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Microstructural Differences of the Cerebellum-Thalamus-Basal Ganglia-Limbic Cortex in Patients with Somatic Symptom Disorders: a Diffusion Kurtosis Imaging Study

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Abstract

Somatic symp tom disorders (SSDs) are a group of psychiatric disorders characterized by persistent disproportionate concern and obsessive behaviors regarding physical conditions. Currently, SSDs lack effective treatments and their pathophysiology is unclear. In this paper, we aimed to examine microstructural abnormalities in the brains of patients with SSD using diffusion kurtosis imaging (DKI) and to investigate the correlation between these abnormalities and clinical indicators. Diffusion kurtosis images were acquired from 30 patients with SSD and 30 healthy controls (HCs). Whole-brain maps of multiple diffusion measures, including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), mean kurtosis (MK), radial kurtosis (RK), and axial kurtosis (AK), were calculated. To analyze differences between the two groups, nonparametric permutation testing with 10,000 randomized permutations and threshold-free cluster enhancement was used with family-wise error-corrected p values < 0.05 as the threshold for statistical significance. Then, the correlations between significant changes in these diffusion measures and clinical factors were examined. Compared to HCs, patients with SSD had significantly higher FA, MK, and RK and significantly lower MD and RD in the cerebellum, thalamus, basal ganglia, and limbic cortex. The FA in the left caudate and the pontine crossing tract were negatively correlated with disease duration; the MD and the RD in the genu of the corpus callosum were positively correlated with disease duration. Our findings highlight the role of the cerebellum-thalamus-basal ganglia-limbic cortex pathway, especially the cerebellum, in SSDs and enhance our understanding of the pathogenesis of SSDs.

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Funding

This research was supported by the National Natural Science Foundation of China (Grant No. 81571658 to X. X. Du and grant No. 81271302 to J.R. Liu), a research project of the Shanghai University of Sport (Grant No. 2022XJ002 to X. X. Du), the Shanghai Municipal Science and Technology Commission (Innovation Research Project, No. 14JC1404300 to J.R. Liu), Shanghai Hospital Development Center (Prevention and Control of Chronic Diseases Project, No. SHDC12015310 to J.R. Liu), SHSMU-ION Research Center for Brain Disorders (project No. 2015NKX006 to J.R. Liu), Shanghai Municipal Education Commission (Gaofeng Clinical Medicine Grant Support, project No. 20161422 to J. R. Liu), Shanghai Jiao Tong University School of Medicine (Clinical Research Project, No. DLY201614 to J.R. Liu), and Shanghai Municipal Science and Technology Commission (Biomedicine Key Program, No. 16411953100 to J.R. Liu). The funders had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.

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  1. Liao Dong and Huai-Bin Liang have contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Psychology, Shanghai University of Sport, Shanghai, 200438, China

    Liao Dong, Yingying Wang, Qichen Zhou, Ziyue Xin, Chenglin Zhou & Xiaoxia Du

  2. Shanghai Key Laboratory of Magnetic Resonance and Department of Physics, School of Physics and Electronic Science, East China Normal University, Shanghai, 200062, China

    Liao Dong

  3. Department of Neurology &Jiuyuan Municipal Stroke Center, Shanghai 9Th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China

    Huai-Bin Liang, Yue Hu, Yi-Sheng Liu, Rong Zhao, Yuan Qiao & Jian-Ren Liu

  4. Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China

    Huai-Bin Liang, Yue Hu, Rong Zhao, Yuan Qiao & Jian-Ren Liu

  5. Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, 4072, Australia

    Jiaxin Du

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Dong, L., Liang, HB., Du, J. et al. Microstructural Differences of the Cerebellum-Thalamus-Basal Ganglia-Limbic Cortex in Patients with Somatic Symptom Disorders: a Diffusion Kurtosis Imaging Study. Cerebellum 22, 840–851 (2023). https://doi.org/10.1007/s12311-022-01461-w

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