Objective:

The aim of this study is to confirm the hypothesis of a functional involvement of the cerebellum in Parkinson’s disease according to a tri-compartmental topography: motor, associative and limbic.

Background: New evidences are merging for the involvment of the cerebellum in non motor functions. Beyond motor dysfunction, executive and psychic disorders are also well described in PD patients, in connection with the functional sensori-motor, associative and limbic tri-compartmentalization of the basal ganglia. This could be associated with either lesional and/or compensatory involvement of these three distinct functional areas of the cerebellum.

Methods: We studied 90 parkinsonian patients included in a pre-surgical assessment for deep brain stimulation. All of them underwent a metabolic imaging with a resting-state ¹⁸FDG-PET-Scan and a full clinical evaluation including motor, neuropsychological and psychiatric scales. A principal component analysis (PCA) was performed on clinical variables in order to obtain a composite score reflecting respectively the motor, cognitive and psychic state. Each of these three scores have been correlated with cerebellar metabolism, using a general linear regression model in Statistical Parametric Mapping 8. Age of the patient and the total levodopa equivalent daily dose were used as covariates.

Results:

A positive correlation between the motor PCA score and the metabolism variation in the bilateral cerebellum, involving both anterior and posterior lobe, and the vermis (p<0.001 FWE cor) was found. In addition we found a positive correlation between the psychic PCA score and the metabolism variation in the right posterior lobe Crus I and Crus II  (p<0.05 FWE cor). Finally a negative correlation (p<0.05 FWE cor) between the cognitive PCA score and the metabolism variation in the right posterior lobe predominently (Crus I,  Crus II, Declive) was observed.

Conclusions:

These results confirm, with a high statistical power, the recent data about the tri-compartmental topographical functional organization of the cerebellum similar to the one observed in the basal ganglia. They suggest the lesionally and/or compensatory involvement of the cerebellum in both motor and non-motor symptoms observed in Parkinson’s disease.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/functional-role-of-the-cerebellum-in-parkinsons-disease-a-pet-study/