated with a broader spectrum of cognitive and affective symptoms, including impairments in executive function, spatial cognition, language processing and emotional regulation. In its extreme form, cerebellar mutism can also develop during childhood following cerebellar vermis surgery. Recent physiological studies have shed light on the underlying neural mechanisms of these syndromes by identifying a common link of dysfunction within the cerebellum's internal forward model. This is essential to the prediction of the outcomes of motor and cognitive actions and underlines dysmetria as the core common element. Despite the diversity in clinical presentation, cerebellar syndromes can be understood as disruptions of a unified neural mechanism, providing a new framework for better understanding of cerebellar deficits.

小脑综合征:辨证论治的临床观察。
小脑综合征传统上分为三种主要类型:小脑运动综合征(CMS)、前庭小脑综合征(VCS)和小脑认知情感综合征(CCAS)或Schmahmann综合征(SS)。第一种类型可细分为五个基本特征:节律障碍、运动性震颤、失能、运动障碍和计时障碍。第二阶段的特征是扫视和快速追逐的不对称,以及轻拍性眼震和凝视诱发性眼震。第三种类型与更广泛的认知和情感症状有关,包括执行功能、空间认知、语言处理和情绪调节方面的障碍。在极端的情况下,小脑性缄默症也可以在小脑蚓手术后的儿童时期发展。最近的生理学研究通过确定小脑内部正向模型中功能障碍的共同联系,揭示了这些综合征的潜在神经机制。这对于预测运动和认知行为的结果至关重要,并强调了不对称是核心的共同因素。尽管临床表现多样,但小脑综合征可以理解为统一神经机制的破坏,为更好地理解小脑缺陷提供了新的框架。
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来源期刊
Arquivos de neuro-psiquiatria
Arquivos de neuro-psiquiatria 医学-精神病学
CiteScore
2.10
自引率
7.10%
发文量
262
审稿时长
4-8 weeks
期刊介绍: Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology. The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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