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Abstract and outlines for Cozumel (Jan 15-22).

Carl M. Anderson, Instructor Harvard Medical School
Assistant Psychobiologist, Developmental Biopsychiatry Research Program
and Brain Imaging Center, McLean Hospital 115 Mill St. Belmont, MA 02178
Ph: 617-855-2972 Fax: 617-855-3712
Email: Carl_anderson@hms.harvard.edu
Web site: http:\\remfractal.mclean.org:8080

 

Sunday, January 16th 2000.
Neural Dynamics and the Fractal Nature of Mind/Brain.

The sciences of non-linear dynamics and fractals speak to a fundamentally new view of how brain and mind are organized, with simple themes recursively nested on multiple sublevels of organization from the activity of ion channels to the growth of the internet. This talk will attempt to give a non-technical overview of how these concepts have been applied to brain and mind by various researchers including Walter Freeman 1-5, Arnold Mandell 6-9, myself 10-14 and others 9,15-17. Walter Freeman's concepts of how the brain uses chaos to make sense of the world will be described along with the concepts of chaos, attractors and spaces of states (a short video will be shown if possible). Then an introduction to the work of Arnold Mandell, a psychiartist who was the first to apply nonlinear dynamics to psychopathology, will be presented. Dr. Mandell and I have developed Benoit Mandelbrot's12-14 concept of fractal-time to describe how spontaneous fluctuations occurring during REM sleep or orienting responses as examples of dynamic brain self-organization. In creating a science of the irregular, Mandelbrot18,19began a renaissance in the way order is perceived in nature, particularly, in the spontaneous irregular patterns of neural activity which are the foundations of mind. Central to the Mandelbrot renaissance is the concept that patterns termed "fractal" or "self-similar" have recurrent irregularity in space or time repeated like the layers of an onion at different levels or scales. Spontaneous behavioral phenomena at all levels of organisms from ion channel currents to the foraging patterns of animals to reaction time fluctuations generated by subjects in cognitive science experiments exhibit these recurrent fluctuations. Fluctuations, once tacitly overlooked and excluded as noisy, random outliers, reveal a previously hidden fractal or self-similar order in time that is transforming the way the biological foundations of brain/mind are conceptualized by a growing number of investigators.
I will conclude by describing recent fMRI work at McLean (supported by the Center for Consciousness Studies) using blood oxygenation level dependent (BOLD) signals to image brain regional networks involving the temporal lobes, brainstem and cerebellum and activated during the recall of neutral or emotional memories. We observed, using wavelet based analysis of fractal fluctuations in BOLD, activation in right hemisphere during recall of emotional memories as well as in the brainstem and cerebellar vermis during "mindfulness" meditation 20.

 

