The role of the cerebellum in sequencing and predicting social and non-social events in patients with bipolar disorder

Abstract

IntroductionAdvances in the operational mode of the cerebellum indicate a role in sequencing and predicting non-social and social events, crucial for individuals to optimize high-order functions, such as Theory of Mind (ToM). ToM deficits have been described in patients with remitted bipolar disorders (BD). The literature on BD patients’ pathophysiology reports cerebellar alterations; however, sequential abilities have never been investigated and no study has previously focused on prediction abilities, which are needed to properly interpret events and to adapt to changes.MethodsTo address this gap, we compared the performance of BD patients in the euthymic phase with healthy controls using two tests that require predictive processing: a ToM test that require implicit sequential processing and a test that explicitly assesses sequential abilities in non-ToM functions. Additionally, patterns of cerebellar gray matter (GM) alterations were compared between BD patients and controls using voxel-based morphometry.ResultsImpaired ToM and sequential skills were detected in BD patients, specifically when tasks required a greater predictive load. Behavioral performances might be consistent with patterns of GM reduction in cerebellar lobules Crus I-II, which are involved in advanced human functions.DiscussionThese results highlight the importance of deepening the cerebellar role in sequential and prediction abilities in patients with BD.

Role of the Cerebellum in Bipolar Disorder: A Systematic Literature Review

“…Siciliano et al (2023) examined the differences in cerebellar gray matter alterations in patients with bipolar disorder compared to healthy controls using voxel-based morphometry [ 22 ]. Two large clusters of gray matter reduction were noted between bipolar disorder and healthy control groups [ 22 ].…”

“…Siciliano et al (2023) examined the differences in cerebellar gray matter alterations in patients with bipolar disorder compared to healthy controls using voxel-based morphometry [ 22 ]. Two large clusters of gray matter reduction were noted between bipolar disorder and healthy control groups [ 22 ]. Cluster one comprised the right crus II, while cluster II comprised the right lobules I-IV and V with extension to lobule VI, crus I, VIIIa, VIIIb, IX, left crus I and II, vermis crus II, vermis VI, and vermis VIIIa [ 22 ].…”

“…Two large clusters of gray matter reduction were noted between bipolar disorder and healthy control groups [ 22 ]. Cluster one comprised the right crus II, while cluster II comprised the right lobules I-IV and V with extension to lobule VI, crus I, VIIIa, VIIIb, IX, left crus I and II, vermis crus II, vermis VI, and vermis VIIIa [ 22 ]. This study also assessed participants using the Faux Pas test, a series of 20 stories where participants had to detect if a social faux pas had occurred [ 22 ].…”

“…Cluster one comprised the right crus II, while cluster II comprised the right lobules I-IV and V with extension to lobule VI, crus I, VIIIa, VIIIb, IX, left crus I and II, vermis crus II, vermis VI, and vermis VIIIa [ 22 ]. This study also assessed participants using the Faux Pas test, a series of 20 stories where participants had to detect if a social faux pas had occurred [ 22 ]. This test is used to assess one's ability to make inferences about another person's state of mind.…”

“…This test is used to assess one's ability to make inferences about another person's state of mind. The authors found that the bipolar group had decreased detection of “social faux pas” and the ability to “justify other people’s behaviors” when they were identified compared to healthy controls, but no differences in “no social pas” detection [ 22 ]. The authors suggest that the cerebellum functions to sequence and predict events in both sensorimotor and cognitive domains and detect deviations from “correct” sequences [ 22 ].…”