ArticleBrain and behavior2020
Bilateral middle cerebellar peduncle lesions: Neuroimaging features and differential diagnoses.
Article in Brain and behavior, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Altered neural activities during emotion regulation in depression: a meta-analysis.Journal of psychiatry & neuroscience : JPNPooled it
- Multiterritory Acute Ischemic Stroke with Bilateral Middle Cerebellar Peduncle T2/FLAIR Hyperintensities in the Setting of a Fatal Systemic Arterial Thrombotic Process: A Case Report.Radiology case reports · 2026Article
- Bilateral Middle Cerebellar Peduncle Lesions in Wernicke's Encephalopathy.Clinical case reports · 2025Article
- Bilateral middle cerebellar peduncle infarcts in a patient with systemic lupus erythematosus.Acta neurologica Belgica · 2025Article
- Wallerian degeneration of the middle cerebellar peduncles due to central pontine myelinolysis.Acta neurologica Belgica · 2025Article
- Anatomic study of the deep structures of the cerebellum: location of the dentate nucleus and its relationship with surgical approaches to tumor lesions.Surgical and radiologic anatomy : SRA · 2025Article
- Wallerian degeneration of the middle cerebellar peduncles secondary to pontine infarction, case report, and review of literature.Radiology case reports · 2025Article
- Long-term effects of simulated microgravity in the central nervous system of rhesus monkeys: a voxel-wise multimodal MRI study.Frontiers in physiology · 2025Article
- Dystonic Tremor as the Clinical Manifestation of Fragile X-Associated Tremor/Ataxia Syndrome.Movement disorders clinical practice · 2024Article
- Neuroimaging and clinical features of bilateral Wallerian degeneration of middle cerebellar peduncles subsequent to pontine infarction.CNS neuroscience & therapeutics · 2024Article
- Antisaccades in Spinocerebellar Ataxia Type 17 With Middle Cerebellar Peduncle Hyperintensities Without Hot-Cross-Bun Sign.Journal of clinical neurology (Seoul, Korea) · 2024Article
- The white matter characteristic of the genu of corpus callosum coupled with pain intensity and negative emotion scores in patients with trigeminal neuralgia: a multivariate analysis.Frontiers in neuroscience · 2024Article
- Late-onset cobalamin C deficiency type in adult with cognitive and behavioral disturbances and significant cortical atrophy and cerebellar damage in the MRI: a case report.Frontiers in neurology · 2023Article
- Artificial neural network applied to fragile X-associated tremor/ataxia syndrome stage diagnosis based on peripheral mitochondrial bioenergetics and brain imaging outcomes.Scientific reports · 2022Article
- The White Matter Functional Abnormalities in Patients with Transient Ischemic Attack: A Reinforcement Learning Approach.Neural plasticity · 2022Article
- Bilateral middle cerebellar peduncle lesions: Neuroimaging features and differential diagnoses.Brain and behavior · 2020Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesLesions limited to the bilateral middle cerebellar peduncles (MCPs) are uncommon. This retrospective study investigated diseases with a proclivity for the bilateral MCPs and explored the associations between their neuroimaging features and clinical findings for the differential diagnosis of such lesions.
methodsWe enrolled 26 patients who were admitted to our department between January 2016 and March 2019 with bilateral MCP abnormalities on magnetic resonance imaging (MRI). The demographic, clinical, and neuroimaging characteristics, and the biomarkers and diagnoses were evaluated.
resultsAlthough all patients exhibited symmetrical bilateral MCP hypointensities on T1-weighted imaging and hyperintensities on T2-weighted and fluid-attenuated inversion recovery imaging, they were diagnosed with different conditions. Diagnoses included acute cerebral infarction (ACI) (n = 9, 34.62%), Wallerian degeneration (WD) (n = 8, 30.77%), multiple system atrophy (MSA) (n = 6, 23.08%), neuromyelitis optica (NMO) (n = 1, 3.85%), heroin-induced leukoencephalopathy (n = 1, 3.85%), and primary central nervous system lymphoma (PCNSL) (n = 1, 3.85%). Patients with ACI exhibited bilateral MCP-restricted diffusion hyperintensities on diffusion-weighted imaging and corresponding stenosis or occlusion of the vertebrobasilar system. The initial MRI of patients with WD depicted pontine infarctions, while symmetrical MCP lesions were observed on follow-up MRI. Symmetrical MCP lesions, cruciform hyperintensity, and marked atrophy in the posterior fossa were characteristic manifestations of MSA. Longitudinally extensive myelitis affecting more than three vertebral segments on cervical MRI and positive serum AQP4-IgG may be indicative of NMO. Heroin-induced leukoencephalopathy was characterized by extra-symmetrical lesions in the posterior limbs of the internal capsules, while the anterior limbs were spared. PCNSL was indicated by a significant and characteristic "fist" sign on contrast-enhanced MRI.
conclusionsBilateral MCP lesions were most frequently observed in cerebrovascular diseases, followed by neurodegenerative diseases, inflammatory diseases, toxic encephalopathies, and lymphomas. Our findings demonstrate that bilateral MCP signal abnormalities are more common in patients with ACI and WD, with fewer degenerative processes than previously believed. The high frequency of WD may be attributed to the specific awareness of this pathology. WD can also present with stage-related restricted diffusion and should not be mistaken for a new infarction. The symmetrical bilateral MCP hypointensities on T1-weighted imaging and hyperintensities on T2-weighted imaging often raise concern regarding a demyelinating process. Our findings emphasize that neurologists should consider the aforementioned conditions and correlate the specific neuroimaging characteristics and medical history before arriving at the final diagnosis.
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