1. Freeman, W.J. The neurobiology of multimodal sensory integration. Integrative Physiological & Behavioral Science 33, 124-9 (1998).
2. Freeman, W.J. The physiological basis of mental images. Biological Psychiatry 18, 1107-25 (1983).
3. Freeman, W.J. & Skarda, C.A. Spatial EEG patterns, non-linear dynamics and perception: the neo-Sherringtonian view. Brain Research 357, 147-75 (1985).
4. Freeman, W.J. The physiology of perception. Scientific American 264, 78-85 (1991).
5. Freeman, W.J. Characterization of state transitions in spatially distributed, chaotic, nonlinear, dynamical systems in cerebral cortex. Integrative Physiological & Behavioral Science 29, 294-306 (1994).
6. Mandell, A.J. From intermittency to transitivity in neuropsychobiological flows. American Journal of Physiology 245, R484-94 (1983).
7. Mandell, A.J. Interhemispheric fusion. Journal of Psychoactive Drugs 17, 257-66 (1985).
8. Mandell, A.J. & Selz, K.A. Nonlinear dynamical patterns as personality theory for neurobiology and psychiatry. Psychiatry 58, 371-90 (1995).
9. Paulus, M.P., Geyer, M.A., Gold, L.H. & Mandell, A.J. Application of entropy measures derived from the ergodic theory of dynamical systems to rat locomotor behavior. Proceedings of the National Academy of Sciences of the United States of America 87, 723-7 (1990).
10. Anderson, C.M. Ibogaine Therapy in Chemical Dependency and Posttraumatic Stress Disorder: A Hypothesis Involving the Fractal Nature of Fetal REM Sleep and Interhemispheric Reintegration. in Multidisciplinary Association For Psychedelic Studies Vol. VIII 5-14 (, 1998).
11. Anderson, C.M. et al. 1/f-Like spectra in cortical and subcortical brain structures: a possible marker of behavioral state-dependent self organization. in Noise in Physical Systems and 1/f Fluctuations, Vol. 285 (eds. Handel, P.J. & Chung, A.J.) 737-740 (American Institute of Physics, St. Louis, 1993).
12. Anderson, C.M. Ph.D Dissertation, Florida Atlantic University (1995).
13. Anderson, C.M. & Mandell, A.J. Fractal time and the foundations of consciousness: vertical convergence of 1/f phenomena from ion channels to behavioral states. in Fractals of Brain, Fractals of Mind, Vol. 7 (eds. Mac Cormac, E. & Stamenov, M.I.) 75-126 (John Benjamins, Amsterdam/Philadelphia, 1996).
14. Anderson, C.M. et al. The development of nuchal atonia associated with active (REM) sleep in fetal sheep: presence of recurrent fractal organization. Brain Research 787, 351-7 (1998).
15. Liebovitch, L.S. Fractals and chaos simplified for the life sciences, 268 (Oxford University Press, New York, 1998).
16. Selz, K.A., Mandell, A.J., Anderson, C.M., Smotherman, W.P. & Teicher, M.H. Distributions of local Mandelbrot-Hurst exponents: Motor activity in fetal rats of cocainized mother and manic-depressives. Fractals 3, 893-904 (1995).
17. Smotherman, W.P., Selz, K.A. & Mandell, A.J. Dynamical entropy is conserved during cocaine-induced changes in fetal rat motor patterns. Psychoneuroendocrinology 21, 173-87 (1996).
18. Mandelbrot, B.B. Multifractals and 1/f Noise: Wild Self-Affinity in Physics(1963-1976), 432 (Springer, New York, 1999).
19. Mandelbrot, B.B. The Fractal Geometry of Nature, (W.H. Freeman, New York, 1983).
20. Anderson CM, SB Lowen, MH Teicher, LC Mass, PF Renshaw. State-of-mind-dependent Fractal Fluctuations in BOLD fMRI. Dynamical Neuroscience, Delray, Fl., Oct21-23th , 1999. (http://remfractal.mclean.org:8080/wave1999.pdf).


 

