Cerebellar activation during classical conditioning of the human flexion reflex: a PET study

The cerebellum, internal models and prediction in 'non-motor' aspects of language: A critical review

The emergence of studies on cerebellar contributions in 'non-motor' aspects of predictive language processing has long been awaited by researchers investigating the neural foundations of language and cognition. Despite (i) progress in research implicating the cerebellum in language processing, (ii) the widely-accepted nature of the uniform, multi-modal computation that the cerebellum implements in the form of internal models, as well as (iii) the long tradition of psycholinguistic studies addressing prediction mechanisms, research directly addressing cerebellar contributions to 'non-motor' predictive language processing has only surfaced in the last five years. This paper provides the first review of this novel field, along with a critical assessment of the studies conducted so far. While encouraging, the evidence for cerebellar involvement in 'non-motor' aspects of predictive language processing remains inconclusive under further scrutiny. Future directions are finally discussed with respect to outstanding questions in this novel field of research.

An adaptive filter model of cerebellar zone C3 as a basis for safe limb control?

The review asks how the adaptive filter model of the cerebellum might be relevant to experimental work on zone C3, one of the most extensively studied regions of cerebellar cortex. As far as features of the cerebellar microcircuit are concerned, the model appears to fit very well with electrophysiological discoveries concerning the importance of molecular layer interneurons and their plasticity, the significance of long-term potentiation and the striking number of silent parallel fibre synapses. Regarding external connectivity and functionality, a key feature of the adaptive filter model is its use of the decorrelation algorithm, which renders it uniquely suited to problems of sensory noise cancellation. However, this capacity can be extended to the avoidance of sensory interference, by appropriate movements of, for example, the eyes in the vestibulo-ocular reflex. Avoidance becomes particularly important when painful signals are involved, and as the climbing fibre input to zone C3 is extremely responsive to nociceptive stimuli, it is proposed that one function of this zone is the avoidance of pain by, for example, adjusting movements of the body to avoid self-harm. This hypothesis appears consistent with evidence from humans and animals concerning the role of the intermediate cerebellum in classically conditioned withdrawal reflexes, but further experiments focusing on conditioned avoidance are required to test the hypothesis more stringently. The proposed architecture may also be useful for automatic self-adjusting damage avoidance in robots, an important consideration for next generation 'soft' robots designed to interact with people.

Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: I. electrophysiological characteristics

The aim of this study was to demonstrate the involvement of the human cerebellum in the classically conditioned lower limb withdrawal reflex in standing subjects. Electromyographic activity was recorded from the main muscle groups of both legs of eight patients with cerebellar disease (CBL) and eight control subjects (CTRL). The unconditioned stimulus (US) consisted of electrical stimulation of the tibial nerve at the medial malleolus. The conditioning stimulus (CS) was an auditory signal given via headphones. Experiments started with 70 paired conditioning stimulus-unconditioned stimulus(CSUS) trials followed by 50 US-alone trials. The general reaction consisted of lifting and flexing the stimulated (stepping) leg with accompanying activation of the contralateral (supporting) leg. In CTRL, the ipsilateral (side of stimulation) flexor and contralateral extensor muscles were activated characteristically. In CBL, the magnitudes of ipsilateral flexor and contralateral extensor muscle activation were reduced comparably. In CTRL, the conditioning process increased the incidence of conditioned responses (CR), following a typical learning curve, while CBL showed a clearly lower CR incidence with a marginal increase, albeit, at a shorter latency. Conditioning processes also modified temporal parameters by shortening unconditioned response (UR) onset latencies and UR times to peak and, more importantly in CBL, also the sequence of activation of muscles, which became similar to that of CTRL. The expression of this reflex in standing subjects showed characteristic differences in the groups tested with the underlying associative processes not being restricted exclusively to the CR but also modifying parameters of the innate UR.

[Studies on cerebral processing of pain using functional imaging : Somatosensory, emotional, cognitive, autonomic and motor aspects]

Functional neuroimaging methods such as positron emission tomography (PET) or functional magnetic resonance imaging (fMRI) provide fascinating insights into the cerebral processing of pain. Neuroimaging studies have shown that no clearly defined "pain centre" exists. Rather, an entire network of brain regions is involved in the processing of nociceptive information, which leads to the subjective impression of "pain". Sophisticated study designs nowadays permit the characterisation of different components of pain processing. In this review, we summarise neuroimaging studies, which contributed to the characterisation of these different aspects of cerebral pain processing, such as somatosensory (discrimination of different stimulus modalities, noxious vs non-noxious, summation), emotional, cognitive (attention, anticipation, distraction), vegetative (homeostasis) and motor aspects.

