Attention Deficit Hyperactivity Disorder (ADHD) has long been viewed through the lens of executive function deficits, with attention focused primarily on the prefrontal cortex, dopamine, and/or norepinephrine deficiencies. However, emerging evidence supports another brain structure’s critical role in the coordination of thoughts and attention. The cerebellum, classically known for its role in the coordination of movement, coordinates our thoughts in the same way. This provides fascinating implications into the value of not only rehabilitating the cerebellum for movement or vestibular disorders, but for cognitive disorders as well.

The cerebellum, which means ‘little brain’ in Latin, is a structure located at the back and bottom of the brain. Although this ‘little brain’ constitutes only 10% of total brain volume, it contains nearly 50% of the brain’s neurons. The cerebellum compares what the brain intends for the body to do with what the body actually does, fine-tuning our movements accordingly. So, when there is a problem with somebody’s cerebellum, we start to see uncoordinated or inaccurate movements, a phenomenon referred to as ‘dymestria.’  More recently, researchers have found that problems with the cerebellum can also result in dysmetria of thought – disruptions in how we think and process information.

A growing body of literature supports the link between cerebellar dysfunction and ADHD symptoms. This relationship is particularly interesting with the realm of function neurology, as it shows that the cerebellum plays a crucial role not just in motor control but also in cognitive coordination. This opens the door to exploring how cerebellum-focused exercises may help improve symptoms in those with ADHD.

One study that explored this idea was conducted by Janmohammadi et al., titled “Effect of a Visual Tracking Intervention on Attention and Behavior of Children with Attention Deficit Hyperactivity Disorder.” The researchers aimed to test whether specific eye-tracking exercises could enhance cognitive function in children with ADHD. They found that the group performing these exercises showed significant improvements in cognitive performance, behavior and hyperactivity. Specifically, they observed better outcomes on tasks like the Continuous Performance Test (CPT).

The exercises included smooth pursuit eye tracking while on a tilt board, which activated not only the visual system but also vestibulocerebellar pathways. As children tracked stimuli that suddenly appeared on a screen, they were asked to recall where each appeared. Another beneficial exercise involved tracing lines in different orientations (vertical, horizontal and diagonal) with a laser pointer while keeping the head in a fixed position. These tasks, which rely heavily on the cerebellum’s role in controlling smooth and precise eye movements, showed marked improvements in ADHD symptoms.

Ultimately, these findings reinforce the broader idea that the cerebellum’s role in ADHD extends beyond just motor control. As we continue to explore the cerebellum’s cognitive functions, treatments that focus on this “little brain” may prove to be a game-changer for ADHD and other neurodevelopmental conditions. This approach presents a low-risk, non-pharmacological option for managing ADHD, either as a standalone treatment or an adjunctive one.

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References:

1. Carrick Institute for Graduate Studies, Inc. Clinical Neuroscience Module 08: Cerebellum. Carrick Institute; 2021.
2. Janmohammadi S, Haghgoo HA, Farahbod M, Overton PG, Pishyareh E. Effect of a visual tracking intervention on attention and behavior of children with Attention Deficit Hyperactivity Disorder. J Eye Mov Res. 2020;12(8):10.16910/jemr.12.8.6. Published 2020 Apr 22. doi:10.16910/jemr.12.8.6