Neurorehabilitation Impact on Neurocognitive Impairments in Cerebellar Lesions

Study Overview
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Brief Summary
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Depending on their localization, cerebellar lesions cause various pronounced cognitive and/or affective dysfunctions, which are causally related to the involvement of cerebellar structures in neuronal networks for higher-order processing of cognitive and emotional items in the association areas of the cerebral cortex. For further investigation, event-related potential (ERP) analyses will be performed to record and visualize specific signals in the surface EEG, which should provide information about the course of treatment of neurorehabilitation with respect to a close correlation and thus predictive power to functional recovery that occurred as a result of cerebellar injury. With EEG parameters and clinical examination findings including neuropsychology, the functions for four thematically distributed domains (affective: prosody; cognitive: abstraction, linguistic and formal incongruence) will be recorded and evaluated over a four-week structured neurorehabilitation with an average therapy volume.

Detailed Description
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Cerebellar damage causes various cognitive and affective dysfunctions to varying degrees depending on its location, with cognitive abnormalities seen primarily in the posterior lobes, whereas disorders of affect modulation are seen more frequently in lesions of the vermis. Causally, cerebellar structures are thought to be involved in neuronal networks distributed primarily within temporal, parietal, and frontal association cortices for higher-order processing of cognitive and emotional items. Based on the evidence to date, cerebellar areas appear to be involved at the level of congruent and incongruent associations with different temporal binding of the cerebral networks responsible for them. For further investigation, event-related potential (ERP) analyses will be performed to capture and represent temporal signal dynamics in surface EEG, which will be used to calculate predictive values for the quality and extent of neurorehabilitation applications for functional recovery and thus clinical outcome via neurophysiological markers. In addition to clinical scales and neuropsychological investigations, the processing of four thematically distributed (prosody, abstraction, linguistic and formal incongruence) trials at the beginning and after about four weeks of a structured neurorehabilitation with a therapy volume of at least 20 hours per week of physical and occupational therapy as well as computer-assisted exercises, in their temporal and topographical characteristics of neurophysiologically tangible functional disorders and their dynamics in the course of treatment will be investigated via the derivation of ERP.

Official Title
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Neurorehabilitation Impact on Neurocognitive Impairments in Cerebellar Lesions

Conditions
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Cerebellum; Injury

Intervention / Treatment
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* Other: Neurorehabilitation cerebellar cognitive disorder


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: active group: patients with a cerebrovascular lesion within the cerebellum comparator group: patients with a cerebrovascular lesion supratentorial Exclusion Criteria: any kind of history in neurological or psychiatric disorders
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment in cerebellar lesioned patient<br>Group of patients with a lesion of the cerebellum gaining a neurorehabilitation intervention | Other: Neurorehabilitation cerebellar cognitive disorder<br>* Influence of neurorehabilitation treatment lines of physiotherapy and exercise therapy including scheduled occupational therapy to adapt and improve cognitive-affective disorders in cerebellar lesions.<br>|
| Active Comparator: Treatment in supratentorial lesioned patient<br>Group of patients with a lesion of the supratentorial area gaining a neurorehabilitation intervention | Other: Neurorehabilitation cerebellar cognitive disorder<br>* Influence of neurorehabilitation treatment lines of physiotherapy and exercise therapy including scheduled occupational therapy to adapt and improve cognitive-affective disorders in cerebellar lesions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of attentional and executive functioning in active group. | Beneficial changes in attentional and executive function performance in ischemic cerebellar injury after structured neurorehabilitation modules. Measurements will be succeed by the Cerebellar Cognitive Affective/ Schmahmann Syndrome Scale (German version) with a maximum of 120 of 120 points, i.e. an increase of the test performance with higher point values along the neurorehabilitation procedure is considered as an indication of clinical improvement. | 26 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Extension of daily activities and life quality. | Growing action behavior (recorded by SF-36 scale) in everyday life, whereby an increase from low point values up to high point values (between a range of 0 points with very low quality of life as minimum, and up to 100 points as a maximum of quality of life) indicates a growing quality of life due to neurologic impromenet . | 52 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebellum - cognitive functions - neurorehabilitation