Consensus Paper. Cerebellar Reserve: From Cerebellar Physiology to Cerebellar Disorders
Name
12311_2019_Article_1091.pdf
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1.58 MB
Format
Adobe PDF
Checksum (MD5)
0f9b6b975af4f84f7d367239bc594dd7
Author(s)
Mitoma, H.
Buffo, A.
Gelfo, F.
Guell, X.
Fucà, E.
Kakei, S.
Lee, J.
Manto, M.
Petrosini, L.
Date Issued
December 26, 2019
Publisher
Springer US
Version
Final published version
Abstract
Abstract
Cerebellar reserve refers to the capacity of the cerebellum to compensate for tissue damage or loss of function resulting from many different etiologies. When the inciting event produces acute focal damage (e.g., stroke, trauma), impaired cerebellar function may be compensated for by other cerebellar areas or by extracerebellar structures (i.e., structural cerebellar reserve). In contrast, when pathological changes compromise cerebellar neuronal integrity gradually leading to cell death (e.g., metabolic and immune-mediated cerebellar ataxias, neurodegenerative ataxias), it is possible that the affected area itself can compensate for the slowly evolving cerebellar lesion (i.e., functional cerebellar reserve). Here, we examine cerebellar reserve from the perspective of the three cornerstones of clinical ataxiology: control of ocular movements, coordination of voluntary axial and appendicular movements, and cognitive functions. Current evidence indicates that cerebellar reserve is potentiated by environmental enrichment through the mechanisms of autophagy and synaptogenesis, suggesting that cerebellar reserve is not rigid or fixed, but exhibits plasticity potentiated by experience. These conclusions have therapeutic implications. During the period when cerebellar reserve is preserved, treatments should be directed at stopping disease progression and/or limiting the pathological process. Simultaneously, cerebellar reserve may be potentiated using multiple approaches. Potentiation of cerebellar reserve may lead to compensation and restoration of function in the setting of cerebellar diseases, and also in disorders primarily of the cerebral hemispheres by enhancing cerebellar mechanisms of action. It therefore appears that cerebellar reserve, and the underlying plasticity of cerebellar microcircuitry that enables it, may be of critical neurobiological importance to a wide range of neurological/neuropsychiatric conditions.
MIT Department
McGovern Institute for Brain Research at MIT
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Creative Commons Attribution
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DOI of Published Version
https://doi.org/10.1007/s12311-019-01091-9
