The influence of cerebellum on visual selective attention in patients with multiple lacunar cerebral infarction and its neuromodulatory mechanisms

Yuan, Xiaodong; Duan, Liqin; Ou, Ya; Ling, Qirong; Wang, Jing; Zhang, Jian; Cao, Lingyun; Qian, Hongchun; Zhang, Pingshu · 2024 · OpenAlex-citations

DOI: 10.3389/fnhum.2024.1380739

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Summary

This study investigates the influence of the cerebellum on visual selective attention in patients with multiple lacunar cerebral infarction (MLCI), a prevalent form of ischemic stroke often associated with cognitive dysfunction. While the cerebellum’s role in cognition is increasingly recognized, its specific neuromodulatory mechanisms in MLCI patients remain unclear. The authors hypothesized that cerebellar infarction exacerbates dysfunction in visual selective attention and sought to identify the underlying neural mechanisms using event-related potentials (ERPs). The researchers conducted a retrospective analysis of 210 patients admitted between 2016 and 2022, dividing them into a case group (62 patients with cerebellar infarction and bilateral MLCI) and a control group (148 patients with bilateral MLCI but no cerebellar infarction). Participants underwent a visual oddball paradigm to elicit P300 ERPs, specifically analyzing the P3a component (reflecting distraction capture) and P3b component (reflecting task-relevant attention). EEG data were recorded using a 64-electode cap and processed using Curry7 software. Source reconstruction techniques, utilizing a boundary element method and moving dipole models, were employed to localize brain activation sources. Statistical analyses compared peak amplitude, latency, and activation strength between groups. Results indicated no significant difference in P300 peak amplitude between the case and control groups. However, the case group exhibited significantly prolonged P300 peak latency compared to controls. Specifically, the P3a peak latency induced by novel stimuli was longer than the P3b peak latency induced by target stimuli. Source reconstruction revealed distinct patterns of decreased and increased activation in various brain regions in the case group relative to the control group. These findings suggest that patients with MLCI and concurrent cerebellar infarction experience more pronounced impairment in capturing distracted attention. The study concludes that the cerebellum indirectly influences the ventral and dorsal frontoparietal attention networks by modulating excitation and inhibition levels within the cerebral cortex. This mechanism appears to regulate visual selective attention in MLCI patients. The findings highlight the cerebellum’s critical role in cognitive processing beyond motor control and suggest that cerebellar involvement may be a key factor in the cognitive deficits observed in MLCI. This provides potential insights for developing targeted therapeutic strategies for cognitive impairment in stroke patients.

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• attention selective divided