Increasing evidence suggests that the cerebellum may have a role in the pathophysiology of Parkinson’s disease (PD). Hence, the scope of this study was to investigate whether there are structural and functional alterations of the cerebellum and whether they correlate with motor and non-motor symptoms in early PD patients. Seventy-six patients with early PD and thirty-one age and sex-matched healthy subjects (HS) were enrolled and underwent a 3 T magnetic resonance imaging (MRI) protocol. The following MRI analyses were performed: (1) volumes of 5 cerebellar regions of interest (sensorimotor and cognitive cerebellum, dentate, interposed, and fastigial nuclei); (2) microstructural integrity of the cerebellar white matter connections (inferior, middle, and superior cerebellar peduncles); (3) functional connectivity at rest of the 5 regions of interest already described in point 1 with the rest of brain. Compared to controls, early PD patients showed a significant decrease in gray matter volume of the dentate, interposed and fastigial nuclei, bilaterally. They also showed abnormal, bilateral white matter microstructural integrity in all 3 cerebellar peduncles. Functional connectivity of the 5 cerebellar regions of interest with several areas in the midbrain, basal ganglia and cerebral cortex was altered. Finally, there was a positive correlation between abnormal functional connectivity of the fastigial nucleus with the volume of the nucleus itself and a negative correlation with axial symptoms severity. Our results showed that structural and functional alterations of the cerebellum are present in PD patients and these changes contribute to the pathophysiology of PD in the early phase.

越来越多的证据表明小脑可能在帕金森病 (PD) 的病理生理学中发挥作用。因此，本研究的范围是调查小脑是否存在结构和功能改变，以及它们是否与早期帕金森病患者的运动和非运动症状相关。 76 名早期 PD 患者和 31 名年龄和性别匹配的健康受试者 (HS) 入组并接受了 3 T 磁共振成像 (MRI) 方案。进行了以下 MRI 分析：(1) 5 个感兴趣小脑区域的体积（感觉运动和认知小脑、齿状核、插入核和顶核）； (2) 小脑白质连接（小脑下脚、中脚和上脚）的微观结构完整性； (3) 第 1 点中已描述的 5 个感兴趣区域的其余部分与大脑其余部分的功能连接。与对照组相比，早期 PD 患者双侧齿状核、间质核和顶核的灰质体积显着减少。他们还在所有 3 个小脑脚中显示出异常的双侧白质微结构完整性。 5 个感兴趣的小脑区域与中脑、基底神经节和大脑皮层的几个区域的功能连接发生了改变。最后，顶核的异常功能连接与核本身的体积呈正相关，与轴症状严重程度呈负相关。我们的研究结果表明，PD 患者小脑存在结构和功能改变，这些变化有助于 PD 早期的病理生理学。