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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.6 no.4 São Paulo Oct./Dec. 2012

https://doi.org/10.1590/S1980-57642012DN06040003 

Artigos Originais

Relationship between structural abnormalities in the cerebellum and dementia, posttraumatic stress disorder and bipolar disorder

Relação entre as alterações estruturais do cerebelo e demência, transtorno do estresse pós-traumático e transtorno bipolar

Leonardo Baldaçara1  2 

João Guilherme Fiorani Borgio1 

Célia Araújo1 

Fabiana Nery-Fernandes3 

Acioly Luiz Taveres Lacerda1 

Walter André dos Santos Moraes1 

Maria Beatriz Marcondes Macedo Montaño1 

Marlos Rocha3 

Lucas C. Quarantini3 

Aline Schoedl1 

Mariana Pupo1 

Marcelo F. Mello1 

Sergio B. Andreoli1 

Angela Miranda-Scippa3 

Luiz Roberto Ramos1 

Jair J. Mari1 

Rodrigo Affonseca Bressan1 

Andrea Parolin Jackowski1 

1Federal University of São Paulo, SP, Brazil.

2Federal University of Tocantins, TO, Brazil.

3Federal University of Bahia, BA, Brazil.


ABSTRACT.

New evidence suggests that the cerebellum has structural and functional abnormalities in psychiatric disorders.

Objective:

In this research, the goal was to measure the volume of the cerebellum and its subregions in individuals with psychiatric disorders and to relate these findings to their symptoms.

Methods:

Patients with different degrees of cognitive impairment (Epidemiology of the Elderly - UNIFESP) and patients with post-traumatic stress disorder (PTSD) from population studies were analyzed. Also, patients with bipolar disorder from an outpatient clinic (Center for the Study of Mood and Anxiety Disorders, Universidade Federal da Bahia) were recruited for this study. All subjects underwent a 1.5T structural magnetic resonance scan. Volumetric measures and symptom measurements, by psychometric scales, were performed and compared between patients and controls.

Results:

The cerebellum volume was reduced in patients with cognitive impairment without dementia and with dementia, in patients with PTSD, and in patients with bipolar disorder compared to controls. In dementia and PTSD, the left cerebellar hemisphere and vermis volume were reduced. In bipolar disorder, volumes of both hemispheres and the vermis were reduced. In the first two studies, these cerebellar volumetric reductions correlated with symptoms of the disease.

Conclusion:

The exact nature of cerebellar involvement in mental processes is still not fully understood. However, abnormalities in cerebellar structure and its functions have been reported in some of these diseases. Future studies with larger samples are needed to clarify these findings and investigate whether they are important for treatment and prognosis.

Key words: cerebellum; neuroimaging; mental disorders; risk factors; comparative study

RESUMO

Novas evidências sugerem que o cerebelo apresenta alterações estruturais e funcionais nos transtornos psiquiátricos.

Objetivo:

Medir o volume do cerebelo e de suas sub-regiões em indivíduos portadores de transtornos psiquiátricos e relacionar tais achados aos sintomas.

Métodos:

Foi realizada a identificação de pacientes com diferentes graus de prejuízo cognitivo proveniente de um estudo populacional (Epidemiologia do Idoso - UNIFESP), pacientes com transtorno do estresse pós-traumático proveniente de outro estudo populacional e portadores de transtorno bipolar proveniente de um ambulatório especializado (Universidade Federal da Bahia). Todos os sujeitos foram submetidos à ressonância magnética estrutural de 1.5T. As medidas de volume, assim como os sintomas medidos por escalas psicométricas foram comparadas entre pacientes e controles.

Resultados:

Foi observado que o volume do cerebelo está reduzido nos portadores de prejuízo cognitivo sem demência e com demência, no transtorno do estresse pós-traumático e no transtorno bipolar quando comparados aos controles. Na demência e no transtorno do estresse pós-traumático o volume do hemisfério cerebelar esquerdo e do vérmis estão reduzidos. No transtorno bipolar os volumes de ambos os hemisférios e do vérmis estão reduzidos. Nos dois primeiros estudos estas reduções correlacionaram com os sintomas.

Conclusão:

A natureza exata do envolvimento do cerebelo nos processos mentais ainda não é compreendida. Entretanto, anormalidades na estrutura cerebelar e em suas funções têm sido relatadas em algumas dessas doenças. Pesquisas futuras, com amostras maiores, ainda são necessárias para esclarecer tais achados e investigar se são importantes para o tratamento e prognóstico.

Palavras-chave: cerebelo; neuroimagem; transtornos mentais; fatores de risco; estudo comparativo

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

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Received: June 10, 2012; Accepted: September 03, 2012

Leonardo Baldaçara. QD 601 Sul / Av. NS 01 / CJ. 02 / Bl 04 / Plano Diretor Sul - 77016-332 Palmas TO - Brazil. E-mail: leonardobaldassara@gmail.com

Disclosure: The authors report no conflicts of interest.

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