The Cerebellar Role in Psychiatric Disorders: Emerging Evidence and Future Perspectives

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Background

For a long time, the role of the cerebellum in motor coordination had been the focus of cerebellar clinical interest and the driving hypothesis behind the experimental investigations of its function. Over the years, an increasing number of findings have supported the fact that the cerebellum, apart from integrating motor information (“sensorimotor cerebellum”), plays an important role in cognitive, as well as emotional and behavioral regulation (“cognitive” and “limbic” cerebellum). The “limbic” cerebellum is mainly represented by the vermis and the “cognitive” cerebellum by posterolateral regions. Structural and functional abnormalities in the connected cerebral cortical regions have been described after focal cerebellar lesions, leading to the description of the “cerebellar cognitive affective syndrome”. The concept of “dysmetria of thought” is central to the exploration of the cerebellar role in some psychiatric disorders and refers to the non-motor impairments that emerge when the distributed neural circuits subserving cognitive and affective functions are deprived of cerebellar modulation.

Given its appreciated role in emotion, affect, and behavioral regulation, the cerebellum has recently attracted substantial attention within the context of studies on neurodevelopmental and adult-onset psychiatric disorders. These have included schizophrenia, obsessive-compulsive disorder, bipolar disorder, anxiety, autism spectrum disorder, and attention deficit/hyperactivity disorder. Both clinical and neuroimaging findings have provided significant insight into the cerebellar role in psychiatric conditions. Characteristically, impairments in emotion and behavioral regulation have been reported following cerebellar focal and neurodegenerative disorders. Likewise, cerebellar structural and functional alterations have been described in a wide range of psychiatric conditions, involving, in particular, regions of the “limbic” and the “cognitive cerebellum”. Although these disorders may involve similar cerebellar abnormalities, their symptoms are remarkably different. The exact nature of cerebellar involvement in psychiatric disorders thus remains unclear. In this framework, analyses of convergent data from genetic, developmental, physiological, neuropsychological, and structural and functional brain imaging studies could provide a unique opportunity to clearly define the role of the cerebellum in the pathophysiology of psychiatric disorders.

This Research Topic is oriented towards developing an integrative view of the cerebellar role in psychiatric disorders, while, in particular:
i) delineating the adult-onset and neurodevelopmental structural and functional abnormalities related to different psychiatric conditions
ii) identifying relationships between the different symptoms within each psychiatric disorder and abnormalities within specific cerebellar subregions, as well as the corresponding cerebro-cerebellar pathways
iii) assessing the efficacy of pharmacological intervention in relation to changes in cerebellar structure, function, and cerebro-cerebellar connectivity
iv) testing therapeutic approaches specifically targeting the cerebellum (i.e. neuromodulation)

We expect to attract contributions (original articles, reviews, and short communications) from different specialists in the field, opening new avenues for future studies. Potential topics of such contributions include: the cerebellum in processing emotion and affect; the cerebellum and behavioral regulation; the cerebellum and social interaction; the cerebellum in anxiety and depression; the cerebellum in schizophrenia and bipolar disorder; the cerebellum in attention-deficit/hyperactivity disorder and autism spectrum disorder.

Keywords: Emotion, cognition, MRI, stimulation, cerebellum, Behavior

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