Cerebellum’s Contribution to Attention, Executive Functions and Timing: Psychophysiological Evidence from Event-Related Potentials

Mannarelli, Daniela; Pauletti, Caterina; Missori, Paolo; Trompetto, Carlo; Cotellessa, Filippo; Fattapposta, Francesco; Currà, Antonio · 2023 · OpenAlex-citations

DOI: 10.3390/brainsci13121683

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Summary

This review article examines the cerebellum’s role in non-motor cognitive functions, specifically attention, executive functions, and timing, using event-related potentials (ERPs) as the primary psychophysiological evidence. The study is motivated by the established concept of the "cerebellar cognitive affective syndrome," which links cerebellar damage to cognitive and emotional impairments. While neuroimaging and neuropsychological studies have identified cerebellar contributions to cognition via cerebral–cerebellar loops, this paper focuses on how ERPs provide real-time, high-temporal-resolution insights into these processes. The authors aim to confirm the cerebellum’s involvement in selective cognitive domains and explore the potential of ERP-based assessments as biomarkers for brain dysfunction and therapeutic targets. The paper synthesizes findings from studies involving healthy subjects and patients with various neurological conditions, including acquired cerebellar lesions, genetic ataxias, and neuropsychiatric disorders. The methodology relies on analyzing specific ERP components—such as P3a, P3b, mismatch negativity (MMN), error-related negativity (ERN), and contingent negative variation (CNV)—elicited by auditory, visual, or somatosensory stimuli. These components are characterized by their amplitude, latency, and scalp distribution to track cognitive processes like attentional switching, error awareness, and predictive coding. The review also incorporates data from studies combining ERPs with non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), to assess causal relationships and therapeutic effects. Key findings indicate that the cerebellum is integral to attentional processing and predictive coding. In patients with acquired cerebellar strokes, reduced P3 amplitude was observed, which recovered alongside cognitive function, suggesting P3b as a marker of cerebellar recovery. Patients with cerebellar lesions also showed absent N1 suppression for self-initiated stimuli, indicating a deficit in generating internal forward predictions. In genetic cerebellar ataxias, abnormalities were found in ERPs related to voluntary cognitive processing (e.g., P3a, Pe) and attentional switching, while automatic processes remained largely intact. Similarly, patients with spinocerebellar ataxia type 2 exhibited prolonged P3 latencies, reflecting attentional and working memory deficits. In neuropsychiatric populations, such as those with ADHD or bipolar disorder, cerebellar dysfunction was linked to reduced cerebellar activity during social attention tasks and improved executive function following cerebellar-inhibitory tDCS, which decreased P3b latency. The significance of this review lies in its confirmation of the cerebellum’s critical role in higher-order cognition beyond motor control. It establishes ERPs as valuable tools for detecting subtle cognitive deficits that may be undetected by traditional clinical assessments. The findings support the use of specific ERP components as biomarkers for monitoring disease progression and treatment efficacy in cerebellar disorders. Furthermore, the evidence suggests that neuromodulation techniques targeting cerebellar-cortical circuits can improve neurocognitive performance, highlighting potential therapeutic avenues for patients with cerebellar-related cognitive impairments.

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• executive function