Abstract
Background/Objectives: The cerebellum contributes to both motor and cognitive functions. As basketball requires the integration of these abilities, basketball athletes provide an ideal model for exploring cerebellar adaptations. This study aimed to examine multidimensional cerebellar adaptations in basketball athletes and their associations with physical performance. Methods: In this study, 55 high-level basketball athletes and 55 non-athletes matched for age and gender were recruited for multimodal magnetic resonance imaging data collection and physical fitness tests. We compared the structural and functional differences in the brain between the two groups and analyzed the correlations between regional brain indices and physical fitness test outcomes. Results: Basketball athletes exhibited increased gray matter volume in Crus I, alongside heightened ALFF signal in Crus I and improved regional homogeneity in Crus II and VII b compared to non-athletes. Diffusion kurtosis imaging analysis demonstrated that athletes perform elevated kurtosis fractional anisotropy and decreased radial kurtosis within the cerebellar cortex and peduncles, with cortical modifications mainly localized around Crus I and lobule VI. Notably, both kurtosis fractional anisotropy and the amplitude of low-frequency fluctuations displayed positive correlations with vertical jump performance, an indicator specific to basketball ability. Conclusions: Basketball athletes exhibit structural, microstructural, and functional cerebellar adaptations, especially in Crus I. These modifications involve regions associated with motor and cognitive representations within the cerebellum, and part of the indexes are linked to the athletes' physical performance. This study enhances our understanding of cerebellar adaptive changes in athletes, providing new insights for future research aimed at fully elucidating the role of the cerebellum in these individuals.