Elsevier

Biological Psychiatry

Volume 68, Issue 9, 1 November 2010, Pages 839-846
Biological Psychiatry

Archival Report
Fronto-Temporal Spontaneous Resting State Functional Connectivity in Pediatric Bipolar Disorder

https://doi.org/10.1016/j.biopsych.2010.06.029Get rights and content

Background

The recent upsurge in interest about pediatric bipolar disorder (BD) has spurred the need for greater understanding of its neurobiology. Structural and functional magnetic resonance imaging studies have implicated fronto-temporal dysfunction in pediatric BD. However, recent data suggest that task-dependent neural changes account for a small fraction of the brain's energy consumption. We now report the first use of task-independent spontaneous resting state functional connectivity (RSFC) to study the neural underpinnings of pediatric BD.

Methods

We acquired task-independent RSFC blood oxygen level-dependent functional magnetic resonance imaging scans while participants were at rest and also a high-resolution anatomical image (both at three Tesla) in BD and control youths (n = 15 of each). We focused, on the basis of prior research, on the left dorsolateral prefrontal cortex (DLPFC), amygdala, and accumbens. Image processing and group-level analyses followed that of prior work.

Results

Our primary analysis showed that pediatric BD participants had significantly greater negative RSFC between the left DLPFC and the right superior temporal gyrus versus control subjects. Secondary analyses using partial correlation showed that BD and control youths had opposite phase relationships between spontaneous RSFC fluctuations in the left DLPFC and right superior temporal gyrus.

Conclusions

Our data indicate that pediatric BD is characterized by altered task-independent functional connectivity in a fronto-temporal circuit that is also implicated in working memory and learning. Further study is warranted to determine the effects of age, gender, development, and treatment on this circuit in pediatric BD.

Section snippets

Participants

Seven- to seventeen-year-old subjects were enrolled in an institutional review board-approved study at Bradley Hospital and Brown University. After study explanation, written informed consent/assent were obtained from parents/children. Recruitment included advertisements in physician offices, local newspapers, and support group websites.

The BD (n = 15) inclusion criteria were: 1) meeting DSM-IV-TR criteria for BD, including at least one episode meeting full DSM-IV-TR criteria for hypomania (≥ 4

Participants

The groups did not differ significantly in age, gender, Tanner pubertal stage, or Full-Scale IQ. The BD sample consisted of 15 participants with type I BD; none had type II BD, although it was not excluded. As a group, our BD participants were euthymic by mood ratings (YMRS 8.9 ± 5.0, CDRS 33.4 ± 15.4), and they were mildly impaired (CGAS 60.0 ± 20.1; nonclinical > 70), although none were acutely symptomatic at the time of the scan. All BD participants were receiving psychopharmacological

Discussion

Our examination of RSFC in youths with pediatric BD has three main findings. First, our primary analysis revealed a significant between-group difference in RSFC between the left DLPFC and right STG. In particular, pediatric BD participants had significantly greater negative RSFC between the left DLPFC and the right STG versus control subjects. Subsequent iterative analyses showed that pediatric BD participants had significantly decreased RSFC between the right STG and bilateral PFC (BA9), left

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