Functional topography of the human cerebellum

Abstract

Cerebellar functions are topographically arranged, enabling cerebellar modulation of vestibular, sensorimotor, and cognitive/limbic domains via cerebrocerebellar circuits. The primary sensorimotor cerebellum linked with cerebral sensorimotor areas is in the anterior lobe-lobules II through V, and adjacent parts of lobule VI; the secondary sensorimotor representation is in lobule VIII. Leg and foot are represented in lobules II, III and VIII; hand in lobules IV, V and VIII; and orofacial movements in paravermal lobules V and VI. The cognitive cerebellum in the posterior lobe is interconnected with association and paralimbic cerebral cortices, and includes lobules VI, VIIA at the vermis, Crus I and II in the hemispheres, and lobule VIIB. Executive function and working memory paradigms engage lobules VI and VII, language recruits the right posterolateral cerebellum, and visual-spatial tasks the left. Lobule IX is coupled with the default mode network. The limbic cerebellum in the posterior vermis regulates affective/emotional processing and autonomic functions. Consistent with this topography, the cerebellar motor syndrome follows damage to cerebellar sensorimotor regions; the cerebellar cognitive affective/ Schmahmann syndrome from damage to the cognitive-limbic cerebellum; and vestibular symptoms from damage to the vestibulocerebellum. These syndromes may coexist, or occur in isolation following circumscribed lesions.