The role of the cerebellum in 'real' and 'imaginary' line bisection explored with 1-Hz repetitive transcranial magnetic stimulation.

The role of the cerebellum is well characterized for many motor processes and for some cognitive tasks, although its contribution to lateralized spatial judgement has never been probed directly. To address this omission, we investigated the effects of cerebellar disruption on two different line bisection tasks in eight healthy subjects. Based on previous evidence of crossed cerebellar-cortical connections we predicted a shift in the perceived midline that would occur in opposite directions depending on the cerebellar hemisphere targeted. Repetitive transcranial magnetic stimulation (rTMS), given at 1-Hz (600 pulses), was used as a non-invasive way to interfere with processing in the cerebellar cortex. Performance was assessed for both 'physical' line bisection using a newly developed Landmark variant task and for 'mental' line bisection using number pairs. The effects for number line bisection were lateralized--left but not right cerebellar rTMS increased rightward errors, whereas for physical line bisection rTMS to either hemisphere did not affect performance. Effects due to neck muscle contraction and changes in eye position were ruled out with appropriate control stimulation sites, and eye-tracking. The results confirm the role of the cerebellum in spatial judgement, and, for the first time, demonstrate direct cerebellar involvement in the generation of the midline in 'imaginal' (number) space. The difference between number line and physical line bisection effects is discussed with reference to pre-existing models of cerebellar hemispheric specialization and functional topography.