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Line Bisection and Cerebellar Damage

Daini, Roberta PhD* †; Arduino, Lisa Saskia PhD‡ §; Di Menza, Donatella MA; Vallar, Giuseppe MD* ¶; Silveri, Maria Caterina MD

Cognitive and Behavioral Neurology: December 2008 - Volume 21 - Issue 4 - p 214-220
doi: 10.1097/WNN.0b013e318190d143
Original Studies

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 and to assess the role of visual monitoring of the movement of the upper limb.

Methods Twelve patients, 6 with left-sided and 6 with right-sided cerebellar damage, and 12 control participants, marked the midpoint of horizontal lines with their left or right hand, under conditions of present versus 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.

*Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca

Istituto Clinico Humanitas, Rozzano

Laboratorio di Neuropsicologia, IRCCS Istituto Auxologico Italiano, Milano

Istituto di Psicologia, Università degli Studi di Urbino, Urbino


Centro di Medicina dell'Invecchiamento, Università Cattolica, Roma, Italy

Disclosure: the authors report no conflicts of interest.

Supported in part by a MIUR PRIN 2005 Grant to Giuseppe Vallar.

Reprints: Giuseppe Vallar, MD, Dipartimento di Psicologia, Università degli Studi di Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy (e-mail:

Received for publication March 5, 2008; accepted September 30, 2008

© 2008 Lippincott Williams & Wilkins, Inc.