Phosphene induction by cerebellar transcranial magnetic stimulation

A chronometric study of the posterior cerebellum's function in emotional processing

The posterior cerebellum is a recently discovered hub of the affective and social brain, with different subsectors contributing to different social functions. However, very little is known about when the posterior cerebellum plays a critical role in social processing. Due to its location and anatomy, it has been difficult to use traditional approaches to directly study the chronometry of the cerebellum. To address this gap in cerebellar knowledge, here we investigated the causal contribution of the posterior cerebellum to social processing using a chronometric transcranial magnetic stimulation (TMS) approach. We show that the posterior cerebellum is recruited at an early stage of emotional processing (starting from 100 ms after stimulus onset), simultaneously with the posterior superior temporal sulcus (pSTS), a key node of the social brain. Moreover, using a condition-and-perturb TMS approach, we found that the recruitment of the pSTS in emotional processing is dependent on cerebellar activation. Our results are the first to shed light on chronometric aspects of cerebellar function and its causal functional connectivity with other nodes of the social brain.

Cerebellar Neurostimulation for Boosting Social and Affective Functions: Implications for the Rehabilitation of Hereditary Ataxia Patients

Beyond motor deficits, spinocerebellar ataxia (SCA) patients also suffer cognitive decline and show socio-affective difficulties, negatively impacting on their social functioning. The possibility to modulate cerebello-cerebral networks involved in social cognition through cerebellar neurostimulation has opened up potential therapeutic applications for ameliorating social and affective difficulties. The present review offers an overview of the research on cerebellar neurostimulation for the modulation of socio-affective functions in both healthy individuals and different clinical populations, published in the time period 2000-2022. A total of 25 records reporting either transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) studies were found. The investigated clinical populations comprised different pathological conditions, including but not limited to SCA syndromes. The reviewed evidence supports that cerebellar neurostimulation is effective in improving social abilities in healthy individuals and reducing social and affective symptoms in different neurological and psychiatric populations associated with cerebellar damage or with impairments in functions that involve the cerebellum. These findings encourage to further explore the rehabilitative effects of cerebellar neurostimulation on socio-affective deficits experienced by patients with cerebellar abnormalities, as SCA patients. Nevertheless, conclusions remain tentative at this stage due to the heterogeneity characterizing stimulation protocols, study methodologies and patients' samples.

Cerebellar contribution to emotional body language perception: a TMS study

Consistent evidence suggests that the cerebellum contributes to the processing of emotional facial expressions. However, it is not yet known whether the cerebellum is recruited when emotions are expressed by body postures or movements, or whether it is recruited differently for positive and negative emotions. In this study, we asked healthy participants to discriminate between body postures (with masked face) expressing emotions of opposite valence (happiness vs anger, Experiment 1), or of the same valence (negative: anger vs sadness; positive: happiness vs surprise, Experiment 2). While performing the task, participants received online transcranial magnetic stimulation (TMS) over a region of the posterior left cerebellum and over two control sites (early visual cortex and vertex). We found that TMS over the cerebellum affected participants' ability to discriminate emotional body postures, but only when one of the emotions was negatively valenced (i.e. anger). These findings suggest that the cerebellar region we stimulated is involved in processing the emotional content conveyed by body postures and gestures. Our findings complement prior evidence on the role of the cerebellum in emotional face processing and have important implications from a clinical perspective, where non-invasive cerebellar stimulation is a promising tool for the treatment of motor, cognitive and affective deficits.

Distinct cerebellar regions for body motion discrimination

Visual processing of human movements is critical for adaptive social behavior. Cerebellar activations have been observed during biological motion discrimination in prior neuroimaging studies, and cerebellar lesions may be detrimental for this task. However, whether the cerebellum plays a causal role in biological motion discrimination has never been tested. Here, we addressed this issue in three different experiments by interfering with the posterior cerebellar lobe using transcranial magnetic stimulation (TMS) during a biological discrimination task. In Experiments 1 and 2, we found that TMS delivered at onset of the visual stimuli over the vermis (vermal lobule VI), but not over the left cerebellar hemisphere (left lobule VI/Crus I), interfered with participants' ability to distinguish biological from scrambled motion compared to stimulation of a control site (vertex). Interestingly, when stimulation was delivered at a later time point (300 ms after stimulus onset), participants performed worse when TMS was delivered over the left cerebellar hemisphere compared to the vermis and the vertex (Experiment 3). Our data show that the posterior cerebellum is causally involved in biological motion discrimination and suggest that different sectors of the posterior cerebellar lobe may contribute to the task at different time points.