Differences in unconditioned and conditioned responses of the human withdrawal reflex during stance: muscle responses and biomechanical data

The aim of this study was to characterize differences between unconditioned and classically conditioned lower limb withdrawal reflexes in young subjects during standing. Electromyographic activity in the main muscle groups and biomechanical signals from a strain-gauge-equipped platform on which subjects stood were recorded from 17 healthy subjects during unconditioned stimulus (US)-alone trials and during auditory conditioning stimuli (CS) and US trials. In US-alone trials the leg muscle activation sequence was characteristic: ipsilateral, distal muscles were activated prior to proximal muscles; contralaterally the sequence was reversed. In CSUS trials latencies were shorter. Subjects unloaded the stimulated leg and shifted body weight to the supporting leg. In US-alone and in CSUS trials leg forces on each side were inversely related and asymmetric, due to preparation for unloading, whilst conditioned responses (CR), representing the unloading preparation, were symmetric. The trajectory of the center of vertical pressure during US-alone trials moved initially forward (a preparatory balance reaction) and to the stimulation side, followed by a large lateral shift to the side of the supporting limb. During CSUS trials the forwards shift was absent but the CR (early lateral shift) represented a preponed preparatory unloading. Electrophysiological and biomechanical responses of the classically conditioned lower limb withdrawal reflex in standing subjects changed significantly in CSUS trials compared to US-alone trials with higher sensitivity in the biomechanics. These findings will serve as a basis for a subsequent study on a group of patients with cerebellar diseases in whom the success of establishing procedural processes is known to be impaired.

Human fear conditioning and extinction in neuroimaging: a systematic review

Fear conditioning and extinction are basic forms of associative learning that have gained considerable clinical relevance in enhancing our understanding of anxiety disorders and facilitating their treatment. Modern neuroimaging techniques have significantly aided the identification of anatomical structures and networks involved in fear conditioning. On closer inspection, there is considerable variation in methodology and results between studies. This systematic review provides an overview of the current neuroimaging literature on fear conditioning and extinction on healthy subjects, taking into account methodological issues such as the conditioning paradigm.

A Pubmed search, as of December 2008, was performed and supplemented by manual searches of bibliographies of key articles. Two independent reviewers made the final study selection and data extraction. A total of 46 studies on cued fear conditioning and/or extinction on healthy volunteers using positron emission tomography or functional magnetic resonance imaging were reviewed. The influence of specific experimental factors, such as contingency and timing parameters, assessment of conditioned responses, and characteristics of conditioned and unconditioned stimuli, on cerebral activation patterns was examined. Results were summarized descriptively. A network consisting of fear-related brain areas, such as amygdala, insula, and anterior cingulate cortex, is activated independently of design parameters. However, some neuroimaging studies do not report these findings in the presence of methodological heterogeneities. Furthermore, other brain areas are differentially activated, depending on specific design parameters. These include stronger hippocampal activation in trace conditioning and tactile stimulation. Furthermore, tactile unconditioned stimuli enhance activation of pain related, motor, and somatosensory areas.

Differences concerning experimental factors may partly explain the variance between neuroimaging investigations on human fear conditioning and extinction and should, therefore, be taken into serious consideration in the planning and the interpretation of research projects.