Thursday, January 20th 2000.
The Cerebellar Vermis and Psychopathology

The cerebellum, heretofore seen as only involved in physical coordination of locomotion, balance and eye movements, appears to be involved in the enduring effects of child abuse and the symptoms of attention deficit hyperactivity disorder or ADHD as well as a wide spectrum of psychopathological disorders (see conclusions). Following a historical overview of the role of the cerebellar vermis in psychopathology, a description of recent fMRI findings implicating it in the enduring effects of child abuse and childhood ADHD as well as a wide spectrum of psychopathological disorders (see conclusions) will be presented.
Early verbal or sexual child abuse can leave invisible scars with lifelong effects on emotional coordination. ADHD is a highly heritable disorder estimated to affect 6% of school-aged children characterized by poor emotional, attentional and physical coordination, as well as by age-inappropriate hyperactivity and impulsivity. These symptoms often respond dramatically to treatment with stimulants.
Although the cerebellum has been viewed primarily as a brain region involved in the coordination of movement, an increasing number of studies have demonstrated that the cerebellum may play a role in higher cognitive function and emotional control. In two functional magnetic resonance imaging studies conducted at McLean Hospital, we have observed activity in the cerebellum that further supports these new roles for this brain region. In the first study of the long-term effects of early abuse in adults, we have observed high activity in a region of the cerebellum called the vermis which strongly correlates with scores on rating scales typically used to assess psychopathology. In the second study, we observed high activity in the vermis associated with behavioral hyperactivity in ADHD children which decreased when these children were treated with the stimulant methylphenidate, also known as "Ritalin." In both studies abnormally high neural activity in the vermis was associated with abnormal behavioral and emotional coordination.
The abused and control subjects who participated in the first study were between the ages of 18 and 22 and were recruited by newspaper advertisements and posters placed at local colleges and on the subway. After completing an extensive questionnaire covering childhood experiences, family history and psychological characteristics, subjects were further screened by a clinician for a history of psychiatric illness, physical injury or trauma which could interfere with the interpretation of their data. The limbic system checklist-33 (LSCL-33), a self-report questionnaire developed to evaluate how frequently abused subjects experience 33 symptoms of temporal lobe epilepsy, was also part of the questionnaire. A typical LSCL-33 question is, "how often have you experienced the sudden, abrupt and unexplained onset of the sensation of something crawling under your skin or a rising or sinking feeling in your stomach - like being in an elevator." Previous studies by our group have shown that adults who have encountered abuse before the age of 18 self-report a higher percentage of these experiences. Higher scores on the LSCL-33 were strongly associated with higher activity in the cerebellar vermis, which has connections to the limbic system and therefore may play a role in the coordination of emotional behavior.
Many researchers believe that early child abuse could cause changes in the brain similar to a process called "kindling" that produces epilepsy in experimental animals. As the term suggests, a small spark set to tender can eventually grow to a large fire. Electrical stimulation of the limbic system can, if repeated frequently, lead to seizures. Similarly, the repeated trauma of verbal or sexual abuse may result in brain electrical abnormalities in humans associated with epileptic-like behavioral experiences. The cerebellar vermis appears to play a role in the control of epilepsy as clinical studies in humans have found that electrical stimulation of the vermis suppresses the spread of epileptic seizures. We interpret our findings to suggest that adults who suffered abuse during childhood may have abnormalities of the cerebellar vermis which impair its ability to coordinate emotional behavior. Abnormal activity or blood flow in the cerebellar vermis may indicate pathology in this region that interferes with the normal ability to suppress strong and impulsive feelings, memories, thoughts and experiences during everyday life, predisposing child abuse victims to recurrent behavioral and psychiatric problems. These findings are significant also in light of the fact that the cerebellum is still growing during childhood and thus may be particularly susceptible to the effects of early verbal or sexual abuse.
Recent neuroanatomical studies at the National Institutes of Health have also found developmental defects in the cerebellar vermis in childhood ADHD. These developmental defects may contribute to the abnormal activity in the cerebellar vermis associated with the hyperactivity, emotional outbursts and inattention that were observed in the ADHD boys we studied. In our study, eight boys who displayed excessive activity during a boring computer test were given different doses of stimulant medication and examined with the same functional imaging procedure used to study the abuse subjects. Abnormal activity in the cerebellar vermis and behavioral hyperactivity in the ADHD boys decreased as higher medication doses were administered. Attention to and performance on the computer test also improved with increasing doses of medication. Although abnormal activity in other brain areas of ADHD children changed with dose, the changes in the cerebellar vermis most closely matched improvements in ADHD symptoms. These findings demonstrate for the first time a functional role for the vermis in childhood ADHD.
In conclusion, although this is not a brain region we normally think of as playing an important role in psychiatric symptomatology, there is an enormous convergence of new data suggesting that the vermis, through the bilateral fastigial nuclei, its primary cerebellar output nuclei, has monosynaptic influence over brainstem sites such as the parabrachial nucleus (PN) (1), locus ceruleus (LC) (2), periaqueductal gray (PAG), ventral tegmental area (VTA), substantia nigra reticulata (SNR) (3,4) and pendunculopontine tegmentum (PPT ) (5) implicating it in bihemispheric emotional and attentional modulation. Neuroanatomical and neurofunctional abnormalities in the vermis have been observed in a wide range of psychopathological conditions with a developmental genesis such as bipolar(6-8) and unipolar depression (9, 10), schizophrenia (8, 11), autism(12), fragile X syndrome(13), fetal alcohol syndrome (14) and ADHD(15, 16). Due to its protracted postnatal anatomical (17-19) and functional development(20) the vermis may be particularly sensitive to the effects of early trauma (21). The vermis, through its influence on brainstem monaminergic and forebrain hypothalamic systems could coordinate bi-hemispheric aspects of limbic system activity during emotional development(22-25) and therefore may represent an "Achilles heel" of susceptibility to early abuse.

