Longitudinal Diffusion Tensor Imaging Study of Adolescents and Young Adults With Bipolar Disorder

J Am Acad Child Adolesc Psychiatry. 2018 Feb;57(2):111-117. doi: 10.1016/j.jaac.2017.11.014. Epub 2017 Nov 26.

Abstract

Objective: Longitudinal neuroimaging during adolescence/young adulthood, when bipolar disorder (BD) commonly emerges, can help elucidate the neurodevelopmental pathophysiology of BD. Adults with BD have shown reduced structural integrity in the uncinate fasciculus (UF), a white matter (WM) tract providing major connections between the amygdala and ventral prefrontal cortex (vPFC), important in emotion regulation. In this longitudinal diffusion tensor imaging (DTI) study of adolescents/young adults, we hypothesized differences in age- and time-related changes in UF integrity in BD compared to healthy controls (HC).

Method: Two DTI scans were obtained in 27 adolescents/young adults with BD and 37 HC adolescents/young adults, on average approximately 2.5 years apart. Interactions between diagnosis with age and with time for UF fractional anisotropy (FA) were assessed. Exploratory analyses were performed including euthymic-only participants with BD, and for potential influences of demographic and clinical factors. Whole-brain analyses were performed to explore for interactions in other regions.

Results: There were significant interactions between diagnosis with age and with time for UF FA (p < .05). Healthy control adolescents/young adults showed significant UF FA increases with age and over time (p < .05), whereas no significant changes with age or over time were observed in the adolescents/young adults with BD. Significant interactions with age and time were also observed in analyses including euthymic-only participants with BD (p < .05).

Conclusion: These findings provide neuroimaging evidence supporting differences in UF WM structural development during adolescence/young adulthood, suggesting that differences in the development of an amygdala-vPFC system subserving emotion regulation may be a trait feature of BD neurodevelopment.

Keywords: adolescent; bipolar disorder; diffusion tensor imaging; white matter.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Amygdala / physiopathology
  • Anisotropy
  • Bipolar Disorder / diagnostic imaging*
  • Bipolar Disorder / physiopathology*
  • Diffusion Tensor Imaging / methods*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Prefrontal Cortex / physiopathology
  • Sex Factors
  • White Matter / physiopathology*
  • Young Adult