title: Anterior Cortical Development During Adolescence in Bipolar Disorder.
abstract: BACKGROUND
  Increasing evidence supports a neurodevelopmental model for bipolar disorder (BD), with adolescence as a critical period in its development. Developmental abnormalities of anterior paralimbic and heteromodal frontal cortices, key structures in emotional regulation processes and central in BD, are implicated. However, few longitudinal studies have been conducted, limiting understanding of trajectory alterations in BD. In this study, we performed longitudinal neuroimaging of adolescents with and without BD and assessed volume changes over time, including changes in tissue overall and within gray and white matter. Larger decreases over time in anterior cortical volumes in the adolescents with BD were hypothesized. Gray matter decreases and white matter increases are typically observed during adolescence in anterior cortices. It was hypothesized that volume decreases over time in BD would reflect alterations in those processes, showing larger gray matter contraction and decreased white matter expansion.
  
  
  METHODS
  Two high-resolution magnetic resonance imaging scans were obtained approximately 2 years apart for 35 adolescents with bipolar I disorder (BDI) and 37 healthy adolescents. Differences over time between groups were investigated for volume overall and specifically for gray and white matter.
  
  
  RESULTS
  Relative to healthy adolescents, adolescents with BDI showed greater volume contraction over time in a region including insula and orbitofrontal, rostral, and dorsolateral prefrontal cortices (p < .05, corrected), including greater gray matter contraction and decreased white matter expansion over time, in the BD compared with the healthy group.
  
  
  CONCLUSIONS
  The findings support neurodevelopmental abnormalities during adolescence in BDI in anterior cortices, including altered developmental trajectories of anterior gray and white matter.
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Pablo
authors.initials: P
authors.lastname: Najt
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Linda
authors.initials: L
authors.lastname: Spencer
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Jennifer A Y
authors.initials: JA
authors.lastname: Johnston
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Cox Lippard
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Pittman
authors.affiliation: Diagnostic Radiology, New Haven, Connecticut.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Lacadie
authors.affiliation: Diagnostic Radiology, New Haven, Connecticut.; Electrical Engineering, New Haven, Connecticut.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Staib
authors.affiliation: Diagnostic Radiology, New Haven, Connecticut.; Biomedical Engineering, New Haven, Connecticut.
authors.forename: Xenophon
authors.initials: X
authors.lastname: Papademetris
authors.affiliation: Departments of Psychiatry, New Haven, Connecticut.; Diagnostic Radiology, New Haven, Connecticut.; Child Study Center, Yale School of Medicine, New Haven, Connecticut.. Electronic address: hilary.blumberg@yale.edu.
authors.forename: Hilary P
authors.initials: HP
authors.lastname: Blumberg
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000503:physiopathology*; D016022:Case-Control Studies; D004644:Emotions; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D017397:Prefrontal Cortex / Q000473:pathology*; D066127:White Matter / Q000473:pathology*; D055815:Young Adult
keywords: Adolescent; Bipolar disorder; Development; Longitudinal studies; Magnetic resonance imaging; Prefrontal cortex