Published online Oct 28, 2017. doi: 10.4329/wjr.v9.i10.371
Peer-review started: February 12, 2017
First decision: April 17, 2017
Revised: July 18, 2017
Accepted: August 2, 2017
Article in press: August 2, 2017
Published online: October 28, 2017
The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases. While conventional magnetic resonance imaging (MRI) is widely used for brain and cerebellar morphologic evaluation, advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics. Volumetry, voxel-based morphometry, diffusion MRI based fiber tractography, resting state and task related functional MRI, perfusion, and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum. In the present review, after providing a brief description of each technique’s advantages and limitations, we focus on their application to the study of cerebellar injury in major neurodegenerative diseases, such as multiple sclerosis, Parkinson’s and Alzheimer’s disease and hereditary ataxia. A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease, followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.
Core tip: The cerebellum is involved in movement control and cognition. Conventional and advanced magnetic resonance imaging (MRI) techniques are widely used for the morphologic evaluation and the microstructural and functional investigation of the cerebellum. In this review we show the state of the art of advanced MRI techniques in the investigation of cerebellum alterations, especially in patients affected by neurodegenerative diseases. In particular, we evaluated advantages, limitations and future perspective of these techniques in multiple sclerosis, Parkinson’s disease and Parkinsonisms, Alzheimer’s disease and hereditary ataxia, highlighting how the investigation of cerebellum may play a key role in the assessment of motor performance and clinical status of these diseases.