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Peer-reviewedCC BY 4.0Schizophrenia

Disrupted cerebellar interactions in the cerebellar-thalamo-cortical triple network model across risk states and first-episode psychosis

  • Minji Ha1,2
  • Inkyung Park3
  • Hyungyou Park3
  • Taekwan Kim4
  • Wu Jeong Hwang3
  • Jiseon Jang2
  • Minah Kim1,2,5
  • Jun Soo Kwon1,6
6 affiliations
  1. 1Institute of Human Behavioral Medicine, SNU-MRC Seoul, Republic of Korea
  2. 2Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
  3. 3Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
  4. 4Department of Bio and Brain Engineering, Information & Electronics Research Institute, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
  5. 5Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
  6. 6Department of Psychiatry, Hanyang University Hospital, Seoul, Republic of Korea
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Abstract

Cerebellar dysconnectivity has been repeatedly linked to psychosis and is often accompanied by disruptions in thalamic and cortical regions. These disturbances are broadly consistent with the triple network model, which conceptualizes psychopathology as arising from abnormal interactions among the salience (SAL), default mode (DMN), and executive control (ECN) networks. However, how the cerebellum interacts with thalamic and cortical components of these networks across different psychosis risk stages and early psychosis remains unclear. Resting-state functional MRI from 37 first-episode psychosis (FEP) patients, 63 clinical high-risk (CHR) individuals, 41 unaffected relatives (URs) of schizophrenia patients, and 100 healthy controls (HCs) were analyzed. The cerebellum and thalamus were parcellated according to their functional connectivity with cortical functional networks, and the DMN, SAL, and ECN subdivisions across all three regions were used to estimate cerebellar–cortical and cerebellar–thalamic connectivity across groups. Compared with HCs, FEP patients showed widespread increases in cerebellar–cortical connectivity across all three networks, together with reduced cerebellar–thalamic connectivity, most prominently within SAL-related circuits. CHR individuals exhibited predominantly increased connectivity, with localized disruptions across cerebellar, thalamic, and cortical regions. URs did not show significant connectivity differences relative to HCs. By extending the triple network framework to include cortico-thalamo-cerebellar pathways, this study characterized how cerebellar network connectivity differs across familial risk, CHR, and FEP groups. The observed pattern suggests that early changes in CTC circuits correspond to disruptions described within the triple network model, and highlights the potential relevance of cerebellar and thalamic involvement when characterizing network alterations across the psychosis spectrum.

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Cite

BibTeXRIS
BibTeX
@article{ha2026disrupted,
  title = {{Disrupted cerebellar interactions in the cerebellar-thalamo-cortical triple network model across risk states and first-episode psychosis}},
  author = {Minji Ha and Inkyung Park and Hyungyou Park and Taekwan Kim and Wu Jeong Hwang and Jiseon Jang and Minah Kim and Jun Soo Kwon},
  journal = {Schizophrenia},
  year = {2026},
  month = jul,
  doi = {10.1038/s41537-026-00783-6},
  url = {https://doi.org/10.1038/s41537-026-00783-6},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Disrupted cerebellar interactions in the cerebellar-thalamo-cortical triple network model across risk states and first-episode psychosis
AU  - Minji Ha
AU  - Inkyung Park
AU  - Hyungyou Park
AU  - Taekwan Kim
AU  - Wu Jeong Hwang
AU  - Jiseon Jang
AU  - Minah Kim
AU  - Jun Soo Kwon
PY  - 2026
DA  - 2026/07/16
JO  - Schizophrenia
DO  - 10.1038/s41537-026-00783-6
UR  - https://doi.org/10.1038/s41537-026-00783-6
AB  - Cerebellar dysconnectivity has been repeatedly linked to psychosis and is often accompanied by disruptions in thalamic and cortical regions. These disturbances are broadly consistent with the triple network model, which conceptualizes psychopathology as arising from abnormal interactions among the salience (SAL), default mode (DMN), and executive control (ECN) networks. However, how the cerebellum interacts with thalamic and cortical components of these networks across different psychosis risk stages and early psychosis remains unclear. Resting-state functional MRI from 37 first-episode psychosis (FEP) patients, 63 clinical high-risk (CHR) individuals, 41 unaffected relatives (URs) of schizophrenia patients, and 100 healthy controls (HCs) were analyzed. The cerebellum and thalamus were parcellated according to their functional connectivity with cortical functional networks, and the DMN, SAL, and ECN subdivisions across all three regions were used to estimate cerebellar–cortical and cerebellar–thalamic connectivity across groups. Compared with HCs, FEP patients showed widespread increases in cerebellar–cortical connectivity across all three networks, together with reduced cerebellar–thalamic connectivity, most prominently within SAL-related circuits. CHR individuals exhibited predominantly increased connectivity, with localized disruptions across cerebellar, thalamic, and cortical regions. URs did not show significant connectivity differences relative to HCs. By extending the triple network framework to include cortico-thalamo-cerebellar pathways, this study characterized how cerebellar network connectivity differs across familial risk, CHR, and FEP groups. The observed pattern suggests that early changes in CTC circuits correspond to disruptions described within the triple network model, and highlights the potential relevance of cerebellar and thalamic involvement when characterizing network alterations across the psychosis spectrum.
SN  - 2754-6993
ER  -