Preface

The cerebral cortex is the most elegant and sophisticated structure of the brain. It plays a dominant role in elaborating sensory perception, organizing voluntary motion, memory, and judgment, emotions and behavior, interior life and thinking, speech and linguistic skills, art and music, learning and creativity, as well as the philosophy and the programming of life.

Personhood and social performance of human beings are developed, organized, and modulated by the cortex of the brain hemispheres in collaboration with the cerebellar cortex.

Each cortical area of the cerebral lobes plays a particularly crucial role in the creation, organization, and harmonization of mental faculties, in adjusting self-control and emotional stability, in developing self-identification and controlling multiple social interactions, shaping also the rational profile and the existential dimensions of a human being.

Amazingly, there is close cerebro-cerebellar connectivity and collaboration with the majority of the subcortical centers, concerning primarily the motor performances as well as most of the higher mental faculties, such as memory, emotions, perception, thinking transpersonal experiences, [1] creativity, innovation, and imagination.

The cerebellum plays a valuable coordinating role in the majority of the activities of the brain hemispheres [2]. Although the organization and uniform cytoarchitecture of the cerebellar cortex are very different from the considerable neuronal morphological variability of the cerebral cortex, the functional collaboration between cerebrum and cerebellum is a continuous harmonious process, resulting in the functional stability of the brain, [3] based on the contribution of the cerebellum in the consistency and appropriateness of motor and cognitive performances [4]. It is thought that the external information analyzed by the brain hemispheres is harmoniously matched with the internal predictions generated by the cerebellum [5].

A substantial body of evidence, based mostly on neuroimaging, advocates in favor of the important role that the cerebellum plays in the timing and adaptive manipulation of the majority of motor and cognitive processes generated and organized in the cortex of the brain hemispheres, including working memory, language processing [6], unconscious learning, music training, [7] and exploration of novel patterns of cognition and social behavior [8].

In pathological conditions, the cerebrum and cerebellum may continue their close functional collaboration via neuronal plasticity and cerebrocerebellar reserve [9, 10]. However, in cases where the underlining etiology of the pathological alterations is severe, such as in toxic conditions, [11] viral diseases [12] affecting the cerebrum or the cerebellum, hereditary ataxias,

cerebrovascular diseases, cortical degenerations, Alzheimer's disease, and other dementias, [13] the disorganization of the neuronal networks in the brain and the cerebellum induces marked alterations in mental performance, characterized by a serious cognitive decline as well as dysmetria of thought [14] and Schmahmann's syndrome [15] as a result of the wide disruption of the homeostatic equilibrium of the mind.

*Cerebral and Cerebellar Cortex – Interaction and Dynamics in Health and Disease* discusses several important issues of cerebro-cerebellar collaboration and interactions, such as the role of the cerebral and cerebellar cortex on consciousness and the orchestration of human consciousness from beyond the brain. In addition, the book analyzes dynamic praxis and spatial postural praxis in children 4–6 years old with typical development using neuropsychological methods to reveal that age is an important factor in the qualitative changes in the motor skills of children. The book also describes and discusses pathological alterations of the brain due to ischemic lesions and the mechanisms of brain damage. Reasonably, recovery from stroke based on neuronal plasticity and neosynaptogenesis would substantially ameliorate the quality of life of the patients. Thus, therapeutic interventions to enhance neuroplasticity would optimize the prognosis of the post-stroke condition of the patients, maximizing recovery from cerebrovascular episodes.

In the field of motor mechanisms and performances, a detailed study of the movement-related cortical potential (MRCP) for jaw movements in patients who underwent jawbone excision revealed that the brain's motor preparation process depends mainly upon a feed-forward system. The disruption of that system would affect seriously the information processing of the brain.

In cases of dementia due to Alzheimer's disease, the morphological alterations of the mitochondria in the cerebral and cerebellar cortex are among the initial phenomena in the broad spectrum of neuropathological changes. Therapeutic strategies protecting the mitochondria in the initial stages of Alzheimer's disease might be beneficial, leading to an escape from the tragic labyrinth of the disease.

In addition, cerebral perfusion plays a fundamental role in the performance of the cognitive function. A decrease of cardiac output associated with asymptomatic postural hypotension may be among the main etiological factors of cognitive aging, given that cardiac output is dependent on venous return. A technique applying soleus muscle stimulation, which would increase the soleus muscle pump function, may increase the venous return of the blood, improving cardiac output and anticipating cognitive aging.

