Functional and Structural Connectivity of the Cerebellar Nuclei With the Striatum and Cerebral Cortex in First-Episode Psychosis

Lee, Kwang Hyuk; Oh, Hyerim; Suh, Jee Hyung S.; Cho, Kang Ik K.; Yoon, Youngwoo Bryan; Shin, Won Gyo; Lee, Tae Young; Kwon, Jun Soo

doi:10.1176/appi.neuropsych.17110276

Cited by 16 publications

(6 citation statements)

References 41 publications

(44 reference statements)

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“…Thus, we speculated that the information transmission could be influenced between the thalamus and prefrontal lobe while the integrity of the ATR was compromised. Simultaneously, the ATR was a part of the cortico-striatal-thalamo-cortical circuit, which played a vital role in several psychiatric disorders [55][56][57]. However, we did not find any correlations between DTI metrics of ATR and HAMA/HAMD-24 scores in the present study, which might limit the relatively small sample size.…”

Section: Discussioncontrasting

confidence: 76%

Segmental Abnormalities of White Matter Microstructure in Primary Hypothyroidism Identified by Automated Fiber Quantification

Cao¹,

Chen²,

Zhang³

et al. 2023

Neuroendocrinology

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Introduction: Hypothyroidism leads to impaired white matter (WM) integrity, associated with cognitive/neuropsychiatric dysfunction. However, the specific segmental abnormalities of the fibers remain unexplored. Therefore, this study aimed to investigate whether the damage of the WM is limited to a specific segment or the entire bundle via diffusion metrics using automated fiber quantification. Methods: A cross-sectional study was conducted on 31 hypothyroid patients and 28 healthy controls. Thyroid-related hormone levels, cognitive/neuropsychiatric function, and diffusion tensor image data were collected and analyzed. Correlation and random forest analyses were also performed. Results: The mean fractional anisotropy (FA) values were reduced at the fiber tract level. The mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were increased in several fiber tracts, i.e., cingulum cingulate (CC), anterior forceps of corpus callosum (CCF_A). Significant correlations were found between cognitive function and diffusion indicators such as the FA value of the left corticospinal tract and arcuate fasciculus (AF), the MD value of left CC, the RD value of left AF, the AD value of left CC, and CCF_A. The widespread microstructure disruption was spread on multiple specific segments of different tracts at the point-wise level. The random forest revealed that the accuracy of recognizing hypothyroid patients was 82.5%, with the anterior component of CCF_A having the most significant contribution. Conclusion: WM microstructural integrity impairments were found in multi-segments of the multiple fiber bundles in hypothyroidism, which might be a potential mechanism of the underlying neurocognitive decline and cerebral impairment. The CCF_A might serve as a neuro biomarker for early warning of cerebral impairment in hypothyroidism.

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Section: Discussioncontrasting

confidence: 76%

Segmental Abnormalities of White Matter Microstructure in Primary Hypothyroidism Identified by Automated Fiber Quantification

Cao¹,

Chen²,

Zhang³

et al. 2023

Neuroendocrinology

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“…The "cognitive dysmetria" (2, 95, 96) and "dysmetria of thought" psychopathological and pathophysiological models (1,4) propose that psychotic symptoms are manifestations of dysmetria, or incoordination, of mental activity resulting from cerebellar and/or cerebro-cerebellar circuit dysfunction. Providing support for these models, there is accumulating evidence for abnormalities of cerebellar structure (8,97,98), function (2, 5-7, 99, 100), and connectivity (78, 79,98,[101][102][103][104][105][106][107][108][109][110][111][112][113][114][115] in psychotic disorders, with some studies suggesting that abnormalities within cerebro-cerebellar circuitry may even precede (109) and predict progression (110,113) cerebellum is a suitable site to interfere with time perception using 1 Hz rTMS (38,60) or cTBS (62). In addition, the IDT is a task that is expected to be sensitive to disruptions in cerebellar functioning: studies suggest that interval-based tasks such as the IDT rely on mechanisms involving the cerebellum (62,116).…”

Section: Discussionmentioning

confidence: 99%

Cerebellar transcranial magnetic stimulation in psychotic disorders: intermittent, continuous, and sham theta-burst stimulation on time perception and symptom severity

