Cerebellar vermal atrophy in psychiatric patients.

Our findings indicate that a notable number of patients who have functional psychosis (50%) or seizures (38%) show cerebellar vermal atrophy on visual inspection of CAT head scans, in contrast to 0.5% to 3.7% of patients with other disorders. In addition to the visual reading of 1700 scans in the present study, we used two methods to demonstrate cerebellar vermal atrophy objectively: (i) low-density measurements of the posterior fossa in relationship to total brain area, and (ii) sagittal reconstruction of the vermis. We postulate that cerebellar vermal atrophy reduces the cerebellum's inhibitory influences on activity of the rostral forebrain structures where unit overactivity has been correlated with emotional dyscontrol and clinical seizures. We further postulate that cerebellar vermal atrophy reduces facilitory activity of the brain's pleasure system (septal region).