Moving forward: age effects on the cerebellum underlie cognitive and motor declines

Alzheimer's disease cerebrospinal fluid biomarker levels and APOE genetic status are associated with hippocampal-cerebellar functional connectivity

Recent research suggests that hippocampal-cerebellar (Hp-CB) functional connectivity may be altered early in the course of Alzheimer's disease (AD), given the early accumulation of AD pathology in the hippocampi and emerging evidence of cerebellar changes in early AD. This study analyzed the role of AD genetic risk (via APOE ε4 carrier status) and cerebrospinal fluid (CSF) biomarkers of AD pathology (ratio of phosphorylated tau (p-tau181) to amyloid beta (Aβ42/Aβ40)) on the relationship between age and functional Hp-CB resting state fMRI connectivity in 161 cognitively unimpaired older adults (M age =67.3; SD =9.0; 37 % APOE ε4 +). In multiple regression analyses with Hp-CB connectivity as the outcome, there were significant interactions between age and APOE ε4 status, and between age and CSF AD biomarkers. Older age was associated with greater Hp-CB connectivity in APOE ε4 non-carriers and participants with less abnormal CSF AD biomarkers. In contrast, Hp-CB connectivity was marginally lower with older age in ε4 carriers and those with more abnormal AD biomarkers. Furthermore, greater Hp-CB connectivity was associated with better episodic memory performance across all groups. These findings suggest that age-related increases in Hp-CB connectivity among APOE ε4 non-carriers and those with low AD biomarker levels reflect age-related changes that are largely unrelated to AD, while age-related decreases in Hp-CB connectivity in APOE ε4 carriers may reflect AD-related alterations. These findings also highlight the importance of cerebellar contributions to cognitive performance among older adults and suggest that Hp-CB connectivity may be altered in preclinical AD.

Age-related differences in task-related modulation of cerebellar brain inhibition

Age-related reductions in cerebellar integrity predict motor impairments in older adults (OA), but the contribution of cerebro-cerebellar interactions to these impairments remains unclear. Understanding these interactions could reveal underlying mechanisms associated with age-related deficits in motor control. To explore this, twenty younger adults (YA) and twenty OA, all right-handed, participated in a dual-site transcranial magnetic stimulation protocol. Cerebellar brain inhibition (CBI) was measured at rest and during the anticipatory period of a bimanual tracking task (BTT). The results revealed that YA outperformed OA on the BTT. Both age groups demonstrated reduced CBI during the anticipatory period of the BTT compared to CBI at rest, with no differences in CBI levels between both groups. Notably, motor performance was influenced by CBI modulation, as learning progressed (early vs. slightly later short-term learning), and this influence differed between age groups. In summary, resting-state CBI and the task-related release of CBI were maintained in OA, challenging previous assumptions of reduced inhibitory function in OA. However, the modulation of CBI appears to influence short-term motor learning differently for both groups, suggesting potential functional reorganization of the cerebellar neural system.

Volumetric Changes in Cerebellar Transverse Zones: Age and Sex Effects in Health and Neurological Disorders

Cerebellar volumetric changes are intricately linked to aging, with distinct patterns across its transverse zones, the functional subdivisions characterized by unique cytoarchitectural and connectivity profiles. Despite research efforts, the cerebellar aging process in health and neurological disorders remains poorly understood. In this study, we investigated the effects of age and sex on total cerebellum, transverse zone, and lobule volumes using MRI data from over 45,000 participants compiled from six neuroimaging datasets. We also propose a framework for estimating cerebellum age as an indicator of cerebellar health. Significant age-dependent volume reductions were observed across transverse zones, with the central zone (CZ; lobules VI and VII) exhibiting the steepest decline in both health and neurological disorders. This finding highlights the CZ's vulnerability to aging and its critical role in cognitive and emotional processing. We also found prominent sex differences in age-dependent volumetric changes. Males exhibited smaller total intracranial volume (TIV)-adjusted cerebellum volume and faster age-dependent volume reduction than females in both health and mild cognitive impairment (MCI), Alzheimer disease (AD), and Parkinson disease (PD). In contrast, females with schizophrenia (SZ) and cocaine use disorder (CUD) revealed faster age-dependent cerebellar volume reduction than males. Patients with MCI, AD, and PD experienced more pronounced atrophy in the posterior (PZ) and nodular (NZ) zones compared to age-matched healthy controls, while SZ patients were characterized by a more prominent reduction in CZ. In CUD, a non-significant volume decline was observed in all zones compared to the controls. Moreover, our framework for estimating cerebellum age revealed a notable difference in cerebellar aging between healthy individuals and neurological patients. Finally, we charted age-dependent changes in cerebellar volume in healthy individuals, focusing on transverse zones capturing the functional subdivisions. These findings underscore the potential of cerebellar volumetric analysis as a biomarker for early detection and monitoring of neurodegenerative and neuropsychiatric disorders. Our novel approach complements and enhances MRI-based analyses, providing essential insights into the pathogenesis of aging, neurodegeneration, and chronic neuropsychiatric conditions.

Assessing age-related proprioceptive changes through active and passive tasks: implications for stroke assessment

Objective.Voluntary control of motor actions requires precise regulation of proprioceptive and somatosensory functions. While aging is known to impair sensory processing, its effect on proprioception remains unclear. Previous studies report conflicting findings on whether passive proprioception (i.e. during externally driven movements) declines with age, and research on age-related changes in active proprioception (i.e. during voluntary movements) remains limited, particularly in the upper limb. Understanding these changes is critical for identifying and preventing impairments that may affect movement performance and mobility, particularly in neurological conditions such as stroke or Parkinson's disease.Approach.We refined a robotic protocol to assess upper-limb active proprioception and validated its robustness and reliability over multiple sessions. Using this protocol, we compared the performance between young and elderly neurologically healthy adults during both active and passive proprioceptive tasks.Main results.Elderly participants exhibited a significant decline in accuracy when sensing limb position in both active and passive proprioceptive tasks, whereas their precision remained unchanged. These findings indicate that aging primarily affects proprioceptive accuracy rather than variability in position sense.Significance.Our findings contribute to the ongoing debate on age-related proprioceptive decline and highlight the importance of distinguishing between active and passive proprioception. Furthermore, our validated robotic protocol provides a reliable tool for assessing proprioception, with potential applications in studying neurological conditions in clinical settings.

Cerebellar-hippocampal volume associations with behavioral outcomes following tDCS modulation

Here, we explore the relationship between transcranial direct current stimulation (tDCS) and brain-behavior interactions. We propose that tDCS perturbation allows for the investigation of relationships between brain volume and behavior. We focused on the hippocampus (HPC) and cerebellum (CB) regions that are implicated in our understanding of memory and motor skill acquisition. Seventy-four young adults (mean age: 22 ± 0.42 years, mean education: 14.7 ± 0.25 years) were randomly assigned to receive either anodal, cathodal, or sham stimulation. Following stimulation, participants completed computerized tasks assessing working memory and sequence learning in a magnetic resonance imaging (MRI) environment. We investigated the statistical interaction between CB and HPC volumes. Our findings showed that individuals with larger cerebellar volumes had shorter reaction times (RT) on a high-load working memory task in the sham stimulation group. In contrast, the anodal stimulation group exhibited faster RTs during the low-load working memory condition. These RT differences were associated with the cortical volumetric interaction between CB-HPC. Literature suggests that anodal stimulation down-regulates the CB and here, those with larger volumes perform more quickly, suggesting the potential need for additional cognitive resources to compensate for cerebellar downregulation or perturbation. This new insight suggests that tDCS can aid in revealing structure-function relationships, due to greater performance variability, especially in young adults. It may also reveal new targets of interest in the study of aging or in diseases where there is also greater behavioral variability.

