Cerebellar microstructural abnormalities in patients with somatic symptom disorders

Abstract Background Somatic Symptom Disorder (SSD) is a condition often linked to excessive health anxiety and somatic symptoms. In recent years, studies have found associations between the cerebellum and various mental illnesses, including SSD. However, the microstructure of cerebellar subregions i...

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Main Authors: Wenshuang Tang, Chao Zhang, Yapeng Qi, Qichen Zhou, Huazhi Li, Xiao-Han Shen, Lan Liu, Weikan Wang, Jian-Ren Liu, Xiaoxia Du
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Psychiatry
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Online Access:https://doi.org/10.1186/s12888-025-06642-5
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author Wenshuang Tang
Chao Zhang
Yapeng Qi
Qichen Zhou
Huazhi Li
Xiao-Han Shen
Lan Liu
Weikan Wang
Jian-Ren Liu
Xiaoxia Du
author_facet Wenshuang Tang
Chao Zhang
Yapeng Qi
Qichen Zhou
Huazhi Li
Xiao-Han Shen
Lan Liu
Weikan Wang
Jian-Ren Liu
Xiaoxia Du
author_sort Wenshuang Tang
collection DOAJ
description Abstract Background Somatic Symptom Disorder (SSD) is a condition often linked to excessive health anxiety and somatic symptoms. In recent years, studies have found associations between the cerebellum and various mental illnesses, including SSD. However, the microstructure of cerebellar subregions in SSD using diffusion magnetic resonance imaging has not been fully defined. Methods This is a cross-sectional study, that included 30 SSD patients and 30 age- and gender-matched healthy controls to investigate the microstructure of the cerebellum using diffusion magnetic resonance imaging. SSD diagnosis followed DSM-5 criteria, excluding major psychiatric comorbidities, while healthy controls underwent rigorous screening to exclude psychiatric or neurological histories. Clinical evaluations utilized standardized scales to assess depressive, anxiety, and cognitive symptoms. MRI data were acquired using a 3T Siemens Prisma scanner, including T1-weighted and diffusion-weighted imaging (30 directions, b = 1000/2000 s/mm²). Multi-compartment diffusion magnetic resonance imaging metrics from free water elimination diffusion tensor imaging and neurite orientation dispersion and density imaging were used to observe microstructural changes in the cerebellum’s white matter and gray matter subregions in SSD patients. Results Compared to the control group, patients with SSD exhibited significant alterations in white matter microstructure. These changes were characterized by increased free water-eliminated fractional anisotropy and neurite density index, as well as decreased free water-eliminated mean diffusivity and radial diffusivity. Furthermore, the cerebellum displayed varying microstructural changes across 26 gray matter subregions. These changes included reduced mean diffusivity, free water-eliminated axial diffusivity, and free water-eliminated radial diffusivity, alongside increased neurite density index and orientation dispersion index. Importantly, the study identified significant correlations between these microstructural changes and clinical symptoms. Specifically, Vermis X and the left lobule VIIb showed significant associations with both depression and anxiety scores. Conclusions The findings suggest greater neurite density and enhanced diffusion restriction in the cerebellum of patients with SSD, which may indicate possible adaptive changes associated with chronic stress.
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spelling doaj-art-eca285d971884bc0998aa59f8a01254b2025-08-20T03:05:46ZengBMCBMC Psychiatry1471-244X2025-03-0125111210.1186/s12888-025-06642-5Cerebellar microstructural abnormalities in patients with somatic symptom disordersWenshuang Tang0Chao Zhang1Yapeng Qi2Qichen Zhou3Huazhi Li4Xiao-Han Shen5Lan Liu6Weikan Wang7Jian-Ren Liu8Xiaoxia Du9School of Psychology, Shanghai University of SportDepartment of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineSchool of Psychology, Shanghai University of SportSchool of Psychology, Shanghai University of SportSchool of Psychology, Shanghai University of SportDepartment of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineSchool of Psychology, Shanghai University of SportAbstract Background Somatic Symptom Disorder (SSD) is a condition often linked to excessive health anxiety and somatic symptoms. In recent years, studies have found associations between the cerebellum and various mental illnesses, including SSD. However, the microstructure of cerebellar subregions in SSD using diffusion magnetic resonance imaging has not been fully defined. Methods This is a cross-sectional study, that included 30 SSD patients and 30 age- and gender-matched healthy controls to investigate the microstructure of the cerebellum using diffusion magnetic resonance imaging. SSD diagnosis followed DSM-5 criteria, excluding major psychiatric comorbidities, while healthy controls underwent rigorous screening to exclude psychiatric or neurological histories. Clinical evaluations utilized standardized scales to assess depressive, anxiety, and cognitive symptoms. MRI data were acquired using a 3T Siemens Prisma scanner, including T1-weighted and diffusion-weighted imaging (30 directions, b = 1000/2000 s/mm²). Multi-compartment diffusion magnetic resonance imaging metrics from free water elimination diffusion tensor imaging and neurite orientation dispersion and density imaging were used to observe microstructural changes in the cerebellum’s white matter and gray matter subregions in SSD patients. Results Compared to the control group, patients with SSD exhibited significant alterations in white matter microstructure. These changes were characterized by increased free water-eliminated fractional anisotropy and neurite density index, as well as decreased free water-eliminated mean diffusivity and radial diffusivity. Furthermore, the cerebellum displayed varying microstructural changes across 26 gray matter subregions. These changes included reduced mean diffusivity, free water-eliminated axial diffusivity, and free water-eliminated radial diffusivity, alongside increased neurite density index and orientation dispersion index. Importantly, the study identified significant correlations between these microstructural changes and clinical symptoms. Specifically, Vermis X and the left lobule VIIb showed significant associations with both depression and anxiety scores. Conclusions The findings suggest greater neurite density and enhanced diffusion restriction in the cerebellum of patients with SSD, which may indicate possible adaptive changes associated with chronic stress.https://doi.org/10.1186/s12888-025-06642-5Somatic symptom disorderCerebellumMicrostructureDiffusion tensor imaging
spellingShingle Wenshuang Tang
Chao Zhang
Yapeng Qi
Qichen Zhou
Huazhi Li
Xiao-Han Shen
Lan Liu
Weikan Wang
Jian-Ren Liu
Xiaoxia Du
Cerebellar microstructural abnormalities in patients with somatic symptom disorders
BMC Psychiatry
Somatic symptom disorder
Cerebellum
Microstructure
Diffusion tensor imaging
title Cerebellar microstructural abnormalities in patients with somatic symptom disorders
title_full Cerebellar microstructural abnormalities in patients with somatic symptom disorders
title_fullStr Cerebellar microstructural abnormalities in patients with somatic symptom disorders
title_full_unstemmed Cerebellar microstructural abnormalities in patients with somatic symptom disorders
title_short Cerebellar microstructural abnormalities in patients with somatic symptom disorders
title_sort cerebellar microstructural abnormalities in patients with somatic symptom disorders
topic Somatic symptom disorder
Cerebellum
Microstructure
Diffusion tensor imaging
url https://doi.org/10.1186/s12888-025-06642-5
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