The involvement of the human cerebellum in eyeblink conditioning

Besides its known importance for motor coordination, the cerebellum plays a major role in associative learning. The form of cerebellum-dependent associative learning, which has been examined in greatest detail, is classical conditioning of eyeblink responses. The much advanced knowledge of anatomical correlates, as well as cellular and molecular mechanisms involved in eyeblink conditioning in animal models are of particular importance because there is general acceptance that findings in humans parallel the animal data. The aim of the present review is to give an update of findings in humans. Emphasis is put on human lesion studies, which take advantage of the advances of high-resolution structural magnetic resonance imaging (MRI). In addition, findings of functional brain imaging in healthy human subjects are reviewed. The former helped to localize areas involved in eyeblink conditioning within the cerebellum, the latter was in particular helpful in delineating extracerebellar neural substrates, which may contribute to eyeblink conditioning. Human lesion studies support the importance of cortical areas of the ipsilateral superior cerebellum both in the acquisition and timing of conditioned eyeblink responses (CR). Furthermore, the ipsilateral cerebellar cortex seems to be also important in extinction of CRs. Cortical areas, which are important for CR acquisition, overlap with areas related to the control of the unconditioned eyeblink response. Likewise, cortical lesions are followed by increased amplitudes of unconditioned eyeblinks. These findings are in good accordance with the animal literature. Knowledge about contributions of the cerebellar nuclei in humans, however, is sparse. Due to methodological limitations both of human lesion and functional MRI studies, at present no clear conclusions can be drawn on the relative contributions of the cerebellar cortex and nuclei.

Comparison of the electrically evoked leg withdrawal reflex in cerebellar patients and healthy controls

The aim of this study was to analyze the contribution of the cerebellum in the performance of the lower limb withdrawal reflexes. This has been accomplished by comparing the electrically evoked responses in cerebellar patients (CBL) with those in sex- and age-matched healthy control subjects (CTRL). The stimulus was applied to the subjects' medial plantar nerve in four blocks of ten trials each with switching the stimulus from one leg to the other after each block. Responses of the main muscle groups (tibial muscle: TA; gastrocnemius muscle: GA; rectus femoris muscle: RF; biceps femoris muscle: BI) of both legs were recorded during each stimulus. The group of CBL patients consisted of both focally lesioned patients (CBLf) and patients presenting a diffuse degenerative pathology (CBLd). (1) For the withdrawal reflex in CTRL subjects, responses were observed in distal and proximal muscles of the ipsilateral side and corresponding concomitant responses on the side contralateral to the stimulation, whereas in CBL patients responses were restricted primarily to distal muscles, particularly the TA of the ipsilateral, i.e. the stimulated, side. (2) The sequence of activation of the different distal and proximal muscles ipsilateral to the stimulation, derived from latencies and times-to-peak, was for the CTRL group: TA-GA-BI-RF. This sequence was found also in the CBLf patients on their unaffected side. However, on their affected side CBLf patients showed very early GA activation, almost simultaneously with TA and RF activations and before BI activation. RF activation before BI activation was also found in CBLd. In the latter group, GA was activated after RF but before BI with all responses typically delayed. (3) The general pattern of the electrically evoked lower limb reflex consisted of an early, excitatory F1 component and a later, excitatory F2 component of larger amplitude observed in the CTRL subjects and the CBLd patients. In contrast to this pattern CBLf patients exhibited large F1 components followed by small F2 components. (4) The characteristic differences in the withdrawal reflex responses of cerebellar patients depended on the type of the lesion, providing evidence for an important involvement of the cerebellum in the control of the performance of withdrawal reflexes.

Hemicerebellectomy impairs the modulation of cutaneomuscular reflexes by the motor cortex following repetitive somatosensory stimulation

We examined the cutaneomuscular reflex of the plantaris muscle of rats in response to cutaneous stimulation in isolation and in conjunction with subthreshold high-frequency trains of stimuli applied on the motor cortex, prior to and following repetitive peripheral stimulation. The cutaneomuscular reflex was also investigated under the same paradigm following hemicerebellectomy. The enhancement of cutaneomuscular responses associated with subthreshold high-frequency trains of stimulation following repetitive peripheral stimulation was prevented by hemicerebellectomy. Our results suggest that the pathways passing through the cerebellum are involved in the calibration of cutaneomuscular responses.

