Clinical cerebellar neuroscience: ataxias — cognitive and affective symptoms in focal cerebellar lesions

Lesion-behavior mapping in patients with focal cerebellar lesions provides important insights into functional compartmentalization of the cerebellum. Advances of magnetic resonance brain imaging have made it possible to map functions even in small cerebellar structures such as the dentate nucleus. Although functions do not strictly follow the boundaries of cerebellar lobules, precise delineation of individual lobules is nonetheless an important prerequisite to localize functions within the cerebellar cortex. In this review, we will summarize recent findings of disordered cognitive and affective functions in patients with focal cerebellar lesions, including strokes and lesions resulting from cerebellar tumor resection. Knowledge of cerebellar lesion sites associated with cerebellar cognitive affective syndrome and postoperative cerebellar mutism syndrome (CMS) has important clinical implications for diagnosis, treatment, and prevention in focal cerebellar disease.