Verbal short-term store-rehearsal system and the cerebellum. Evidence from a patient with a right cerebellar lesion

We describe an 18-year-old patient who underwent surgical removal of the right cerebellar hemisphere for the presence of a neoplastic lesion. After surgery, the patient's neuropsychological examination was normal except for a transient selective verbal short-term memory (STM) impairment characterized by reduced verbal digit span and rapid forgetting of verbal material. An extensive examination of the patient's deficit was performed in order to identify which of the two components of STM (phonological short-term store and/or rehearsal system) was impaired. The functional locus of the deficit was identified at the level of the phonological output buffer, a component of the rehearsal system, as suggested by the pattern of results obtained, namely: the improvement of the digit span seen with pointing compared with the verbal response; the advantage of auditory over visual presentation of digits; and the lack of a phonological-similarity effect with visual presentation of letters. On the other hand, the functioning of the phonological store was demonstrated by the normal amplitude of the recency effect in free recall of words and by the phonological-similarity effect with auditory presentation of letters. Our finding is consistent with previous functional (PET) studies showing the involvement of the right cerebellum during tasks requiring silent recirculation of verbal information. We conclude that the cerebellum takes part in the planning of speech production at a level that does not require an overt articulation.