Anatomical, physiological and functional neuroimaging studies suggest that the cerebellum participates in the organization of higher order function, but there are very few descriptions of clinically relevant cases that address this possibility. We performed neurological examinations, bedside mental state tests, neuropsychological studies and anatomical neuroimaging on 20 patients with diseases confined to the cerebellum, and evaluated the nature and severity of the changes in neurological and mental function. Behavioural changes were clinically prominent in patients with lesions involving the posterior lobe of the cerebellum and the vermis, and in some cases they were the most noticeable aspects of the presentation. These changes were characterized by: impairment of executive functions such as planning, set-shifting, verbal fluency, abstract reasoning and working memory; difficulties with spatial cognition including visual-spatial organization and memory; personality change with blunting of affect or disinhibited and inappropriate behaviour; and language deficits including agrammatism and dysprosodia. Lesions of the anterior lobe of the cerebellum produced only minor changes in executive and visual-spatial functions. We have called this newly defined clinical entity the 'cerebellar cognitive affective syndrome'. The constellation of deficits is suggestive of disruption of the cerebellar modulation of neural circuits that link prefrontal, posterior parietal, superior temporal and limbic cortices with the cerebellum.

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The cerebellar cognitive affective syndrome.

The Prefrontal Cortex, Fifth Edition, provides users with a thoroughly updated version of this comprehensive work that has historically served as the classic reference on this part of the brain. The book offers a unifying, interdisciplinary perspective that is lacking in other volumes written about the frontal lobes, and is, once again, written by the award-winning author who discovered "memory cells," the physiological substrate of working memory. The fifth edition constitutes a comprehensive update, including all the major advances made on the physiology and cognitive neuroscience of the region since publication in 2008. All chapters have been fully revised, and the overview of prefrontal functions now interprets experimental data within the theoretical framework of the new paradigm of cortical structure and dynamics (the Cognit Paradigm), addressing the accompanying social, economic, and cultural implications. * Provides a distinctly interdisciplinary view of the prefrontal cortex, covering all major methodologies, from comparative anatomy to modern imaging* Unique analysis and synthesis of a large body of basic and clinical data on the subject (more than 2000 references)* Written by an award-winning author who discovered "memory cells," the physiological substrate of working memory* Synthesizes evidence that the prefrontal cortex constitutes a complex pre-adaptive system* Incorporates emerging study of the role of the frontal lobes in social, economic, and cultural adaptation

The prefrontal cortex

Converging evidence now indicates that the amygdala plays a crucial role in the development and expression of conditioned fear. Conditioned fear is a hypothetical construct used to explain the cluster of behavioral effects produced when an initially neutral stimulus is consistently paired with an aversive stimulus. For example, when a light, which initially has no behavioral effect, is paired with an aversive stimulus such as a footshock, the light alone can elicit a constellation of behaviors that are typically used to define a state of fear in animals. To explain these findings, it is generally assumed (cf. McAllister & McAllister 1971 ) that during light-shock pair­ ings (training session ), the shock elicits a variety of behaviors that can be used to infer a central state of fear (unconditioned responses-Figure 1 ). After pairing , the light can produce the same central fear state and thus the same set of bchaviors formerly produced by thc shock. Moreover, the behavioral effects that are produced in animals by this formerly neutral stimulus (now called a conditioned stimulus-CS ) are similar in many respects to the constellation of behaviors that are used to diagnose gener­ alized anxiety in humans (Table 1 ). This chapter summarizes data sup­ porting the idea that the amygdala, and its many efferent projections, may represent a central fear system involved in both the expression and acquisition of conditioned fear.

The role of the amygdala in fear and anxiety

The prevalence of obesity has increased worldwide in the past ~50 years, reaching pandemic levels. Obesity represents a major health challenge because it substantially increases the risk of diseases such as type 2 diabetes mellitus, fatty liver disease, hypertension, myocardial infarction, stroke, dementia, osteoarthritis, obstructive sleep apnoea and several cancers, thereby contributing to a decline in both quality of life and life expectancy. Obesity is also associated with unemployment, social disadvantages and reduced socio-economic productivity, thus increasingly creating an economic burden. Thus far, obesity prevention and treatment strategies - both at the individual and population level - have not been successful in the long term. Lifestyle and behavioural interventions aimed at reducing calorie intake and increasing energy expenditure have limited effectiveness because complex and persistent hormonal, metabolic and neurochemical adaptations defend against weight loss and promote weight regain. Reducing the obesity burden requires approaches that combine individual interventions with changes in the environment and society. Therefore, a better understanding of the remarkable regional differences in obesity prevalence and trends might help to identify societal causes of obesity and provide guidance on which are the most promising intervention strategies.

Obesity: global epidemiology and pathogenesis.

Effects of Mindfulness on Psychological Health: A Review of Empirical Studies

Marked variations in food intake have been described in various species following injury to certain parts of the hypothalamus, including an increased food intake or hyperphagia caused by lesions in the medial hypothalamus, especially lesions in or ventrolateral to the ventromedial nucleus; this hyperphagia leads to obesity.\"1418' 20 24 A decrease or complete inhibition of food intake has also been reported as an incidental finding in animals with hypothalamic lesions, by Hetherington and Ranson16 in rats, and by Clark, Magoun, and Ranson'0 during their study of temperature regulation in cats. Similar observations were also made in cats by Ingram, Barris, and Ranson,\" by Ranson' in monkeys, and by Anand and Brobeck' in certain rats which were being prepared for studies of food intake and activity. The present investigation, therefore, was undertaken as an attempt to localize in the hypothalamus the areas the destruction of which leads to diminution or failure of eating with emaciation, as destruction of certain other areas leads to overeating and obesity. As a result of these studies a small, welllocalized area has been found in the lateral hypothalamus; the bilateral destruction of this area is followed by a complete absence of spontaneous eating.2 This area has been tentatively designated as a \"feeding center.\" An attempt has also been made to discover whether there is any correlation between different areas of the hypothalamus in the regulation of food intake.

Hypothalamic control of food intake in rats and cats.

Unit activity from neurons of hypothalamic feeding and satiety mechanisms, and from adjacent hypothalamic regions was recorded in anesthetized dogs with surgically exposed hypothalamus, and in Flax...

B.K. Anand

Papers

Hypothalamic control of food intake in rats and cats.

Activity of single neurons in the hypothalamic feeding centers: effect of glucose.

Some aspects of electroencephalographic studies in Yogis

Nervous Regulation of Food Intake

Cerebellar projections to limbic system