Background

During the past 15 years, neuroimaging has provided valuable information about the structural brain abnormalities that may play a role in the etiology or mechanism of primary and secondary mood disorders. The first study using computed tomography (CT) in patients with mood disorders was reported in 1980 and the first study using magnetic resonance imaging (MRI) in mood disorders was published in 1983.

One of the major problems in using neuroimaging techniques to study primary mood disorders is that the neuropathology that is etiologically related to this disorder remains unknown (hence the term primary mood disorder). In patients with secondary mood disorders, however, neuroimaging techniques are particularly suited to identify the location and size of structural lesions associated with mood disorders. This technique, based on clinical pathological correlation with spontaneous brain lesion, was first utilized by Broca in the 1860s to identify brain regions that play an important role in specific behaviors.

Broca (1878) also first described an area of cortex that he called the limbus cortex that surrounded the midbrain. This limbus cortex included phylogeneti-cally older areas of cortex which formed a ring around the lower brain stem structures. This term gave rise to the limbic system, which has been the presumed anatomical basis of emotion in humans. Many of these phylogenetically older areas of cortex, such as the basal temporal and inferior frontal cortex, have also been implicated in the mechanism of mood disorders.

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