The lower limb flexion reflex in humans

The flexion or flexor reflex (FR) recorded in the lower limbs in humans (LLFR) is a widely investigated neurophysiological tool. It is a polysynaptic and multisegmental spinal response that produces a withdrawal of the stimulated limb and resembles (having several features in common) the hind-paw FR in animals. The FR, in both animals and humans, is mediated by a complex circuitry modulated at spinal and supraspinal level. At rest, the LLFR (usually obtained by stimulating the sural/tibial nerve and by recording from the biceps femoris/tibial anterior muscle) appears as a double burst composed of an early, inconstantly present component, called the RII reflex, and a late, larger and stable component, called the RIII reflex. Numerous studies have shown that the afferents mediating the RII reflex are conveyed by large-diameter, low-threshold, non-nociceptive A-beta fibers, and those mediating the RIII reflex by small-diameter, high-threshold nociceptive A-delta fibers. However, several afferents, including nociceptive and non-nociceptive fibers from skin and muscles, have been found to contribute to LLFR activation. Since the threshold of the RIII reflex has been shown to correspond to the pain threshold and the size of the reflex to be related to the level of pain perception, it has been suggested that the RIII reflex might constitute a useful tool to investigate pain processing at spinal and supraspinal level, pharmacological modulation and pathological pain conditions. As stated in EFNS guidelines, the RIII reflex is the most widely used of all the nociceptive reflexes, and appears to be the most reliable in the assessment of treatment efficacy. However, the RIII reflex use in the clinical evaluation of neuropathic pain is still limited. In addition to its nocifensive function, the LLFR seems to be linked to posture and locomotion. This may be explained by the fact that its neuronal circuitry, made up of a complex pool of interneurons, is interposed in motor control and, during movements, receives both peripheral afferents (flexion reflex afferents, FRAs) and descending commands, forming a multisensorial feedback mechanism and projecting the output to motoneurons. LLFR excitability, mediated by this complex circuitry, is finely modulated in a state- and phase-dependent manner, rather as we observe in the FR in animal models. Several studies have demonstrated that LLFR excitability may be influenced by numerous physiological conditions (menstrual cycle, stress, attention, sleep and so on) and pathological states (spinal lesions, spasticity, Wallenberg's syndrome, fibromyalgia, headaches and so on). Finally, the LLFR is modulated by several drugs and neurotransmitters. In summary, study of the LLFR in humans has proved to be an interesting functional window onto the spinal and supraspinal mechanisms of pain processing and onto the spinal neural control mechanisms operating during posture and locomotion.

Cerebellar activation during leg withdrawal reflex conditioning: an fMRI study

OBJECTIVE

The aim of the present study was to examine cerebellar areas related to conditioning of the nociceptive leg withdrawal reflex using event-related functional magnetic resonance imaging (fMRI). Because of the aversive nature of the unconditioned stimulus effects of accompanying fear conditioning were expected.

METHODS

In 20 healthy adult subjects leg withdrawal reflex conditioning was performed using a standard delay protocol during MR-scanning. Electromyographic recordings from the anterior tibial and biceps femoris muscles were used to quantify conditioned responses. Fear-related changes of heart rate were assessed.

RESULTS

In the group of all subjects a significant increase of cerebellar activation was found in the anterior and posterior vermis. In the group of subjects (n=9) who showed conditioned leg withdrawal responses cerebellar activation was more pronounced in parts of the anterior vermis, which correspond to the known leg representation. In the group of subjects (n=11) who did not develop conditioned responses cerebellar activation was more pronounced in the posterolateral hemispheres. Changes of heart rate, however, did not significantly differ between groups.

CONCLUSIONS

Results suggest that areas within the anterior vermis are involved in conditioning of the leg withdrawal response. The present results, however, do not allow to differentiate between motor performance, learning or timing-related processes. Areas in the posterior vermis and cerebellar hemispheres may be related to concomitant fear conditioning.

SIGNIFICANCE

Results of the present event-related fMRI study suggest involvement of the human cerebellum in conditioning of the nociceptive leg withdrawal response.

Role of the cerebellum in eyeblink conditioning

The mammalian cerebellum is thought to participate in motor control and motor learning. The specific cerebellar contribution to these processes is not clear, however. Advances in understanding cerebellar function have been relatively slow, because, at least in most cases, the cerebellum appears to play only an ancillary role in the behaviors studied to date. A remarkable exception is classical conditioning of eyeblink responses in the rabbit. In this model, an intact cerebellum is critical for both the acquisition and expression of conditioned responses. Recent experiments suggest that the cerebellar role in classical conditioning might be similar in all mammals, including the human. Moreover, anticipatory defensive reflexes in other effector systems show a similar dependence on the intermediate cerebellum. Further developments in our understanding of cerebellar function will depend on examination of a wider array of cerebellar-involved neural networks. There is also need for the development of new experimental approaches to associative learning in both the nonhuman primate and the human.