Shinn,

Hurtado-Puerto,

Roh

et al. 2023

Front. Psychiatry

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BackgroundThe cerebellum contributes to the precise timing of non-motor and motor functions, and cerebellum abnormalities have been implicated in psychosis pathophysiology. In this study, we explored the effects of cerebellar theta burst stimulation (TBS), an efficient transcranial magnetic stimulation protocol, on temporal discrimination and self-reported mood and psychotic symptoms.MethodsWe conducted a case-crossover study in which patients with psychosis (schizophrenias, schizoaffective disorders, or bipolar disorders with psychotic features) were assigned to three sessions of TBS to the cerebellar vermis: one session each of intermittent (iTBS), continuous (cTBS), and sham TBS. Of 28 enrolled patients, 26 underwent at least one TBS session, and 20 completed all three. Before and immediately following TBS, participants rated their mood and psychotic symptoms and performed a time interval discrimination task (IDT). We hypothesized that cerebellar iTBS and cTBS would modulate these measures in opposing directions, with iTBS being adaptive and cTBS maladaptive.ResultsReaction time (RT) in the IDT decreased significantly after iTBS vs. Sham (LS-mean difference = −73.3, p = 0.0001, Cohen’s d = 1.62), after iTBS vs. cTBS (LS-mean difference = −137.6, p < 0.0001, d = 2.03), and after Sham vs. cTBS (LS-mean difference = −64.4, p < 0.0001, d = 1.33). We found no effect on IDT accuracy. We did not observe any effects on symptom severity after correcting for multiple comparisons.ConclusionWe observed a frequency-dependent dissociation between the effects of iTBS vs. cTBS to the cerebellar midline on the reaction time of interval discrimination in patients with psychosis. iTBS showed improved (adaptive) while cTBS led to worsening (maladaptive) speed of response. These results demonstrate behavioral target engagement in a cognitive dimension of relevance to patients with psychosis and generate testable hypotheses about the potential therapeutic role of cerebellar iTBS in this clinical population.Clinical Trial Registrationclinicaltrials.gov, identifier NCT02642029.

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“…The masks for deep cerebellar nuclei, dentate nucleus (DN), and interpositus nucleus (IN), were taken from the SPM neuroanatomy toolbox ( 51 ) and were imported in the CONN toolbox. All ROIs were thresholded to contain only voxels that were inside each ROI with a probability threshold above 60% ( 52 ). Notably, when extracting ROI-level BOLD signal, we opted to use the unsmoothed images to further avoid signal contamination from neighboring voxels of other proximal regions, which was especially important in using cerebellar ROIs that are very close to each other ( 53 ).…”

Section: Methodsmentioning

confidence: 99%

Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

et al. 2022

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Magnetic Resonance-guided high-intensity Focused Ultrasound (MRgFUS) of the thalamic ventral intermediate nucleus (Vim) for tremor has increasingly gained interest as a new non-invasive alternative to standard neurosurgery. Resting state functional connectivity (rs-FC) correlates of MRgFUS have not been extensively investigated yet. A region of interest (ROI)-to-ROI rs-FC MRI “connectomic” analysis focusing on brain regions relevant for tremor was conducted on 15 tremor-dominant patients with Parkinson's disease who underwent MRgFUS. We tested whether rs-FC between tremor-related areas was modulated by MRgFUS at 1 and 3 months post-operatively, and whether such changes correlated with individual clinical outcomes assessed by the MDS-UPDRS-III sub items for tremor. Significant increase in FC was detected within bilateral primary motor (M1) cortices, as well as between bilateral M1 and crossed primary somatosensory cortices, and also between pallidum and the dentate nucleus of the untreated hemisphere. Correlation between disease duration and FC increase at 3 months was found between the putamen of both cerebral hemispheres and the Lobe VI of both cerebellar hemispheres, as well as between the Lobe VI of untreated cerebellar hemisphere with bilateral supplementary motor area (SMA). Drop-points value of MDS-UPDRS at 3 months correlated with post-treatment decrease in FC, between the anterior cingulate cortex and bilateral SMA, as well as between the Lobe VI of treated cerebellar hemisphere and the interpositus nucleus of untreated cerebellum. Tremor improvement at 3 months, expressed as percentage of intra-subject MDS-UPDRS changes, correlated with FC decrease between bilateral occipital fusiform gyrus and crossed Lobe VI and Vermis VI. Good responders (≥50% of baseline tremor improvement) showed reduced FC between bilateral SMA, between the interpositus nucleus of untreated cerebellum and the Lobe VI of treated cerebellum, as well as between the untreated SMA and the contralateral putamen. Good responders were characterized at baseline by crossed hypoconnectivity between bilateral putamen and M1, as well as between the putamen of the treated hemisphere and the contralateral SMA. We conclude that MRgFUS can effectively modulate brain FC within the tremor network. Such changes are associated with clinical outcome. The shifting mode of integration among the constituents of this network is, therefore, susceptible to external redirection despite the chronic nature of PD.

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Functional and Structural Connectivity of the Cerebellar Nuclei With the Striatum and Cerebral Cortex in First-Episode Psychosis

Cited by 16 publications

References 41 publications

Segmental Abnormalities of White Matter Microstructure in Primary Hypothyroidism Identified by Automated Fiber Quantification

Segmental Abnormalities of White Matter Microstructure in Primary Hypothyroidism Identified by Automated Fiber Quantification

Cerebellar transcranial magnetic stimulation in psychotic disorders: intermittent, continuous, and sham theta-burst stimulation on time perception and symptom severity

Resting State Functional Connectivity Signatures of MRgFUS Vim Thalamotomy in Parkinson's Disease: A Preliminary Study

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