Altered cerebellar activation patterns in Alzheimer's disease: An activation likelihood estimation Meta-Analysis

The past decade has seen an increased interest in the cerebellum, particularly in non-motor behaviors. Emerging work across model systems and in humans has also implicated the cerebellum in Alzheimer's Disease (AD) and in mild cognitive impairment (MCI). While the cerebellum is not seen as being central to the etiology of the disease, it is however recognized as being increasingly important, and most certainly not immune from disease-related pathology and atrophy. In cognitively normal older adults (OA), the cerebellum has been conceptualized as being critical scaffolding for cortical function. This scaffolding may extend to AD and MCI. With respect to functional imaging, this is largely unexplored in AD, as this is a nascent literature. While there are very few studies focused on the cerebellum in AD at this stage, meta-analysis provides a powerful tool for expanding our knowledge of the cerebellum in neurodegenerative disease, and, in turn, for hypothesis generation. We took advantage of activation likelihood estimation (ALE) meta-analysis to investigate overlap in functional activation present in the existing literature. We focused on AD, but also included an exploratory analysis of MCI, based on papers available in our AD search. Our analysis included a total of 29 studies, representing data from 236 individuals with AD, 159 with MCI, and 382 OA. Across these studies, there is no significant overlap in cerebellar activation in AD, though this is present in MCI. Analyses of group differences also suggest that across studies, there are patterns indicative of both greater and reduced activation in AD/MCI relative to OA. Across all findings, overlap was primarily centered on Crus I and Lobule VI. These findings suggest that cerebellar function is negatively impacted in AD, which in turn may impact behavior and symptomatology.

Cerebellar Purkinje cell stripe patterns reveal a differential vulnerability and resistance to cell loss during normal aging in mice

Age-related neurodegenerative diseases involve reduced cell numbers and impaired behavioral capacity. Neurodegeneration and behavioral deficits also occur during aging, and notably in the absence of disease. The cerebellum, which modulates movement and cognition, is susceptible to cell loss in both aging and disease. Here, we demonstrate that cerebellar Purkinje cell loss in aged mice is not spatially random but rather occurs in a pattern of parasagittal stripes. We also find that aged mice exhibit impaired motor coordination and more severe tremor compared to younger mice. However, the relationship between patterned Purkinje cell loss and motor dysfunction is not straightforward. Examination of postmortem samples of human cerebella from neurologically typical individuals supports the presence of selective loss of Purkinje cells during aging. These data reveal a spatiotemporal cellular substrate for aging in the cerebellum that may inform about how neuronal vulnerability leads to neurodegeneration and the ensuing deterioration of behavior.

Atrophy of cerebellum Crus I indicates poor outcome of cochlear implantation in the elderly

Cochlear implantation (CI) is a highly effective treatment for profound hearing loss in elderly individuals, including those with ARHL. However, factors influencing the success of CI in the elderly population are not fully understood. Hence, we sought to investigate the association of regional cerebellar gray matter volume with effectiveness of CI in the elderly. This retrospective cross-sectional study included CI implantees and healthy controls aged ≥ 70 years. We used voxel-based morphometry to investigate the cerebellar gray matter associated with speech perception outcome in the CI group. Among the study participants, cerebellar gray matter volume loss, particularly in the Crus I region, was associated with poorer CI outcomes. Notably, this association was stronger than that observed for the duration of hearing deprivation (DoD). Moreover, the degree of cerebellar atrophy and DoD were found to be independent of each other. No significant correlation was found between the age of the implant and CI outcomes. The findings suggest that cerebellar gray matter atrophy, specifically in the Crus I region, may serve as a predictor of poor outcomes following cochlear implantation in elderly individuals. These results underscore the importance of assessing cerebellar volume loss alongside other factors when counseling elderly patients considering CI.

Time Dependent Effects of Cerebellar tDCS on Cerebello-cortical Connectivity Networks in Young Adults

The cerebellum is involved in non-motor processing, supported by topographically distinct cerebellar activations and closed-loop circuits between the cerebellum and the cortex. Disruptions to cerebellar function may negatively impact prefrontal function and processing. Cerebellar resources may be important for offloading cortical processing, providing crucial scaffolding for normative performance and function. Here, we used transcranial direct current stimulation (tDCS) to temporarily alter cerebellar function and subsequently investigated resting state network connectivity. Critically, what happens to these circuits if the cerebellum is not functioning optimally, or after stimulation, remains relatively unknown. We employed a between-subjects design with 74 participants total (38 female; M = 22.0 years, SD = 3.45), applying anodal (n = 25), cathodal (n = 25), or sham (n = 24) stimulation to the cerebellum to examine the effect of stimulation on cerebello-cortical resting state connectivity in young adults. We predicted increased functional connectivity following cathodal stimulation and decreased functional connectivity following anodal stimulation. We found, anodal stimulation resulted in increased connectivity in both ipsilateral and contralateral regions of the cortex, perhaps indicative of a compensatory response to degraded cerebellar output. Additionally, a window analysis also demonstrated a time dependent nature to the impacts of cerebellar tDCS on connectivity, particularly with cognitive regions of the cerebral cortex. This work suggests that when cerebellar outputs are degraded, in this case by tDCS, the cerebellum offloads its processing responsibility which encourages more cortical regions to engage to compensate for the degraded cerebellar output. This results in in differences in cortical activation patterns and performance deficits. These results might inform and update existing compensatory models, which focus primarily on the cortex, to include the cerebellum as a vital structure involved in the scaffolding of cortical processing.

Differential Effects of Continuous Theta Burst Stimulation over the Bilateral and Unilateral Cerebellum on Working Memory

Recent functional MRI studies have implicated the cerebellum in working memory (WM) alongside the prefrontal cortex. Some findings indicate that the right cerebellum is activated during verbal tasks, while the left is engaged during visuospatial tasks, suggesting cerebellar lateralization in WM function. The cerebellum could be a potential target for non-invasive brain stimulation (NIBS) to enhance WM function in cognitive disorders. However, the comprehensive influence of cerebellar lateralization on different types of WM and the effect of stimulation over the unilateral or bilateral cerebellum remain uncertain. This study was to investigate the cerebellum's functional lateralization and its specific impact on various aspects of WM in a causal manner using unilateral or bilateral cerebellar continuous theta burst stimulation (cTBS), a form of inhibitroy NIBS. Twenty-four healthy participants underwent four sessions of cTBS targeting the left, right, or bilateral Crus I of the cerebellum, or a sham condition, in a controlled cross-over design. WM performance was assessed pre- and post-stimulation using neuropsychological tests, including the 3-back task, spatial WM task, and digit span task. Results indicated that cTBS over the bilateral and right cerebellum both led to a greater improvement in 3-back task performance compared to sham stimulation. Additionally, active cTBS over the bilateral cerebellum yielded better performance in the spatial WM task than sham stimulation. However, no significant differences were observed between stimulation conditions for the auditory digit span task. This study may provide novel causal evidence highlighting the specific involvement of the right and bilateral cerebellum in various types of WM. Specifically, the right cerebellum appears crucial for updating and tracking 3-back WM content, while spatial WM processes require the coordinated engagement of both cerebellar hemispheres.

Cerebellar representation during phonetic processing in tonal and non-tonal language speakers: An ALE meta-analysis

The role of the cerebellum in phonetic processing has been discovered and widely discussed for decades. However, with the idea that the cerebral representation of phonetic processing is different in tonal language and non-tonal language speakers, whether the cerebellar representation of phonetic processing differs based on language background remains unknown. In the present study, we conducted an activation likelihood estimation (ALE) analysis among 33 functional neuroimaging studies involving 541 healthy adults (213 tonal language speakers and 328 non-tonal language speakers). The aim was to explore the cerebellar representation of phonetic perception and phonetic production in these two language backgrounds. Our results demonstrated the involvement of cerebellum left Crus I, right Crus II, lobules VI, and VIIb in phonetic perception among tonal language speakers, whereas only one focal cluster (right Crus I and Crus II) was demonstrated in non-tonal language speakers. Conjunction analysis revealed overlapping regions located in the right Crus II both in tonal and non-tonal language speakers during phonetic perception. During phonetic production, no significant cluster was detected among tonal language speakers, whereas one focal cluster (within right lobule VI) was detected in non-tonal language speakers. These results highlight the specific cerebellar representation of phonetic processing in tonal and non-tonal languages. Overall, this ALE analysis provides a profound view of the neural mechanism of phonetic processing.

