Preliminary evidence for progressive prefrontal abnormalities in adolescents and young adults with bipolar disorder

Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut 06511, USA.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 05/2009; 15(3):476-81. DOI: 10.1017/S1355617709090584
Source: PubMed


Previous cross-sectional study of ventral prefrontal cortex (VPFC) implicated progressive volume abnormalities during adolescence in bipolar disorder (BD). In the present study, a within-subject, longitudinal design was implemented to examine brain volume changes during adolescence/young adulthood. We hypothesized that VPFC volume decreases over time would be greater in adolescents/young adults with BD than in healthy comparison adolescents/young adults. Eighteen adolescents/young adults (10 with BD I and 8 healthy comparison participants) underwent two high-resolution magnetic resonance imaging scans over approximately 2 years. Regional volume changes over time were measured. Adolescents/young adults with BD displayed significantly greater volume loss over time, compared to healthy comparison participants, in a region encompassing VPFC and rostral PFC and extending to rostral anterior cingulate cortex (p < .05). Additional areas where volume change differed between groups were observed. While data should be interpreted cautiously due to modest sample size, this study provides preliminary evidence to support the presence of accelerated loss in VPFC and rostral PFC volume in adolescents/young adults with BD.

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    • "Based on previous studies (Altshuler et al., 2005; Ochsner and Gross, 2005; Gogtay et al., 2007; Foland et al., 2008; Pavuluri et al., 2008; Kalmar et al., 2009; Passarotti et al., 2010; Ladouceur et al., 2011; Deveney et al., 2013; Wu et al., 2013), we used the WFU PickAtlas (Maldjian et al., 2003) to create a single ROI mask including the striatum (caudate head and body, putamen, and ventral striatum [bilateral spheres centered on MNI coordinates À 9, 9, À 8 and 9, 9, À 8; radius¼ 8 mm (Postuma and Dagher, 2006; Di Martino et al., 2008)]), prefrontal cortical regions: medial prefrontal cortex (mPFC; BA10), orbitofrontal cortex (OFC; BA11), ventrolateral prefrontal cortex (VLPFC; BA47), dorsal anterior cingulate cortex (dACC; BA24/32), and insula. Using one large ROI mask avoided problems associated with conducting multiple statistical tests over the entire brain. "
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