Anatomical MRI findings in mood and anxiety disorders

RIASSUNTO Scopo – Gli studi con Risonanza Magnetica Nucleare (RMN) hanno permesso la valutazione in vivo dell'anatomia cerebrale di vari disturbi psichiatrici e l'approfondimento degli ipotetici circuiti cerebrali disfunzionali coinvolti nella patofisiologia di queste malattie. In questo articolo abbiamo revisionato la letteratura comprendente gli studi con RMN condotti nei disturbi dell'umore e d'ansia. Metodi – Tutti gli studi in Inglese con RMN condotti in pazienti con disturbo dell'umore o d'ansia pubblicati tra il 1966 ed il gennaio 2002 sono stati identificati attraverso una ricerca Medline, completata dall'analisi manuale delle referenze bibliografiche. Risultati – Differenti aree anatomiche cerebrali sembrano essere coinvolte nei diversi sottotipi di disturbo dell'umore. Infatti, l'ippocampo ed i gangli della base sembrano essere anormali nei disturbo unipolare, mentre l'amigdala ed il cervelletto in quello bipolare. Questo suggerisce che le due malattie abbiano un substrata biologico distinto. Per quanto riguarda i disturbi d'ansia, le regioni orbito-frontali ed i gangli della base sembrano avere un'anatomia anormale nei disturbo ossessivo-compulsivo, i lobi temporali nei disturbo da attacchi di panico e l'ippocampo nei disturbo post-traumatico da stress. Conclusioni – I dati della letteratura riassunti in questo articolo suggeriscono che specifiche aree cerebrali siano coinvolte nella patofisiologia dei disturbi dell'umore e d'ansia. Tuttavia, gli studi a tutt'oggi a disposizione sono stati condotti su campioni relativamente piccoli di soggetti, spesso sottoposti a medicamenti psicotropi, e sono in gran parte studi trasversali. Per tale motivo gli studi con RMN in futuro dovranno avere un disegno di tipo longitudinale ed arruolare campioni più ampi di soggetti, possibilmente senza trattamento psicofarmacologico, al primo episodio di malattia o ad alto rischio di sviluppare un disturbo dell'umore o d'ansia. Inoltre, l'associazione di questo tipo di ricerche con studi di tipo genetico potranno essere estremamente utili per separare anomalie anatomiche cerebrali di stato da quelle di tratto e per ulteriormente caratterizzare la patofisiologia di questi disturbi. SUMMARY Objective – In vivo structural magnetic resonance imaging (MRI) studies have evaluated the brain anatomy of various psychiatric disorders, allowing the investigation of putative abnormal brain circuits possibly involved in the patophysiology of psychiatric disorders. Here we reviewed the structural MRI literature in mood and anxiety disorders. Methods – All anatomical MRI studies evaluating mood and anxiety disorder patients were identified through a comprehensive Medline search conducted for the period from 1966 to January 2002, and a manual search of bibliographic cross-referencing complemented the Medline search. Results – Differential patterns of anatomical brain abnormalities appear to be involved in subtypes of mood disorders, with hippocampus and basal ganglia being abnormal in unipolar disorder, and amygdala and cerebellum in bipolar disorders, suggesting that these two mood disorders are biologically distinct. As for anxiety disorders, orbital frontal regions and basal ganglia have been reported to be anatomically abnormal in obsessive-compulsive disorder, temporal lobe was found to be abnormally reduced in panic disorder, and abnormal hippocampus shrinkage was shown in posttraumatic stress disorder. Conclusions – The structural MRI findings reviewed here suggest abnormalities in specific brain regions participating in proposed neuroanatomic models possibly involved in the pathophysiology of mood disorders and anxiety disorders. Nonetheless, available MRI studies have suffered from limitations related to relatively small patient samples and involvement of medicated patients, and were largely cross-sectional investigations. Therefore, longitudinal MRI studies involving more sizeable samples of drug-free patients, patients at first episode of illness or at high risk for mood or anxiety disorders, associated to genetic studies, are likely to be extremely valuable to separate state from trait brain abnormalities and to characterize further the pathophysiology of these disorders.

