Lupo Michela, Olivito Giusy, Siciliano Libera, Masciullo Marcella, Molinari Marco, Cercignani Mara, Bozzali Marco, Leggio Maria
Ataxia Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
Neuroimaging Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
Front Neurol. 2018 Sep 12;9:774. doi: 10.3389/fneur.2018.00774. eCollection 2018.
We described the cerebello-cerebral functional connectivity in a subject who developed a manic state after a cerebellar lesion. Whole brain investigation, performed by means of an advanced MRI examination, evidenced an isolated lesion involving the left lobules VI, VIIa (crus I), and IX and the posterior area of the vermis. The cerebello-cerebral functional connectivity analysis detected a pattern of altered connectivity in specific areas of the prefrontal-striatal-thalamic circuits that are typically altered in bipolar subjects during the manic state. Specifically, a pattern of hypo-connectivity was found between the cerebellum and cerebral regions known to be implicated in emotion modulation and social interaction. Conversely, a pattern of hyper-connectivity was found between the cerebellum and posterior cerebral cortical regions that are involved in sensorimotor functions. The present study represents the first evidence that dysregulation of cerebral networks consequent to a cerebellar lesion is at the root of bipolar disorder, at least the manic state, and provides a new framework for interpreting cerebellar modulation in the regulation of mood in specific psychiatric conditions.
我们描述了一名在小脑病变后出现躁狂状态的受试者的小脑-大脑功能连接情况。通过先进的MRI检查进行的全脑研究表明，存在一个孤立性病变，累及左侧小叶VI、VIIa（小脑脚I）和IX以及蚓部后部区域。小脑-大脑功能连接分析检测到前额叶-纹状体-丘脑回路特定区域的连接模式改变，这在双相情感障碍患者躁狂状态时通常会发生改变。具体而言，在小脑与已知参与情绪调节和社交互动的大脑区域之间发现了低连接模式。相反，在小脑与参与感觉运动功能的大脑后皮质区域之间发现了高连接模式。本研究首次证明，小脑病变导致的脑网络失调是双相情感障碍（至少是躁狂状态）的根源，并为解释特定精神疾病中情绪调节的小脑调制提供了一个新框架。
