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The cerebrocerebellum receives input from the cerebral cortex and projects to the motor and premotor cortices and the ventrolateral nucleus of the thalamus via the dentate nucleus (DN). Dentothalamocortical projections modulate the activity of the contralateral primary motor (M1) cortex and are involved in movement planning. Acute ischemic injury of the cerebellar nuclei leads to ataxia and a loss of physiologic excitatory inputs from the DN to the contralateral M1 cortex.1 However, chronic cerebellar ischemic lesions have been associated with a reemerging decrease in intracortical inhibition (ICI) in the contralesional M1, leading to marked interhemispheric asymmetry in cortical excitability, which could account for the functional impairment observed after strokes.2
Footnotes
Supplemental data at Neurology.org
Author contributions: Manoel Jacobsen Teixeira: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data, study supervision. Rubens Gisbert Cury: drafting/revising the manuscript, study concept or design, accepts responsibility for conduct of research and final approval, acquisition of data, study supervision. Ricardo Galhardoni: drafting/revising the manuscript, analysis or interpretation of data, accepts responsibility for conduct of research and final approval. Victor R. Barboza: analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data. André R. Brunoni: drafting/revising the manuscript, accepts responsibility for conduct of research and final approval. Eduardo Alho: drafting/revising the manuscript, analysis or interpretation of data, accepts responsibility for conduct of research and final approval. Guilherme Lepski: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, acquisition of data, participation in the surgical procedure. Daniel Ciampi de Andrade: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and final approval, study supervision.
Study funding: No targeted funding reported.
Disclosure: The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.
- Received March 27, 2015.
- Accepted in final form August 4, 2015.
- © 2015 American Academy of Neurology
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