 

References:

1. Supple WF, Jr., Kapp BS: Anatomical and physiological relationships between the anterior cerebellar vermis and the pontine parabrachial nucleus in the rabbit. Brain Research Bulletin 1994; 33(5):561-74
2. Reis DJ, Golanov EV: Autonomic and vasomotor regulation. International Review of Neurobiology 1997; 41:121-49
3. Snider RS, Maiti A: Cerebellar contributions to the Papez circuit. Journal of Neuroscience Research 1976; 2(2):133-46
4. Snider RS, Maiti A, Snider SR: Cerebellar pathways to ventral midbrain and nigra. Experimental Neurology 1976; 53(3):714-28
5. Haines DE, Dietrichs E, Mihailoff GA, McDonald EF: The cerebellar-hypothalamic axis: basic circuits and clinical observations. International Review of Neurobiology 1997; 41:83-107
6. Fischler B, D'Haenen H, Cluydts R, Michiels V, Demets K, Bossuyt A, Kaufman L, De Meirleir K: Comparison of 99m Tc HMPAO SPECT scan between chronic fatigue syndrome, major depression and healthy controls: an exploratory study of clinical correlates of regional cerebral blood flow. Neuropsychobiology 1996; 34(4):175-83
7. Lauterbach EC: Bipolar disorders, dystonia, and compulsion after dysfunction of the cerebellum, dentatorubrothalamic tract, and substantia nigra. Biological Psychiatry 1996; 40(8):726-30
8. Loeber RT, Sherwood AR, Renshaw PF, Cohen BM, Yurgelun-Todd DA: Differences in cerebellar blood volume in schizophrenia and bipolar disorder. Schizophrenia Research 1999; 37(1):81-89
9. Beauregard M, Leroux JM, Bergman S, Arzoumanian Y, Beaudoin G, Bourgouin P, Stip E: The functional neuroanatomy of major depression: an fMRI study using an emotional activation paradigm. Neuroreport 1998; 9(14):3253-8
10. Pillay SS, Yurgelun-Todd DA, Bonello CM, Lafer B, Fava M, Renshaw PF: 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. Biological Psychiatry 1997; 42(2):79-84
11. Jacobsen LK, Giedd JN, Berquin PC, Krain AL, Hamburger SD, Kumra S, Rapoport JL: Quantitative morphology of the cerebellum and fourth ventricle in childhood-onset schizophrenia. American Journal of Psychiatry 1997; 154(12):1663-9
12. Courchesne E: Neuroanatomic imaging in autism. Pediatrics 1991; 87(5 Pt 2):781-90
13. Mostofsky SH, Reiss AL, Lockhart P, Denckla MB: Evaluation of cerebellar size in attention-deficit hyperactivity disorder. Journal of Child Neurology 1998; 13(9):434-9
14. Sowell ER, Jernigan TL, Mattson SN, Riley EP, Sobel DF, Jones KL: Abnormal Development of the Cerebellar Vermis in Children Prenatally Exposed to Alcohol - Size Reduction in Lobules I-V. Alcoholism, Clinical & Experimental Research 1996; 20(1):31-34
15. Berquin PC, Giedd JN, Jacobsen LK, Hamburger SD, Krain AL, Rapoport JL, Castellanos FX: Cerebellum in Attention-Deficit Hyperactivity Disorder - a Morphometric Mri Study. Neurology 1998; 50(4):1087-1093
16. Mostofsky SH, Mazzocco MMM, Aakalu G, Warsofsky IS, Denckla MB, Reiss AL: Decreased Cerebellar Posterior Vermis Size in Fragile X Syndrome - Correlation With Neurocognitive Performance. Neurology 1998; 50(1):121-130
17. Hayakawa K, Konishi Y, Matsuda T, Kuriyama M, Konishi K, Yamashita K, Okumura R, Hamanaka D: Development and aging of brain midline structures: assessment with MR imaging. Radiology 1989; 172(1):171-7
18. Isumi H, Mizuguchi M, Takashima S: Differential Development of the Human Cerebellar Vermis - Immunohistochemical and Morphometrical Evaluation. Brain & Development 1997; 19(4):254-257
19. Jernigan TL, Tallal P: Late childhood changes in brain morphology observable with MRI. Developmental Medicine & Child Neurology 1990; 32(5):379-85
20. Chugani HT: A Critical Period of Brain Development - Studies of Cerebral Glucose Utilization With Pet. Preventive Medicine 1998; 27(2):184-188
21. Altman J: Morphological and behavioral markers of environmentally induced retardation of brain development: an animal model. Environmental Health Perspectives 1987; 74:153-68
22. Giedd JN, Snell JW, Lange N, Rajapakse JC, Casey BJ, Kozuch PL, Vaituzis AC, Vauss YC, Hamburger SD, Kaysen D, Rapoport JL: Quantitative magnetic resonance imaging of human brain development: ages 4-18. Cerebral Cortex 1996; 6(4):551-60
23. Flor-Henry P: Observations, reflections and speculations on the cerebral determinants of mood and on the bilaterally asymmetrical distributions of the major neurotransmitter systems. Acta Neurologica Scandinavica. Supplementum 1986; 109:75-89
24. Liederman J: The dynamics of interhemispheric collaboration and hemispheric control. Brain & Cognition 1998; 36(2):193-208
25. Pettigrew JD, Miller SM: A 'sticky' interhemispheric switch in bipolar disorder? Proceedings of the Royal Society of London - Series B: Biological Sciences 1998; 265(1411):2141-8


