Op-brai130070 1..3

Sir, Fumagalli and Priori (2012) present an overview of the functional neuroanatomy of morality, in which they discuss cortical and subcortical structures involved in normal and aberrant moral behaviour. Recognizing the complexities of moral judgement and action, the authors invoke in their dissertation a consideration of cognitive processes critical to morality. These include theory of mind, social cognition, moral decision processing, conflict resolution and emotional regulation. The authors also analyse aggression, violence and psychopathy as specific indicators of subverted morality. These high level human attributes are embodied in distributed neural systems comprising association and paralimbic cortical areas and subcortical nuclei, all included in the review. Fumagalli and Priori (2012) do not, however, mention the cerebellum, which renders incomplete the full consideration of the neural basis of moral cognition. Anatomical investigations in non-human primates show that the cerebellum is reciprocally interlinked with precisely those areas discussed in the review implicated in the neural basis of reason, emotion, moral behaviour and aggression. These include the dorsolateral prefrontal, medial prefrontal, anterior and posterior cingulate, superior and middle temporal, posterior parietal and posterior parahippocampal cortices and the hypothalamus (Schmahmann and Pandya, 1997; Strick et al., 2009; Schmahmann, 2010). Further, the basis pontis and thalamus are obligatory way stations in the feedforward and feedback limbs of the cerebellar connections with the cerebral hemispheres, and physiological studies point to cerebellar connections with the amygdala, septum and hippocampus (Heath and Harper, 1974; Schmahmann, 1991). The cerebellum is essential not only for motor control, but also for intellectual function, decision making, and emotional processing (Heath et al., 1974; Berman et al., 1978; Leiner et al., 1986; Schmahmann, 1991; Schmahmann and Sherman, 1998; Baumann and Mattingley, 2012; Rosenbloom et al., 2012) including the behaviours underlying anger, aggression and violence that are pertinent to moral judgement and action (Scarpa and Raine, 1997; Moll et al., 2005; Nelson and Trainor, 2007; Ugazio et al., 2012). Neuroimaging studies underscore the cerebellar contribution to several aspects of moral processing discussed by Fumagalli and Priori (2012): theory of mind (Brunet et al., 2000; Gallagher et al., 2000; Calarge et al., 2003; Grèzes et al., 2004), moral judgement (Harada et al., 2009), deception (Gamer et al., 2007), and empathy (Singer et al., 2004; Jackson et al., 2005; Shamay-Tsoory et al., 2005; Lamm et al., 2007; Schulte-Rüther et al., 2007; Lang et al., 2011). Impairments of theory of mind and/or social cognition are reported in patients with cerebellar damage (Roldan Gerschcovich et al., 2011) and spinocerebellar ataxias (Garrard et al., 2008; Sokolovsky et al., 2010; D’Agata et al., 2011). Lability of mood is described with irritability, anger, aggression and pathological laughing and crying in patients with both acquired and developmental cerebellar lesions (Schmahmann and Sherman, 1998; Levisohn et al., 2000; Parvizi et al., 2007; Schmahmann et al., 2007) and spinocerebellar ataxias (Genis et al., 1995; Stone et al., 2001; Rolfs et al., 2003). These clinical reports are consistent with behavioural studies in doi:10.1093/brain/awt070 Brain 2013: 136; 1–3 | e244