Longitudinal autophagy profiling of the mammalian brain reveals sustained mitophagy throughout healthy aging

Mitophagy neutralizes mitochondrial damage, thereby preventing cellular dysfunction and apoptosis. Defects in mitophagy have been strongly implicated in age-related neurodegenerative disorders such as Parkinson's and Alzheimer's disease. While mitophagy decreases throughout the lifespan of short-lived model organisms, it remains unknown whether such a decline occurs in the aging mammalian brain-a question of fundamental importance for understanding cell type- and region-specific susceptibility to neurodegeneration. Here, we define the longitudinal dynamics of basal mitophagy and macroautophagy across neuronal and non-neuronal cell types within the intact aging mouse brain in vivo. Quantitative profiling of reporter mouse cohorts from young to geriatric ages reveals cell- and tissue-specific alterations in mitophagy and macroautophagy between distinct subregions and cell populations, including dopaminergic neurons, cerebellar Purkinje cells, astrocytes, microglia and interneurons. We also find that healthy aging is hallmarked by the dynamic accumulation of differentially acidified lysosomes in several neural cell subsets. Our findings argue against any widespread age-related decline in mitophagic activity, instead demonstrating dynamic fluctuations in mitophagy across the aging trajectory, with strong implications for ongoing theragnostic development.

Cerebello-Hippocampal Interactions in the Human Brain: A New Pathway for Insights Into Aging

The cerebellum is recognized as being important for optimal behavioral performance across task domains, including motor function, cognition, and affect. Decades of work have highlighted cerebello-thalamo-cortical circuits, from both structural and functional perspectives. However, these circuits of interest have been primarily (though not exclusively) focused on targets in the cerebral cortex. In addition to these cortical connections, the circuit linking the cerebellum and hippocampus is of particular interest. Recently, there has been an increased interest in this circuit, thanks in large part to novel findings in the animal literature demonstrating that neuronal firing in the cerebellum impacts that in the hippocampus. Work in the human brain has provided evidence for interactions between the cerebellum and hippocampus, though primarily this has been in the context of spatial navigation. Given the role of both regions in cognition and aging, and emerging evidence indicating that the cerebellum is impacted in age-related neurodegenerative disease such as Alzheimer's, I propose that further attention to this circuit is warranted. Here, I provide an overview of cerebello-hippocampal interactions in animal models and from human imaging and outline the possible utility of further investigations to improve our understanding of aging and age-related cognitive decline.

Brain plasticity following lumbar disc herniation treatment with spinal manipulation therapy based on resting-state functional magnetic resonance imaging

As a prevalent spine disorder, Lumbar disc herniation (LDH) has been affecting more than 2 % of the worldwide population and is characterised by uncertain causes and recurring episodes. Studying the brain activity of patients could potentially provide insights into its pathogenesis and significantly enhance therapy. Therefore, we here examined brain function in patients under Spinal Manipulative Therapy (SMT). By analysing regional homogeneity (ReHo) at different frequency bands, we identified the discrepancies in brain activity between LDH patients and healthy people, highlighting the frequency dependence of spontaneous low-frequency oscillations among patients with LDH. Choosing seeds based on the peak ReHo differences helped to elucidate the functional connectivity alterations in the brain regions of LDH. Overall, this study showed that SMT significantly reduced pain, improved dysfunction, and partially rectified aberrant local consistency and functional connection in patients with LDH, not only offering insights into the pathophysiology of LDH from a neurological standpoint, but also providing inspiration for the development of new therapies based on neurobiology.

Subcortical volume in middle-aged adults with fetal alcohol spectrum disorders

Studies of youth and young adults with prenatal alcohol exposure (PAE) have most consistently reported reduced volumes of the corpus callosum, cerebellum and subcortical structures. However, it is unknown whether this continues into middle adulthood or if individuals with PAE may experience premature volumetric decline with aging. Forty-eight individuals with fetal alcohol spectrum disorders (FASD) and 28 healthy comparison participants aged 30 to 65 participated in a 3T MRI session that resulted in usable T1-weighted and T2-weighted structural images. Primary analyses included volumetric measurements of the caudate, putamen, pallidum, cerebellum and corpus callosum using FreeSurfer software. Analyses were conducted examining both raw volumetric measurements and subcortical volumes adjusted for overall intracranial volume (ICV). Models tested for main effects of age, sex and group, as well as interactions of group with age and group with sex. We found the main effects for group; all regions were significantly smaller in participants with FASD for models using raw volumes (P's < 0.001) as well as for models using volumes adjusted for ICV (P's < 0.046). Although there were no significant interactions of group with age, females with FASD had smaller corpus callosum volumes relative to both healthy comparison females and males with FASD (P's < 0.001). As seen in children and adolescents, adults aged 30 to 65 with FASD showed reduced volumes of subcortical structures relative to healthy comparison adults, suggesting persistent impact of PAE. Moreover, the observed volumetric reduction of the corpus callosum in females with FASD could suggest more rapid degeneration, which may have implications for cognition as these individuals continue to age.

Understanding music and aging through the lens of Bayesian inference

Bayesian inference has recently gained momentum in explaining music perception and aging. A fundamental mechanism underlying Bayesian inference is the notion of prediction. This framework could explain how predictions pertaining to musical (melodic, rhythmic, harmonic) structures engender action, emotion, and learning, expanding related concepts of music research, such as musical expectancies, groove, pleasure, and tension. Moreover, a Bayesian perspective of music perception may shed new insights on the beneficial effects of music in aging. Aging could be framed as an optimization process of Bayesian inference. As predictive inferences refine over time, the reliance on consolidated priors increases, while the updating of prior models through Bayesian inference attenuates. This may affect the ability of older adults to estimate uncertainties in their environment, limiting their cognitive and behavioral repertoire. With Bayesian inference as an overarching framework, this review synthesizes the literature on predictive inferences in music and aging, and details how music could be a promising tool in preventive and rehabilitative interventions for older adults through the lens of Bayesian inference.

Multiscale brain age prediction reveals region-specific accelerated brain aging in Parkinson's disease

Brain biological age, which measures the aging process in the brain using neuroimaging data, has been used to assess advanced brain aging in neurodegenerative diseases, including Parkinson disease (PD). However, assuming that whole brain degeneration is uniform may not be sufficient for assessing the complex neurodegenerative processes in PD. In this study we constructed a multiscale brain age prediction models based on structural MRI of 1240 healthy participants. To assess the brain aging patterns using the brain age prediction model, 93 PD patients and 91 healthy controls matching for sex and age were included. We found increased global and regional brain age in PD patients. The advanced aging regions were predominantly noted in the frontal and temporal cortices, limbic system, basal ganglia, thalamus, and cerebellum. Furthermore, region-level rather than global brain age in PD patients was associated with disease severity. Our multiscale brain age prediction model could aid in the development of objective image-based biomarkers to detect advanced brain aging in neurodegenerative diseases.

Sex as a Determinant of Age-Related Changes in the Brain

The notion of notable anatomical, biochemical, and behavioral distinctions within male and female brains has been a contentious topic of interest within the scientific community over several decades. Advancements in neuroimaging and molecular biological techniques have increasingly elucidated common mechanisms characterizing brain aging while also revealing disparities between sexes in these processes. Variations in cognitive functions; susceptibility to and progression of neurodegenerative conditions, notably Alzheimer's and Parkinson's diseases; and notable disparities in life expectancy between sexes, underscore the significance of evaluating aging within the framework of gender differences. This comprehensive review surveys contemporary literature on the restructuring of brain structures and fundamental processes unfolding in the aging brain at cellular and molecular levels, with a focus on gender distinctions. Additionally, the review delves into age-related cognitive alterations, exploring factors influencing the acceleration or deceleration of aging, with particular attention to estrogen's hormonal support of the central nervous system.

