title: Posterior cerebellar vermal deficits in bipolar disorder.
abstract: BACKGROUND
  Based on growing evidence of the crucial role of the cerebellum in emotional regulation, we sought to identify cerebellar structural deficits in a large sample of patients with bipolar disorder (BD).
  
  
  METHODS
  Cerebellar gray matter density was examined in 49 BD patients (24 medication-naive and 25 medication-treated) and 50 carefully matched healthy individuals, using voxel-based morphometry with a high-resolution spatially unbiased atlas template of the human cerebellum. This recently developed methodology is specifically optimized for the assessment of cerebellar structures. We further explored whether antimanic treatment could attenuate cerebellar structural deficits.
  
  
  RESULTS
  BD patients showed a greater reduction in gray matter density of the posterior cerebellar regions, including the bilateral vermi and the right crus relative to healthy individuals (corrected p<.05). A stepwise linear reduction in gray matter density was observed in bilateral vermal regions between healthy individuals, medication-treated, and medication-naive BD patients. Furthermore, positive correlations of longer duration of illness with bilateral vermal gray matter deficits were observed only in medication-naive BD patients, but not in patients with medication history.
  
  
  CONCLUSIONS
  This study adopted a cross-sectional design. The automatic intensity-normalization method for the measurement of cerebellar gray matter density may have a limitation in providing detailed anatomical information at a cerebellar folia level.
  
  
  CONCLUSIONS
  The current findings suggest that BD-related deficits in the posterior cerebellar regions, which appear to progress over the course of illness, could potentially be ameliorated by proper treatment with mood stabilizers.
authors.affiliation: Interdisciplinary Program in Neuroscience, Seoul National University, Seoul, South Korea.
authors.forename: Dajung
authors.initials: D
authors.lastname: Kim
authors.forename: Han Byul
authors.initials: HB
authors.lastname: Cho
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Dager
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Yurgelun-Todd
authors.forename: Sujung
authors.initials: S
authors.lastname: Yoon
authors.forename: Junghyun H
authors.initials: JH
authors.lastname: Lee
authors.forename: Sun Hea
authors.initials: SH
authors.lastname: Lee
authors.forename: Sunho
authors.initials: S
authors.lastname: Lee
authors.forename: Perry F
authors.initials: PF
authors.lastname: Renshaw
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000473:pathology*; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D055815:Young Adult
keywords: Bipolar disorder; Cerebellum; Magnetic resonance imaging; Mood stabilizers