Line bisection and cerebellar damage

Background. The cerebellum plays a role in higher-order cognitive processes, although the evidence concerning spatial cognition is not definite. Objective: To investigate the role of the cerebellum in setting the midpoint of a horizontal line, assessing the role of visual monitoring of the movement of the upper limb. Methods. Twelve patients, six with left and six with right cerebellar damage, and 12 control participants, marked the mid-point of horizontal lines with their left or right hand, under conditions of present vs. absent visual control of the movement of the upper limb. Results. When visual feedback was available, the patients’ accuracy was comparable to that of control participants with a minor leftward bias. Without visual feedback, controls and right-sided cerebellar patients exhibited a rightward bias. Conversely, left-sided cerebellar patients still showed a leftward bias. Conclusions. The leftward bias may be related to the visual monitoring of the movement of the upper limb, being reversed when this is not available. Under these conditions, kinesthetic information becomes more relevant, and may contribute to the rightward bias. This effect is not shown by left cerebellar patients, possibly due to the disconnection between the left cerebellum and the right hemisphere, involved in spatial cognition.