Chronic mania in childhood: case report of a possible association with a radiological picture of cerebellar disease

Cutting, John

doi:10.1017/s0033291700018286

Cited by 22 publications

(13 citation statements)

References 16 publications

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“…Several case reports have identified cerebellar atrophy in patients with mood dysregulation and in patients with bipolar disorder (Cutting 1976;Hamilton et al 1983;Joseph et al 1985;Yadalam et al 1985;Jurjus et al 1994).…”

Section: Since Qualitative Ct Studies Have Suggested Decreased Cerebementioning

confidence: 99%

MRI Analysis of the Cerebellum in Bipolar Disorder A Pilot Study

DelBello

Strakowski

Zimmerman

et al. 1999

Neuropsychopharmacology

212

132

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Since qualitative CT studies have suggested decreased cerebellar size in patients with bipolar disorder, we performed a quantitative analysis of the cerebellum in patients with bipolar disorder to determine whether highresolution, thin slice magnetic resonance imaging (MRI) morphometry would reveal similar results. Bipolar patients hospitalized for a first manic episode ( n ϭ 16), bipolar patients with prior manic episodes hospitalized for a manic episode ( n ϭ 14), and normal volunteers ( n ϭ15Although traditionally regarded as a regulator of motor function, the cerebellum has also been found to project to regions of the brain that modulate mood (Anand et al. 1959;Heath et al. 1978;Courchesne et al. 1989). Several case reports have identified cerebellar atrophy in patients with mood dysregulation and in patients with bipolar disorder (Cutting 1976;Hamilton et al. 1983;Joseph et al. 1985;Yadalam et al. 1985;Jurjus et al. 1994).Moreover, several studies have found abnormal cerebellar anatomy in patients with affective disorders (reviewed in Soares and Mann 1997). Two studies reported a greater rate of cerebellar atrophy in manic patients than in patients with schizophrenia or normal controls (Nasrallah et al. 1981(Nasrallah et al. , 1982. Additionally, Yates et al. (1987) found a greater rate of cerebellar atrophy in patients with bipolar disorder who were over fifty years old, but not in younger bipolar patients compared with healthy volunteers. Lippmann et al. (1982) found bipolar patients with co-occurring alcohol abuse had increased rates of both vermal atrophy and cerebellar hemisphere atrophy compared with normal healthy volunteers, suggesting that alcohol abuse may contribute to abnormal cerebellar anatomy in bipolar patients. Rieder et al. (1983) found no difference in cerebellar size among patients with bipolar disorder, schizophrenia, and schizoaffective disorder. 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. Yates et al. (1987) found that multiple-episode bipolar patients had a greater rate of cerebellar atrophy that healthy volunteers. Studying bipolar patients at the onset of their illnesses may eliminate confounding variables associated with ch...

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Section: Since Qualitative Ct Studies Have Suggested Decreased Cerebementioning

confidence: 99%

MRI Analysis of the Cerebellum in Bipolar Disorder A Pilot Study

DelBello

Strakowski

Zimmerman

et al. 1999

Neuropsychopharmacology

212

132

View full text Add to dashboard Cite

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“…Indeed, a growing body of evidence points to clinical (5–14), molecular (15–19), neurochemical (20–22), structural (23–39), and functional (40–44) abnormalities of the cerebellum in BP. The cerebellum is reciprocally connected to higher-level association areas in prefrontal (45) and posterior parietal (46) cortices and limbic regions in medial temporal lobe (47–49), and cerebellar dysfunction may mirror or contribute to well-established dysfunctions of these higher-level association areas in BP.…”