[1]  D. Zald,et al.  Anatomy and function of the orbital frontal cortex, I: anatomy, neurocircuitry; and obsessive-compulsive disorder. , 1996, The Journal of neuropsychiatry and clinical neurosciences.

[2]  S. Olarte,et al.  Psychotherapist-patient sexual contact after termination of treatment. , 1992 .

[3]  C. Golden,et al.  Ventricular enlargement in major depression , 1983, Psychiatry Research.

[4]  G. Bartzokis,et al.  An MRI study of temporal lobe structures in men with bipolar disorder or schizophrenia , 2000, Biological Psychiatry.

[5]  S. Strakowski,et al.  Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. , 1999, Archives of general psychiatry.

[6]  K. Krishnan,et al.  Magnetic-resonance morphometry in patients with major depression , 1998, Psychiatry Research: Neuroimaging.

[7]  D. Nutt,et al.  Conditioned anticipatory anxiety in normal volunteers , 1996, NeuroImage.

[8]  Henry A. Nasrallah,et al.  Cognitive impairment and cerebral structure by MRI in bipolar disorder , 1990, Biological Psychiatry.

[9]  Y. Sheline,et al.  White matter hyperintensities and gray matter lesions in physically healthy depressed subjects. , 1999, The American journal of psychiatry.

[10]  R. Kikinis,et al.  Subgenual cingulate cortex volume in first-episode psychosis. , 1999, The American journal of psychiatry.

[11]  K. Boone,et al.  Brain injury and cognitive function in late-onset psychotic depression. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[12]  L. Altshuler,et al.  Reduction of temporal lobe volume in bipolar disorder: a preliminary report of magnetic resonance imaging. , 1991, Archives of general psychiatry.

[13]  A. J. Kumar,et al.  Basal ganglia volumes and white matter hyperintensities in patients with bipolar disorder. , 1994, The American journal of psychiatry.

[14]  P. Mazzoni,et al.  Lower left temporal lobe MRI volumes in patients with first-episode schizophrenia compared with psychotic patients with first-episode affective disorder and normal subjects. , 1998, The American journal of psychiatry.

[15]  K. Krishnan,et al.  A magnetic resonance imaging study of putamen nuclei in major depression , 1991, Psychiatry Research: Neuroimaging.

[16]  G. Bartzokis,et al.  Amygdala enlargement in bipolar disorder and hippocampal reduction in schizophrenia: an MRI study demonstrating neuroanatomic specificity. , 1998, Archives of general psychiatry.

[17]  Joseph Frank,et al.  Seasonality and pituitary volume , 1997, Psychiatry Research: Neuroimaging.

[18]  A. J. Kumar,et al.  Cortical magnetic resonance imaging changes in elderly inpatients with major depression. , 1991, The American journal of psychiatry.

[19]  P. Cosyns,et al.  Computed tomography of the brain in unipolar depression. , 1991, Journal of affective disorders.

[20]  A computerized tomographic study in patients with depressive disorder: a comparison with schizophrenic patients and controls. , 1989, Acta psychiatrica Belgica.

[21]  S. Rauch,et al.  Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. , 2000, The Psychiatric clinics of North America.

[22]  P. Tibbo,et al.  Toward an integrative understanding of social phobia. , 2001, Journal of psychiatry & neuroscience : JPN.

[23]  H. Mayberg Limbic-cortical dysregulation: a proposed model of depression. , 1997, The Journal of neuropsychiatry and clinical neurosciences.

[24]  E. Vieta,et al.  Cognitive Dysfunctions in Bipolar Disorder: Evidence of Neuropsychological Disturbances , 1999, Psychotherapy and Psychosomatics.

[25]  D. Delis,et al.  Subcortical abnormalities detected in bipolar affective disorder using magnetic resonance imaging. Clinical and neuropsychological significance. , 1990, Archives of general psychiatry.

[26]  L. Friedman,et al.  Meta-analyses of studies of ventricular enlargement and cortical sulcal prominence in mood disorders. Comparisons with controls or patients with schizophrenia. , 1995, Archives of general psychiatry.