Thursday, January 20th 2000.
The Cerebellar Vermis as the Cortex of Damasio's Proto-Self

Antonio Damasio in his new work " The Feeling of What Happens: Body and Emotion in the Making of Consciousness" proposes the concept of an unconscious dynamic "proto-self" as the "spine" of conscious experience, associated with right hemisphere and brainstem regions, particularly the parabrachial nucleus. However, Damasio neglects to describe the important unifying contribution of the vermis to the upper brainstem. This talk will focus on conceptualizing the Cerebellar Vermis (CV), Parabrachial Nucleus (PN) and the Extended Amygdala (EA) as bi-hemispheric channels from the body through the brainstem and limbic system by which fractal time fluctuations vertically converge in cognitive, emotional and meditative processes. I will expand upon his concept of the "proto-self" using the mathematical and new anatomical concepts: fractal time and bilateral CV-PN-EA networks. This will synthesize the preceding two talks and provide a more encompassing perspective from which to view the role of emotion in all aspects of sentience from REM sleep to meditative states.

The central idea, as stated in several recent papers and web documents, is that spontaneous changes in emotion and thought arise from nonlinear interactions over a wide range of time scales among brain structures, mind and body. The functional "binding" underlying brain/mind interactions is a "broad-band" binding (as proposed in our 1996 article6 ) originating from coherence among vertically convergent fractal fluctuations. Our preliminary findings confirm the existence of state-of-mind-dependent nonlinear "fractal processes". Further, mindfulness meditation may enhance coherence in CV-PN-EA networks.

