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. 2023 Feb 15:17:1095157.
doi: 10.3389/fncel.2023.1095157. eCollection 2023.

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

Libera Siciliano  1   2 , Giusy Olivito  1   2 , Michela Lupo  3 , Nicole Urbini  1   2 , Andrea Gragnani  4   5 , Marco Saettoni  4   6 , Roberto Delle Chiaie  7 , Maria Leggio  1   2
Affiliations

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

Libera Siciliano et al. Front Cell Neurosci. .

Abstract

Introduction: Advances 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.

Methods: To 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.

Results: Impaired 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.

Discussion: These results highlight the importance of deepening the cerebellar role in sequential and prediction abilities in patients with BD.

Keywords: bipolar disorder; cerebellar atrophy; prediction; sequential processing; theory of mind; voxel-based morphometry.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Behavioral results in BD patients as compared to HS. The results for Sequence Test (A) and Faux Pas Test (B) are presented as the percentage of the total number of correct responses (accuracy); 0% indicates no correct answers, and 100% indicates totally correct answers. The mean and standard deviation of the accuracy are reported for BD and HS. ** Statistical significance at p-values < 0.001. *Statistical significance at p-values < 0.05.
FIGURE 2
FIGURE 2
Between-group voxel-based comparison of cerebellar GM density. Clusters of significantly reduced cerebellar GM in BD compared to HS-MRI are reported and superimposed on the Spatially Unbiased Infratentorial Template (SUIT) (Diedrichsen et al., 2009) in coronal (y), sagittal (x) and axial (z) slices. The results are significant at p-values < 0.05 after FWE cluster-level correction. L: left; R: right.
See this image and copyright information in PMC

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