OBJECTIVE: The cerebellum is involved in cognitive processing and emotion control. Cerebellar alterations could explain symptoms of schizophrenia spectrum disorder (SZ) and bipolar disorder (BD). In addition, literature suggests that lithium might influence cerebellar anatomy. Our aim was to study cerebellar anatomy in SZ and BD, and investigate the effect of lithium. METHODS: Participants from 7 centers worldwide underwent a 3T MRI. We included 182 patients with SZ, 144 patients with BD, and 322 controls. We automatically segmented the cerebellum using the CERES pipeline. All outputs were visually inspected. RESULTS: Patients with SZ showed a smaller global cerebellar gray matter volume compared to controls, with most of the changes located to the cognitive part of the cerebellum (Crus II and lobule VIIb). This decrease was present in the subgroup of patients with recent-onset SZ. We did not find any alterations in the cerebellum in patients with BD. However, patients medicated with lithium had a larger size of the anterior cerebellum, compared to patients not treated with lithium. CONCLUSION: Our multicenter study supports a distinct pattern of cerebellar alterations in SZ and BD.

Department of Clinical Psychology and Neuropsychology Johannes Gutenberg University Mainz Germany

Department of Neurosciences and Mental Health Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy

Department of Psychiatry Assistance Publique Hôpitaux de Paris Hôpital Corentin Celton Paris Descartes University Près Sorbonne Paris Cité Issy les Moulineaux France

Department of Psychiatry Dalhousie University Halifax NS Canada

Department of Psychiatry Western Psychiatric Institute and Clinic University of Pittsburgh Pittsburgh PA USA

Fondation Fondamental Créteil France

Grenoble Institute of Neuroscience INSERM U1216 Hôpital Grenoble Alpes Grenoble Alpes University Grenoble France

Institut National de la Santé et de la Recherche Médicale U955 Translational Psychiatry Institut Mondor de Recherche Biomédicale Psychiatrie Créteil France

Instituto Universitario de Tecnologías de la Información y Comunicaciones Universitat Politècnica de València Valencia España

National Institute of Mental Health Klecany Czech Republic

NeuroSpin CEA Paris Saclay University Gif sur Yvette France

Pictura Research Group Unité Mixte de Recherche Centre National de la Recherche Scientifique Laboratoire Bordelais de Recherche en Informatique Centre National de la Recherche Scientifique Talence France

Pictura Research Group Unité Mixte de Recherche Centre National de la Recherche Scientifique Laboratoire Bordelais de Recherche en Informatique University Bordeaux Talence France

Pôle de Psychiatrie Assistance Publique Hôpitaux de Paris Faculté de Médecine de Créteil DHU PePsy Hôpitaux Universitaires Mondor Créteil France

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