Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jun 15:331:238-244.
doi: 10.1016/j.jad.2023.03.025. Epub 2023 Mar 15.

Brain functional activation and first mood episode in youth at risk for bipolar disorder

Fabiano G Nery  1 , Jeffrey A Welge  2 , David Fleck  2 , Wade Weber  3 , L Rodrigo Patino  2 , Jeffrey R Strawn  2 , Caleb M Adler  2 , Stephen M Strakowski  3 , Melissa P DelBello  2
Affiliations

Brain functional activation and first mood episode in youth at risk for bipolar disorder

Fabiano G Nery et al. J Affect Disord. .

Abstract

Background: In order to identify biomarkers of prodromal mood disorders, we examined functional brain activation in children and adolescent at familial risk for bipolar disorder.

Methods: Offspring of parents with bipolar I disorder (at-risk youth; N = 115, mean ± SD age: 13.6 ± 2.7; 54 % girls) and group-matched offspring of healthy parents (healthy controls; N = 58, mean ± SD age: 14.2 ± 3.0; 53 % girls) underwent functional magnetic resonance imaging while performing a continuous performance task with emotional and neutral distracters. At baseline, at-risk youth had no history of mood episodes or psychotic disorders. Subjects were followed longitudinally until developing their first mood episode or being lost to follow-up. Standard event-related region-of-interest (ROI) analyses were performed to compare brain activation at baseline between groups and in survival analyses.

Results: At baseline, at-risk youth exhibited reduced activation to emotional distracters in the right ventrolateral prefrontal cortex (VLPFC) (p = 0.04). Activation was not significantly altered in additional ROIs, including left VLPFC, bilateral amygdala, caudate, or putamen. In those at-risk youth who developed their first mood episode during follow-up (n = 17), baseline increased activation in right VLPFC, right caudate, and right putamen activation predicted the development of a mood episode.

Limitations: Sample size of converters, loss to follow-up, and number of statistical comparisons.

Conclusions: We found preliminary evidence that a reduced activation in right VLPFC might be a marker of risk for or resilience to mood disorders in at-risk youth. Conversely, an increased activation in the right VLPFC, caudate, and putamen might indicate an increased risk for the later development of their first mood episode.

Keywords: Amygdala; Depression; Magnetic resonance imaging; Mood disorders; Offspring; Prefrontal cortex.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest Dr. Nery's spouse is an employee of Eli Lilly & Co. Dr. Patino has received research support from Acadia, Allergan, Janssen, Johnson and Johnson, Lundbeck, Otsuka, Pfizer, Sunovion and Supernus. Dr. Strawn has received research support from Edgemont, Shire, AbbVie, Otsuka, the Yung Family Foundation and the National Institutes of Health (NICHD, NIMH and NIEHS). He receives royalties from Springer Publishing for two texts and has received material support from Myriad genetics and honoraria from CMEology and Neuroscience Educational Institute. He provided consultation to the U.S. Food and Drug Administration as a Special Government Employee and consulted to Intracellular Therapeutics. Dr. Adler has spoken for Otsuka and Janssen. He has received research support from Merck, Forest, and Alkermes, and provided consultation for Janssen. Dr. Strakowski chairs Data Safety and Monitoring Boards for Sunovion and has grant funding (through the University of Texas) from Janssen. Dr. DelBello is on the lecture bureau for Otsuka; has received research support from Acadia, Allergan, Janssen, Johnson and Johnson, Lundbeck, Otsuka, Pfizer, Sunovion and Supernus; and has provided consultation or advisory board services for Alkermes, Allergan, Assurex, CMEology, Janssen, Johnson and Johnson, Lundbeck, Neuronetics, Otsuka, Pfizer, Sunovion and Supernus. The remaining authors reported no conflicts of interests.

Figures

Figure 1:
Figure 1:
Example of cues and instructions showed in CPT-END task Abbreviation: CPT-END (continuous performance task with emotional and neutral distracters)
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Acuff HE, Versace A, Bertocci MA, Ladouceur CD, Hanford LC, Manelis A, Monk K, Bonar L, McCaffrey A, Goldstein BI, Goldstein TR, Sakolsky D, Axelson D, Birmaher B, Phillips ML, 2019. Baseline and follow-up activity and functional connectivity in reward neural circuitries in offspring at risk for bipolar disorder. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 44, 1570–1578. - PMC - PubMed
    1. Berger JO, 1980. Statistical Decision Theory and Bayesian Analysis, Second ed. Springer-Verlag, New York.
    1. Birmaher B, Axelson D, Monk K, Kalas C, Goldstein B, Hickey MB, Obreja M, Ehmann M, Iyengar S, Shamseddeen W, Kupfer D, Brent D, 2009. Lifetime psychiatric disorders in school-aged offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring study. Arch Gen Psychiatry 66, 287–296. - PMC - PubMed
    1. Cox RW, 1996. AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. Computers and biomedical research, an international journal 29, 162–173. - PubMed
    1. Cox RW, Hyde JS, 1997. Software tools for analysis and visualization of fMRI data. NMR in biomedicine 10, 171–178. - PubMed

Publication types