[27]  K. Krishnan,et al.  Hyperintense lesions on magnetic resonance images in bipolar disorder , 1999, Biological Psychiatry.

[28]  L. Selemon,et al.  Reductions in neuronal and glial density characterize the dorsolateral prefrontal cortex in bipolar disorder , 2001, Biological Psychiatry.

[29]  E. Aylward,et al.  Normal caudate nucleus in obsessive-compulsive disorder assessed by quantitative neuroimaging. , 1996, Archives of general psychiatry.

[30]  B. Bogerts,et al.  Brain morphology assessed by computed tomography in patients with geriatric depression, patients with degenerative dementia, and normal control subjects , 1995, Psychiatry Research: Neuroimaging.

[31]  H. Meltzer,et al.  Lateral ventricular size, psychopathology, and medication response in the psychoses. , 1984, Biological psychiatry.

[32]  N. Kalin,et al.  Limbic-hypothalamic-pituitary-adrenal axis activity and ventricular-to-brain ratio studies in affective illness and schizophrenia. , 1992, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[33]  A. Phillips,et al.  Cognition and the Basal Ganglia: A Possible Substrate for Procedural Knowledge , 1987, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[34]  G. Villarreal,et al.  Brain imaging in posttraumatic stress disorder. , 2001, Seminars in clinical neuropsychiatry.

[35]  H. Manji,et al.  The Mood‐Stabilizing Agents Lithium and Valproate RobustlIncrease the Levels of the Neuroprotective Protein bcl‐2 in the CNS , 1999, Journal of neurochemistry.

[36]  B. Woods,et al.  Structural brain abnormalities in first-episode mania , 1993, Biological Psychiatry.

[37]  H. Hazama,et al.  Computerized Tomography of the Brain in Manic‐Depressive Patients–A Controlled Study , 1982, Folia psychiatrica et neurologica japonica.

[38]  N. Andreasen,et al.  Cerebellar atrophy in schizophrenia and affective disorder. , 1987, The American journal of psychiatry.

[39]  James R MacFall,et al.  Hippocampal volume in geriatric depression , 2000, Biological Psychiatry.

[40]  A L Malizia,et al.  What do brain imaging studies tell us about anxiety disorders? , 1999, Journal of psychopharmacology.

[41]  F. W. Brown,et al.  White matter hyperintensity signals in psychiatric and nonpsychiatric subjects. , 1992, The American journal of psychiatry.

[42]  S. Schlegel,et al.  Computed tomography in affective disorders. Part I. Ventricular and sulcal measurements , 1987, Biological Psychiatry.

[43]  M. Keshavan,et al.  Corpus callosal signal intensity in treatment-naive pediatric obsessive compulsive disorders , 1999, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[44]  J. Cummings,et al.  Frontal-subcortical circuits and human behavior. , 1993, Journal of psychosomatic research.

[45]  R Levy,et al.  Neuropsychological deficits and CT scan changes in elderly depressives , 1990, Psychological Medicine.

[46]  A. Ontiveros,et al.  Correlation of severity of panic disorder and neuroanatomical changes on magnetic resonance imaging. , 1989, The Journal of neuropsychiatry and clinical neurosciences.

[47]  K. Krishnan,et al.  Nuclear magnetic resonance spectroscopy: new insights into the pathophysiology of mood disorders. , 1996, Depression.

[48]  Michele Laraia,et al.  Brain MRI in obsessive-compulsive disorder , 1991, Psychiatry Research.

[49]  C. Coffey,et al.  Subcortical hyperintensity on magnetic resonance imaging: a comparison of normal and depressed elderly subjects. , 1990, The American journal of psychiatry.

[50]  G. Moore,et al.  Lithium up-regulates the cytoprotective protein Bcl-2 in the CNS in vivo: a role for neurotrophic and neuroprotective effects in manic depressive illness. , 2000, The Journal of clinical psychiatry.

[51]  M. Fava,et al.  A quantitative magnetic resonance imaging study of cerebral and cerebellar gray matter volume in primary unipolar major depression: Relationship to treatment response and clinical severity , 1997, Biological Psychiatry.

