Cerebellum And Non-Invasive Brain Stimulation (NIBS)
The meta-analysis by Pezzetta et al. (2023, Neuroscience & Biobehavioral Reviews) provides the most comprehensive quantitative synthesis to date of how non-invasive brain stimulation (NIBS)—including transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES)—modulates cerebellar-associated cognitive processes in healthy adults. Analyzing 66 studies and 91 experiments, the authors investigated how stimulation parameters, site, and timing influence cognition when targeting the cerebellum, a structure increasingly recognized for its pivotal role in executive, affective, and social functions beyond motor control. The study’s major findings reveal that: Anodal tDCS applied to the medial cerebellum (vermis) significantly enhances cognitive performance, suggesting a facilitatory role of the “limbic cerebellum” in emotional and cognitive integration. High-frequency TMS over the lateral cerebellar hemispheres leads to performance disruption, particularly when applied during active tasks (online protocols), indicating its potential to transiently interfere with ongoing cognitive computations. Conversely, low-frequency TMS and continuous theta-burst stimulation (cTBS) induce offline inhibitory effects, aligning with long-term depression–like mechanisms observed in cortical stimulation. Beyond technical insights, this work demonstrates that the cerebellum can be effectively and selectively modulated by NIBS, challenging traditional cortico-centric models of cognitive control. The findings offer critical methodological guidance for designing future NIBS interventions and highlight the cerebellum as a promising target for enhancing cognition and preventing decline in aging and neurological disorders. By bridging causal stimulation evidence with cerebellar functional neuroanatomy, this meta-analysis establishes a scientific foundation for precision neuromodulation—paving the way for preventive and rehabilitative strategies aimed at maintaining cognitive health through targeted cerebellar engagement.