Section: Introductionmentioning

confidence: 99%

Aberrant Cerebellar Connectivity in Bipolar Disorder With Psychosis

Shinn

Roh²,

Ravichandran

et al. 2017

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

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Background The cerebellum, which modulates affect and cognition in addition to motor functions, may contribute substantially to the pathophysiology of mood and psychotic disorders, such as bipolar disorder. A growing literature points to cerebellar abnormalities in bipolar disorder. However, no studies have investigated the topographic representations of resting state cerebellar networks in bipolar disorder, specifically their functional connectivity to cerebral cortical networks. Methods Using a well-defined cerebral cortical parcellation scheme as functional connectivity seeds, we compared ten cerebellar resting state networks in 49 patients with bipolar disorder and a lifetime history of psychotic features and 55 healthy control participants matched for age, sex, and image signal-to-noise ratio. Results Patients with psychotic bipolar disorder showed reduced cerebro-cerebellar functional connectivity in somatomotor A, ventral attention, salience, and frontoparietal control A and B networks relative to healthy control participants. These findings were not significantly correlated with current symptoms. Conclusions Patients with psychotic bipolar disorder showed evidence of cerebro-cerebellar dysconnectivity in selective networks. These disease-related changes were substantial and not explained by medication exposure or substance use. Therefore, they may be mechanistically relevant to the underlying susceptibility to mood dysregulation and psychosis. Cerebellar mechanisms deserve further exploration in psychiatric conditions, and this study’s findings may have value in guiding future studies on pathophysiology and treatment of mood and psychotic disorders, in particular.

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“…More recently, empirical and theoretical evidence have indicated that the cerebellum plays a significant role in psychological functions as well, including modulation of perceptual, cognitive, and affective functions [8], [9], [10], [11], [12], which is believed to occur via its modulation of the anterior limbic network [1], [13], [14], [15]. Structural imaging studies indicate cerebellar abnormalities, in particular, cerebellar atrophy in BD [13], [16], [17], [18], [19], [20], [21], [22]. Neurochemical alterations have also been reported [23], [24], [25], [26].…”

Section: Introductionmentioning

confidence: 99%

Postural Control in Bipolar Disorder: Increased Sway Area and Decreased Dynamical Complexity

et al. 2011

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Structural, neurochemical, and functional abnormalities have been identified in the brains of individuals with bipolar disorder, including in key brain structures implicated in postural control, i.e. the cerebellum, brainstem, and basal ganglia. Given these findings, we tested the hypothesis that postural control deficits are present in individuals with bipolar disorder. Sixteen participants with bipolar disorder (BD) and 16 age-matched non-psychiatric healthy controls were asked to stand as still as possible on a force platform for 2 minutes under 4 conditions: (1) eyes open-open base; (2) eyes closed-open base; (3) eyes open-closed base; and (4) eyes closed-closed base. Postural sway data were submitted to conventional quantitative analyses of the magnitude of sway area using the center of pressure measurement. In addition, data were submitted to detrended fluctuation analysis, a nonlinear dynamical systems analytic technique that measures complexity of a time-series, on both the anterior-posterior and medio-lateral directions. The bipolar disorder group had increased sway area, indicative of reduced postural control. Decreased complexity in the medio-lateral direction was also observed for the bipolar disorder group, suggesting both a reduction in dynamic range available to them for postural control, and that their postural corrections were primarily dominated by longer time-scales. On both of these measures, significant interactions between diagnostic group and visual condition were also observed, suggesting that the BD participants were impaired in their ability to make corrections to their sway pattern when no visual information was available. Greater sway magnitude and reduced complexity suggest that individuals with bipolar disorder have deficits in sensorimotor integration and a reduced range of timescales available on which to make postural corrections.

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Chronic mania in childhood: case report of a possible association with a radiological picture of cerebellar disease

Cited by 22 publications

References 16 publications

MRI Analysis of the Cerebellum in Bipolar Disorder A Pilot Study

MRI Analysis of the Cerebellum in Bipolar Disorder A Pilot Study

Aberrant Cerebellar Connectivity in Bipolar Disorder With Psychosis

Postural Control in Bipolar Disorder: Increased Sway Area and Decreased Dynamical Complexity

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