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Bipolar disorders occurred in 3 of 15 (20%) subjects after focal cerebellar circuit
lesions. Two presented with rapid cycling bipolar disorder and dystonia, including
one with a checking compulsion. Lesions included right cerebellar hypoplasia (bipolar
disorder), bilateral cerebellar atrophy (rapid cycling unipolar mania and dystonia),
and left midbrain pathology (mixed bipolar disorder, dystonia, and compulsion). Bipolar
disorders were associated with cerebellar circuit pathology (p = 0.032) and were more prevalent than in population controls (p = 0.004). Diminished cerebellar output (to cortical, thalamic, basal ganglia, limbic,
or other circuits) or nigral pars reticulata dysfunction may result in abnormal neuronal
oscillation in bipolar disorders, especially rapid-cycling types, or in dystonia.
Review of the literature supports the concept of nigral and cerebellar direct and
indirect connections with thalamofrontotemporal and basal ganglia circuits in bipolar
disorders, dystonia, and compulsions, as well as possible clinical relationships between
these disorders.
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Article info
Publication history
Received in revised form:
September 6,
1995
Received:
December 2,
1994
Footnotes
This research was supported in part by Grant #16-121-50 from the MedCen Foundation Clinical Research Center, Macon, Georgia.
Identification
Copyright
© 1996 Society of Biological Psychiatry. Published by Elsevier Inc.
