Characteristics of Alpha Band Frequency in Adolescents with Bipolar II Disorder: A Resting-State QEEG Study

The aim of this study was to compare the QEEG of adolescents affected by bipolar II disorder with age and gender matched healthy controls, and to extract the characteristics of the alpha frequency band to better understand this disorder.

Twenty one adolescents affected by acute episodes of bipolar II disorder (BMD II), both hypomanic and depressive episodes, were selected via convenience sampling based on DSM IV criteria and child and adolescent psychiatrist diagnosis. Eleven patients were going through a hypomanic episode and 10 patients were going through a depression episode. Of the participants, 18 who were matched with the patient group participated in this study as a normal group. Any major comorbidities and intellectual disabilities were excluded through applying K-SADS-PL and Raven's IQ test for all the patients and the healthy participants. Electroencephalogram signals were obtained according to 10-20 international system by 21 electrodes from participants in open and closed eyes in a resting state. We selected 40 seconds length segments from each recorded EEG signals that had minimal noise and artifacts. Power spectrum density (PSD) was estimated for each segment and extracted alpha band frequency. We used only referential (unipolar) montage for comparison. Eventually, data were analyzed by independent Mann-Whitney test and independent t test.

We observed significant differences in the alpha frequency band in some brain regions. Alpha power increased in the fronto-central region and right parietal lobe in the patients (P < 0.05). In the patients with BMD II, entropy of alpha oscillations was larger than the normal participants in the central region and in the F3, F4 and P4 channels. Also, there were differences in the variance of alpha oscillations in these regions between the two groups (P < 0.05). In the occipital lobe, alpha wave had different skewness between the two groups (P < 0.05).

Thalamus as a generator and modulator of at least a part of alpha oscillations may be involved in this disorder and hence this explains the major symptoms like distractibility and inattention in both hypomanic and depressive episodes of bipolar II disorder.