Journal of the International Neuropsychological Society

Brief Communications

Preliminary evidence for progressive prefrontal abnormalities in adolescents and young adults with bipolar disorder

JESSICA H. KALMARa1a2 c1, FEI WANGa1a2, LINDA SPENCERa1a2, ERIN EDMISTONa1a2, CHERYL M. LACADIEa3, ANDRÉS MARTINa1a4, R. TODD CONSTABLEa3a5a6, JAMES S. DUNCANa3a5a7, LAWRENCE H. STAIBa3a5a7, XENOPHON PAPADEMETRISa3a5 and HILARY P. BLUMBERGa1a2a3a4

a1 Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut

a2 Department of Psychiatry, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut

a3 Department of Diagnostic Radiology, Yale School of Medicine, New Haven, Connecticut

a4 Child Study Center, Yale School of Medicine, New Haven, Connecticut

a5 Department of Biomedical Engineering, Yale School of Medicine, New Haven, Connecticut

a6 Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut

a7 Department of Electrical Engineering, Yale School of Medicine, New Haven, Connecticut

Abstract

Previous cross-sectional study of ventral prefrontal cortex (VPFC) implicated progressive volume abnormalities during adolescence in bipolar disorder (BD). In the present study, a within-subject, longitudinal design was implemented to examine brain volume changes during adolescence/young adulthood. We hypothesized that VPFC volume decreases over time would be greater in adolescents/young adults with BD than in healthy comparison adolescents/young adults. Eighteen adolescents/young adults (10 with BD I and 8 healthy comparison participants) underwent two high-resolution magnetic resonance imaging scans over approximately 2 years. Regional volume changes over time were measured. Adolescents/young adults with BD displayed significantly greater volume loss over time, compared to healthy comparison participants, in a region encompassing VPFC and rostral PFC and extending to rostral anterior cingulate cortex (p < .05). Additional areas where volume change differed between groups were observed. While data should be interpreted cautiously due to modest sample size, this study provides preliminary evidence to support the presence of accelerated loss in VPFC and rostral PFC volume in adolescents/young adults with BD. (JINS, 2009, 15, 476–481.)

(Received August 17 2008)

(Reviewed January 27 2009)

(Accepted January 28 2009)

Correspondence:

c1 Correspondence and reprint requests to: Jessica H. Kalmar, Mood Disorders Research Program, Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, Connecticut 06511. E-mail: jessica.kalmar@yale.edu

Footnotes

H.P.B. has consulted to Pfizer, Inc. and has received honoraria from Abbott and Lilly. The authors report no other potential conflicts of interest.