The Role of the Posterior Cerebellum in Dysfunctional Social Sequencing

Recent advances in social neuroscience have highlighted the critical role of the cerebellum in social cognition, and especially the posterior cerebellum. Studies have supported the view that the posterior cerebellum builds internal action models of our social interactions to predict how other people's actions will be executed and what our most likely responses are to these actions. This mechanism allows to better anticipate action sequences during social interactions in an automatic and intuitive way and to fine-tune these anticipations, making it easier to understand other's social behaviors and mental states (e.g., beliefs, intentions, traits). In this paper, we argue that the central role of the posterior cerebellum in identifying and automatizing social action sequencing provides a fruitful starting point for investigating social dysfunctions in a variety of clinical pathologies, such as autism, obsessive-compulsive and bipolar disorder, depression, and addiction. Our key hypothesis is that dysfunctions of the posterior cerebellum lead to under- or overuse of inflexible social routines and lack of plasticity for learning new, more adaptive, social automatisms. We briefly review past research supporting this view and propose a program of research to test our hypothesis. This approach might alleviate a variety of mental problems of individuals who suffer from inflexible automatizations that stand in the way of adjustable and intuitive social behavior, by increasing posterior cerebellar plasticity using noninvasive neurostimulation or neuro-guided training programs.

A causal role for the cerebellum in semantic integration: a transcranial magnetic stimulation study

Mounting evidence suggests that the cerebellum, a structure previously linked to motor function, is also involved in a wide range of non-motor processes. It has been proposed that the cerebellum performs the same computational processes in both motor and non-motor domains. Within motor functions, the cerebellum is involved in the integration of signals from multiple systems. Here we hypothesized that cerebellum may be involved in integration within semantic memory as well. Specifically, understanding a noun-adjective combination (e.g. red apple) requires combining the meaning of the adjective (red) with the meaning of the noun (apple). In two experiments, participants were asked to judge whether noun-adjective word-pairs were semantically related (e.g., red apple) or not (e.g., lucky milk) while online transcranial magnetic stimulation (TMS) was administered over the right cerebellum or over a control site (vertex in Experiment 1 and visual cortex in Experiment 2). Cerebellar TMS caused a decrease in participants’ accuracy for related word-pairs while accuracy for unrelated stimuli was not affected. A third experiment using a control task where subjects compared pairs of random letters showed no effect of TMS. Taken together these results indicate that the right cerebellum is involved specifically in the processing of semantically related stimuli. These results are consistent with theories that proposed the existence of a unified cerebellar function within motor and non-motor domains, as well with recent perspectives about cerebellar involvement in semantic memory and predictive cognition.

TMS over the posterior cerebellum modulates motor cortical excitability in response to facial emotional expressions

Evidence suggests that the posterior cerebellum is involved in emotional processing. Specific mechanisms by which the cerebellum contributes to the perception of and reaction to the emotional state of others are not well-known. It is likely that perceived emotions trigger anticipatory/preparatory motor changes. However, the extent to which the cerebellum modulates the activity of the motor cortex to contribute to emotional processing has not been directly investigated. In this study, we assessed whether the activity of the posterior cerebellum influences the modulation of motor cortical excitability in response to emotional stimuli. To this end, we transiently disrupted the neural activity of the left posterior cerebellum using 1 Hz repetitive transcranial magnetic stimulation (rTMS) and examined its effect on motor cortical excitability witnessed during emotional face processing (in comparison to the effects of sham rTMS). Motor excitability was measured as TMS-based motor evoked potentials (MEPs) recorded from bilateral first dorsal interosseous (FDI) muscles during the viewing of negative emotional (i.e. fearful) and neutral facial expressions. In line with previous evidence, we found that MEP amplitude was increased during the viewing of fearful compared to neutral faces. Critically, when left posterior cerebellar activity was transiently inhibited with 1 Hz rTMS, we observed a reduction in amplitude of MEPs recorded from the contralateral (right) motor cortex during the viewing of emotional (but not neutral) faces. In turn, inhibition of the left posterior cerebellum did not affect the amplitude of MEPs recorded from the ipsilateral motor cortex. Our findings suggest that the posterolateral (left) cerebellum modulates motor cortical response to negative emotional stimuli and may serve as an interface between limbic, cognitive, and motor systems.

The left posterior cerebellum is involved in orienting attention along the mental number line: An online-TMS study

Although converging evidence suggests that the posterior cerebellum is involved in visuospatial functions and in the orienting of attention, a clear topography of cerebellar regions causally involved in the control of spatial attention is still missing. In this study, we aimed to shed light on this issue by using online neuronavigated transcranial magnetic stimulation (TMS) to temporarily interfere with posterior medial (Vermis lobule VII) and left lateral (Crus I/II) cerebellar activity during a task measuring visuospatial (landmark task, Experiment 1 and 2) and representational (number bisection task, Experiment 2) asymmetries in the orienting of attention. At baseline, participants showed attentional biases consistent with the literature, that is a leftward and upward bias with horizontal and vertical lines, respectively, and a leftward bias in number bisection. Critically, TMS over the left cerebellar hemisphere significantly counteracted pseudoneglect in the number bisection task, whilst not affecting attentional biases in the landmark task. In turn, TMS over the posterior vermis did not affect performance in either task. Taken together, our findings suggest that the left posterior cerebellar hemisphere (but not the posterior vermis) is a critical node of an extended brain network subtending the control of spatial attention, at least when attention needs to be allocated to an internal representational space and a certain degree of mental manipulation is required (as in the number bisection task).