The CV directly, and indirectly by way of the fastigial nucleus (FN), has extensive projections to monoamine brainstem cell body regions such as the ventral tegmental area (VTA), substantia nigra (SN) and medial raphe nuclei (mRN), as well as the midline periaqueductal gray (PAG), parabrachial nucleus (PB), and intralaminar thalamus (IT) and thus may be ideally positioned to bilaterally coordinate the basal ganglia and the interhemispheric synchronization of homogenous frontal and temporal cortical regions with ongoing sensory-affective-motor experience 7-14, 45-49 . The CV appears to play a critical role in emotional and cognitive coordination as evidenced by its extensive involvement with psychopathology. In humans with affective disorders, electrical stimulation of the CV produces improvement in affect, profound reductions in symptoms such as violence and rage15, tension and anxiety16, and increases in alertness7,18. Robert Heath found that chronic CV stimulation was profoundly effective for symptom relief in a wide range of psychiatric disorders such as violence, depression and schizophrenia15. Violently aggressive rhesus monkeys raised under conditions of maternal deprivation were tamed with cerebellar lesions that included the vermis19. These striking behavioral and physiological observations can easily be reconciled with neuroanatomical, neurochemical and neurodevelopmental knowledge of the CV7-13,20, 45-49. Neuroanatomical and neurofunctional abnormalities in the CV have been observed in a wide range of psychopathological conditions with a developmental genesis such as bipolar 21-23and unipolar depression24,25, schizophrenia23,26, autism27, fragile X syndrome28, fetal alcohol syndrome29 and ADHD30-31. The protracted postnatal anatomical32-34and functional35 development of the CV may render it particularly sensitive to effects of early trauma.
Our recent functional imaging observations2-4 that ADHD children and subjects with a history of sexual or verbal child abuse have increases in vermal blood flow that strongly correlate with a number of measures of psychopathology is consistent with the hypothesis that developmental lesions of the CV could result in abnormalities of bilateral modulation of the limbic system. The limbic system checklist-33 (LSCL-33)36, a self-report questionnaire developed to evaluate how frequently subjects with a history of abuse experience 33 symptoms of temporal lobe epilepsy, was also part of the questionnaire. A typical LSCL-33 question is, "how often have you experienced the sudden, abrupt and unexplained onset of the sensation of something crawling under your skin or a rising or sinking feeling in your stomach - like being in an elevator." Teicher et al. have shown that adults who have encountered abuse before the age of 18 self-report a higher percentage of these experiences. Higher scores on the LSCL-33 were strongly associated with blood flow in the CV. ADHD children show stimulant mediated dose-dependent decreases in CV blood flow correlated with improved control of movement and attention3,4. Also, the CV appears to play a role in the control of epilepsy as preclinical37,38and clinical studies in humans16,18,39 use electrical stimulation of the vermis to suppress the onset and spread of seizures. Perhaps those who suffered abuse during childhood may have abnormalities of the CV which impair its ability to coordinate bi-hemispheric emotional behavior, interfering with the ability to suppress "seizure-like" impulsive behavior or the unwanted intrusion of feelings, memories, thoughts and experiences.
PET imaging has demonstrated that the CV is the primary region involved in upright postural equilibrium during bimanual locomotion18,41. Perhaps the CV, through its influence on brainstem monaminergic systems, PB, PAG and EA coordinates bilateral aspects of hemispheric activity during emotional behavior42-44 which is disordered by early abuse or congenital lesions in ADHD30,31. We therefore conceptualized the CV as the cortex of the proto-self, primarily outside of our awareness, coordinating contextually the switching of the right and left hemispheres as we experience the "stream" of consciousness43,44. The CV may also suppress visual experience during saccadic eye movements, or loss of balance, switching the search light of awareness on and off by way of the intralaminar thalamus, when the glare would be distracting to self preservation.
The process of meditation may enhance fractal-time coherence by bringing the conscious mind into contact with the internal milieu of the proto-self. During meditative practice, such as focusing attention and maintaining it on the physical sensation of air entering the nasal passages, many levels of coordination along CV-PN-EA networks unite, and functional hemispheric asymmetry may abate.

References:

