Cerebellar dysfunction typically causes imbalance and disrupts movement control, causing abnormalities of gait, coordination, speech, and eye movements. Yet, scientists are beginning to view cerebellar dysfunction in a whole new way. It is not just what happens in the cerebellum, but also how cerebellar dysfunction impacts many other parts of the brain with which it connects, the so-called “foreign policy” of the cerebellum.

Because of these widespread connections, particularly with the cerebral cortex, many cases of cerebellar disease are associated with “non-motor” symptoms. While the clinical picture in most cases is dominated by motor disturbances, abnormalities of language, attention, emotional control, and learning are increasingly linked to cerebellar disease. Mounting evidence over the past decade has pointed to a role for the cerebellum in cognition and social skills.

Abnormal development of the cerebellum or early injury to the structure disrupt not only cerebellar function, but also its widespread connections, causing a range of motor and non-motor neurodevelopmental challenges. Conversely, many neurodevelopmental disorders not previously believed to involve the cerebellum, including autism, are increasingly being found to include cerebellar dysfunction as a contributor to motor, cognitive, and behavioral challenges.

Rapid advances in several technologies, including brain imaging, genetics, and laboratory techniques enabling precise mapping and manipulation of connected brain regions are powering this new understanding of the cerebellum and its functions and hold great promise for future discoveries critical for better therapeutics.