Neural Substrates of Eyeblink Conditioning: Acquisition and Retention

Classical conditioning of the eyeblink reflex to a neutral stimulus that predicts an aversive stimulus is a basic form of associative learning. Acquisition and retention of this learned response require the cerebellum and associated sensory and motor pathways and engage several other brain regions including the hippocampus, neocortex, neostriatum, septum, and amygdala. The cerebellum and its associated circuitry form the essential neural system for delay eyeblink conditioning. Trace eyeblink conditioning, a learning paradigm in which the conditioned and unconditioned stimuli are noncontiguous, requires both the cerebellum and the hippocampus and exhibits striking parallels to declarative memory formation in humans. Identification of the neural structures critical to the development and maintenance of the conditioned eyeblink response is an essential precursor to the investigation of the mechanisms responsible for the formation of these associative memories. In this review, we describe the evidence used to identify the neural substrates of classical eyeblink conditioning and potential mechanisms of memory formation in critical regions of the hippocampus and cerebellum. Addressing a central goal of behavioral neuroscience, exploitation of this simple yet robust model of learning and memory has yielded one of the most comprehensive descriptions to date of the physical basis of a learned behavior in mammals.

Cerebellar responses evoked by nociceptive leg withdrawal reflex as revealed by event-related FMRI

The aim of the present study was to examine nociceptive leg withdrawal reflex-related areas in the human cerebellum using event-related functional brain imaging (fMRI). Knowledge about cerebellar areas involved in unconditioned limb withdrawal reflex control has some relevance in understanding data of limb withdrawal reflex conditioning studies. Sixteen healthy adult subjects participated. Nociceptive leg withdrawal reflexes were evoked by electrical stimulation of the left tibial nerve behind the medial malleolus. An event-related fMRI paradigm was applied with a total of 30 stimuli being delivered pseudorandomly during 500 consecutive MR scans. Surface electromyographic (EMG) recordings were performed from the left anterior tibial muscle. Only trials with significant reflex EMG activity were used as active events in fMRI statistical analysis. The specified contrasts compared the active event condition with rest. Leg withdrawal reflex-related areas were located within the vermis, paravermis, and lateral posterior cerebellar hemispheres bilaterally. Vermal and paravermal areas in lobules III/IV in the anterior lobe and in lobule VIII in the posterior lobe agree with the cerebellar representation of climbing and mossy fiber hindlimb afferents and voluntary leg movements. They are likely related to efferent modulation of the leg withdrawal reflex and/or sensory processing of afferent inputs from the reflex and/or the noxious stimulus. Additional activation within vermal lobule VI and hemispheral lobules VI/Crus I may be related to other pain-related processes (e.g., facial grimacing, fear, and startlelike reactions).

Limb flexion reflex-related areas in human cerebellum

Numerous studies have shown that the cerebellum is involved in classical conditioning of specific aversive reactions. Only few studies, however, have examined the exact localization of cerebellar areas involved in the control of unconditioned reflex responses. The present study investigated cerebellar areas, which are activated during eliciting of the limb flexion reflex in healthy controls using [15O]H2O PET. Limb flexion reflex related areas were found in vermal lobules III-VI with the local maximum in vermal lobule V. Areas of activation were more widespread compared to a voluntary foot movement and a sensory foot stimulation condition. Limb flexion reflex areas probably reflect efferent reflex modulation as well as sensory inputs from the stimulus itself and/or the reflex response.

Imaging learning and memory: classical conditioning

The search for the biological basis of learning and memory has, until recently, been constrained by the limits of technology to classic anatomic and electrophysiologic studies. With the advent of functional imaging, we have begun to delve into what, for many, was a "black box." We review several different types of imaging experiments, including steady state animal experiments that image the functional labeling of fixed tissues, and dynamic human studies based on functional imaging of the intact brain during learning. The data suggest that learning and memory involve a surprising conservation of mechanisms and the integrated networking of a number of structures and processes.

