July 25, 2005

MRI & Early-Onset Bipolar Disorder

Magnetic resonance imaging studies in early-onset bipolar disorder: a critical review. Frazier JA, Ahn MS, DeJong S, Bent EK, Breeze JL, Giuliano AJ.

Not many studies use magnetic resonance imaging (MRI) to study bipolar disorder in children. There are advantages to focusing on bipolar disorder in adolescents and children. Unlike adult sufferers, children suffering from bipolar disorder are less likely (if at all) to experience a larger number of mood episodes (as compared to adults), substance abuse problems, "a lengthy duration of illness", etc. Further, focusing on bipolar disorder in children may help us figure out whether abnormalities unique to children or adolescent sufferers exist.

A recent study has examine early-onset bipolar disorder by using PubMed "to identify peer-reviewed publications from the past 15 years (January 1990 to January 2005) that used brain-imaging techniques (anatomic, functional, and biochemical) to research" bipolar disorder in children and adolescents.

The results of the study involve and include the following:

(1) Of the studies identified, "...eleven (used) anatomic magnetic resonance imaging (MRI), seven (used) magnetic resonance spectroscopy (MRS), and two (used) functional MRI (fMRI)..."

(2)The studies discovered structural abnormalities "...in total cerebral, white matter, superior temporal gyrus, putamen, thalamus, amygdala, and hippocampal volumes."

(3)"Deficits in cortical gray matter were also (discovered)."

(4)The use of magnetic resonance spectroscopy (MRS) yielded abnormalities "in the dorsolateral prefrontal cortex, anterior cingulate, and basal ganglia."

(5)"One fMRI study found increased activation in the putamen and thalamus of BD youths compared to controls, and a second found abnormal prefrontal-subcortical activation in familial pediatric BD."

Despite these results, it's important to remember that only a few published MRI studies exist on the topic of bipolar disorder in children and adolescents. Still, the study demonstrates a biological component of the disorder by identifying abnormalities in brain regions associated with the ability to "regulate mood and cognition." The authors of the study state that it may be difficult to create an "overall model" for the disorder because of problems with the studies such as the use of small samples, the lack of diversity in samples, etc. These problems make the results less generalizable. As a result, the authors have provided advice for future studies:

...(F)uture studies (should) reproduce prior findings and determine which findings are unique to early-onset BD, relative to adult-onset illness. In addition, studies will need to establish the extent to which early-onset BD may overlap with comorbid disruptive, mood, anxiety, or psychotic disorders.

More on Childhood Bipolar Disorder
More on MRI & Bipolar Disorder

Title: Magnetic resonance imaging studies in early-onset bipolar disorder: a critical review.
Authors: Frazier JA, Ahn MS, DeJong S, Bent EK, Breeze JL, Giuliano AJ.
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

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