Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan.
Department of Brain and Behavioral Sciences, University of Pavia, Pavia.
Int Clin Psychopharmacol. 2024 Jul 1;39(4):223-231. doi: 10.1097/YIC.0000000000000535. Epub 2024 Feb 13.
Cerebellar alterations, including both volumetric changes in the cerebellar vermis and dysfunctions of the corticocerebellar connections, have been documented in psychotic disorders. Starting from the clinical observation of a bipolar patient with cerebellar hypoplasia, the purpose of this review is to summarize the data in the literature about the association between hypoplasia of the cerebellar vermis and psychotic disorders [schizophrenia (SCZ) and bipolar disorder (BD)].
A bibliographic search on PubMed has been conducted, and 18 articles were finally included in the review: five used patients with BD, 12 patients with SCZ and one subject at psychotic risk.
For SCZ patients and subjects at psychotic risk, the results of most of the reviewed studies seem to suggest a gray matter volume reduction coupled with an increase in white matter volumes in the cerebellar vermis, compared to healthy controls. Instead, the results of the studies on BD patients are more heterogeneous with evidence showing a reduction, no difference or even an increase in cerebellar vermis volume compared to healthy controls.
From the results of the reviewed studies, a possible correlation emerged between cerebellar vermis hypoplasia and psychotic disorders, especially SCZ, ultimately supporting the hypothesis of psychotic disorders as neurodevelopmental disorders.
小脑的改变，包括小脑蚓部的体积变化和皮质-小脑连接的功能障碍，在精神疾病中已有记载。从一位双相障碍患者小脑发育不良的临床观察出发，本综述的目的是总结文献中关于小脑蚓部发育不良与精神障碍（精神分裂症（SCZ）和双相障碍（BD））之间关联的数据。
在 PubMed 上进行了文献检索，最终有 18 篇文章被纳入综述：5 篇使用了 BD 患者，12 篇使用了 SCZ 患者，1 篇使用了精神病风险患者。
对于 SCZ 患者和精神病风险患者，大多数综述研究的结果似乎表明与健康对照组相比，小脑蚓部的灰质体积减少，同时白质体积增加。相比之下，BD 患者研究的结果更为多样化，有证据表明与健康对照组相比，小脑蚓部体积减少、无差异甚至增加。
从综述研究的结果中，可以看出小脑蚓部发育不良与精神障碍之间存在可能的相关性，尤其是 SCZ，最终支持了精神障碍是神经发育障碍的假说。