[52]  R. Sapolsky,et al.  The possibility of neurotoxicity in the hippocampus in major depression: a primer on neuron death , 2000, Biological Psychiatry.

[53]  K. Krishnan,et al.  Hippocampal abnormalities in depression. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[54]  N. Andreasen,et al.  Ventricular abnormalities in affective disorder: clinical and demographic correlates. , 1990, The American journal of psychiatry.

[55]  M. Raichle,et al.  Subgenual prefrontal cortex abnormalities in mood disorders , 1997, Nature.

[56]  D. Kupfer,et al.  Decreased pituitary volume in patients with bipolar disorder , 2001, Biological Psychiatry.

[57]  Godfrey D. Pearlson,et al.  Lateral ventricular enlargement associated with persistent unemployment and negative symptoms in both schizophrenia and bipolar disorder , 1984, Psychiatry Research.

[58]  D. Kupfer,et al.  Increased gray matter volume in lithium-treated bipolar disorder patients , 2002, Neuroscience Letters.

[59]  T. Uhde,et al.  Cerebral ventricular size in panic disorder. , 1987, Journal of affective disorders.

[60]  T. Insel,et al.  Neurological and neuropsychological studies of patients with obsessive-compulsive disorder. , 1983, Biological psychiatry.

[61]  C. Coffey,et al.  Quantitative cerebral anatomy in depression. A controlled magnetic resonance imaging study. , 1993, Archives of general psychiatry.

[62]  H. Nasrallah,et al.  Cortical atrophy in schizophrenia and mania: a comparative CT study. , 1982, The Journal of clinical psychiatry.

[63]  Cerebral CAT scan imaging in schizophrenic and bipolar patients. , 1985, The Journal of the Kentucky Medical Association.

[64]  D. Perrett,et al.  A differential neural response in the human amygdala to fearful and happy facial expressions , 1996, Nature.

[65]  T. Iidaka,et al.  Signal hyperintensities on brain magnetic resonance imaging in elderly depressed patients. , 1996, European neurology.

[66]  G. Breton,et al.  Temporal lobe abnormalities in panic disorder: An MRI study , 1990, Biological Psychiatry.

[67]  H. Nasrallah,et al.  Cerebral venticular enlargement in young manic males , 1982 .

[68]  K. Frustaci,et al.  A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder , 2001, Biological Psychiatry.

[69]  J. Pierri,et al.  Frontostriatal measurement in treatment-naive children with obsessive-compulsive disorder. , 1997, Archives of general psychiatry.

[70]  S. Strakowski,et al.  Neuroimaging in bipolar disorder. , 2000, Bipolar disorders.

[71]  K. Krishnan,et al.  Magnetic resonance imaging of the caudate nuclei in depression. Preliminary observations. , 1992, Archives of general psychiatry.

[72]  R. Dolan,et al.  Cerebral ventricular size in depressed subjects , 1985, Psychological Medicine.

[73]  G. Pearlson,et al.  Medial and superior temporal gyral volumes and cerebral asymmetry in schizophrenia versus bipolar disorder , 1997, Biological Psychiatry.

[74]  G L Wolf,et al.  Brain imaging abnormalities in mental disorders of late life. , 1990, Archives of neurology.

[75]  Cheuk Y. Tang,et al.  Neuroimaging Bipolar Illness With Positron Emission Tomography and Magnetic Resonance Imaging , 1997 .

[76]  S. Lippmann,et al.  Cerebellar vermis dimensions on computerized tomographic scans of schizophrenic and bipolar patients. , 1982, The American journal of psychiatry.

[77]  B. Roth,et al.  Morphometric evidence for neuronal and glial prefrontal cell pathology in major depression∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[78]  D. Kupfer,et al.  MRI study of posterior fossa structures and brain ventricles in bipolar patients. , 2001, Journal of psychiatric research.

[79]  B. McEwen,et al.  Effects of adverse experiences for brain structure and function , 2000, Biological Psychiatry.

[80]  J M Gorman,et al.  Neuroanatomical hypothesis of panic disorder, revised. , 2000, The American journal of psychiatry.