In the enigmatic and unclear etiopathology of Alzheimer's disease, lipid rafts may also have a place as potential causative factors, participating in the amyloidogenic process of the amyloid precursor protein, given that in the initial stages of the disease a substantial lipid raft destabilization can be detected.

This book supports the concept of the close functional unity and harmonization of the brain and the cerebellum, underlining the important role that the

**V**

body [17].

cerebellar cortex plays in the performance of higher mental faculties, including creativity, [16] emotional processes, and homeostatic equilibrium of the human

> **Stavros J. Baloyannis** Professor Emeritus, Departmet of Neurology, Aristotelian University, Thessaloniki, Greece

We extend our gratitude to the authors for their excellent contributions.

cerebellar cortex plays in the performance of higher mental faculties, including creativity, [16] emotional processes, and homeostatic equilibrium of the human body [17].

We extend our gratitude to the authors for their excellent contributions.

## **Stavros J. Baloyannis**

Professor Emeritus, Departmet of Neurology, Aristotelian University, Thessaloniki, Greece

## **References**

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[2] Van Essen DC, Donahue C J, Glasser MF. Development and evolution of cerebral and cerebellar cortex. Brain, behavior and evolution 2018;91: 158-169.

[3] Buckner RL, Krienen FM, Castellanos A, Diaz JC, Yeo BT. The organization of the human cerebellum estimated by intrinsic functional connectivity. J Neurophysiol. 2011;106:2322-2345.

[4] Schmahmann JD. An emerging concept. The cerebellar contribution to higher function. Arch Neurol. 1991;48(11):1178-1187.

[5] Van Overwalle F, Mariën P. Functional connectivity between the cerebrum and cerebellum in social cognition: a multi-study analysis. NeuroImage 2016;124: 248-255.

[6] Chein JM, Ravizza SM, Fiez JA. Using neuroimaging to evaluate models of working memory and their implications for language processing. Journal of Neurolinguistics. 2003; 16: 315-339.

[7] Vandervert L. How music training enhances working memory: a cerebrocerebellar blending mechanism that can lead equally to scientific discovery and therapeutic efficacy in neurological disorders. Cerebellum and ataxias 2015; 2(1): 1-10.

[8] Vandervert L,. Schimpf PH, Hesheng Liu. How working memory and the cerebellum collaborate to produce creativity and innovation. Creativity Research Journal 2007; 19(1): 1-18.

[9] Serra L, Gelfo F. What good is the reserve? A translational perspective

for the managing of cognitive decline. Neural Regen Res. 2019;14:1219-1220.

[10] Mitoma H, Buffo A, Gelfo F, Guell X, Fucà E, Kakei S et al. Consensus paper. Cerebellar reserve: from cerebellar physiology to cerebellar disorders. The Cerebellum, 2020; 19(1):131-153.

[11] Abdallah M, Zahr N M, Saranathan M, Honnorat N, Farrugia N., Pfefferbaum A.et al. Altered Cerebro-Cerebellar Dynamic Functional Connectivity in Alcohol Use Disorder: a Resting-State fMRI Study. The Cerebellum.2021; 1-13. doi: 10.1007/ s12311-021-01241-y

[12] Wang H, Li R, Zhou Y. et al. Altered cerebro-cerebellum resting-state functional connectivity in HIV-infected male patients. J. Neurovirol. 2018 ;24 : 587-596.

[13] Chen Y, Landin-Romero R, Kumfor F, Irish M, Hodges JR, Piguet O. Cerebellar structural connectivity and contributions to cognition in frontotemporal dementias. Cortex. 2020;129:57-67.

[14] Schmahmann JD. Dysmetria of thought. Clinical consequences of cerebellar dysfunction on cognition and affect. Trends Cogn. Sci. 1998; 2:362-370.

[15] Manto M, Mariën P.. Schmahmann's syndrome—identification of the third cornerstone of clinical ataxiology. Cerebellum Ataxias 2015; 2:2.

[16] Coolidge F L. The role of the cerebellum in creativity and expert stone knapping. Adaptive Behavior 2021;29 (2): 217-229.

[17] Cao H, Cannon TD. Cerebellar Dysfunction and Schizophrenia: From "Cognitive Dysmetria" to a Potential Therapeutic Target. Am J Psychiatry 2019; 176(7): 498-500.

**1**

Section 1

Physiology and Function

Section 1
