The cerebellum gains weight! A systematic review of alterations in cerebellar volume and cerebro-cerebellar functional connectivity in individuals with eating disorders.

Background: Brain imaging studies of individuals with eating disorders (EDs) often reported volumetric and connectivity changes involving the cerebellum. Nevertheless, very few studies performed in-depth examinations and suggested a role for the cerebellum in the EDs’ pathophysiology. Methods: A systematic literature search on cerebellar volumetric changes and connectivity patterns involving the cerebellum in individuals with EDs was conducted using PubMed, PsychInfo and Web of Science. This review was conducted according to the Preferred Reporting Items for Systematic Reviews (PRISMA) statement and Rayyan web application for screening studies. Results: Twenty-four papers reporting cerebellar alterations in individuals with EDs were included in the study: 9 assessing brain volumetric changes, 9 investigating brain functional connectivity while participants performed tasks and 6 investigating brain functional connectivity at rest. Most of the studies focused on anorectic-type EDs, while fewer involved bulimic-type EDs and eating disorders not otherwise specified. Conclusions: This review proposes critical arguments to consider the cerebellum as a key structure implicated in the pathophysiology of EDs that requires further exploration in forthcoming research.