[81]  K. Krishnan,et al.  Pituitary size in depression. , 1991, The Journal of clinical endocrinology and metabolism.

[82]  R. Kikinis,et al.  Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder , 1996, Biological Psychiatry.

[83]  D. Kupfer,et al.  Differential Effects of Age on Brain Gray Matter in Bipolar Patients and Healthy Individuals , 2001, Neuropsychobiology.

[84]  D. Kupfer,et al.  Anatomical MRI study of basal ganglia in bipolar disorder patients , 2001, Psychiatry Research: Neuroimaging.

[85]  H. Nasrallah,et al.  Cerebral ventricular enlargement in young manic males. A controlled CT study. , 1982, Journal of affective disorders.

[86]  R. Langevin,et al.  Deficits in gray matter volume are present in schizophrenia but not bipolar disorder 1 This work was presented at the Meeting of the Society of Biological Psychiatry, Philadelphia, PA, USA, May 1994. 1 , 1997, Schizophrenia Research.

[87]  M Ashtari,et al.  MRI signal hyperintensities in geriatric depression. , 1996, The American journal of psychiatry.

[88]  M E Raichle,et al.  Neuroanatomical circuits in depression: implications for treatment mechanisms. , 1992, Psychopharmacology bulletin.

[89]  L. Altshuler,et al.  Temporal lobe measurement in primary affective disorder by magnetic resonance imaging. , 1989, The Journal of neuropsychiatry and clinical neurosciences.

[90]  M Ashtari,et al.  Orbital frontal and amygdala volume reductions in obsessive-compulsive disorder. , 1999, Archives of general psychiatry.

[91]  N. Butters,et al.  Magnetic resonance imaging and mood disorders. Localization of white matter and other subcortical abnormalities. , 1995, Archives of general psychiatry.

[92]  T. Crow,et al.  Temporal lobe structure as determined by nuclear magnetic resonance in schizophrenia and bipolar affective disorder. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[93]  W. Iacono,et al.  Ventricular and sulcal size at the onset of psychosis. , 1988, The American journal of psychiatry.

[94]  Yvette I. Sheline,et al.  Depression Duration But Not Age Predicts Hippocampal Volume Loss in Medically Healthy Women with Recurrent Major Depression , 1999, The Journal of Neuroscience.

[95]  Increased hippocampal volume in bipolar disorder , 1994, Biological Psychiatry.

[96]  M S Buchsbaum,et al.  Magnetic resonance and positron emission tomography imaging of the corpus callosum: size, shape and metabolic rate in unipolar depression. , 1993, Journal of affective disorders.

[97]  S. Rauch,et al.  Investigating the pathogenesis of posttraumatic stress disorder with neuroimaging. , 2001, The Journal of clinical psychiatry.

[98]  K. Krishnan,et al.  Posterior fossa abnormalities in major depression: a controlled magnetic resonance imaging study , 1992, Acta psychiatrica Scandinavica.

[99]  Mustafa M. Husain,et al.  MRI of corpus callosum and septum pellucidum in depression , 1991, Biological Psychiatry.

[100]  Jun Soo Kwon,et al.  Grey matter abnormalities in obsessive–compulsive disorder , 2001, British Journal of Psychiatry.

[101]  J. Rapoport,et al.  Neuroanatomical abnormalities in obsessive-compulsive disorder detected with quantitative X-ray computed tomography. , 1988, The American journal of psychiatry.

[102]  G. E. Alexander,et al.  Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, "prefrontal" and "limbic" functions. , 1990, Progress in brain research.

[103]  M Ashtari,et al.  Reduced caudate nucleus volume in obsessive-compulsive disorder. , 1995, Archives of general psychiatry.

[104]  P. Murali Doraiswamy,et al.  Magnetic resonance imaging in social phobia , 1994, Psychiatry Research.

[105]  M. Szuba,et al.  Leukoencephalopathy and major depression: A preliminary report , 1992, Psychiatry Research: Neuroimaging.

[106]  J. Soares,et al.  The anatomy of mood disorders—review of structural neuroimaging studies , 1997, Biological Psychiatry.