TMS Over the Cerebellum Interferes with Short-term Memory of Visual Sequences

Growing evidence suggests that the cerebellum is not only involved in motor functions, but it significantly contributes to sensory and cognitive processing as well. In particular, it has been hypothesized that the cerebellum identifies recurrent serial events and recognizes their violations. Here we used transcranial magnetic stimulation (TMS) to shed light on the role of the cerebellum in short-term memory of visual sequences. In two experiments, we found that TMS over the right cerebellar hemisphere impaired participants' ability to recognize the correct order of appearance of geometrical stimuli varying in shape and/or size. In turn, cerebellar TMS did not affect recognition of highly familiar short sequences of letters or numbers. Overall, our data suggest that the cerebellum is involved in memorizing the order in which (concatenated) stimuli appear, this process being important for sequence learning.

The role of the cerebellum in explicit and incidental processing of facial emotional expressions: A study with transcranial magnetic stimulation

Growing evidence suggests that the cerebellum plays a critical role in non-motor functions, contributing to cognitive and affective processing. In particular, the cerebellum might represent an important node of the "limbic" network, underlying not only emotion regulation but also emotion perception and recognition. Here, we used transcranial magnetic stimulation (TMS) to shed further light on the role of the cerebellum in emotional perception by specifically testing cerebellar contribution to explicit and incidental emotional processing. In particular, in three different experiments, we found that TMS over the (left) cerebellum impaired participants' ability to categorize facial emotional expressions (explicit task) and to classify the gender of emotional faces (incidental emotional processing task), but not the gender of neutral faces. Overall, our results indicate that the cerebellum is involved in perceiving the emotional content of facial stimuli, even when this is task irrelevant.

Dorsomedial prefrontal cortex and cerebellar contribution to in-group attitudes: a transcranial magnetic stimulation study

We tend to express more positive judgments and behaviors toward individuals belonging to our own group compared to other (out-) groups. In this study, we assessed the role of the cerebellum and of the dorsomedial prefrontal cortex (dmPFC) - two regions critically implicated in social cognition processes - in mediating implicit valenced attitudes toward in-group and out-group individuals. To this aim, we used transcranial magnetic stimulation (TMS) in combination with a standard attitude priming task, in which Caucasian participants had to categorize the valence of a series of adjectives primed by either an in-group or an out-group face. In two behavioral experiments, we found an in-group bias (i.e. faster categorization of positive adjectives when preceded by in-group faces) but no evidence of an out-group bias. Interestingly, TMS over both the dmPFC and over the (right) cerebellum significantly interfered with the modulation exerted by group membership on adjective valence classification, abolishing the in-group bias observed at baseline. Overall, our data suggest that both the dmPFC and the cerebellum play a causal role in mediating implicit social attitudes.

A TMS investigation on the role of the cerebellum in pitch and timbre discrimination

Background

Growing neuroimaging and clinical evidence suggests that the cerebellum plays a critical role in perception. In the auditory domain, the cerebellum seems to be important in different aspects of music and sound processing. Here we investigated the possible causal role of the cerebellum in two auditory tasks, a pitch discrimination and a timbre discrimination task. Specifically, participants performed a pitch and a timbre discrimination task prior and after receiving offline low frequency transcranical magnetic stimulation (TMS) over their (right) cerebellum.

Results

Suppressing activity in the right cerebellum by means of inhibitory 1 Hz TMS affected participants’ ability to discriminate pitch but not timbre.

Conclusion

These findings point to a causal role of the cerebellum in at least certain aspects of sound processing and are important in a clinical perspective helping understanding the impact of cerebellar lesions on sensory functions.

Cerebellar vermis plays a causal role in visual motion discrimination

Cerebellar patients have been found to show deficits in visual motion discrimination, suggesting that the cerebellum may play a role in visual sensory processing beyond mediating motor control. Here we show that triple-pulse online transcranial magnetic stimulation (TMS) over cerebellar vermis but not over the cerebellar hemispheres significantly impaired motion discrimination. Critically, the interference caused by vermis TMS on motion discrimination did not depend on an indirect effect of TMS over nearby visual areas, as demonstrated by a control experiment in which TMS over V1 but not over cerebellar vermis significantly impaired orientation discrimination. These findings demonstrate the causal role of the cerebellar vermis in visual motion processing in neurologically normal participants.