Morphology of the subgenual prefrontal cortex in pediatric bipolar disorder.
OBJECTIVE
The subgenual prefrontal cortex (SGPFC) is an important brain region involved in emotional regulation and reward mechanisms. Volumetric abnormalities in this region have been identified in adults with bipolar disorder but thus far not in pediatric cases. We examined the volume of this brain region in subjects with pediatric bipolar disorder (PBD) and compared them to healthy controls.


METHODS
Fifty one children and adolescents (mean age ± SD; 13.2 ± 2.9 y) with DSM-IV PBD and 41 (mean age ± SD; 13.7 ± 2.7 y) healthy comparison subjects (HC) underwent 1.5 T structural magnetic resonance imaging (MRI) brain scans. We traced the SGPFC manually and compared SGPFC gray matter volumes using analysis of covariance with age, gender, and intracranial volume as covariates. We also examined the relationship of family history of affective disorders and medication status to SGPFC volumes.


RESULTS
SGPFC volumes were not significantly different in PBD and HC subjects. However, exploratory analysis showed PBD subjects who had one or more first degree relatives with mood disorders (n = 33) had significantly smaller left hemisphere SGPFC compared to HC (p = 0.03 Sidak corrected). Current usage of a mood stabilizer was significantly associated with larger right SGPFC volume in PBD (F = 4.82, df = 1/41, p = 0.03).


CONCLUSIONS
Subjects with PBD and a close family history of mood disorders may have smaller left SGPFC volumes than HC. Mood stabilizing medication may also impact SGPFC size and could have masked more subtle abnormalities overall.
Baloch
Hasan A
HA
CERT-BD, Department of Psychiatry, The University of North Carolina at Chapel Hill, 10614 Neurosciences Hospital, Campus Box 7160, Chapel Hill, NC 27599-7160, USA. Baloch@med.unc.edu
Hatch
John P
JP
Olvera
Rene L
RL
Nicoletti
Mark
M
Caetano
Sheila C
SC
Zunta-Soares
Giovana B
GB
Soares
Jair C
JC
D000293:Adolescent; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000473:pathology*; D002648:Child; D002658:Developmental Disabilities / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010372:Pediatrics; D017397:Prefrontal Cortex / Q000473:pathology*