[107]  C. Nemeroff,et al.  Hypercortisolemia and hippocampal changes in depression , 1993, Psychiatry Research.

[108]  G. Pearlson,et al.  Decreased regional cortical gray matter volume in schizophrenia. , 1994, The American journal of psychiatry.

[109]  Klaus P. Ebmeier,et al.  Cortical grey matter reductions associated with treatment-resistant chronic unipolar depression , 1998, British Journal of Psychiatry.

[110]  J. Saint-Cyr,et al.  Temporal horn enlargement is present in schizophrenia and bipolar disorder , 1998, Biological Psychiatry.

[111]  Andrew W. Douglas,et al.  MRI subcortical signal hyperintensities in Mania at first hospitalization , 1993, Biological Psychiatry.

[112]  L. Staib,et al.  Hippocampal volume reduction in major depression. , 2000, The American journal of psychiatry.

[113]  S. Southwick,et al.  MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. , 1995, The American journal of psychiatry.

[114]  L. Altshuler,et al.  MRI-based measurements of temporal lobe and ventricular structures in patients with bipolar I and bipolar II disorders. , 2000, Journal of affective disorders.

[115]  E. Smeraldi,et al.  Increased right caudate nucleus size in obsessive-compulsive disorder: Detection with magnetic resonance imaging , 1992, Psychiatry Research: Neuroimaging.

[116]  J. Kleinman,et al.  Neuropathology of bipolar disorder , 2000, Biological Psychiatry.

[117]  M. Keshavan,et al.  Corpus callosal morphology in treatment-naive pediatric obsessive compulsive disorder , 1997, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[118]  D. Delis,et al.  Subcortical signal hyperintensities in bipolar patients detected by MRI , 1987, Psychiatry Research.

[119]  H. Nasrallah,et al.  CEREBELLAR ATROPHY IN SCHIZOPHRENIA AND MANIA , 1981, The Lancet.

[120]  K. Krishnan,et al.  Reduction of orbital frontal cortex volume in geriatric depression , 2000, Biological Psychiatry.

[121]  B. Woods,et al.  Age-related MRI abnormalities in bipolar illness: A clinical study , 1995, Biological Psychiatry.

[122]  Lee Friedman,et al.  A magnetic resonance imaging study of thalamic area in adolescent patients with either schizophrenia or bipolar disorder as compared to healthy controls , 1999, Psychiatry Research: Neuroimaging.

[123]  R. Bronen,et al.  Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report , 1997, Biological Psychiatry.

[124]  Y. Sheline,et al.  Absence of striatal volume differences between depressed subjects with no comorbid medical illness and matched comparison subjects. , 1999, The American journal of psychiatry.

[125]  J. Ehrhardt,et al.  Structural brain abnormalities in bipolar affective disorder. Ventricular enlargement and focal signal hyperintensities. , 1990, Archives of general psychiatry.

[126]  Richard B. Ivry,et al.  Is the cerebellum involved in learning and cognition? , 1992, Current Biology.

[127]  M E Shenton,et al.  Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD. , 2001, The American journal of psychiatry.

[128]  K. Krishnan,et al.  Subcortical hyperintensities on brain magnetic resonance imaging: a comparison of normal and bipolar subjects. , 1991, The Journal of neuropsychiatry and clinical neurosciences.

[129]  Ellen Frank,et al.  Anatomical MRI Study of Subgenual Prefrontal Cortex in Bipolar and Unipolar Subjects , 2002, Neuropsychopharmacology.

[130]  William W. McDonald,et al.  Reduction of cerebellar volume in major depression: A controlled MRI study , 1993 .

[131]  M Ashtari,et al.  Hippocampal/amygdala volumes in geriatric depression , 1999, Psychological Medicine.

[132]  Deborah A Yurgelun-Todd,et al.  Hippocampal volume in primary unipolar major depression: a magnetic resonance imaging study , 2000, Biological Psychiatry.

[133]  A L Brody,et al.  Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder , 1998, British Journal of Psychiatry.

[134]  W. Krieg Functional Neuroanatomy , 1953, Springer Series in Experimental Entomology.