MRI-assessed volume of cerebellum correlates with associative learning

Richard F. Thompson's cerebellar model of classical eyeblink conditioning highlights Purkinje cells in cerebellar cortex and principal cells in the deep cerebellar nucleus as the integrating cells for acquisition of conditioned responses (CRs). CR acquisition is significantly slower in rabbits with lesions to cerebellar cortex and in Purkinje cell-deficient mice that lose all cerebellar cortical Purkinje cells. Purkinje cells are the largest neurons in the cerebellum and contribute significantly to cerebellar volume. Magnetic resonance imaging (MRI) was used to assess cerebellar volume in humans. Cerebellar volume was related to eyeblink conditioning (400-ms delay procedure) in 8 adults (21-35 years) and compared to 8 older adults (77-95 years) tested previously (Woodruff-Pak, Goldenberg, Downey-Lamb, Boyko, & Lemieux, 2000). In the young adult sample, there was a high correlation between percentage of CRs in a session and cerebellar volume (corrected for total intracranial volume [TIV], r =.58, p =.066). There were statistically significant age differences in cerebellar volume, t(14) = 8.96, p <.001, and percentage of CRs, t(14) = 3.85, p <.002, but no age difference in TIV. Combining the young and older adult sample, the correlation between percentage of CRs and cerebellar volume (corrected for TIV) was.832 (p <.001). Cerebellar volume showed age-related deficits likely due to Purkinje cell loss. Individual differences in classical eyeblink conditioning are associated with differences in cerebellar volume, supporting Thompson's model of a cerebellar cortical role in facilitating this form of associative learning.

Eyeblink classical conditioning differentiates normal aging from Alzheimer's disease

Eyeblink classical conditioning is a useful paradigm for the study of the neurobiology of learning, memory, and aging, which also has application in the differential diagnosis of neurodegenerative diseases expressed in advancing age. Converging evidence from studies of eyeblink conditioning in neurological patients and brain imaging in normal adults document parallels in the neural substrates of this form of associative learning in humans and non-human mammals. Age differences in the short-delay procedure (400 ms CS-US interval) appear in middle age in humans and may be caused at least in part by cerebellar cortical changes such as loss of Purkinje cells. Whereas the hippocampus is not essential for conditioning in the delay procedure, disruption of hippocampal cholinergic neurotransmission impairs acquisition and slows the rate of learning. Alzheimer's disease (AD) profoundly disrupts the hippocampaL cholinergic system, and patients with AD consistently perform poorly in eyeblink conditioning. We hypothesize that disruption of hippocampal cholinergic pathways in AD in addition to age-associated Purkinje cell loss results in severely impaired eyeblink conditioning. The earliest pathology in AD occurs in entorhinal cortical input to hippocampus, and eyeblink conditioning may detect this early disruption before declarative learning and memory circuits become impaired. A case study is presented in which eyeblink conditioning detected impending dementia six years before changes on other screening tests indicated impairment. Because eyeblink conditioning is simple, non-threatening, and non-invasive, it may become a useful addition to test batteries designed to differentiate normal aging from mild cognitive impairment that progresses to AD and AD from other types of dementia.

A possible role of the human cerebellum in conditioning of the jaw-opening reflex

The role of the human cerebellum in classical conditioning of the jaw-opening reflex was investigated using positron emission tomography (PET) in healthy subjects. The jaw-opening reflex was elicited by electrical stimulation of the right corner of the mouth (unconditioned stimulus, US). The conditioned stimulus was a tone preceding the US and coterminating with the US. Changes of regional cerebral blood flow (rCBF) were correlated with the rate of conditioning per PET scan. Conditioning effects were present in one third of all subjects. In these subjects, a significant increase of rCBF in the ipsilateral, intermediate cerebellum was shown during ongoing conditioning. Thus, the intermediate cerebellum appears to be involved in classical conditioning of the jaw-opening reflex in humans.

Classical fear conditioning in functional neuroimaging

Classical conditioning, the simplest form of associative learning, is one of the most studied paradigms in behavioural psychology. Since the formal description of classical conditioning by Pavlov, lesion studies in animals have identified a number of anatomical structures involved in, and necessary for, classical conditioning. In the 1980s, with the advent of functional brain imaging techniques, particularly positron emission tomography (PET), it has been possible to study the functional anatomy of classical conditioning in humans. The development of functional magnetic resonance imaging (fMRI)--in particular single-trial or event-related fMRI--has now considerably advanced the potential of neuroimaging for the study of this form of learning. Recent event-related fMRI and PET studies are adding crucial data to the current discussion about the putative role of the amygdala in classical fear conditioning in humans.