Loss of calcitonin gene-related peptide (αCGRP) and use of a vestibular challenge highlight balance deficiencies in aging mice

Aging impacts the vestibular system and contributes to imbalance. In fact, imbalance precedes changes in cognition in the elderly. However, research is limited in assessing aging mouse models that are deficient in crucial neuromodulators like Calcitonin Gene-Related Peptide (CGRP). We studied the loss of CGRP and its effects in the aging mouse, namely its effect on both static and dynamic imbalances. Postural sway and rotarod testing were performed before and after a vestibular challenge (VC) in the 129S wild type and the αCGRP (-/-) null mice. Four age groups were tested that correspond to young adulthood, late adulthood, middle age, and senescence in humans. Our results suggest wild type mice experience a decline in rotarod ability due to aging after they reach their prime performance at 6-10 months of age, while the αCGRP (-/-) null mice perform poorly on rotarod early in life but improve with age as they get older, potentially due to vestibular compensation. Our postural sway study suggests that a vestibular challenge can lead to significantly reduced CoP ellipse areas (freezing behaviors) in older mice, and this change occurs earlier in the αCGRP (-/-) null but requires future studies to evaluate anxiety effects. These results indicate that αCGRP is an important component of proper balance and that the loss of αCGRP can contribute to balance complications that may compound with aging.

Heritability of cerebellar subregion volumes in adolescent and young adult twins

Twin studies have found gross cerebellar volume to be highly heritable. However, whether fine-grained regional volumes within the cerebellum are similarly heritable is still being determined. Anatomical MRI scans from two independent datasets (QTIM: Queensland Twin IMaging, N = 798, mean age 22.1 years; QTAB: Queensland Twin Adolescent Brain, N = 396, mean age 11.3 years) were combined with an optimised and automated cerebellum parcellation algorithm to segment and measure 28 cerebellar regions. We show that the heritability of regional volumetric measures varies widely across the cerebellum (h 2 $$ {h}^2 $$ 47%-91%). Additionally, the good to excellent test-retest reliability for a subsample of QTIM participants suggests that non-genetic variance in cerebellar volumes is due primarily to unique environmental influences rather than measurement error. We also show a consistent pattern of strong associations between the volumes of homologous left and right hemisphere regions. Associations were predominantly driven by genetic effects shared between lobules, with only sparse contributions from environmental effects. These findings are consistent with similar studies of the cerebrum and provide a first approximation of the upper bound of heritability detectable by genome-wide association studies.

Comparing the effects of cerebellar and prefrontal anodal transcranial direct current stimulation concurrent with postural training on balance and fatigue in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial

Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5 mA for a period of 20 min. While, in the sham group, tDCS was only activated for 30 s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients.

Human Cerebellum Gangliosides: A Comprehensive Analysis by Ion Mobility Tandem Mass Spectrometry

The human cerebellum is an ultraspecialized region of the brain responsible for cognitive functions and movement coordination. The fine mechanisms through which the process of aging impacts such functions are not well understood; therefore, a rigorous exploration of this brain region at the molecular level is deemed necessary. Gangliosides, sialylated glycosphingolipids, highly and specifically expressed in the human central nervous system, represent possible molecular markers of cerebellum development and aging. In this context, for a comprehensive determination of development- and age-specific components, we have conducted here a comparative profiling and structural determination of the gangliosides expressed in fetal cerebellum in two intrauterine developmental stages and aged cerebellum by ion mobility separation (IMS) mass spectrometry (MS) and tandem MS (MS/MS). Due to the high sensitivity and efficiency of separation provided by IMS MS, no less than 551 chemically distinct species were identified, which represents 4.5 times more gangliosides than ever discovered in this brain region. The detailed assessment of fetal vs aged cerebellum gangliosidome showed marked discrepancies not only in the general number of the species expressed, but also in their sialylation patterns, the modifications of the glycan core, and the composition of the ceramides. All of these characteristics are potential markers of cerebellum development and aging. The structural analysis by collision-induced dissociation (CID) documented the occurrence of GD1b (d18:1/18:0) isomer in the fetal cerebellum in the second gestational trimester, with all probability of GQ1b (t18:1/18:0) in the near-term fetus and of GQ1b (d18:1/18:0) in aged cerebellum.

Non-invasive neuromodulation of cerebello-hippocampal volume-behavior relationships

The study here explores the link between transcranial direct current stimulation (tDCS) and brain-behavior relationships. We propose that tDCS may indirectly influence the complex relationships between brain volume and behavior. We focused on the dynamics between the hippocampus (HPC) and cerebellum (CB) in cognitive processes, a relationship with significant implications for understanding memory and motor skills. Seventy-four young adults (mean age: 22±0.42 years, mean education: 14.7±0.25 years) were randomly assigned to receive either anodal, cathodal, or sham stimulation. Following stimulation, participants completed computerized tasks assessing working memory and sequence learning in a magnetic resonance imaging (MRI) environment. We investigated the statistical interaction between CB and HPC volumes. Our findings showed that individuals with larger cerebellar volumes had shorter reaction times (RT) on a high-load working memory task in the sham stimulation group. In contrast, the anodal stimulation group exhibited faster RTs during the low-load working memory condition. These RT differences were associated with the cortical volumetric interaction between CB-HPC. Literature suggests that anodal stimulation down-regulates the CB and here, those with larger volumes perform more quickly, suggesting the potential need for additional cognitive resources to compensate for cerebellar downregulation. This new insight suggests that tDCS can aid in revealing structure-function relationships, due to greater performance variability, especially in young adults. It may also reveal new targets of interest in the study of aging or in diseases where there is also greater behavioral variability.

Cerebellum and Aging: Update and Challenges

The cerebellum plays a vital role in the aging process. With the aging of the cerebellum, there is a decline in balance and motor function, particularly fine motor skills, and an increased risk of falling. However, in recent years, numerous studies have revealed that the cerebellum has several roles besides balance and fine motor skills, such as cognitive function and memory. It also plays a role in many neurodegenerative diseases. Interestingly, the cerebellum ages more rapidly than other brain regions, including the hippocampus. With increasing studies reporting that the cerebellum has a more prominent and interconnected role in the brain, it is essential to understand why aging affects it more, leading to solutions to help curb the accelerated decline. Here, we summarize the cerebellum's function and look at how it ages at the cellular, molecular, and functional levels. Additionally, we explore the the effects of alcoholism on the aging cerebellum as well as the role of the cerebellum in diseases such as Alzheimer's, Parkinson's, and Multiple Sclerosis.

The tool effect is lower in older adults with or without cognitive impairments than in young adults

Grabbing a phone from a table or stepping over an obstacle on the ground are daily activities that require the brain to take account of both object and the body's parameters. Research has shown that a person's estimated maximum reach is temporarily overestimated after using a tool, even when the tool is no longer in hand. This tool effect reflects the high plasticity of the perceptual-motor system (e.g., body schema updating)-at least in young individuals. The objective of the present study was to determine whether the tool effect is smaller in older adults. Forty-four young adults, 37 older adults without cognitive impairment and 30 older adults with cognitive impairment took part in the experiment. The task consisted in visually estimating the ability to reach (using the index finger) a target positioned at different locations on a table, both before and after using a rake. We observed a strong after-effect of tool use in the young adults only. Conversely, a tool effect was similarly absent in the older adults without and with cognitive impairment. Moreover, even before the tool was used, the maximum reach was overestimated in each of the three groups, although the overestimation was greatest in the two groups of older adults. In summary, we showed that the tool effect, observed in young adults, was absent in older adults; this finding suggests that with advancing age, the perceptual-motor system is less able to adapt to novel sensorimotor contexts. This lack of adaptation might explain (at least in part) the overestimation of motor skills often reported in the elderly.

