Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Cortex. 2021 Oct;143:290-294. doi: 10.1016/j.cortex.2021.07.010. Epub 2021 Aug 6.
Our recent neuroimaging study identified structural differences in cerebellar subfields linked to cortical attentional networks in patients with eye disease or Parkinson's disease who experience visual hallucinations and a commentary on the study by Zorzi et al. provided additional evidence of functional cerebellar changes in Dementia with Lewy bodies. Here, we review evidence for cerebellar involvement in hallucinations across multiple clinical conditions and sensory modalities as well as examine its wider clinical and mechanistic implications. The combined structural and functional evidence is consistent with two models of cerebellar contribution to hallucination which differ in their implied direction of cause, effect and temporal sequence. Additionally, we contend that the relatively neuroanatomically localised nature of the cerebellum makes it particularly suited to identifying changes affecting distributed cortical networks using imaging techniques. As such, cerebellar subfield differences may offer value as candidate prognostic and predictive biomarkers as well as targets for neuromodulatory treatment across a range of clinical conditions.
我们最近的神经影像学研究发现，与眼部疾病或帕金森病患者的皮质注意网络相关的小脑小叶结构存在差异，这些患者会出现幻视。Zorzi 等人对该研究的评论提供了进一步的证据，表明路易体痴呆症患者的小脑功能发生了变化。在这里，我们回顾了跨多种临床情况和感觉模式的小脑参与幻觉的证据，并探讨了其更广泛的临床和机制意义。综合结构和功能证据支持两种不同的小脑对幻觉的贡献模型，它们在因果关系、影响和时间顺序上的含义不同。此外，我们认为小脑相对神经解剖学上的局部性质使其特别适合使用成像技术识别影响分布式皮质网络的变化。因此，小脑小叶的差异可能作为候选的预后和预测生物标志物，以及在一系列临床情况下进行神经调节治疗的靶点。
