title: Dynamic mapping of cortical development before and after the onset of pediatric bipolar illness.
abstract: BACKGROUND
  There are, to date, no pre-post onset longitudinal imaging studies of bipolar disorder at any age. We report the first prospective study of cortical brain development in pediatric bipolar illness for 9 male children, visualized before and after illness onset.
  
  
  METHODS
  We contrast this pattern with that observed in a matched group of healthy children as well as in a matched group of 8 children with 'atypical psychosis' who had similar initial presentation marked by mood dysregulation and transient psychosis (labeled as 'multi-dimensionally impaired' (MDI)) as in the bipolar group, but have not, to date, developed bipolar illness.
  
  
  RESULTS
  Dynamic maps, reconstructed by applying novel cortical pattern matching algorithms, for the children who became bipolar I showed subtle, regionally specific, bilaterally asymmetrical cortical changes. Cortical GM increased over the left temporal cortex and decreased bilaterally in the anterior (and sub genual) cingulate cortex. This was seen most strikingly after the illness onset, and showed a pattern distinct from that seen in childhood onset schizophrenia. The bipolar neurodevelopmental trajectory was generally shared by the children who remained with MDI diagnosis without converting to bipolar I, suggesting that this pattern of cortical development may reflect affective dysregulation (lability) in general.
  
  
  CONCLUSIONS
  These dynamic trajectories of cortical development may explain age-related disparate findings from cross-sectional studies of bipolar illness, and suggest the importance of mood disordered non-bipolar control group in future studies.
authors: Child Psychiatry Branch, NIMH, Bethesda, MD 20892, USA. gogtayn@intra.nimh.nih.gov
authors: Nitin
authors: N
authors: Gogtay
authors: Anna
authors: A
authors: Ordonez
authors: David H
authors: DH
authors: Herman
authors: Kiralee M
authors: KM
authors: Hayashi
authors: Deanna
authors: D
authors: Greenstein
authors: Cathy
authors: C
authors: Vaituzis
authors: Marge
authors: M
authors: Lenane
authors: Liv
authors: L
authors: Clasen
authors: Wendy
authors: W
authors: Sharp
authors: Jay N
authors: JN
authors: Giedd
authors: David
authors: D
authors: Jung
authors: Tom F
authors: TF
authors: Nugent
authors: Arthur W
authors: AW
authors: Toga
authors: Ellen
authors: E
authors: Leibenluft
authors: Paul M
authors: PM
authors: Thompson
authors: Judith L
authors: JL
authors: Rapoport
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D001931:Brain Mapping / Q000379:methods; D002540:Cerebral Cortex / Q000002:abnormalities* / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008403:Mass Screening; D012720:Severity of Illness Index