Effectiveness of Cerebellar Circuitry Modulation in Schizophrenia: A Systematic Review
Abstract
Structural and functional abnormalities of the cerebellum have been observed in schizophrenia since the first neuroimaging studies. More recently, the functions of the cerebellum have been extended beyond sensorimotor control to include participation in higher-level cognition and affective regulation. Consistently, the "cognitive dysmetria" theory posits that dysfunctions of cortical-subcortical-cerebellar circuitry may be crucial for the pathogenesis of different clinical features of schizophrenia. This conceptual framework offers a set of testable hypotheses, now that various tools to exert direct modulation of cerebellar activity are available. We conducted a systematic review of studies examining the effects of cerebellar modulation in schizophrenia. Two independent authors conducted a search within PubMed for articles published up to April 2019 and identified 10 studies (three randomized controlled trials, two open-label studies, two case reports, one preclinical study) describing the effects of cerebellar circuitry modulation in patients with schizophrenia or animal models. The majority of interventions were uncontrolled and used stimulation of the cerebellar vermis, using transcranial magnetic stimulation or transcranial direct-current stimulation. Most studies detected improvements after cerebellar modulation. Clinical changes mostly pertained the domains of negative symptoms, depressive symptoms and cognitive functions. In conclusion, few studies examined the effects of cerebellar modulation in schizophrenia but yielded promising results. This approach may hold therapeutic potential, pending further methodologically robust replication.
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The cerebellum plays an abnormal role in the pathophysiology of mood disorders, psychiatric disorders, and predictive impairments.
“The cerebellum was found to play an abnormal role in the patho physiology of mood disorders (Schutter, 2016; Olivito et al., 2022), psychiatric disorders (Escelsior et al., 2019), and predictive impairments (Friston and Herreros, 2016).”
From Predictive coding in neuropsychiatric disorders: a systematic transdiagnostic review. (2025) · cites this paper as Escelsior et al., 2019
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- Authors
- Escelsior, A., Belvederi Murri, M., Calcagno, P., Cervetti, A., Caruso, R., Croce, E., Grassi, L., & Amore, M.
- Affiliations
- Ospedale Policlinico San Martino (IT)
- University of Ferrara (IT)
- Corresponding author
- Escelsior, Andrea
- Calcagno, Pietro
- Cervetti, Alice
- Amore, Mario
- Venue
- Journal of Nervous & Mental Disease
- Published
- 2019-09-10
- Volume
- 207
- Issue
- 11
- Pages
- 977-986
- ISSN
- 0022-3018 (ISSN-L)
- 1539-736X
- OpenAlex
- W2972796602
- Cited by
- 32
- References
- 112
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 7 · 2020: 2
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Nervous and Mental Disease (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- schizophrenia, cerebellum, cognitive dysmetria, transcranial magnetic stimulation, transcranial direct current stimulation, negative symptoms, depressive symptoms, cognitive function
- MeSH terms
- Animals, Cerebellum, Humans, Nerve Net, Schizophrenia, Treatment Outcome, Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation
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