In less than three decades, the concept “cerebellar neurocognition” has evolved from a mere afterthought to an entirely new and multifaceted area of neuroscientific research. A close interplay between three main strands of contemporary neuroscience induced a substantial modification of the traditional view of the cerebellum as a mere coordinator of autonomic and somatic motor functions. Indeed, the wealth of current evidence derived from detailed neuroanatomical investigations, functional neuroimaging studies with healthy subjects and patients and in-depth neuropsychological assessment of patients with cerebellar disorders shows that the cerebellum has a cardinal role to play in affective regulation, cognitive processing, and linguistic function. Although considerable progress has been made in models of cerebellar function, controversy remains regarding the exact role of the “linguistic cerebellum” in a broad variety of nonmotor language processes. This consensus paper brings together a range of different viewpoints and opinions regarding the contribution of the cerebellum to language function. Recent developments and insights in the nonmotor modulatory role of the cerebellum in language and some related disorders will be discussed. The role of the cerebellum in speech and language perception, in motor speech planning including apraxia of speech, in verbal working memory, in phonological and semantic verbal fluency, in syntax processing, in the dynamics of language production, in reading and in writing will be addressed. In addition, the functional topography of the linguistic cerebellum and the contribution of the deep nuclei to linguistic function will be briefly discussed. As such, a framework for debate and discussion will be offered in this consensus paper.

These findings provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain and highlight the potential clinical applications for language rehabilitation post-stroke.

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential therapeutic tool for the rehabilitation of language in chronic non-fluent aphasia post-stroke. Previous studies report that low frequency (1 Hz) rTMS applied to homologous language sites can facilitate behavioural language changes. Improvements in picture naming performance and speech output are frequently reported. OBJECTIVES: This study aims to assess the efficacy of inhibitory rTMS to modulate language performance in non-fluent aphasia. METHODS: Low-frequency (1 Hz) rTMS was applied to six active stimulation and six placebo patients for 20 min per day over 10 days, as outlined in a previous published investigation. Behavioural language outcome measures were taken at baseline (pre-stimulation) and 1 week, 2 months, 8 months and 12 months post-stimulation. RESULTS: The findings demonstrate treatment-related changes observed in the stimulation group, up to 12 months poststimulation, when compared to the placebo control group over time for naming performance, expressive language and auditory comprehension. CONCLUSION: These outcomes provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain, and highlight the potential clinical application of rTMS for language rehabilitation in chronic aphasia.

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