[135]  D. Nutt,et al.  The neurobiology of social phobia , 1999, European Archives of Psychiatry and Clinical Neuroscience.

[136]  K. O Lim,et al.  Cortical gray matter deficit in patients with bipolar disorder , 1999, Schizophrenia Research.

[137]  I. I. Rushakov,et al.  Computed Tomography , 2019, Compendium of Biomedical Instrumentation.

[138]  Hans Förstl,et al.  Ventricular enlargement and caudate hyperdensity in elderly depressives , 1991, Biological Psychiatry.

[139]  Dan J Stein,et al.  Computed tomography and neurological soft signs in obsessive-compulsive disorder , 1993, Psychiatry Research: Neuroimaging.

[140]  F. J. Friedrich,et al.  COGNITION AND THE BASAL GANGLIA , 1984 .

[141]  S. Kanba,et al.  Depression and ventricular enlargement , 1984, Acta psychiatrica Scandinavica.

[142]  S. Folstein,et al.  Huntington's disease as a model for mood disorders. Clues from neuropathology and neurochemistry. , 1990, Molecular and chemical neuropathology.

[143]  S. Strakowski,et al.  Frontosubcortical neuroanatomy and the continuous performance test in mania. , 1999, The American journal of psychiatry.

[144]  James C. Ehrhardt,et al.  Subcortical and temporal structures in affective disorder and schizophrenia: A magnetic resonance imaging study , 1992, Biological Psychiatry.

[145]  J. Mann,et al.  The functional neuroanatomy of mood disorders. , 1997, Journal of psychiatric research.

[146]  R. Murray,et al.  Volumetric MRI measurements in bipolars compared with schizophrenics and healthy controls , 1994, Psychological Medicine.

[147]  M. Fava,et al.  A quantitative magnetic resonance imaging study of caudate and lenticular nucleus gray matter volume in primary unipolar major depression: relationship to treatment response and clinical severity , 1998, Psychiatry Research: Neuroimaging.

[148]  Joel Gelernter,et al.  Corpus callosum dimensions measured by magnetic resonance imaging in bipolar affective disorder and schizophrenia , 1989, Biological Psychiatry.

[149]  D. Kupfer,et al.  MRI study of thalamic volumes in bipolar and unipolar patients and healthy individuals , 2001, Psychiatry Research: Neuroimaging.

[150]  Lawrence H. Staib,et al.  Temporal lobe volume in panic disorder — a quantitative magnetic resonance imaging study , 2000, Psychiatry Research: Neuroimaging.

[151]  L. DeLisi,et al.  Computed tomography in schizophreniform disorder and other acute psychiatric disorders. , 1982, Archives of general psychiatry.

[152]  B. J. Casey,et al.  Developmental traumatology part II: brain development∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[153]  B. Bogerts,et al.  Changes in CSF spaces differ in endogenous and neurotic depression. A planimetric CT scan study. , 1997, Journal of affective disorders.

[154]  J L Rapoport,et al.  Computerized tomography and neuropsychological test measures in adolescents with obsessive-compulsive disorder. , 1984, The American journal of psychiatry.

[155]  P. Videbech MRI findings in patients with affective disorder: a meta‐analysis , 1997, Acta psychiatrica Scandinavica.

[156]  D. Weinberger,et al.  Computed tomographic scans in patients with schizophrenia, schizoaffective, and bipolar affective disorder. , 1983, Archives of general psychiatry.

[157]  J. Csernansky,et al.  Hippocampal atrophy in recurrent major depression. , 1996, Proceedings of the National Academy of Sciences of the United States of America.

[158]  V S Caviness,et al.  Cerebral structural abnormalities in obsessive-compulsive disorder. A quantitative morphometric magnetic resonance imaging study. , 1996, Archives of general psychiatry.

[159]  J. Cummings,et al.  Depression in patients with Parkinson's disease , 1999, International journal of geriatric psychiatry.

[160]  G. Rajkowska,et al.  Postmortem studies in mood disorders indicate altered numbers of neurons and glial cells , 2000, Biological Psychiatry.