Whiting, Bryony Anneke; (2005) Motor and cognitive function in children with neurodevelopmental versus acquired pathology of the cerebellum. Doctoral thesis , UCL (University College London).

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Abstract

This thesis examines the motor and cognitive difficulties that result when the cerebellum is compromised through neurodevelopmental or acquired damage. There is much disagreement over the role that the cerebellum might play in a range of motor, cognitive and socioemotional functions. To address this issue, tests of motor and cognitive function were carried out on two patient populations, one with focal acquired cerebellar excisions (Posterior Fossa Tumours - PFT) and one with relatively subtle neurodevelopmental cerebellar abnormalities (Asperger's Syndrome - AS). The results showed that patients with PFT performed more poorly than controls on almost all tests of motor function, and had particular difficulty with cognitive tests of executive function and reading comprehension. Individuals with AS performed more poorly than controls on a number of tests of motor function, and had difficulties with verbal and spatial working memory, some aspects of attention and with face matching. MR imaging techniques (conventional clinical imaging and voxel-based morphometry) were used to identify the location and extent of pathology in the patients with PFT and to investigate subtle changes in the density of grey and white matter for both patient groups. Patients with PFT showed a decrease in grey matter near the fourth ventricle. In addition, patients with midline damage showed a decrease in grey matter in the cerebellum; and patients with right hemisphere damage showed a decrease in grey matter in the cerebellum, thalamus, hypothalamus and globus pallidus and a decrease in white matter in frontal, parietal and occipital regions. The patients with AS showed an increase in grey matter in the cerebellum, superior and middle temporal gyri, temporal pole, occipital lobe and in regions close to the amygdala and hippocampus. Finally, the results of diffusion tensor imaging methods showed no abnormalities in the integrity of white matter tracts in either of the patient groups.

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