The cerebellum plays more than one role in the dysregulation of appetite: Review of structural evidence from typical and eating disorder populations

Abstract

ObjectiveDysregulated appetite control is characteristic of anorexia nervosa (AN), bulimia nervosa (BN), and obesity (OB). Studies using a broad range of methods suggest the cerebellum plays an important role in aspects of weight and appetite control, and is implicated in both AN and OB by reports of aberrant gray matter volume (GMV) compared to nonclinical populations. As functions of the cerebellum are anatomically segregated, specific localization of aberrant anatomy may indicate the mechanisms of its relationship with weight and appetite in different states. We sought to determine if there were consistencies in regions of cerebellar GMV changes in AN/BN and OB, as well as across normative (NOR) variation.MethodSystematic review and meta‐analysis using GingerALE.ResultsTwenty‐six publications were identified as either case–control studies (nOB = 277; nAN/BN = 510) or regressed weight from NOR data against brain volume (total n = 3830). AN/BN and OB analyses both showed consistently decreased GMV within Crus I and Lobule VI, but volume reduction was bilateral for AN/BN and unilateral for OB. Analysis of the NOR data set identified a cluster in right posterior lobe that overlapped with AN/BN cerebellar reduction. Sensitivity analyses indicated robust repeatability for NOR and AN/BN cohorts, but found OB‐specific heterogeneity.DiscussionFindings suggest that more than one area of the cerebellum is involved in control of eating behavior and may be differentially affected in normal variation and pathological conditions. Specifically, we hypothesize an association with sensorimotor and emotional learning via Lobule VI in AN/BN, and executive function via Crus I in OB.

Early adversity affects cerebellar structure and function – A systematic review of human and animal studies

“…Complementing the classic role of the cerebellum in motor learning, motor coordination, and timing of muscle groups for fluid movements (Manto et al, 2012), recent evidence has highlighted the involvement of the cerebellum in several cognitive and affective functions such as executive control (e.g., Bellebaum and Daum, 2007;Brunamonti et al, 2014), error and feedback processing (Peterburs et al, 2012(Peterburs et al, , 2015(Peterburs et al, , 2018, reward processing (Kostadinov & Häusser, 2022) and performance monitoring in general (Peterburs & Desmond, 2016), working memory (Ben-Yehudah et al, 2007;Chen & Desmond, 2005;Cooper et al, 2012;Desmond et al, 1997;Peterburs et al, 2019Peterburs et al, , 2021, language and verbal fluency (Ackermann et al, 2007;Mariën et al, 2014;Peterburs et al, 2010;Vias & Dick, 2017), social cognition (Van Overwalle et al, 2020) emotion regulation (Ferrari et al, 2022;Frazier et al, 2022;Schraa-Tam et al, 2012;Schutter & van Honk, 2009), visual attention (Brissenden & Somers, 2019;Kellermann et al, 2012), appetite (Sader et al, 2023), and circadian rhythmicity (Yalçin et al, 2022). Notably, these cognitive and affective functions involving the cerebellum are altered in several psychiatric disorders, with altered affect in mood and anxiety disorders as well as altered cognitive functioning in schizophrenia or posttraumatic stress disorders (American Psychiatric Association, 2013) as prominent examples.…”