Comparison of cerebellar grey matter alterations in bipolar and cerebellar patients: evidence from voxel-based analysis

The aim of this study was to compare the patterns of cerebellar alterations associated with bipolar disease with those induced by the presence of cerebellar neurodegenerative pathologies to clarify the potential cerebellar contribution to bipolar affective disturbance. Twenty-nine patients affected by bipolar disorder, 32 subjects affected by cerebellar neurodegenerative pathologies, and 37 age-matched healthy subjects underwent a 3T MRI protocol. A voxel-based morphometry analysis was used to show similarities and differences in cerebellar grey matter (GM) loss between the groups. We found a pattern of GM cerebellar alterations in both bipolar and cerebellar groups that involved the anterior and posterior cerebellar regions (p = 0.05). The direct comparison between bipolar and cerebellar patients demonstrated a significant difference in GM loss in cerebellar neurodegenerative patients in the bilateral anterior and posterior motor cerebellar regions, such as lobules I−IV, V, VI, VIIIa, VIIIb, IX, VIIb and vermis VI, while a pattern of overlapping GM loss was evident in right lobule V, right crus I and bilateral crus II. Our findings showed, for the first time, common and different alteration patterns of specific cerebellar lobules in bipolar and neurodegenerative cerebellar patients, which allowed us to hypothesize a cerebellar role in the cognitive and mood dysregulation symptoms that characterize bipolar disorder

Aberrant cerebello-cerebral connectivity in remitted bipolar patients 1 and 2: new insight into understanding the cerebellar role in mania and hypomania

Bipolar disorder (BD) is a major mental illness characterized by periods of (hypo) mania and depression with inter-episode remission periods. Functional studies in BD have consistently implicated a set of linked cortical and subcortical limbic regions in the pathophysiology of the disorder, also including the cerebellum. However, the cerebellar role in the neurobiology of BD still needs to be clarified. Seventeen euthymic patients with BD type1 (BD1) (mean age/SD, 38.64/13.48; M/F, 9/8) and 13 euthymic patients with BD type 2 (BD2) (mean age/SD, 41.42/14.38; M/F, 6/7) were compared with 37 sex- and age-matched healthy subjects (HS) (mean age/SD, 45.65/14.15; M/F, 15/22). T1 weighted and resting-state functional connectivity (FC) scans were acquired. The left and right dentate nucleus were used as seed regions for the seed based analysis. FC between each seed and the rest of the brain was compared between patients and HS. Correlations between altered cerebello-cerebral connectivity and clinical scores were then investigated. Different patterns of altered dentate-cerebral connectivity were found in BD1 and BD2. Overall, impaired dentate-cerebral connectivity involved regions of the anterior limbic network specifically related to the (hypo)manic states of BD. Cerebello-cerebral connectivity is altered in BD1 and BD2. Interestingly, the fact that these altered FC patterns persist during euthymia, supports the hypothesis that cerebello-cerebral FC changes reflect the neural correlate of subthreshold symptoms, as trait-based pathophysiology and/or compensatory mechanism to maintain a state of euthymia

The Cerebellum Gets Social: Evidence from an Exploratory Study of Cerebellar, Neurodevelopmental, and Psychiatric Disorders

Social prediction is a key feature of social cognition (SC), a function in which the modulating role of the cerebellum is recognized. Accordingly, cerebellar alterations are reported in cerebellar pathologies, neurodevelopmental disorders, and psychiatric conditions that show SC deficits. Nevertheless, to date, no study has directly compared populations representative of these three conditions with respect to SC and cerebellar alterations. Therefore, the present exploratory study aimed to compare the SC profiles of individuals with cerebellar neurodegenerative disorders (CB), autism (ASD), bipolar disorder type 2 (BD2), or healthy subjects (HS) using a battery of social tests requiring different degrees of prediction processing. The patterns of cerebellar gray matter (GM) alterations were compared among the groups using voxel-based morphometry. Compared to HS, the clinical groups showed common SC deficits in tasks involving a moderate to high level of prediction. The behavioral results of the clinical groups are consistent with the presence of overlapping GM reduction in cerebellar right Crus II, an area notably involved in complex social processing and prediction. Although exploratory and preliminary, these results deepen the cerebellar role in social prediction and highlight the transdiagnostic value of the cerebellum in social functioning and prediction in pathologies of different aetiologies, forecasting novel possibilities for shared interventions

Validation and psychometric properties of the Italian version of the Fear of Guilt Scale

Numerosi studi e osservazioni cliniche hanno dimostrato il ruolo centrale del timore di colpa nella genesi e nel mantenimento del disturbo ossessivo-compulsivo. Ad oggi, in lingua italiana sono disponibili questionari che misurano la propensione a sperimentare il senso di colpa e la sensibilità individuale verso questa emozione, ma nessuno strumento per valutare il timore di colpa e l’impegno a prevenire o neutralizzare questa esperienza. Lo scopo dello studio è di validare la versione italiana della Fear of Guilt Scale (FOGS), uno strumento che aiuterebbe a discriminare il peso di questo specifico fattore nella sintomatologia ossessiva. A tal fine, la FOGS è stata somministrata a due campioni non clinici (Studio 1) e a una popolazione clinica composta da un sottogruppo con diagnosi di Disturbo ossessivo-compulsivo, uno con diagnosi di Disturbo depressivo maggiore e un altro con diagnosi di Disturbo d’ansia (Studio2). Lo Studio 1 ha confermato la struttura originaria a due fattori (Punizione e Prevenzione del Danno) e ha mostrato un’adeguata coerenza interna, validità convergente e divergente della versione italiana della FOGS. Lo studio 2 ha rivelato che la FOGS è in grado di discriminare i pazienti con disturbo ossessivo-compulsivo dagli altri gruppi di controllo clinico e di prevedere la gravità dei sintomi ossessivi. Si discutono le implicazioni cliniche e di ricerca di questi risultati.Several studies and clinical observations have proven the central role of the fear of guilt in the genesis and maintenance of Obsessive-Compulsive Disorder. To date, questionnaires are available in Italian that measure one’s propensity to experience guilt and sensitivity towards this emotion, understood as a tendency to negatively judge this experience and its effects, but not the fear of guilt and the commitment to prevent or neutralise this experience. The purpose of this study is to validate the Italian version of the Fear of Guilt Scale (FOGS), a tool that would facilitate a more comprehensive understanding of the weight of this specific factor in the obsessive symptomatology. To this end, the FOGS was administered to two non-clinical samples (Study 1) and to a clinical population diagnosed with either Obsessive-Compulsive Disorder, Major Depressive Disorder or Anxiety Disorder (Study2). Study 1 confirmed the original two-factors structure (Punishment and Harm Prevention), and showed adequate internal consistency, convergent and divergent validity of the Italian version of the FOGS. Study 2 revealed that the Italian version of the FOGS was able to discriminate between patients with Obsessive-Compulsive Disorder and the other clinical control groups, and in predicting the severity of obsessive symptoms. Clinical and research implications are also discussed