Neural recruitment during failed motor inhibition differentiates youths with bipolar disorder and severe mood dysregulation.
Controversy exists about whether non-episodic irritability (operationalized as severe mood dysregulation, SMD) should be considered a developmental presentation of pediatric bipolar disorder (BD). While assessments of brain function may address this controversy, only one fMRI study has compared BD versus SMD. We compared neural activation in BD, SMD, and controls during a motor inhibition task, since motor disinhibition is an important clinical feature in both BD and SMD. During failed inhibition, BD youths exhibited less activation in the right anterior cingulate cortex (ACC) and right nucleus accumbens relative to both SMD and healthy youths. Exploratory analyses indicate that, in BD youths, reduced activation in the right ACC may be independent of comorbid ADHD. These findings highlight neural distinctions between the phenotypically related BD and SMD populations.
Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, 15K North Drive, MSC 2670, Bethesda, MD 20892-2670, USA. deveneycm@mail.nih.gov
Christen M
CM
Deveney
Megan E
ME
Connolly
Sarah E
SE
Jenkins
Pilyoung
P
Kim
Stephen J
SJ
Fromm
Daniel S
DS
Pine
Ellen
E
Leibenluft
D000293:Adolescent; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology; D001714:Bipolar Disorder / Q000473:pathology* / Q000523:psychology*; D001931:Brain Mapping; D002648:Child; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007266:Inhibition, Psychological; D007508:Irritable Mood / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D019964:Mood Disorders; D009043:Motor Activity / Q000502:physiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D017603:Signal Detection, Psychological / Q000502:physiology