Cerebellum-Cerebral Neural Loop After ECT For Schizophrenia: New Study From China

Functional reconfiguration of cerebellum-cerebral neural loop in schizophrenia following electroconvulsive therapy.

Hu H, Jiang Y, Xia M, Tang Y, Zhang T, Cui H, Wang J, Xu L, Curtin A, Sheng J, Cao X, Guo Q, Jia Y, Li C, Wang Z, Luo C, Wang J.Psychiatry Res Neuroimaging. 2022 Jan 22;320:111441. doi: 10.1016/j.pscychresns.2022.111441. Online ahead of print.PMID: 35085957

The abstract is copied below:

Recent evidence highlights the role of the cerebellum-cerebral loop in the pathophysiology of schizophrenia (SZ). Electroconvulsive therapy (ECT) is clinically applied to augment the effect of antipsychotic drugs. The study aims to address whether the cerebellum-cerebral loop is involved in the mechanisms of ECT's augmentation effect. Forty-two SZ patients and 23 healthy controls (HC) were recruited and scanned using resting-state functional MRI (rs-fMRI). Twenty-one patients received modified ECT plus antipsychotics (MSZ group), and 21 patients took antipsychotics only (DSZ group). All patients were re-scanned four weeks later. Brain functional network was constructed according to the graph theory. The sub-network exhibited longitudinal changes after ECT or medications were constructed. For the MSZ group, a sub-network involving default-mode network and cerebellum showed significant longitudinal changes. For the DSZ group, a different sub-network involving the thalamus, frontal and occipital cortex was found to be altered in the follow-up scan. In addition, the changing FC of the left cerebellar crus2 region was correlated with the changing scores of the psychotic symptoms only in the MSZ group but not in the DSZ group. In conclusion, the cerebral-cerebellum loop is possibly involved in the antipsychotic mechanisms of ECT for schizophrenia.

Keywords: Cerebellum; ECT; Large scale network; Schizophrenia.

The article is here.

And from the text:

The most significant finding of our study is that the aberrant FC between the cerebellum and cerebrum could be restored by an entire course of ECT. Specifically, our result showed that ECT could largely increase the FC between the cerebellum and cerebrum.

Conclusion Schizophrenia is an illness of the whole brain, including the cerebellum. The cerebral-cerebellum loop is possibly involved in the antipsychotic mechanisms of ECT. 

With apologies for my Ludditic cynicism, there is not much to see here. As is typical of such neuroimaging studies, the figures are pretty and the methods pretty obtuse. One interesting detail is the combined use of etomidate and propofol for ECT anesthesia. And of course, it is noteworthy that the cerebellum is getting so much attention for the processing of higher order functions, not just movement and balance.

So ECT normalizes a bit of abnormal connectivity involving the cerebellum, and psychotic symptoms improve. True, true, related?

Neuroimaging/connectivity scholars will want to read this in full (~25 minutes), but the rest of us could better use the time reading other ECT articles.