Background: Cerebello-thalamo-cortical (CTC) network dysfunctions are well-documented in schizophrenia spectrum disorders (SSD) and preclinical states. However, small samples and methodological heterogeneity often limit individual neuroimaging studies. To overcome these challenges, we conducted a coordinate-based meta-analysis to characterize CTC alterations across illness stages and examine associations with symptom dimensions.

Methods: Our meta-analysis was preregistered and followed the PRISMA guideline and the recommendations of the Cochrane Handbook. A systematic search was conducted in three databases in September 2023. Included articles used seed-based resting-state fMRI in patients with schizophrenia-spectrum disorders, first-episode psychosis, clinical high-risk for psychosis, and healthy control groups. Seeds were defined in the thalamus and the cerebellum. Two coordinate-based meta-analytic methods, Activation Likelihood Estimation and Seed-based D Mapping were used. Risk of bias was evaluated per the OHBM recommendations.

Results: Thalamic hypoconnectivity in the prefrontal cortex, limbic lobe, thalamus and the cerebellum, and hyperconnectivity in the somato-motor and visual association areas was found in SSD (29 studies, 2768 patients). Dysconnectivity was linked to disease progression and symptoms. Cerebellar analysis indicated hypoconnectivity in the prefrontal cortex, cerebellum, and thalamus, with hyperconnectivity in the motor cortex, somatosensory cortex, and orbitofrontal cortex (19 studies, 1159 patients). Cerebellar clusters did not survive multiple comparison correction.

Conclusions: Our findings provide robust meta-analytic evidence of cerebello-thalamo-cortical dysconnectivity in SSD, suggesting this network captures a core neurobiological feature of psychotic disorders. Consistent patterns of altered CTC connectivity underscore the importance of future clinical investigations of this network as a potential target for therapeutic interventions.

Keywords: cerebellar; connectivity; fMRI; meta-analysis; schizophrenia; thalamocortical.

Copyright © 2025. Published by Elsevier Inc.

背景： 在精神分裂症谱系障碍（SSD）及其前临床状态下，小脑-丘脑-皮质（CTC）网络的功能异常已有大量文献记载。然而，样本量较小和方法学异质性通常限制了单一神经影像研究的有效性。为了克服这些挑战，我们进行了一项基于坐标的荟萃分析，以描述不同疾病阶段的 CTC 改变，并考察其与症状维度的相关性。

方法： 我们的荟萃分析在 PRISMA 指南和 Cochrane 手册推荐的基础上进行了预注册。2023年9月，我们在三个数据库中进行了一项系统搜索。纳入的文章使用静息态功能磁共振成像（fMRI）的种子点法来研究精神分裂症谱系障碍、首发精神病、临床高危人群和健康对照组患者的数据。在丘脑和小脑中定义了种子点。采用基于坐标的荟萃分析方法，包括激活可能性估计（Activation Likelihood Estimation, ALE）和基于种子的 D 映射（Seed-based D Mapping）。根据 OHBM 推荐评估偏倚风险。

结果： 在 SSD 中发现丘脑与前额皮质、边缘叶、丘脑及小脑之间的低连通性，以及躯体-运动和视觉关联区的高连通性（29项研究，2768名患者）。这种失联与疾病进展和症状有关。小脑分析显示，在前额皮质、小脑和丘脑之间存在低连通性，在运动皮质、躯体感觉皮质及眶额皮质中则显示出高连通性（19项研究，1159名患者）。但小脑簇在多重比较校正后并未通过统计检验。

结论： 我们的发现为 SSD 中 CTC 失联提供了稳健的荟萃分析证据，表明该网络捕捉到了精神疾病的核心神经生物学特征。一致改变的 CTC 连接模式强调了未来临床研究中探讨这一网络作为潜在治疗靶点的重要性。

关键词： 小脑；连接性；fMRI；荟萃分析；精神分裂症；丘脑皮质