1. Anderson CM, SB Lowen, MH Teicher, LC Mass, PF Renshaw. State-of-mind-dependent Fractal Fluctuations in BOLD fMRI. Dynamical Neuroscience, Delray, Fl., Oct21-23th , 1999. (http://remfractal.mclean.org:8080/wave1999.pdf).
2. Anderson CM, Polcari AM, McGreenery CE, Maas LC, Renshaw PF, Teicher MH. Methyphendate dose-dependently decresses blood flow in the cerebellar vermis of children with ADHD. poster presented at NCDEU June 1999 (http://remfractal.mclean.org:8080/NCDEU.pdf).
3. Anderson CM, Polcari AM, McGreenery CE, Maas LC, Renshaw PF, Teicher MH. Childhood Abuse: Limbic System Checklist-33 and Cerebellar Vermis Blood Flow. APA May 1999 (http://remfractal.mclean.org:8080/apa99.pdf).
4. Anderson CM, Polcari AM, McGreenery CE, Maas LC, Renshaw PF, Teicher MH. Cerebellar Vermis Blood Flow: Associations with Psychiatric Symptoms in Child Abuse and ADHD. Soc. Neurosci. Abstr. Vol. 25, Part 2, p. 1637. (http://remfractal.mclean.org:8080/ns1999.pdf)
5. Damasion, A (1999). The Feeling of What Happens:Body and Emotion in the Making of Consciousness. Harcourt Brace & Company, N.Y., N.Y.
6. Anderson CM, Mandell AJ. Fractal Time and the Foundations of Consciousness: Vertical Convergence of 1/f Phenomena from Ion Channels to Behavioral States. In: Fractals of Brain, Fractals of Mind: In Search of a Secret Symmetry Bond: Advances in Consciousnes Research, 7, M. Stamenov & G. Globus (Series. Eds.) & E Mac Cormac & M Stamenov (Vol. Eds.), published
by "John Benjamin" (Amsterdam & Philadelphia). 1996.
7. Haines DE, Dietrichs E, Mihailoff GA, McDonald EF: The cerebellar-hypothalamic axis: basic circuits and clinical observations. International Review of Neurobiology 1997; 41:83-107
8. Harper JW, Heath RG: Anatomic connections of the fastigial nucleus to the rostral forebrain in the cat. Experimental Neurology 1973; 39(2):285-92
9. Harper JW, Heath RG: Ascending projections of the cerebellar fastigial nuclei: connections to the ectosylvian gyrus. Experimental Neurology 1974; 42(2):241-7
10. Albert TJ, Dempesy CW, Sorenson CA: Anterior cerebellar vermal stimulation: effect on behavior and basal forebrain neurochemistry in rat. Biological Psychiatry 1985; 20(12):1267-76
11. Dempesy CW, Tootle DM, Fontana CJ, Fitzjarrell AT, Garey RE, Heath RG: Stimulation of the paleocerebellar cortex of the cat: increased rate of synthesis and release of catecholamines at limbic sites. Biological Psychiatry 1983; 18(1):127-32
12. Dempesy CW, Albert TJ, Schlein AE: Changed turnover of monoamines in limbic nuclei in response to stimulation and lesion of the anterior vermal cortex of the cerebellum: studies in cat and rat. International Journal of Neurology 1984; 18:94-104
13. Nieoullon A, Cheramy A, Glowinski J: Release of dopamine in both caudate nuclei and both substantia nigrae in response to unilateral stimulation of cerebellar nuclei in the cat. Brain Research 1978; 148(1):143-52
14. Snider RS, Maiti A, Snider SR: Cerebellar connections to catecholamine systems: anatomical and biochemical studies. Transactions of the American Neurological Association 1976; 101:295-7
15. Heath RG: Modulation of emotion with a brain pacemamer. Treatment for intractable psychiatric illness. Journal of Nervous & Mental Disease 1977; 165(5):300-17
16. Cooper IS, Riklan M, Waltz JM, Amin I, Pani K: A study of chronic cerebellar stimulation in disorders of sensory communication in the central nervous system. Boletin de Estudios Medicos y Biologicos 1974; 28(8-10):347-90
17. Riklan M, Cullinan T, Shulman M, Cooper IS: A psychometric study of chronic cerebellar stimulation in man. Biological Psychiatry 1976; 11(5):543-74
18. Riklan M, Cullinan T, Cooper IS: Tension reduction and alerting in man following chronic cerebellar stimulation for the relief of spasticity or intractable seizures. Journal of Nervous & Mental Disease 1977; 164(3):176-81
