title: Relation between amygdala structure and function in adolescents with bipolar disorder.
abstract: OBJECTIVE
  Previous study supports the presence of reduced volume and elevated response to emotional stimuli in amygdala in adolescents with bipolar disorder (BD). In the present study, structural and functional magnetic resonance imaging scans were obtained during the same neuroimaging session to examine amygdala structure-function relations in adolescents with BD. We hypothesized that amygdala volume would be inversely associated with amygdala response to emotional stimuli, such that BD participants with the smallest amygdala volumes would exhibit the highest amygdala response.
  
  
  METHODS
  Fifty-one adolescents (21 with BD I and 30 control adolescents, ages 10-18 years) underwent structural and functional magnetic resonance imaging scans. Amygdala volume (n = 49) and signal change (n = 44) during emotional face processing were compared between groups, and structure-function correlations were examined within the BD group (n = 16).
  
  
  RESULTS
  Adolescents with BD showed decreased amygdala volume (p =.009) and increased amygdala response to emotional faces (p =.043). There was no significant interaction between diagnosis and emotion type. A significant inverse association between amygdala volume and activation during emotional face processing was observed (r = -0.54, p =.029).
  
  
  CONCLUSIONS
  Decreased volume and increased response to emotional stimuli in the amygdala in adolescents with BD are consistent with previous reports. This study represents the first report, to our knowledge, of the two findings in the same adolescent BD sample and supports an amygdala structure-function relation characterized by an inverse association between volume and response to emotional stimuli. This preliminary finding requires replication and suggests a possible pathophysiological link between abnormalities in amygdala structure and response to emotional stimuli in BD.
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine. Electronic address: jessica.kalmar@yale.edu.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Kalmar
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Lara G
authors.initials: LG
authors.lastname: Chepenik
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Fay Y
authors.initials: FY
authors.lastname: Womer
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Monique M
authors.initials: MM
authors.lastname: Jones
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Brian
authors.initials: B
authors.lastname: Pittman
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Maulik P
authors.initials: MP
authors.lastname: Shah
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Andrés
authors.initials: A
authors.lastname: Martin
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: R Todd
authors.initials: RT
authors.lastname: Constable
authors.affiliation: Drs. Kalmar, Wang, Chepenik, Womer, Blumberg, and Shah are with the Yale School of Medicine and the Veterans Affairs Connecticut Healthcare System; Drs. Martin and Constable, and Ms. Jones and Mr. Pittman are with the Yale School of Medicine.
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D000679:Amygdala / Q000473:pathology* / Q000503:physiopathology*; D001143:Arousal / Q000502:physiology; D001714:Bipolar Disorder / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D004292:Dominance, Cerebral / Q000502:physiology; D004644:Emotions / Q000502:physiology; D005149:Facial Expression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D010364:Pattern Recognition, Visual / Q000502:physiology; D013223:Statistics as Topic