Cerebellar Cognitive Affective Syndrome (CCAS) is a condition caused by damage (lesions) to the cerebellum. This syndrome, described by Dr. Jeremy Schmahmann and his colleagues (see below) concern problems in the cognitive domains of executive functions, spatial cognition and language.

In particular, problems arise in executive functions, for example:

  • Scheduling,
  • Switching tasks,
  • Abstract reasoning,
  • Working memory,
  • Persevereration
  • Absent-mindedness and inattention,
  • Language problems:
    • dysprosodia: the person seems emotionless or it is difficult to determine if he / she is happy, angry or sad,
    • Agrammatism, inability to make grammatically correct sentences,
    • Anomie in a mild form (= reduction of values)
  • Deficits in spatial cognition: visual-spatial disorganization and poor visual-spatial memory,
  • Personality changes, for example bluntness, numbness, disinhibition and maladjustment.


These cognitive disorders lead to an overall reduction in intellectual function.

The discovery of CCAS caused a shift in the view that the little brains are only responsible for the regulation of the movement functions (motor functions).
It is now assumed that the little brains are responsible for coordinating both functions of movement and emotions and the right rhythm of fluent speech.

The non-functioning of connections from the cerebellum with the cerebral cortex and the limbic system seem to be the cause for the non-motoric handicaps that are described in CCAS.
CCAS symptoms are described in both adults and children.

The exact symptoms vary per individual. This is partly due to the different damaged locations in the small brains. The scientists did make a connection with:
  • Distractibility,
  • Hyperactivity,
  • Impulsivity,
  • Disinhibition,
  • Fear,
  • Ritual and stereotype behaviors,
  • Non-logical thinking,
  • Lack of empathy,
  • Aggression,
  • Irritability,
  • Repeatedly long-term thinking or ruminating (ruminating),
  • Compulsive (obsessive) behavior,
  • Gloomy mood (dysphoria) and depression,
  • Sensory overstimulation,
  • Apathy,
  • Childlike behavior,
  • The inability to understand social boundaries.


Read about Bram Bakker, a Dutch psychiatrist who, after months of searching, recognized his complaints as being the Cognitive Cerebellar Affective Syndrome. He had recognized these complaints on our Dutch website. Read his story (in Dutch) :