title: A preliminary study of the neural mechanisms of frustration in pediatric bipolar disorder using magnetoencephalography.
abstract: BACKGROUND
  Irritability is prevalent and impairing in pediatric bipolar disorder (BD) but has been minimally studied using neuroimaging techniques. We used magnetoencephalography (MEG) to study theta band oscillations in the anterior cingulate cortex (ACC) during frustration in BD youth. ACC theta power is associated with attention to emotional stimuli, and the ACC may mediate responses to frustrating stimuli.
  
  
  METHODS
  We used the affective Posner task, an attention paradigm that uses rigged feedback to induce frustration, to compare 20 medicated BD youth (14.9+/-2.0 years; 45% male) and 20 healthy controls (14.7+/-1.7 years; 45% male). MEG measured neuronal activity after negative and positive feedback; we also compared groups on reaction time, response accuracy, and self-reported affect. Patients met strict DSM-IV BD criteria and were euthymic. Controls had no psychiatric history.
  
  
  RESULTS
  BD youth reported more negative affective responses than controls. After negative feedback, BD subjects, relative to controls, displayed greater theta power in the right ACC and bilateral parietal lobe. After positive feedback, BD subjects displayed lower theta power in the left ACC than did controls. Correlations between MEG, behavior, and affect were nonsignificant.
  
  
  CONCLUSIONS
  In this first MEG study of BD youth, BD youth displayed patterns of theta oscillations in the ACC and parietal lobe in response to frustration-inducing negative feedback that differed from healthy controls. These data suggest that BD youth may display heightened processing of negative feedback and exaggerated self-monitoring after frustrating emotional stimuli. Future studies are needed with unmedicated bipolar youth, and comparison ADHD and anxiety groups.
authors.affiliation: Department of Psychology, The Catholic University of America, 4001 Harewood Road NE, Washington, DC 20064, USA. richb@cua.edu
authors.forename: Brendan A
authors.initials: BA
authors.lastname: Rich
authors.forename: Tom
authors.initials: T
authors.lastname: Holroyd
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Carver
authors.forename: Laura M
authors.initials: LM
authors.lastname: Onelio
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Mendoza
authors.forename: Brian R
authors.initials: BR
authors.lastname: Cornwell
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: Richard
authors.initials: R
authors.lastname: Coppola
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
mesh_terms: D000293:Adolescent; D000339:Affect; D001714:Bipolar Disorder / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D002648:Child; D019260:Expressed Emotion; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D010296:Parietal Lobe / Q000503:physiopathology