Fear conditioned potentiation of the acoustic blink reflex in patients with cerebellar lesions

OBJECTIVE

To investigate whether the human cerebellum takes part in fear conditioned potentiation of the acoustic blink reflex.

METHODS

A group of 10 cerebellar patients (eight patients with lesions involving the medial cerebellum, two patients with circumscribed lesions of the cerebellar hemispheres) was compared with a group of 16 age and sex matched healthy control subjects. The fear conditioned potentiation paradigm consisted of three phases. During the first, habituation phase subjects received 20 successive acoustic blink stimuli. In the subsequent fear conditioning phase, subjects passed through 20 paired presentations of the unconditioned fear stimulus (US; an electric shock) and the conditioned stimulus (CS; a light). Thereafter, subjects underwent the potentiation phase, which consisted of a pseudorandom order of 12 trials of the acoustic blink stimulus alone, 12 acoustic blink stimuli paired with the conditioned stimulus, and six conditioned stimuli paired with the unconditioned stimulus. The EMG of the acoustic blink reflex was recorded at the orbicularis oculi muscles. The potentiation effect was determined as the difference in normalised peak amplitude of the blink reflex evoked by pairs of CS and acoustic blink stimuli and evoked by the acoustic stimulus alone.

RESULTS

In the habituation phase, short term habituation of the acoustic blink reflex was preserved in all cerebellar patients. However, in the potentiation phase, the potentiation effect of the blink reflex was significantly reduced in patients with medial cerebellar lesions compared with the controls (mean (SD) potentiation effect (%), patients: -6.4 (15.3), controls: 21.6 (35.6)), but was within normal limits in the two patients with lateral lesions.

CONCLUSIONS

The present findings suggest that the human medial cerebellum is involved in associative learning of non-specific aversive reactions-that is, the fear conditioned potentiation of the acoustic blink reflex.

Conditioning, awareness, and the hippocampus

For the past 50 years, psychologists have wrestled with questions regarding the relationship between conscious awareness and human conditioned behavior. A recent proposal that the hippocampus mediates awareness during trace conditioning (Clark, Squire, Science 1998;280:77-81) has extended the awareness-conditioning debate to the neuroscience arena. In the following commentary, we raise specific theoretical and methodological issues regarding the Clark and Squire study and place their finding into a broader context. Throughout our discussion, we consider the difficulties in assessing subjective awareness, the importance of establishing necessary and sufficient conditions for cognitive mediation effects, the influence of conditioned response modality, and the nature of hippocampal requirements across conditioning protocols. It is clear that trace eyeblink conditioning is a hippocampal-dependent task, but whether awareness is a necessary component of trace conditioning is not definitively proven. We propose that future functional neuroimaging studies and behavioral experiments using on-line measures of awareness may help clarify the relationship among classical conditioning, awareness, and the hippocampus.

Non-motor associative learning in patients with isolated degenerative cerebellar disease

In recent decades it has become clear that the cerebellum is involved in associative motor learning, but its exact role in motor learning as such is still controversial. Recently, a contribution of the cerebellum to different cognitive abilities has also been considered, but it remains unclear whether the cerebellum contributes to cognitive associative learning. We compared nine patients with an isolated cerebellar degenerative disease in a cognitive associative learning task with 10 controls. Patients and controls were matched for age, sex, handedness, level of education, intelligence and capabilities of visual memory. The subjects were asked to learn the association between six pairs of colours and numerals by trial and error. Additionally, a simple reaction time and a visual scanning test were conducted in order to control for the influence of motor performance deficits in cerebellar patients. In comparison with the controls, it took the patients significantly longer to learn the correct associations between colours and numerals, and they were impaired in recognizing them later on. Two patients showed no associative learning effect at all. Neither the simple reaction time nor the visual scanning time correlated substantially with the results of associative learning. Therefore, motor-associated disabilities are unlikely to be the reason for the learning deficit in cerebellar patients. Our results suggest that the cerebellum might contribute to motor-independent processes that are generally involved in associative learning.