Shinn Ann K, Roh Youkyung S, Ravichandran Caitlin T, Baker Justin T, Öngür Dost, Cohen Bruce M
Schizophrenia and Bipolar Disorder Program, McLean Hospital, Belmont, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2017 Jul;2(5):438-448. doi: 10.1016/j.bpsc.2016.07.002.
The cerebellum, which modulates affect and cognition in addition to motor functions, may contribute substantially to the pathophysiology of mood and psychotic disorders, such as bipolar disorder. A growing literature points to cerebellar abnormalities in bipolar disorder. However, no studies have investigated the topographic representations of resting state cerebellar networks in bipolar disorder, specifically their functional connectivity to cerebral cortical networks.
Using a well-defined cerebral cortical parcellation scheme as functional connectivity seeds, we compared ten cerebellar resting state networks in 49 patients with bipolar disorder and a lifetime history of psychotic features and 55 healthy control participants matched for age, sex, and image signal-to-noise ratio.
Patients with psychotic bipolar disorder showed reduced cerebro-cerebellar functional connectivity in somatomotor A, ventral attention, salience, and frontoparietal control A and B networks relative to healthy control participants. These findings were not significantly correlated with current symptoms.
Patients with psychotic bipolar disorder showed evidence of cerebro-cerebellar dysconnectivity in selective networks. These disease-related changes were substantial and not explained by medication exposure or substance use. Therefore, they may be mechanistically relevant to the underlying susceptibility to mood dysregulation and psychosis. Cerebellar mechanisms deserve further exploration in psychiatric conditions, and this study's findings may have value in guiding future studies on pathophysiology and treatment of mood and psychotic disorders, in particular.
小脑除了调节运动功能外，还调节情感和认知，可能在双相情感障碍等情绪和精神障碍的病理生理学中起重要作用。越来越多的文献指出双相情感障碍存在小脑异常。然而，尚无研究调查双相情感障碍静息态小脑网络的拓扑表征，特别是它们与大脑皮层网络的功能连接。
使用定义明确的大脑皮层分区方案作为功能连接种子，我们比较了49例有精神病性特征病史的双相情感障碍患者和55名年龄、性别及图像信噪比相匹配的健康对照参与者的十个小脑静息态网络。
与健康对照参与者相比，患有精神病性双相情感障碍的患者在躯体运动A、腹侧注意、突显以及额顶叶控制A和B网络中，脑-小脑功能连接降低。这些发现与当前症状无显著相关性。
患有精神病性双相情感障碍的患者在选择性网络中存在脑-小脑连接障碍的证据。这些与疾病相关的变化很显著，且不能用药物暴露或物质使用来解释。因此，它们可能在机制上与情绪调节障碍和精神病的潜在易感性相关。小脑机制在精神疾病中值得进一步探索，本研究结果可能对指导未来情绪和精神障碍的病理生理学及治疗研究具有价值，尤其是。