Long-term suboptimal dietary trace element supply does not affect trace element homeostasis in murine cerebellum

The ageing process is associated with alterations of systemic trace element (TE) homeostasis increasing the risk, e.g. neurodegenerative diseases. Here, the impact of long-term modulation of dietary intake of copper, iron, selenium, and zinc was investigated in murine cerebellum. Four- and 40-wk-old mice of both sexes were supplied with different amounts of those TEs for 26 wk. In an adequate supply group, TE concentrations were in accordance with recommendations for laboratory mice while suboptimally supplied animals received only limited amounts of copper, iron, selenium, and zinc. An additional age-adjusted group was fed selenium and zinc in amounts exceeding recommendations. Cerebellar TE concentrations were measured by inductively coupled plasma-tandem mass spectrometry. Furthermore, the expression of genes involved in TE transport, DNA damage response, and DNA repair as well as selected markers of genomic stability [8-oxoguanine, incision efficiency toward 8-oxoguanine, 5-hydroxyuracil, and apurinic/apyrimidinic sites and global DNA (hydroxy)methylation] were analysed. Ageing resulted in a mild increase of iron and copper concentrations in the cerebellum, which was most pronounced in the suboptimally supplied groups. Thus, TE changes in the cerebellum were predominantly driven by age and less by nutritional intervention. Interestingly, deviation from adequate TE supply resulted in higher manganese concentrations of female mice even though the manganese supply itself was not modulated. Parameters of genomic stability were neither affected by age, sex, nor diet. Overall, this study revealed that suboptimal dietary TE supply does not substantially affect TE homeostasis in the murine cerebellum.

Rhythmic musical activities may strengthen connectivity between brain networks associated with aging-related deficits in timing and executive functions

Brain aging and common conditions of aging (e.g., hypertension) affect networks important in organizing information, processing speed and action programming (i.e., executive functions). Declines in these networks may affect timing and could have an impact on the ability to perceive and perform musical rhythms. There is evidence that participation in rhythmic musical activities may help to maintain and even improve executive functioning (near transfer), perhaps due to similarities in brain regions underlying timing, musical rhythm perception and production, and executive functioning. Rhythmic musical activities may present as a novel and fun activity for older adults to stimulate interacting brain regions that deteriorate with aging. However, relatively little is known about neurobehavioral interactions between aging, timing, rhythm perception and production, and executive functioning. In this review, we account for these brain-behavior interactions to suggest that deeper knowledge of overlapping brain regions associated with timing, rhythm, and cognition may assist in designing more targeted preventive and rehabilitative interventions to reduce age-related cognitive decline and improve quality of life in populations with neurodegenerative disease. Further research is needed to elucidate the functional relationships between brain regions associated with aging, timing, rhythm perception and production, and executive functioning to direct design of targeted interventions.

Cerebellar EEG source localization reveals age-related compensatory activity moderated by genetic risk for Alzheimer's disease

The apolipoprotein-E (APOE) ε4 allele is the greatest genetic risk factor for late-onset Alzheimer's disease (AD), but alone it is not sufficiently predictive. Because neuropathological changes associated with AD begin decades before cognitive symptoms, neuroimaging of healthy, cognitively intact ε4 carriers (ε4+) may enable early characterization of patterns associated with risk for future decline. Research in the cerebral cortex highlights a period of compensatory recruitment in elders and ε4+, which serves to maintain cognitive functioning. Yet, AD-related changes may occur even earlier in the cerebellum. Advances in electroencephalography (EEG) source localization now allow effective modeling of cerebellar activity. Importantly, healthy aging and AD are associated with declines in both cerebellar functions and executive functioning (EF). However, it is not known whether cerebellar activity can detect pre-symptomatic AD risk. Thus, the current study analyzed cerebellar EEG source localization during an EF-dependent stop-signal task (i.e., inhibitory control) in healthy, intact older adults (Mage  = 80 years; 20 ε4+, 25 ε4-). Task performance was comparable between groups. Older age predicted greater activity in left crus II and lobule VIIb during the P300 window (i.e., performance evaluation), consistent with age-related compensation. Age*ε4 moderations specifically showed that compensatory patterns were evident only in ε4-, suggesting that cerebellar compensatory resources may already be depleted in healthy ε4+ elders. Thus, the posterolateral cerebellum is sensitive to AD-related neural deficits in healthy elders. Characterization of these patterns may be essential for the earliest possible detection of AD risk, which would enable critical early intervention prior to symptom onset.

New Frontiers for the Understanding of Aging: The Power and Possibilities of Studying the Cerebellum

Understanding behavior in aging has benefited greatly from cognitive neuroscience. Our foundational understanding of the brain in advanced age is based on what now amounts to several decades of work demonstrating differences in brain structure, network organization, and function. Earlier work in this field was focused primarily on the prefrontal cortex and hippocampus. More recent evidence has expanded our understanding of the aging brain to also implicate the cerebellum. Recent frameworks have suggested that the cerebellum may act as scaffolding for cortical function, and there is an emerging literature implicating the structure in Alzheimer's disease. At this juncture, there is evidence highlighting the potential importance of the cerebellum in advanced age, though the field of study is relatively nascent. Here, we provide an overview of key findings in the literature as it stands now and highlight several key future directions for study with respect to the cerebellum in aging.

Epigenetic analysis suggests aberrant cerebellum brain aging in old-aged adults with autism spectrum disorder and schizophrenia

The aberrant aging hypothesis of schizophrenia (SCZ) and autism spectrum disorder (ASD) has been proposed, and the DNA methylation (DNAm) clock, which is a cumulative evaluation of DNAm levels at age-related CpGs, could serve as a biological aging indicator. This study evaluated epigenetic brain aging of ASD and SCZ using Horvath's epigenetic clock, based on two public genome-wide DNA methylation datasets of post-mortem brain samples (NASD = 222; NSCZ = 142). Total subjects were further divided into subgroups by gender and age. The epigenetic age acceleration (AgeAccel) for each sample was calculated as the residual value resulting from the regression model and compared between groups. Results showed DNAm age has a strong correlation with chronological age in both datasets across multiple brain regions (P < 0.05). When divided into equally sized age groups, the AgeAccel of the cerebellum (CB) region from people over 45 years of age was greater compared to the control sample (AgeAccel of ASD vs control: 5.069 vs -6.249; P < 0.001). And a decelerated epigenetic aging process was observed in the CB region of individuals with SCZ aged 50-70 years (AgeAccel of SCZ vs control: -3.171 vs 2.418; P < 0.05). However, our results showed no significant difference in AgeAccel between ASD and control groups, and between SCZ and control groups in the total and gender-specific groups (P > 0.05). This study's results revealed some evidence for aberrant epigenetic CB brain aging in old-aged patients with ASD and SCZ, indicating a different pattern of CB aging in older adults with these two diseases. However, further studies of larger ASD and SCZ cohorts are necessary to make definitive conclusions on this observation.

Assessing cognitive decline in the aging brain: lessons from rodent and human studies

As life expectancy continues to increase worldwide, age-related dysfunction will largely impact our societies in the future. Aging is well established to promote the deterioration of cognitive function and is the primary risk factor for the development of prevalent neurological disorders. Even in the absence of dementia, age-related cognitive decline impacts specific types of memories and brain structures in humans and animal models. Despite this, preclinical and clinical studies that investigate age-related changes in brain physiology often use largely different methods, which hinders the translational potential of findings. This review seeks to integrate what is known about age-related changes in the brain with analogue cognitive tests used in humans and rodent studies, ranging from "pen and paper" tests to virtual-reality-based paradigms. Finally, we draw parallels between the behavior paradigms used in research compared to the enrollment into clinical trials that aim to study age-related cognitive decline.

