Abstract
INTRODUCTION/PURPOSE: Recent studies point to an important role for the cerebellum in nonmotor functions, primarily including higher cognitive functions and affect. However, the available evidence on the cerebellar contribution to social cognitive faculties are currently sparse and the exact role of the cerebellum in social cognition is yet to be elucidated. The present study aimed to investigate the impairments in social cognition in a group of patients who suffered from isolated cerebellar stroke. We hypothesized that patients in earlier stages of their stroke and patients with posterior cerebellar lesions would be more affected in the social cognition domain than the rest of the group. MATERIALS/METHODS: We tested 30 patients with isolated ischemic cerebellar stroke and 30 age, sex‐ and education‐matched healthy controls. Patients were classified according to the duration after stroke (acute, subacute and chronic) as well as the location of the cerebellar lesion. A cognitive battery primarily focusing on social cognition was performed and included Montreal Cognitive Assessment (MoCA), Reading the Mind in the Eyes Test, Penn CNB Emotion Recognition Test, Faux Pas test, Tromso Social Intelligent Scale, The Social‐Emotional Expertise Scale and Geriatric Depression Scale. A thorough neurological examination was performed and Brief Ataxia Rating Scale was administered to assess ataxia symptoms specifically. The results were analyzed according to the timeline of ischemic insult and location of the lesions (e.g. anterior cerebellum, posterior cerebellum, right and left cerebellar hemispheres). RESULTS: Our results revealed a significant difference for the Penn Emotion Recognition Test pointing to significantly reduced anger recognition in the cerebellar stroke group compared to the healthy controls (p<0.05). The Faux‐Pas test revealed a significant impairment confined to the affective theory of mind section of the test (p<0.05). Data from the Reading the mind in the Eyes test did not reveal statistical significance between the cerebellar stroke and control groups (p>0.05). However, when analyzed for subgroups, the performance score was significantly lower in patients with left posterior cerebellar stroke (p=0.015). The scales and the MOCA test did not show significant differences among the patients and the healthy controls (p>0.05). CONCLUSION: Our findings provide critical information regarding the cerebellar contributions on the social cognition network and expands the available evidence regarding the impairment in the social cognition following cerebellar stroke. Further research comprising more patients and detailed neuroimaging data will be able to illuminate the details of social cognition after cerebellar insult.