Neural correlates of response inhibition in pediatric bipolar disorder.
OBJECTIVE
Pediatric bipolar disorder is characterized by core deficits in mood and executive function and commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD). We aimed to examine response inhibition in this population, as an element of executive function, which, if aberrant, may interfere with learning and information processing.


METHODS
Children (9-18 years) with bipolar I or II disorder (BD, n = 26) and age, gender, and intelligence quotient (IQ) comparable healthy children (HC, n = 22) without any psychopathology were given a standardized Go/NoGo computerized task measuring response inhibition. A whole-brain functional magnetic resonance imaging (MRI) group analysis was performed using statistical parametric mapping software (SPM2) for comparing NoGo to Go epochs.


RESULTS
There were no statistically significant group differences between groups in age, gender, or ethnicity. The BD group had high rates of co-morbid disorders, including 81% with ADHD, 62% with oppositional defiant disorder (ODD), and 46% with anxiety disorders. This BD group had fewer correct responses on Go (84% vs. 96%, T[46] = 3.35, p = 0.002) and overall (85% vs. 94%, T[46] = 4.12, p = 0.0002) trials as compared to the HC group. However, there were no statistically significant group differences in response inhibition on NoGo trials (p = 0.11). In the NoGo-Go contrast, the BD group showed increased neural activation in the right dorsolateral prefrontal cortex (DLPFC) compared to HC (T[46] = 4.21, p < 0.001).


CONCLUSIONS
During accurate NoGo but impaired Go trial performance, children with BD showed increased right DLPFC activation versus controls, suggesting increased recruitment of executive control regions for accurate response inhibition. Studies relating these results to mood regulation in pediatric BD are warranted.
Singh
Manpreet K
MK
Pediatric Bipolar Disorders Program, Stanford University School of Medicine, Stanford, California 94305-5719, USA.
Chang
Kiki D
KD
Mazaika
Paul
P
Garrett
Amy
A
Adleman
Nancy
N
Kelley
Ryan
R
Howe
Meghan
M
Reiss
Allan
A
D000293:Adolescent; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology* / Q000473:pathology / Q000523:psychology; D001714:Bipolar Disorder / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D003071:Cognition; D015897:Comorbidity; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000503:physiopathology; D011597:Psychomotor Performance