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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(12): s00451814368
DOI: 10.1055/s-0045-1814368
Review Article

The cerebellum in dystonia: key player or background support?

Authors

  • Carlos Henrique Ferreira Camargo 

    1   Universidade Federal do Paraná, Programa de Pós-Graduação em Medicina Interna, Disciplina de Doenças Neurodegenerativas, Curitiba PR, Brazil.

  • Hélio Afonso Ghizoni Teive 

    1   Universidade Federal do Paraná, Programa de Pós-Graduação em Medicina Interna, Disciplina de Doenças Neurodegenerativas, Curitiba PR, Brazil.
    2   Universidade Federal do Paraná, Departamento de Clínica Médica, Serviço de Neurologia, Curitiba PR, Brazil.
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Abstract

Since the 1960s, the pathophysiology of dystonia has been primarily attributed to dysfunction of the basal ganglia and their associated pathways. However, growing evidence from both basic and clinical research has highlighted the additional importance of the cerebellum, suggesting that dystonia arises from a motor-network dysfunction involving not only the basal ganglia, but also the cerebellum. Neuroimaging studies reinforce this concept, revealing structural and functional abnormalities in the cerebellum and its afferent pathways in patients with dystonia. Moreover, the dual involvement of the cerebellum and basal ganglia may help explain the frequent co-occurrence of dystonia in patients with ataxia and vice versa. The present review aims to integrate evidence from pathophysiology, clinical studies, genetics, and neuroimaging to underscore the crucial role of the cerebellum in the genesis of dystonia.

Keywords

Dystonia - Cerebellum - Purkinje Cells - Inferior Olivary Complex - Cholinergic Antagonists - Basal Ganglia

Authors' Contributions

Conceptualization: CHFC; Methodology: CHFC; Project administration: CHFC, HAGT; Supervision: CHFC, HAGT; Validation: CHFC, HAGT; Visualization: CHFC, HAGT; Writing – original draft: CHFC; Writing – review & editing: CHFC, HAGT.


Data Availability Statement

Data will be available upon request to the corresponding author.


Editor-in-Chief: Ayrton Roberto Massaro (ORCID: 0000-0003-2305-1073).


Associate Editor: Orlando Graziani Povoas Barsottini (ORCID: 0000-0002-0107-0831).




Publication History

Received: 05 September 2025

Accepted: 13 October 2025

Article published online:
22 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Carlos Henrique Ferreira Camargo, Hélio Afonso Ghizoni Teive. The cerebellum in dystonia: key player or background support?. Arq Neuropsiquiatr 2025; 83: s00451814368.
DOI: 10.1055/s-0045-1814368