The Cerebellum

, Volume 11, Issue 2, pp 549–556 | Cite as

Cerebellar Cognitive Affective Syndrome in Machado Joseph Disease: Core Clinical Features

  • Pedro Braga-Neto
  • José Luiz Pedroso
  • Helena Alessi
  • Lívia Almeida Dutra
  • André Carvalho Felício
  • Thaís Minett
  • Patrícia Weisman
  • Ruth F. Santos-Galduroz
  • Paulo Henrique F. Bertolucci
  • Alberto Alain Gabbai
  • Orlando Graziani Povoas Barsottini
Original Paper


The cerebellum is no longer considered a purely motor control device, and convincing evidence has demonstrated its relationship to cognitive and emotional neural circuits. The aims of the present study were to establish the core cognitive features in our patient population and to determine the presence of Cerebellar Cognitive Affective Syndrome (CCAS) in this group. We recruited 38 patients with spinocerebellar ataxia type 3 (SCA3) or Machado–Joseph disease (MJD)-SCA3/MJD and 31 controls. Data on disease status were recorded (disease duration, age, age at onset, ataxia severity, and CAG repeat length). The severity of cerebellar symptoms was measured using the International Cooperative Ataxia Rating Scale and the Scale for the Assessment and Rating of Ataxia. The neuropsychological assessment consisted of the Mini-Mental State Examination, Clock Drawing Test, Wechsler Adult Intelligence Scale, Rey–Osterrieth Complex Figure, Wisconsin Card Sorting Test, Stroop Color–Word Test, Trail-Making Test, Verbal Paired Associates, and verbal fluency tests. All subjects were also submitted to the Hamilton Anxiety Scale and Beck Depression Inventory. After controlling for multiple comparisons, spatial span, picture completion, symbol search, Stroop Color–Word Test, phonemic verbal fluency, and Trail-Making Tests A and B were significantly more impaired in patients with SCA3/MJD than in controls. Executive and visuospatial functions are impaired in patients with SCA3/MJD, consistent with the symptoms reported in the CCAS. We speculate on a possible role in visual cortical processing degeneration and executive dysfunction in our patients as a model to explain their main cognitive deficit.


Spinocerebellar ataxia type 3 Machado–Joseph disease Cognitive deficits Cerebellar Cognitive Affective Syndrome 


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Pedro Braga-Neto
    • 1
    • 2
  • José Luiz Pedroso
    • 1
    • 2
  • Helena Alessi
    • 1
  • Lívia Almeida Dutra
    • 1
    • 2
  • André Carvalho Felício
    • 1
  • Thaís Minett
    • 3
    • 4
  • Patrícia Weisman
    • 1
  • Ruth F. Santos-Galduroz
    • 5
    • 6
  • Paulo Henrique F. Bertolucci
    • 1
  • Alberto Alain Gabbai
    • 1
    • 2
  • Orlando Graziani Povoas Barsottini
    • 1
    • 2
  1. 1.Department of Neurology and NeurosurgeryUniversidade Federal de São PauloSão PauloBrazil
  2. 2.Instituto Israelita de Ensino e Pesquisa Albert EinsteinHospital Israelita Albert EinsteinSão PauloBrazil
  3. 3.Department of Preventive MedicineUniversidade Federal de São PauloSão PauloBrazil
  4. 4.Department of Public Health and Primary CareUniversity of CambridgeCambridgeUK
  5. 5.Center of Mathematics, Computer and CognitionUniversidade Federal do ABCSão PauloBrazil
  6. 6.Institute of Biosciences, UNESPRio ClaroBrazil

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