Multi-muscle synergies in preparation for gait initiation in Parkinson's disease

OBJECTIVE

We investigated changes in indices of muscle synergies prior to gait initiation and the effects of gaze shift in patients with Parkinson's disease (PD). A long-term objective of the study is to develop a method for quantitative assessment of gait-initiation problems in PD.

METHODS

PD patients without clinical signs of postural instability and two control groups (age-matched and young) performed a gait initiation task in a self-paced manner, with and without a quick prior gaze shift produced by turning the head. Muscle groups with parallel scaling of activation levels (muscle modes) were identified as factors in the muscle activation space. Synergy index stabilizing center of pressure trajectory in the anterior-posterior and medio-lateral directions (indices of stability) was quantified in the muscle mode space. A drop in the synergy index in preparation to gait initiation (anticipatory synergy adjustment, ASA) was quantified.

RESULTS

Compared to the control groups, PD patients showed significantly smaller synergy indices and ASA for both directions of the center of pressure shift. Both PD and age-matched controls, but not younger controls, showed detrimental effects of the prior gaze shift on the ASA indices.

CONCLUSIONS

PD patients without clinically significant posture or gait disorders show impaired stability of the center of pressure and its diminished adjustment during gait initiation.

SIGNIFICANCE

The indices of stability and ASA may be useful to monitor pre-clinical gait disorders, and lower ASA may be relevant to emergence of freezing of gait in PD.

The cerebellum is causally involved in episodic memory under aging

Episodic memory decline is a major signature of both normal and pathological aging. Many neural regions have been implicated in the processes subserving both episodic memory and typical aging decline. Here, we demonstrate that the cerebellum is causally involved episodic memory under aging. We show that a 12-day neurostimulation program delivered to the right cerebellum led to improvements in episodic memory performance under healthy aging that long outlast the stimulation period - healthy elderly individuals show episodic memory improvement both immediately after the intervention program and in a 4-month follow-up. These results demonstrate the causal relevance of the cerebellum in processes associated with long-term episodic memory, potentially highlighting its role in regulating and maintaining cognitive processing. Moreover, they point to the importance of non-pharmacological interventions that prevent or diminish cognitive decline in healthy aging.

Time dependent effects of cerebellar tDCS on cerebello-cortical connectivity networks in young adults

The cerebellum is involved in non-motor processing, supported by topographically distinct cerebellar activations and closed loop circuits between the cerebellum and the cortex. Disruptions to cerebellar function and network connectivity in aging or disease may negatively impact prefrontal function and processing. Cerebellar resources may be important for offloading cortical processing, providing crucial scaffolding for normative performance and function. Here, we used transcranial direct current stimulation (tDCS) to temporarily alter cerebellar function and subsequently investigated resting state network connectivity. This allows us to investigate network changes that may parallel what is seen in aging and clinical populations, providing additional insights into these key circuits. Critically, what happens to these circuits if the cerebellum is not functioning optimally remains relatively unknown. We employed a between-subjects design applying anodal (n=25), cathodal (n=25), or sham (n=24) stimulation to the cerebellum to examine the effect of stimulation on cerebello-cortical resting state connectivity in young adults. We predicted increased functional connectivity following cathodal stimulation and decreased functional connectivity following anodal stimulation. We found, anodal stimulation resulted in increased connectivity in both ipsilateral and contralateral regions of the cortex, perhaps indicative of a compensatory response to degraded cerebellar output. Additionally, a sliding window analysis also demonstrated a time dependent nature to the impacts of cerebellar tDCS on connectivity, particularly in cognitive region in the cortex. Assuming the difference in connectivity and network-behavior relationships here parallels what occurs in aging or disease, this may provide a mechanism whereby offloading of function to the cerebellum is negatively impacted, resulting in subsequent differences in prefrontal cortical activation patterns and performance deficits. These results might inform and update existing compensatory models of function to include the cerebellum as a vital structure needed for scaffolding.

Hericium erinaceus in Neurodegenerative Diseases: From Bench to Bedside and Beyond, How Far from the Shoreline?

A growing number of studies is focusing on the pharmacology and feasibility of bioactive compounds as a novel valuable approach to target a variety of human diseases related to neurological degeneration. Among the group of the so-called medicinal mushrooms (MMs), Hericium erinaceus has become one of the most promising candidates. In fact, some of the bioactive compounds extracted from H. erinaceus have been shown to recover, or at least ameliorate, a wide range of pathological brain conditions such as Alzheimer's disease, depression, Parkinson's disease, and spinal cord injury. In a large body of in vitro and in vivo preclinical studies on the central nervous system (CNS), the effects of erinacines have been correlated with a significant increase in the production of neurotrophic factors. Despite the promising outcome of preclinical investigations, only a limited number of clinical trials have been carried out so far in different neurological conditions. In this survey, we summarized the current state of knowledge on H. erinaceus dietary supplementation and its therapeutic potential in clinical settings. The bulk collected evidence underlies the urgent need to carry out further/wider clinical trials to prove the safety and efficacy of H. erinaceus supplementation, offering significant neuroprotective applications in brain pathologies.

Age-related differences of cerebellar cortex and nuclei: MRI findings in healthy controls and its application to spinocerebellar ataxia (SCA6) patients

Understanding cerebellar alterations due to healthy aging provides a reference point against which pathological findings in late-onset disease, for example spinocerebellar ataxia type 6 (SCA6), can be contrasted. In the present study, we investigated the impact of aging on the cerebellar nuclei and cerebellar cortex in 109 healthy controls (age range: 16 - 78 years) using 3 Tesla magnetic resonance imaging (MRI). Findings were compared with 25 SCA6 patients (age range: 38 - 78 years). A subset of 16 SCA6 (included: 14) patients and 50 controls (included: 45) received an additional MRI scan at 7 Tesla and were re-scanned after one year. MRI included T1-weighted, T2-weighted FLAIR, and multi-echo T2*-weighted imaging. The T2*-weighted phase images were converted to quantitative susceptibility maps (QSM). Since the cerebellar nuclei are characterized by elevated iron content with respect to their surroundings, two independent raters manually outlined them on the susceptibility maps. T1-weighted images acquired at 3T were utilized to automatically identify the cerebellar gray matter (GM) volume. Linear correlations revealed significant atrophy of the cerebellum due to tissue loss of cerebellar cortical GM in healthy controls with increasing age. Reduction of the cerebellar GM was substantially stronger in SCA6 patients. The volume of the dentate nuclei did not exhibit a significant relationship with age, at least in the age range between 18 and 78 years, whereas mean susceptibilities of the dentate nuclei increased with age. As previously shown, the dentate nuclei volumes were smaller and magnetic susceptibilities were lower in SCA6 patients compared to age- and sex-matched controls. The significant dentate volume loss in SCA6 patients could also be confirmed with 7T MRI. Linear mixed effects models and individual paired t-tests accounting for multiple comparisons revealed no statistical significant change in volume and susceptibility of the dentate nuclei after one year in neither patients nor controls. Importantly, dentate volumes were more sensitive to differentiate between SCA6 (Cohen's d = 3.02) and matched controls than the cerebellar cortex volume (d = 2.04). In addition to age-related decline of the cerebellar cortex and atrophy in SCA6 patients, age-related increase of susceptibility of the dentate nuclei was found in controls, whereas dentate volume and susceptibility was significantly decreased in SCA6 patients. Because no significant changes of any of these parameters was found at follow-up, these measures do not allow to monitor disease progression at short intervals.

