Neuroimaging studies of children with serious emotional disturbances: a selective review.
OBJECTIVE
To critically review and integrate, from a developmental perspective, recent magnetic resonance imaging (MRI) studies of 4 childhood psychiatric disorders: schizophrenia, bipolar disorder (BD), attention-deficit hyperactivity disorder (ADHD), and major depressive disorder (MDD).


METHODS
We reviewed published reports in refereed journals. We briefly describe the major findings with respect to the brain morphometry, chemistry, and function of children with psychiatric disorders and synthesize the reports in a summary to update clinicians.


RESULTS
Some cortical grey matter abnormalities associated with schizophrenia appear to predate the onset of frank psychosis and continue to advance after the onset of psychosis, at least in more severe cases. Pediatric BD is associated with abnormalities in a circuit, thought to be involved in mood regulation, that encompasses the amygdala, striatum, and ventral PFC. Frontostriatal abnormalities are reported consistently in ADHD, potentially reflecting abnormalities in the development of cognitive control. Children with MDD show prefrontal cortical alterations that may differ in familial and nonfamilial subtypes of MDD.


CONCLUSIONS
Results from neuroimaging studies of childhood psychopathology reveal abnormalities in the developmental trajectories observed in healthy children. Although MRI has increased our understanding of the pathophysiology of these disorders, routine neuroimaging for children with severe emotional disturbances is not indicated for diagnostic purposes.
Serene
Jane Avery
JA
Harvard Medical School, Boston, Massachusetts, USA.
Ashtari
Manzar
M
Szeszko
Philip R
PR
Kumra
Sanjiv
S
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D001921:Brain / Q000002:abnormalities*; D002648:Child; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D012559:Schizophrenia / Q000175:diagnosis*; D012720:Severity of Illness Index