The prefrontal cortex (PFC) ventral to the genu of the corpus callosum has been implicated in the modulation of visceral responses to stressful and emotionally provocative stimuli, based upon analysis of lesion effects involving this area in humans and experimental animals. In a recent magnetic resonance imaging (MRI) study of familial mood disorders, we demonstrated that the mean grey matter volume of this cortex is abnormally reduced in subjects with major depressive disorder (MDD) and bipolar disorder, irrespective of their treatment status or current mood state. Moreover, in preliminary histopathological assessments of subgenual PFC tissue taken post mortem from subjects with MDD and bipolar disorder we obtained results suggesting that this decrement in grey matter volume is associated with a reduction in glia without an equivalent loss of neurons. The potential functional significance of these neuroimaging and microscopic abnormalities is discussed with respect to evidence that subgenual PFC dysfunction may disturb stress-related autonomic and neuroendocrine responses and reward-related mesolimbic dopamine function. These data may thus hold important implications for the development of neural models of mood disorders that can account for the abnormal hedonic, motivational, neuroendocrine, and autonomic manifestations evident in these idiopathic conditions. Keywords: anterior cingulate; glia; MRI; PET; major depression; bipolar disorder; emotionIn a recent neuroimaging study of mood disorders we reported that the grey matter volume of the prefrontal cortex (PFC) ventral to the genu of the corpus callosum is reduced in familial bipolar disorder and familial major depressive disorder (MDD). 1 The magnetic resonance imaging (MRI)-based neuromorphometric measures acquired to demonstrate this abnormality in the 'subgenual' PFC were guided by positron emission tomographic (PET) images that showed an abnormal reduction of cerebral blood flow (BF) and glucose metabolism in this area in depression. [2][3][4] Because antidepressant treatment did not reverse these physiological abnormalities, the MRI measures of grey matter volume were obtained to determine whether the decrements in regional BF and metabolism were at least partly explained by a corresponding reduction in cortex. 5 This hypothesis was confirmed, as the mean grey matter volume of the left subgenual PFC was reduced by 39% and 48% in the bipolar disordered and unipolar depressed samples, respectively, relative to the controls (F = 9.8; P Ͻ 0.0002, after covarying for age, gender and whole brain volume). 1 This volumetric Correspondence: WC Drevets, MD, B 938,