Hormone-sleep interactions predict cerebellar connectivity and behavior in aging females

Sex hormones fluctuate over the course of the female lifespan and are associated with brain health and cognition. Thus, hormonal changes throughout female adulthood, and with menopause in particular, may contribute to sex differences in brain function and behavior. Further, sex hormones have been correlated with sleep patterns, which also exhibit sex-specific impacts on the brain and behavior. As such, the interplay between hormones and sleep may contribute to late-life brain and behavioral outcomes in females. Here, in a sample of healthy adult females (n = 79, ages 35-86), we evaluated the effect of hormone-sleep interactions on cognitive and motor performance as well as cerebellar-frontal network connectivity. Salivary samples were used to measure 17β-estradiol, progesterone, and testosterone levels while overnight actigraphy was used to quantify sleep patterns. Cognitive behavior was quantified using the composite average of standardized scores on memory, processing speed, and attentional tasks, and motor behavior was indexed with sequence learning, balance, and dexterity tasks. We analyzed resting-state connectivity correlations for two specific cerebellar-frontal networks: a Crus I to dorsolateral prefrontal cortex network and a Lobule V to primary motor cortex network. In sum, results indicate that sex hormones and sleep patterns interact to predict cerebellar-frontal connectivity and behavior in aging females. Together, the current findings further highlight the potential consequences of endocrine aging in females and suggest that the link between sex hormones and sleep patterns may contribute, in part, to divergent outcomes between sexes in advanced age.

Little brain, little minds: The big role of the cerebellum in social development

Seminal work in the 1990's found alterations in the cerebellum of individuals with social disorders including autism spectrum disorder and schizophrenia. In neurotypical populations, distinct portions of the posterior cerebellum are consistently activated in fMRI studies of social cognition and it has been hypothesized that the cerebellum plays an essential role in social cognition, particularly in theory of mind. Here we review the lesion literature and find that the effect of cerebellar damage on social cognition is strongly linked to the age of insult, with dramatic impairments observed after prenatal insult, strong deficits observed after childhood damage, and mild and inconsistent deficits observed following damage to the adult cerebellum. To explain the developmental gradient, we propose that early in life, the forward model dominates cerebellar computations. The forward model learns and uses errors to help build schemas of our interpersonal worlds. Subsequently, we argue that once these schemas have been built up, the inverse model, which is the foundation of automatic processing, becomes dominant. We provide suggestions for how to test this, and also outline directions for future research.

Anodal cerebellar stimulation increases cortical activation: Evidence for cerebellar scaffolding of cortical processing

While the cerebellum contributes to nonmotor task performance, the specific contributions of the structure remain unknown. One possibility is that the cerebellum allows for the offloading of cortical processing, providing support during task performance, using internal models. Here we used transcranial direct current stimulation to modulate cerebellar function and investigate the impact on cortical activation patterns. Participants (n = 74; 22.03 ± 3.44 years) received either cathodal, anodal, or sham stimulation over the right cerebellum before a functional magnetic resonance imaging scan during which they completed a sequence learning and a working memory task. We predicted that cathodal stimulation would improve, and anodal stimulation would hinder task performance and cortical activation. Behaviorally, anodal stimulation negatively impacted behavior during late-phase sequence learning. Functionally, we found that anodal cerebellar stimulation resulted in increased bilateral cortical activation, particularly in parietal and frontal regions known to be involved in cognitive processing. This suggests that if the cerebellum is not functioning optimally, there is a greater need for cortical resources.

Does tandem balance test predict cognitive impairment among older adults? Findings from Longitudinal Ageing Study in India, 2017-18

BACKGROUND

Ageing entails a decline in physical and functional abilities including a reduced body balance due to complex integration and coordination of sensory acuity, motor control, neural and cognitive functions. This study aimed to examine the association between tandem balance test and cognitive impairment among older Indian adults. The study also examined the gender differentials in the associations with an interaction analysis.

METHODS

Data for this study were drawn from the recent release of the Longitudinal Ageing Study in India (2017-18). The total sample size for the present study included 26,539 older adults age 60 years and above. Descriptive statistics and bivariate analysis were used to present the preliminary results. Two sample proportion test was used to evaluate the significance for gender differences. Further, multivariable binary logistic regression analysis was used to evaluate the independent association of balance test performance and cognitive impairment among older adults.

RESULTS

Nearly 16% of male and 26% of female older adults could not finish full tandem test in this study. There were significant gender differences in cognitive impairment among older adults (male-6.5% and female-18.9%). The likelihood of cognitive impairment was significantly higher among older adults who could not finish the full tandem test compared to those who finished the tandem test [AOR: 1.22; CI: 1.09-1.36]. The interaction model revealed that older females who could not finish the full tandem test were 2.11 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.11; CI: 1.81,2.45]. Similarly, older females who finished the full tandem test were 2.42 times significantly more likely to be cognitively impaired in reference to older males who finished the full tandem test [AOR: 2.42; CI: 2.02,2.88].

CONCLUSION

The findings of the study suggest that healthcare professionals working with older adults should consider the results of a balance test to screen for their risk of cognitive impairment. Results from the relationship between failing to finish the tandem test and cognitive impairment may be helpful for identifying older men and women who are at higher risk of experiencing mobility decline and their progression to dementia.

The impact of aging on morphometric changes in the cerebellum: A voxel-based morphometry study

Introduction

Aging influences the morphology of the central nervous system. While several previous studies focused on morphometric changes of the supratentorial parts, investigations on age-related cerebellar changes are rare. The literature concerning the morphological changes in the cerebellum is heterogenous depending (i) on the methods used (cerebellar analysis in the context of a whole brain analysis or specific methods for a cerebellar analysis), (ii) the life span that was investigated, and (iii) the analytic approach (i.e., using linear or non-linear methods).

Methods

We fill this research gap by investigating age-dependent cerebellar changes in the aging process occurring before the age of 70 in healthy participants, using non-linear methods and the spatially unbiased infratentorial template (SUIT) toolbox which is specifically developed to examine the cerebellum. Furthermore, to derive an overview of the possible behavioral correlates, we relate our findings to functional maps of the cerebellum. Twenty-four older participants (mean age 64.42 years, SD ± 4.8) and 25 younger participants (mean age 24.6 years, SD ± 2.14) were scanned using a 3 T-MRI, and the resulting data were processed using a SUIT.

Results

Gray matter (GM) volume loss was found in older participants in three clusters in the right cerebellar region, namely crus I/II and lobule VI related to the frontoparietal network, with crus I being functionally related to the default-mode network and lobule VI extending into vermis VIIa related to the ventral-attention-network.

Discussion

Our results underline an age-related decline in GM volume in the right cerebellar regions that are functionally predominantly related to non-motor networks and cognitive tasks regions of the cerebellum before the age of 70.

Working Memory and Manual Dexterity in Dyslexic Children: A Systematic Review and Meta-Analysis

Dyslexic children have impairments in working memory and manual dexterity. Studies have shown that when cognitive development has deficits, motor development is often impaired, indicating a strong interconnection between both domains, and the possibility of interference with each other's proper functioning. Thus, a new literature review is necessary to understand which components of working memory and manual dexterity are affected in dyslexic children and the possible relationship between them. This review aimed to perform a systematic review and meta-analysis to analyze both skills in dyslexic children. The protocol was carried out according to the criteria established by PRISMA being registered at PROSPERO under number CRD 42021238901. Six literature databases were searched to locate studies published between 2001 and 2021: EMBASE, ERIC, ISI Web of Science, PubMed, PsycINFO, and Scopus. 21 studies met the inclusion criteria. The findings suggest that dyslexic children have significantly poorer visuospatial and verbal working memory with more impairments in the phonological loop. No significant differences were found in manual dexterity.

Muscle Health Patterns and Brain MRI Indices: A Cluster Analysis

Background and Objectives

The interplay between muscle and brain lacks a holistic approach to assess the combined effect of multiple factors. This study utilizes clustering analysis to identify muscle health patterns and their relationships with various brain magnetic resonance imaging (MRI) indices.

