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Cerebellar-thalamic circuits play a critical role in psychomotor function

Molecular Psychiatry volume 26, pages 3666–3668 (2021)Cite this article

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We read the recent conceptual review on the biochemical modulation of psychomotor mechanisms [1] with great interest. The distinction between purely motor functions and the modulatory influence of non-motor functions such as cognition and emotion (putting the “psycho” in “psychomotor”) provides a fresh perspective for understanding motor symptoms from a transdiagnostic perspective. However, we do believe the proposed model was incomplete in that it did not consider cerebello-thalamo-cortical-cerebellar (CTCC) circuits. We argue that “non-motor” influences on motor behaviors regulated by the cerebellar circuit also closely align with the authors’ definition of “psychomotor”, and further, provide additional considerations for framing an otherwise excellent model.

The authors highlight dopamine and cortical-striatal-thalamic circuits, as purely “motor” and indicate that “psycho”motor modulation occurs through serotonin and cortical networks (e.g., default mode network; DMN). However, this conception neglects CTCC “motor” circuits, which are also rich with afferent and efferent connections to networks that modulate motor, cognitive, and affective processing. We suggest extending the model of Northoff et al. [1] to include the cerebellum. Broadly, cerebellar circuits allow for the processing of information shared from the cortex with the cerebellum, allowing for fluid and coordinated movement and thought. One critical function is the precise timing of action and subjective time perception [2]. Notably, the cerebellum is also innervated by serotonergic fibers [3], and neurotransmission includes GABAergic and cholinergic action. In addition, projections heavily interact with dopaminergic and glutamatergic systems [4]. As such, the CTCC is in large part an extension to the dopaminergic model proposed by Northoff et al. [1], and cerebellar action in particular may in part further modulate the action of these dopaminergic systems in the cortex [4]. Similar to the mechanisms highlighted by the authors, CTCC-mediated motor behaviors are influenced by “psycho”logical function as well. For example, consider Gerhard Anderson’s seminal work indicating that postural control is impacted by cognitive load, and cognitive performance is influenced by balance perturbation in turn [5]. The CTCC has also been implicated in affective symptoms of schizophrenia. Brady et al. [6] demonstrated that CTCC connectivity is associated with negative symptom severity (e.g., affective flattening and slowing) and that symptom course improves with noninvasive brain stimulation. As our knowledge of this circuit grows and we investigate its contributions across diagnoses (e.g., clinically relevant abnormalities in motor balance, gait, coordination, timing, integration and learning occur across a full range of psychiatric disorders), inclusion of this circuit in the broader model is of utmost importance.

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Fig. 1: Psychomotor circuit interactions between cortical motor areas, basal ganglia, thalamus, and cerebellum.

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Authors and Affiliations

  1. Departments of Psychology, Psychiatry, Medical Social Sciences, Northwestern University, Evanston, IL, USA

    Vijay A. Mittal

  2. Texas A&M University, Department of Psychological and Brain Sciences, Texas A&M Institute for Neuroscience, Texas A&M University, College Station, TX, USA

    Jessica A. Bernard

  3. Translational Research CenterUniversity Hospital of Psychiatry, University of Bern, Bern, Switzerland

    Sebastian Walther

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All authors contributed equally to the conceptual planning, drafting, and revision of the manuscript.

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Correspondence to Vijay A. Mittal.

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Mittal, V.A., Bernard, J.A. & Walther, S. Cerebellar-thalamic circuits play a critical role in psychomotor function. Mol Psychiatry 26, 3666–3668 (2021). https://doi.org/10.1038/s41380-020-00935-9

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