title: Neurofunctional changes in adolescent cannabis users with and without bipolar disorder.
abstract: OBJECTIVE
  To compare regional brain activation among adolescents with bipolar disorder and co-occurring cannabis use disorder.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Cincinnati, OH, USA.
  
  
  METHODS
  Adolescents with bipolar disorder (BP, n = 14), adolescents with cannabis use disorder (MJ, n = 13), adolescents with co-occurring cannabis use and bipolar disorders (BPMJ, n = 25) and healthy adolescents (HC, n = 15).
  
  
  METHODS
  Cannabis craving, substance use, Blood Oxygenation Level Dependent (BOLD) signal assessed by the Marijuana Craving Questionnaire (MCQ), Teen-Addiction Severity Index (T-ASI) and a cannabis cue-reactivity task during a functional magnetic resonance imaging (fMRI) session, respectively.
  
  
  RESULTS
  The BP group exhibited significantly greater brain activation than the BPMJ group in the right amygdala (F = 4.14, P = 0.046), left nucleus accumbens (F = 3.8, P = 0.02), left thalamus (F = 3.8, P < 0.05) and the right thalamus (F = 6.2, P = 0.02). The BP group exhibited significantly greater activation than the HC group in the left nucleus accumbens (F = 11.5, P = 0.0001), right thalamus (F = 4.9, P = 0.03) and the left striatum (F = 3.6, P = 0.04). Left amygdala activation of the BPMJ group trended towards being significantly negatively correlated with the number of joints smoked (R = -0.4, P = 0.06).
  
  
  CONCLUSIONS
  Bipolar adolescents with comorbid cannabis use do not exhibit the same over-activation of the regions involved in emotional processing as seen in adolescents with bipolar disorder alone. The absence of these findings in patients with comorbid bipolar and cannabis use disorders suggests that these individuals may have a unique endophenotype of bipolar disorder or that cannabis use may alter brain activation uniquely in bipolar disorder patients who use cannabis.
authors: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorder Research, University of Cincinnati College of Medicine, Cincinnati, OH, USA; University Research Council's (URC) Undergraduate Student Research Fellowship, University of Cincinnati, Cincinnati, OH, USA; School of Energy, Environmental, Biological and Medical Engineering, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA.
authors: Samantha M
authors: SM
authors: Bitter
authors: Caleb M
authors: CM
authors: Adler
authors: James C
authors: JC
authors: Eliassen
authors: Wade A
authors: WA
authors: Weber
authors: Jeffrey A
authors: JA
authors: Welge
authors: Joaquin
authors: J
authors: Burciaga
authors: Paula K
authors: PK
authors: Shear
authors: Stephen M
authors: SM
authors: Strakowski
authors: Melissa P
authors: MP
authors: DelBello
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000503:physiopathology*; D055815:Young Adult
keywords: Adolescent; bipolar disorder; cannabis; fMRI; functional magnetic resonance imaging; marijuana