US researchers have found that men, but not women, with bipolar disorder (BD) have larger cerebellar vermis volumes than healthy individuals.

The vermis is interconnected with brain regions linked to the pathophysiology of BD, including the hypothalamus, amygdala, hippocampus, anterior cingulate, and ventral prefrontal cortices.

Prior magnetic resonance imaging (MRI) studies have found vermis structural abnormalities in BD while others have not.

Fay Womer (Yale University School of Medicine, New Haven, Connecticut) and colleagues therefore measured volumes for total vermis and vermis subregions V1, V2, and V3 using high-resolution MRI in 44 BD patients (of whom 10 were unmedicated) and 43 healthy individuals with no history of psychiatric disorders.

The team found that total vermis volumes were significantly greater in male BD patients compared with controls, at 7500 vs 6650 mm³, respectively. By contrast, vermis volumes were nearly identical in female BD patients and controls.

Further analysis of the vermis subregions revealed significantly larger V1 volumes in the BD group compared with control group, particularly among males. No significant differences in V2 or V3 subregions were seen between groups.

“The findings reported herein raise interesting questions regarding how [gender]-related factors, such as hormonal levels, may interact with the development of the vermis in BD and whether vermis abnormalities may contribute to clinical features of BD that tend to be more characteristic of males with the disorder,” write the researchers in the journal Bipolar Disorders.

They add that since increases in vermis volume have been observed in autism and schizophrenia, which share genetic vulnerabilities with BD, commonalities in the pathophysiology of these disorders with BD are a possibility.

Womer and team call for further studies to “elucidate the role of the vermis in BD pathophysiology and the potential influences of [gender] on this role.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

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