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Brain. 2014 Jun;137(Pt 6):1830-7. doi: 10.1093/brain/awu072. Epub 2014 Apr 16.

Occipital bending in depression.

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1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia
1 Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, Melbourne Victoria, Australia.
2 Division of Clinical Sciences and Department of Surgery, Central Clinical School, Monash University, Professor and Director, Department of Neurosurgery, Alfred Hospital, Melbourne Victoria, Australia.
3 Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.


There are reports of differences in occipital lobe asymmetry within psychiatric populations when compared with healthy control subjects. Anecdotal evidence and enlarged lateral ventricles suggests that there may also be a different pattern of curvature whereby one occipital lobe wraps around the other, termed 'occipital bending'. We investigated the prevalence of occipital bending in 51 patients with major depressive disorder (males mean age = 41.96 ± 14.00 years, females mean age = 40.71 ± 12.41 years) and 48 age- and sex-matched healthy control subjects (males mean age = 40.29 ± 10.23 years, females mean age = 42.47 ± 14.25 years) and found the prevalence to be three times higher among patients with major depressive disorder (18/51, 35.3%) when compared with control subjects (6/48, 12.5%). The results suggest that occipital bending is more common among patients with major depressive disorder than healthy subjects, and that occipital asymmetry and occipital bending are separate phenomena. Incomplete neural pruning may lead to the cranial space available for brain growth being restricted, or ventricular enlargement may exacerbate the natural occipital curvature patterns, subsequently causing the brain to become squashed and forced to 'wrap' around the other occipital lobe. Although the clinical implications of these results are unclear, they provide an impetus for further research into the relevance of occipital bending in major depression disorder.


bending; depression; magnetic resonance imaging; occipital; torque

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