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The Cerebellum and Premenstrual Dysphoric Disorder

1 USA David Geffen School of Medicine at UCLA, Box 951740, 27-139 CHS, Los Angeles, CA 90095, USA;
2 Center for Addictive Behaviors, Department of Psychiatry and Biobehavioral Sciences UCLA, 90095 USA;
3 Department of Psychiatry and Biobehavioral Sciences, Department of Molecular and Medical Pharmacology, and Brain Research Institute, UCLA, 90095 USA

Special Issues: What is the role of the cerebellum in emotional processing and behavior?

The cerebellum constitutes ten percent of brain volume and contains the majority of brain neurons. Although it was historically viewed primarily as processing motoric computations, current evidence supports a more comprehensive role, where cerebro-cerebellar feedback loops also modulate various forms of cognitive and affective processing. Here we present evidence for a role of the cerebellum in premenstrual dysphoric disorder (PMDD), which is characterized by severe negative mood symptoms during the luteal phase of the menstrual cycle. Although a link between menstruation and cyclical dysphoria has long been recognized, neuroscientific investigations of this common disorder have only recently been explored. This article reviews functional and structural brain imaging studies of PMDD and the similar but less well defined condition of premenstrual syndrome (PMS). The most consistent findings are that women with premenstrual dysphoria exhibit greater relative activity than other women in the dorsolateral prefrontal cortex and posterior lobules VI and VII of the neocerebellum. Since both brain areas have been implicated in emotional processing and mood disorders, working memory and executive functions, this greater activity probably represents coactivation within a cerebro-cerebellar feedback loop regulating emotional and cognitive processing. Some of the evidence suggests that increased activity within this circuit may preserve cerebellar structure during aging, and possible mechanisms and implications of this finding are discussed.
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