Research Design and Methods

Two hundred and seventy-five cognitively intact participants who completed brain MRI from the Health, Aging, and Body Composition Study were enrolled. Muscle health-related markers that showed significant relationship with total gray matter volume entered the cluster analysis. Subsequently, macrostructural and microstructural MRI indices were examined with analysis of variance and multiple linear regression analysis to determine significant associations with muscle health clusters. The muscle health cluster included 6 variables: age, skeletal muscle mass index, gait speed, handgrip strength, change of total body fat, and serum leptin level. Clustering method produced 3 clusters which had characteristics of obese, leptin-resistant, and sarcopenia, respectively.

Results

Brain MRI indices that revealed significant associations with the clusters included gray matter volume (GMV) in cerebellum (p < .001), superior frontal gyrus (p = .019), inferior frontal gyrus (p = .003), posterior cingulum (p = .021), vermis (p = .045), and gray matter density (GMD) in gyrus rectus (p < .001) and temporal pole (p < .001). The leptin-resistant group had most degree of reduction in GMV, whereas the sarcopenia group had most degree of reduction in GMD.

Discussion and Implications

The leptin-resistant and sarcopenia populations had higher risk of neuroimaging alterations. Clinicians should raise awareness on the brain MRI findings in clinical settings. Because these patients mostly had central nervous system conditions or other critical illnesses, the risk of sarcopenia as a comorbidity will substantially affect the prognosis and medical care.

Mediating effect of lower extremity muscle strength on the relationship between mobility and cognitive function in Chinese older adults: A cross-sectional study

Aging is a multifactorial process associated with irreversible decline in mobility and cognitive function. However, the mechanisms underlying the relationship between mobility and cognitive function remain elusive. In specific, the mediating effect of muscle strength, which is essential to maintain mobility, on this relationship has yet to be clarified. Accordingly, we performed a cross-sectional study involving Chinese older adults to understand the role of muscle strength in the relationship between mobility and cognitive function. The cognitive function and physical performance of 657 community-dwelling participants aged over 65 years old were observed. Cognitive function was assessed using the Mini-Mental State Examination, whereas physical performance, including mobility and muscle strength, was measured via Timed Up-and-Go Test and knee extension strength measurement. Data were statistically analyzed using PROCESS Model 4 developed by Hayes, and 595 complete data were finally included. Physical performance (mobility and muscle strength) was significantly correlated with cognitive function (p < 0.01). Muscle strength was negatively correlated with mobility (r = -0.273, p < 0.001) and positively correlated with cognitive function (r = 0.145, p < 0.001). Muscle strength accounted for 20.1% of the total mediating effects on the relationship between mobility and cognitive function, which revealed the partial mediating role of lower extremity muscle strength in this relationship.

Age-related strengthening of cerebello-cortical motor circuits

Effective connectivity between the cerebellum and primary motor cortex (M1) is critical for motor learning and motor control. Despite evidence of cerebellar atrophy and declines in motor learning and motor control with advanced age, recent behavioral studies indicate that cerebellar-dependent motor learning processes are preserved or even enhanced in older adults. However, physiological evidence of heightened cerebellar excitability leading to strengthened cerebellar-M1 connectivity with advanced age is lacking. Here, we used transcranial magnetic stimulation to assess age-related effects on cerebellar inhibition, a measure of cerebellar-M1 connectivity, in 20 young and 19 older adults. We observed stronger cerebellar inhibition in older compared with young adults. The behavioral implications of strengthened cerebellar inhibition with advanced age found in this study remain to be determined.

The association of reproductive stage with lobular cerebellar network connectivity across female adulthood

Sex-specific differences in the aging cerebellum may be related to hormone changes with menopause. We evaluated the association between reproductive stage and lobular cerebellar network connectivity using data from the Cambridge Centre for Ageing and Neuroscience repository. We used raw structural and resting state neuroimaging data and information regarding age, sex, and menopause-related variables. Crus I and II and Lobules V and VI were our cerebellar seeds of interest. We characterized reproductive stage using the Stages of Reproductive Aging Workshop criteria. Results show that postmenopausal females have lower cerebello-striatal and cerebello-cortical connectivity, particularly in frontal regions, along with lower connectivity within the cerebellum, compared to reproductive females. Postmenopausal females also exhibit greater connectivity in some brain areas as well. Differences begin to emerge across transitional stages of menopause. Further, results reveal sex-specific differences in connectivity between female reproductive groups and age-matched male control groups. This suggests that menopause may be associated with cerebellar network connectivity in aging females, and sex differences in the aging brain may be related to this biological process.

Cognitive decline is associated with frequency-specific resting state functional changes in normal aging

Resting state low-frequency brain activity may aid in our understanding of the mechanisms of aging-related cognitive decline. Our purpose was to explore the characteristics of the amplitude of low-frequency fluctuations (ALFF) in different frequency bands of fMRI to better understand cognitive aging. Thirty-seven cognitively normal older individuals underwent a battery of neuropsychological tests and MRI scans at baseline and four years later. ALFF from five different frequency bands (typical band, slow-5, slow-4, slow-3, and slow-2) were calculated and analyzed. A two-way ANOVA was used to explore the interaction effects in voxel-wise whole brain ALFF of the time and frequency bands. Paired-sample t-test was used to explore within-group changes over four years. Partial correlation analysis was performed to assess associations between the altered ALFF and cognitive function. Significant interaction effects of time × frequency were distributed over inferior frontal gyrus, superior frontal gyrus, right rolandic operculum, left thalamus, and right putamen. Significant ALFF reductions in all five frequency bands were mainly found in the right hemisphere and the posterior cerebellum; whereas localization of the significantly increased ALFF were mainly found in the cerebellum at typical band, slow-5 and slow-4 bands, and left hemisphere and the cerebellum at slow-3, slow-2 bands. In addition, ALFF changes showed frequency-specific correlations with changes in cognition. These results suggest that changes of local brain activity in cognitively normal aging should be investigated in multiple frequency bands. The association between ALFF changes and cognitive function can potentially aid better understanding of the mechanisms underlying normal cognitive aging.

Does essential tremor increase risk of cognitive impairment and dementia? Yes

Essential Tremor (ET), by definition, is a disorder of movement. Yet over the years, epidemiologic, clinical, pathologic, and neuroimaging studies have converged to reveal a cognitive side of ET. The cognitive symptoms in ET are heterogeneous and are likely to reflect heterogeneous underlying mechanisms. In this chapter, we review and synthesize a diverse set of studies from both population-based settings to cohorts with more detailed investigations into cognition to consider the various mechanisms by which cognitive symptoms may emerge in a subset of individuals with ET. As part of our analysis, we consider questions surrounding ET diagnosis and the possibility of comorbid disease as potential factors that, upon closer examination, appear to strengthen the argument in favor of ET as a risk factor for dementia. Importantly, we also consider the clinical relevance of cognitive impairment in ET. While ET is not universally characterized by significant cognitive deficits, the data from epidemiological, cognitive, neuroimaging, and postmortem neuropathologic studies converge to reveal an increased risk for cognitive impairment and dementia among individuals with ET. We conclude by offering directions for future research, and a neurocognitive framework with which to consider existing findings and to use in the design of novel studies dedicated to clarifying the basis, nature, and course of cognitive impairments in ET.

Don't forget the little brain: A framework for incorporating the cerebellum into the understanding of cognitive aging

With the rapidly growing population of older adults, an improved understanding of brain and cognitive aging is critical, given the impacts on health, independence, and quality of life. To this point, we have a well-developed literature on the cortical contributions to cognition in advanced age. However, while this work has been foundational for our understanding of brain and behavior in older adults, subcortical contributions, particularly those from the cerebellum, have not been integrated into these models and frameworks. Incorporating the cerebellum into models of cognitive aging is an important step for moving the field forward. There has also been recent interest in this structure in Alzheimer's dementia, indicating that such work may be beneficial to our understanding of neurodegenerative disease. Here, I provide an updated overview of the cerebellum in advanced age and propose that it serves as a critical source of scaffolding or reserve for cortical function. Age-related impacts on cerebellar function further impact cortical processing, perhaps resulting in many of the activation patterns commonly seen in aging.