Posterior Fossa Sub-Arachnoid Cysts Observed in Patients with Bipolar Disorder: a Retrospective Cohort Study
Open accessAbstract
Posterior fossa arachnoid cysts (PFACs) are rare congenital abnormalities observed in 0.3 to 1.7% of the population and are traditionally thought to be benign. While conducting a neuroimaging study investigating cerebellar structure in bipolar disorder, we observed a higher incidence of PFACs in bipolar patients (5 of 75; 6.6%) compared to the neuronormative control group (1 of 54; 1.8%). In this report, we detail the cases of the five patients with bipolar disorder who presented with PFACs. Additionally, we compare neuropsychiatric measures and cerebellar volumes of these patients to neuronormative controls and bipolar controls (those with bipolar disorder without neuroanatomical abnormalities). Our findings suggest that patients with bipolar disorder who also present with PFACs may have a milder symptom constellation relative to patients with bipolar disorder and no neuroanatomical abnormalities. Furthermore, our observations align with prior literature suggesting an association between PFACs and psychiatric symptoms that warrants further study. While acknowledging sample size limitations, our primary aim in the present work is to highlight a connection between PFACs and BD-associated symptoms and encourage further study of cerebellar abnormalities in psychiatry.
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Cerebellar lesions and peri-cerebellar cysts are associated with a higher risk of bipolar disorder symptom presentation.
“Additionally, cerebellar lesions and peri-cerebellar cysts have been associated with a higher risk of bipolar disorder symptom presentation (Ewald et al., 2022; Lauterbach, 1996).”
From A double-blind, randomized, sham-controlled clinical trial of cerebellar intermittent theta burst stimulation for bipolar disorder: Safety, tolerability, mood and cognitive effects (2025) · cites this paper as Ewald et al., 2022
The Introduction reports that posterior fossa arachnoid cysts occurred more often in participants with bipolar disorder than in controls, and the Discussion describes a connection between the cysts and bipolar-disorder-associated symptoms. But the study does not establish that cerebellar lesions or cysts increase the risk of symptom presentation; its Discussion cautions against causal conclusions, and its Results suggest milder symptoms in the bipolar group with cysts than in the bipolar group without them. Page numbers were not available in our copy. (LLM, conf=0.86)
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- Authors
- Ewald, V. A. M., Purnell, J. R., Bruss, J. E., Barsotti, E. J., Aldine, A. S., Mahachi, K. G., Wemmie, J. A., Magnotta, V. A., Boes, A. D., Parker, K. L., & Fiedorowicz, J. G.
- Affiliations
- University of Iowa (US)
- Louisiana State University Health Sciences Center New Orleans (US)
- University of Ottawa (CA)
- Corresponding author
- Parker, Krystal L.
- ORCID
- Venue
- The Cerebellum
- Published
- 2022-05-14
- Volume
- 22
- Issue
- 3
- Pages
- 370-378
- ISSN
- 1473-4222 (ISSN-L)
- 1473-4230
- PMC
- PMC9659668
- OpenAlex
- W4280505350
- Cited by
- 2
- References
- 47
- Citations by year
- 2024: 1 · 2023: 1
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- The Cerebellum (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (RO1 MH 118240)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Cerebrospinal fluid and hydrocephalus
- Keywords
- posterior fossa arachnoid cyst, bipolar disorder, cerebellar abnormalities, cerebellar volume, neuropsychiatric symptoms, congenital brain anomalies, symptom severity
- MeSH terms
- Bipolar Disorder, Cerebellum, Cranial Fossa, Posterior, Humans, Magnetic Resonance Imaging, Retrospective Studies, Arachnoid Cysts
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