Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Commentary
3 (
3
); 423-424

Commentary

Department of Neurology, Catholic University, Rome, Italy
Address for correspondence: Dr. Domenico Restuccia, Department of Neurology, Catholic University, Rome, Italy. E-mail: drestuccia@rm.unicatt.it

Read COMMENTARY-ARTICLE associated with this -

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

In this interesting article, Menon describes a case of crossed cerebellar atrophy.[1] Since the very first article of Baron et al.,[2] it is well known that supratentorial lesions can entail metabolic changes in the contralateral cerebellar hemisphere. Such a phenomenon, usually revealed by positron emission tomographic (PET) scans, has been ascribed to functional disconnection of the contralateral cerebellar hemisphere from cerebral cortex. The notion that an area remote from the site of brain lesion can show a transient impairment of its function was not new, since it was already described in 1914 by von Monakow,[3] who coined the term diaschisis to define this phenomenon. More recently, Tien and Ashdown[4] reported that a consistent percentage of patients who presented clear signs of cerebellar diaschisis, also showed hemiatrophy of the cerebellum in Magnetic Rseonance Imaging (MRI) scans. As a matter of fact, they studied 26 patients of cerebellar diaschisis demonstrated by PET scans, and in eight of them, MRI showed signs of hemiatrophy of the cerebellum. Interruption of cortico-cerebellar fibers sparing the neurons has been claimed to explain diaschisis; however,,the presence of cerebellar morphological changes obviously requires other explanations, such as, for example, anterograde transneuronal degeneration. In my opinion, this as well as further studies on cerebro-cerebellar diaschisis and atrophy show two main reasons of interest. First of all, the relative rarity of similar reports might depend on an underestimation of the real extent of the phenomenon.Patients with crossed cerebellar atrophy show only few, if any, clinical signs of cerebellum impairment, and hence mild cerebellar atrophy might be underestimated by the radiologist. Furthermore, the relationship between cerebral cortex and cerebellum in crossed cerebellar diaschisis as well as crossed cerebellar atrophy is a hot topic for discussion. PET scan studies have also revealed remote involvement of the cerebral cortex following cerebellar lesion, which can be considered as the reverse of the cerebro-cerebellar diaschisis.[56] The metabolic involvement of the somatosensory postcentral cortex fitted well with some of the neurophysiological findings, suggesting a functional involvement of the primary somatosensory cortex.[7] In the last few years, it has become more and more evident that the cerebellar functions are not only limited to the fine tuning of motor control, but also involve the sensory processing and cognitive functions.[8] With this view, neuroradiological studies could be extremely relevant in disclosing metabolic as well as morphologic abnormalities of the cerebral cortex subsequent to cerebellar damage.

References

  1. , . Crossed cerebellar atrophy. J Neurosci Rural Pract. 2012;3:422-3.
    [Google Scholar]
  2. , , , , . “Crossed cerebellar diaschisis” in human supratentorial brain infarction. Trans Am Neurol Assoc. 1981;105:459-61.
    [Google Scholar]
  3. , . Die lokalisation in Grosshirn und der Abbau der Funktion durch Kortikale Herde. Wiesbaden, Germany: Bergmann; .
  4. , , . Crossed cerebellar diaschisis and crossed cerebellar atrophy: Correlation of MR findings, clinical symptoms and supratentorial diseases in 26 patients. AJR Am J Roentgenol. 1992;158:1155-9.
    [Google Scholar]
  5. , , , , , . Reduced contralateral hemispheric flow measured by SPECT in cerebellar lesions: Crossed cerebral diaschisis. Acta Neurol Scand. 1993;87:275-80.
    [Google Scholar]
  6. , , , , . Crossed cerebellocerebral diaschisis in patients with cerebellar stroke. Acta Neurol Scand. 2000;101:8-12.
    [Google Scholar]
  7. , , , , , , . Functional changes of the primary somatosensory cortex in patients with unilateral cerebellar lesions. Brain. 2001;124:757-68.
    [Google Scholar]
  8. , , , . State estimation, response prediction, and cerebellar sensory processing for behavioral control. Cerebellum. 2009;8:399-402.
    [Google Scholar]

    Fulltext Views
    134

    PDF downloads
    112
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections