Posterior fossa abnormalities in major depression: a controlled magnetic resonance imaging study

Abstract

High-field magnetic resonance (MR) images were used to study posterior fossa morphology in 27 patients with major depression and 36 normal control subjects. Depressed patients demonstrated smaller brain stem and cerebellar vermis than controls. These differences were highly significant for the anterior cerebellar vermis and medulla. There was also a striking age-related decline in midbrain size in depressed patients as well as in controls. Our results are consistent with several lines of evidence implicating a role for the cerebellar vermis in affective disorders and, in addition, provide the first MR documentation of the differential effects of aging on posterior fossa morphology in normal subjects compared with patients with major depression.

MRI Analysis of the Cerebellum in Bipolar Disorder A Pilot Study

“…The number of previous episodes of depression may be largely associated with the smaller V3 area in multiple-episode patients, but this requires future study. Others (Shah et al 1992) found that depressed patients have smaller anterior, posterior and total vermal areas compared to healthy volunteers. Vermal area 3 consists of the inferior posterior lobe and nodulus (flocculonodular lobe) of the vermis.…”

“…Effect size was based on the F -value obtained from the ANCOVA using the formula f ϭ ͙ (k-1)F/N (Cohen 1977). A multiple regression analysis was preformed to assess the variables that based on previous studies would be hypothesized to contribute to small vermal size specifically, number of previous episodes of depression (Shah et al 1992;Escalona et al 1993), lithium exposure (Donaldson and Cuningham 1983;Kores and Lader 1997) and history of substance abuse (Aasly et al 1993). Other analyses were performed as necessary.…”

“…Previous investigators have found that lithium toxicity (Donaldson and Cuningham 1983;Kores and Lader 1997), depression (Shah et al 1992;Escalona et al 1993), and alcohol use (Lippmann et al 1982) are associated with smaller cerebellar size. Therefore, cerebellar size may be associated with chronic affective illness or confounding variables associated with chronicity, such as number of previous episodes of depression, substance use, and medication effects.…”

“…Results of these contradic- Despite numerous studies suggesting an association between cerebellar atrophy and bipolar disorder, there are no quantitative analyses of the cerebellum in patients with mania using MRI morphometry (Soares and Mann 1997). The aim of this study was to morphometrically assess the cerebellum of patients with bipolar disorder using high-resolution, thin slice, MRI, which allows for superior visualization of cerebellar anatomy.Previous investigators have found that lithium toxicity (Donaldson and Cuningham 1983;Kores and Lader 1997), depression (Shah et al 1992;Escalona et al 1993), and alcohol use (Lippmann et al 1982) are associated with smaller cerebellar size. Therefore, cerebellar size may be associated with chronic affective illness or confounding variables associated with chronicity, such as number of previous episodes of depression, substance use, and medication effects.…”

Morphological integration in human skull and its possible role in etiogenesis of neuropsychiatric disorders: Deciphering the link between evolution, development and disease

“…Even a small change in the dimensionality of a single landmark, in the course of evolution, has capacity to redirect the dimensionality of all the skull landmarks, and hence to create a different data set of measurements for inter-landmark distances (3). Although, such a re-modeling of the human skull may not always result in a functional gain and may predispose individuals to certain neuropsychiatric disorders (8,20,21), as a cost to the evolutionary benefits of the survival (22)(23)(24).…”