Neurofunctional Differences Among Youth With and at Varying Risk for Developing Mania.
To examine prefrontal and amygdala activation during emotional processing in youth with or at varying risk for developing mania to identify candidate central prodromal risk biomarkers.



Four groups of medication-free adolescents (10-20 years old) participated: adolescents with first-episode bipolar I disorder (BP-I; n = 32), adolescents with a parent with bipolar disorder and a depressive disorder (at-risk depressed [ARD]; n = 32), healthy adolescents with a parent with bipolar disorder (at-risk healthy [ARH]; n = 32), and healthy adolescents with no personal or family history of psychiatric illness (healthy comparison [HC]; n = 32). Participants underwent functional magnetic resonance imaging while performing a continuous performance task with emotional and neutral distracters. Region-of-interest analyses were performed for the bilateral amygdala and for subregions of the ventrolateral prefrontal cortex and anterior cingulate cortex.



Overall, no group differences in bilateral amygdala and ventrolateral prefrontal cortex (Brodmann area [BA] 45/47) activation during emotional or neutral stimuli were observed. The BP-I group exhibited lower right pregenual anterior cingulate cortex activation compared with the HC group, and activation in the left BA 44 was greater in the ARH and ARD groups compared with the HC group. BP-I and ARD groups exhibited blunted activation in the right BA 10 compared with the ARH group.



During emotional processing, amygdala and ventrolateral prefrontal cortex (BA 45/47) activation does not differ in youth with or at increasing risk for BP-I. However, blunted pregenual anterior cingulate cortex activation in first-episode mania could represent an illness biomarker, and greater prefrontal BA 10 and BA 44 activations in at-risk youth could represent a biomarker of risk or resilience warranting additional investigation in prospective longitudinal studies.
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Jeffrey A
JA
Welge
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Lawrence J
LJ
Saliba
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Jeffrey R
JR
Strawn
Center for Imaging Research, University of Cincinnati College of Medicine.
James C
JC
Eliassen
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
L Rodrigo
LR
Patino
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati; Center for Imaging Research, University of Cincinnati College of Medicine.
Caleb M
CM
Adler
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Wade
W
Weber
Medical Scientist Training Program, Graduate Program in Neuroscience, University of Cincinnati College of Medicine.
Marguerite Reid
MR
Schneider
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Drew H
DH
Barzman
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati; Center for Imaging Research, University of Cincinnati College of Medicine.
Stephen M
SM
Strakowski
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati.
Melissa P
MP
DelBello
Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati. Electronic address: robert.mcnamara@uc.edu.
Robert K
RK
McNamara
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001714:Bipolar Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D016241:Child of Impaired Parents; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012306:Risk; D055815:Young Adult
adolescent; amygdala; bipolar disorder; functional magnetic resonance imaging; prefrontal