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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    • "These alterations, according to different data, may exist well before an affective episode, underlying and contributing to additional developmental abnormalities during adolescence, and ultimately leading to emotional dysregulation and illness onset (Botteron et al. 1992, Lyoo et al. 2002, Sprooten et al. 2012). Some investigators observed that structural abnormalities were correlated to age and temporal illness progression, such as decreases in subgenual cingulate cortex volumes, ventral prefrontal cortex reductions, and increases in amygdala (Blumberg et al. 2006, Kalmar et al. 2009, Sanches et al. 2005). "
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