Cerebellar Structural Abnormalities Associated With Cognitive Function in Patients With First-Episode Psychosis

Abstract

Introduction: The fundamental role of the cerebellum in higher cognitive processing has recently been highlighted. However, inconsistent findings exist in schizophrenia with respect to the exact nature of cerebellar structural abnormalities and their associations with cognitive and clinical features. Materials and Methods: We undertook a detailed investigation of cerebellar lobular volumes in 40 patients with first-episode psychosis (FEP) and 40 healthy controls (HCs) using the spatially unbiased atlas template of the cerebellum (SUIT). We examined the functional significance of cerebellar structural abnormalities in relation to cognitive and clinical outcomes in patients. Results: We found that left cerebellar lobules VI and X volumes were lower in FEP patients, compared to HCs. Smaller left lobules VI and X volumes were associated with fewer number of categories completed on the Wisconsin Card Sorting Test (WCST) in patients. In addition, smaller left lobule X volume was related to performance delay on the Trail Making Test (TMT) Part B in patients. Conclusion: Our results demonstrate that cerebellar structural abnormalities are present at the early stage of schizophrenia. We suggest functional associations of cerebellar structural changes with non-verbal executive dysfunctions in FEP.

Keywords: FEP; SUIT; cerebellum; executive function; neurocognition; neuroimaging; schizophrenia.

Figure 1

Volumetric differences of cerebellar lobules between FEP patients and HCs. (A) Regions of interest (ROIs) were selected from 28 cerebellar lobules using the SUIT cerebellum atlas, and ROIs of left lobules VI and X that significantly differed between groups are shown in the figure. (B) Cerebellar volumes of left lobules VI and X are smaller in FEP patients compared to HCs.