RT Journal
A1 Dickstein DP, Milham MP, Nugent AC, et al
T1 Frontotemporal alterations in pediatric bipolar disorder: Results of a voxel-based morphometry study
JF Archives of General Psychiatry
JO Archives of General Psychiatry
YR 2005
FD July 1
VO 62
IS 7
SP 734
OP 741
DO 10.1001/archpsyc.62.7.734
UL http://dx.doi.org/10.1001/archpsyc.62.7.734
AB Context 
    While numerous magnetic resonance imaging (MRI) studies have evaluated adults with bipolar disorder (BPD), few have examined MRI changes in children with BPD.Objective 
    To determine volume alterations in children with BPD using voxel-based morphometry, an automated MRI analysis method with reduced susceptibility to various biases. A priori regions of interest included amygdala, accumbens, hippocampus, dorsolateral prefrontal cortex (DLPFC), and orbitofrontal cortex.Design 
    Ongoing study of the pathophysiology of pediatric BPD.Setting 
    Intramural National Institute of Mental Health; approved by the institutional review board.Patients 
    Pediatric subjects with BPD (n = 20) with at least 1 manic or hypomanic episode meeting strict DSM-IV criteria for duration and elevated, expansive mood. Controls (n = 20) and their first-degree relatives lacked psychiatric disorders. Groups were matched for age and sex and did not differ in IQ.Main Outcome Measures 
    With a 1.5-T MRI machine, we collected 1.2-mm axial sections (124 per subject) with an axial 3-dimensional spoiled gradient recalled echo in the steady state sequence. Image analysis was by optimized voxel-based morphometry.Results 
    Subjects with BPD had reduced gray matter volume in the left DLPFC. With a less conservative statistical threshold, additional gray matter reductions were found in the left accumbens and left amygdala. No difference was found in the hippocampus or orbitofrontal cortex.Conclusions 
    Our results are consistent with data implicating the prefrontal cortex in emotion regulation, a process that is perturbed in BPD. Reductions in amygdala and accumbens volumes are consistent with neuropsychological data on pediatric BPD. Further study is required to determine the relationship between these findings in children and adults with BPD.