The cerebellum and its role in word generation: a cTBS study

The purpose of this study was to investigate the role of the cerebellum in the executive control of word generation using a phonemic and semantic fluency task. Phonemic fluency tasks require novel strategy to organize verbal output, and are more effortful than semantic fluency tasks. The number of category switches made between subcategories of words is a measure of mental flexibility, and is greatest during the early phase of the task (first 15 sec). Both tasks were tested on healthy participants, before and after the application of transcranial magnetic stimulation using continuous theta burst stimulation (cTBS) applied over the left or the right posterior/lateral cerebellar cortex in separate groups. We hypothesized that the number of category switches and number of words produced within the first 15 sec would be reduced after cTBS to the right, posterior-lateral cerebellum during phonemic fluency tasks. The results from the study were consistent with the hypothesis. Within the first 15 sec of each trial, right cTBS participants displayed significantly lower switching scores (p = .05) after stimulation. Previous studies have illustrated similar impairments in switching between categories during phonemic fluency performance in patients with damage to the left frontal cortex. Our findings support the general hypothesis of cerebellar involvement in executive control through connections to the frontal cortex.