Social prediction in pediatric patients with congenital, non-progressive malformations of the cerebellum: From deficits in predicting movements to rehabilitation in virtual reality

It has been proposed that impairments of the predictive function exerted by the cerebellum may account for social cognition deficits. Here, we integrated cerebellar functions in a predictive coding framework to elucidate how congenital, non-progressive cerebellar alterations could affect the predictive processing of others' behavior. Experiment 1 demonstrated that cerebellar patients were impaired in relying on contextual information during prediction of other persons' movement, and this impairment was significantly associated with social cognition abilities. Experiment 2 indicated that children and adolescents with congenital, non-progressive cerebellar malformation showed a domain-general deficit in using contextual information to predict both others' movements and physical events, and that this impairment was independent from patients' cognitive abilities. Experiment 3 provided first evidence that a social-prediction training in virtual reality could boost the ability to use context-based predictions to understand others’ intentions. These findings shed new light on the predictive role of the cerebellum and its contribution to social cognition, paving the way for new approaches to the rehabilitation of the Cerebellar Cognitive Affective Syndrome.