The cerebellum specializes for language even in the absence of contralateral neocortical inputs

Long considered a structure dedicated primarily to motor control, the cerebellum is now known to contain regions that respond selectively to language. However, how cerebellar language specialization emerges during development remains unknown. The prevailing proposal is that cerebellar functional specialization critically depends on inputs from the contralateral neocortex, received through well-established reciprocal cortico-cerebellar connections. Here, we test this hypothesis in a right-handed woman (EG) who lacks most of her left temporal lobe (presumably, from birth) and whose neocortical language network resides in her right hemisphere. Using precision functional MRI in EG and a cohort of 74 typically developing adults, we find that EG's cerebellar language network shows a strong left-hemispheric bias, mirroring the atypical lateralization of language in her cerebral cortex, while preserving canonical topography and response profiles of the language-dominant cerebellar regions. Critically, however, EG's right cerebellar hemisphere also responds to language and even contains a language-selective region despite the absence of language regions in the neocortical left hemisphere. These findings challenge the view that cerebellar specialization critically requires contralateral neocortical inputs, and point instead to some degree of intrinsic neocortex-independent cerebellar organization.