The cerebellum regulates execution of skilled movements through neural connections with the primary motor cortex. A main projection
from the cerebellum to the primary motor cortex is a disynaptic excitatory pathway relayed at the ventral thalamus. This dentatothalamocortical
pathway receives inhibitory inputs from Purkinje cells of the cerebellar cortex. These pathways (cerebellothalamocortical
pathways) have been characterized extensively using cellular approaches in animals. Advances in non-invasive transcranial
activation of neural structures using electrical and magnetic stimulation have allowed us to investigate these neural connections
in humans. This review summarizes various studies of the cerebellothalamo-cortical pathway in humans using current transcranial
electrical and magnetic stimulation techniques. We studied effects on motor cortical excitability elicited by electrical or
magnetic stimulation over the cerebellum by recording surface electromyographic (EMG) responses from the first dorsal interosseous
(FDI) muscle. Magnetic stimuli were given with a round or figure eight coil (test stimulation) for primary motor cortical
activation. For cerebellar stimulation, we gave high-voltage electrical stimuli or magnetic stimuli through a cone-shaped
coil ipsilateral to the surface EMG recording (conditioning stimulation). We examined effects of interstimulus intervals (ISIs)
with randomized condition-test paradigm, using a test stimulus given preceded by a conditioning stimulus by ISIs of several
milliseconds. We demonstrated significant gain of EMG responses at an ISI of 3 ms (facilitatory effect) and reduced responses
starting at 5 ms, which lasted 3–7 ms (inhibitory effect). We applied this method to patients with ataxia and showed that
the inhibitory effect was only absent in patients with a lesion at cerebellar efferent pathways or dentatothalamocortical
pathway. These results imply that this method activates the unilateral cerebellar structures. We confirmed facilitatory and
inhibitory natures of cerebellothala-mocortical pathways in humans. We can differentiate ataxia attributable to somewhere
in the cerebello-thalamo-cortical pathways from that caused by other pathways.
Key words Cerebellum - facilitation - inhibition - motor cortex - dentatothalamocortical pathway - transcranial magnetic stimulation (TMS)