19. Berman AJ: Amelioration of aggression: response to selective cerebellar lesions in the rhesus monkey. International Review of Neurobiology 1997; 41:111-9
20. Schmahmann JD: From Movement to Thought - Anatomic Substrates of the Cerebellar Contribution to Cognitive Processing [Review]. Human Brain Mapping 1996; 4(3):174-198
21. Fischler B, D'Haenen H, Cluydts R, Michiels V, Demets K, Bossuyt A, Kaufman L, De Meirleir K: Comparison of 99m Tc HMPAO SPECT scan between chronic fatigue syndrome, major depression and healthy controls: an exploratory study of clinical correlates of regional cerebral blood flow. Neuropsychobiology 1996; 34(4):175-83
22. Lauterbach EC: Bipolar disorders, dystonia, and compulsion after dysfunction of the cerebellum, dentatorubrothalamic tract, and substantia nigra. Biological Psychiatry 1996; 40(8):726-30
23. Loeber RT, Sherwood AR, Renshaw PF, Cohen BM, Yurgelun-Todd DA: Differences in cerebellar blood volume in schizophrenia and bipolar disorder. Schizophrenia Research 1999; 37(1):81-89
24. Beauregard M, Leroux JM, Bergman S, Arzoumanian Y, Beaudoin G, Bourgouin P, Stip E: The functional neuroanatomy of major depression: an fMRI study using an emotional activation paradigm. Neuroreport 1998; 9(14):3253-8
25. Pillay SS, Yurgelun-Todd DA, Bonello CM, Lafer B, Fava M, Renshaw PF: 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. Biological Psychiatry 1997; 42(2):79-84
26. Jacobsen LK, Giedd JN, Berquin PC, Krain AL, Hamburger SD, Kumra S, Rapoport JL: Quantitative Morphology of the Cerebellum and Fourth Ventricle in Childhood-Onset Schizophrenia. American Journal of Psychiatry 1997; 154(12):1663-1669
27. Courchesne E: Neuroanatomic imaging in autism. Pediatrics 1991; 87(5 Pt 2):781-90
28. Mostofsky SH, Mazzocco MMM, Aakalu G, Warsofsky IS, Denckla MB, Reiss AL: Decreased Cerebellar Posterior Vermis Size in Fragile X Syndrome - Correlation With Neurocognitive Performance. Neurology 1998; 50(1):121-130
29. Sowell ER, Jernigan TL, Mattson SN, Riley EP, Sobel DF, Jones KL: Abnormal Development of the Cerebellar Vermis in Children Prenatally Exposed to Alcohol - Size Reduction in Lobules I-V. Alcoholism, Clinical & Experimental Research 1996; 20(1):31-34
30. Berquin PC, Giedd JN, Jacobsen LK, Hamburger SD, Krain AL, Rapoport JL, Castellanos FX: Cerebellum in Attention-Deficit Hyperactivity Disorder - a Morphometric Mri Study. Neurology 1998; 50(4):1087-1093
31. Mostofsky SH, Reiss AL, Lockhart P, Denckla MB: Evaluation of cerebellar size in attention-deficit hyperactivity disorder. Journal of Child Neurology 1998; 13(9):434-9
32. Hayakawa K, Konishi Y, Matsuda T, Kuriyama M, Konishi K, Yamashita K, Okumura R, Hamanaka D: Development and aging of brain midline structures: assessment with MR imaging. Radiology 1989; 172(1):171-7
33. Isumi H, Mizuguchi M, Takashima S: Differential Development of the Human Cerebellar Vermis - Immunohistochemical and Morphometrical Evaluation. Brain & Development 1997; 19(4):254-257
34. Jernigan TL, Tallal P: Late childhood changes in brain morphology observable with MRI. Developmental Medicine & Child Neurology 1990; 32(5):379-85
35. Chugani HT, Phelps ME, Mazziotta JC: Positron emission tomography study of human brain functional development. Annals of Neurology 1987; 22(4):487-97
36. Teicher MH, Glod CA, Surrey J, Swett C, Jr.: Early childhood abuse and limbic system ratings in adult psychiatric outpatients. Journal of Neuropsychiatry & Clinical Neurosciences 1993; 5(3):301-6
37. Heath RG: Brain function in epilepsy: midbrain, medullary, and cerebellar interaction with the rostral forebrain. Journal of Neurology, Neurosurgery & Psychiatry 1976; 39(11):1037-51
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