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Altered spatiotemporal consistency in pediatric bipolar disorder patients with and without psychotic symptoms

Weijia Gao¹, Dong Cui², Qing Jiao³

¹Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, No. 3333 Binsheng Road, Zhejiang, Hangzhou, China.

|October 16, 2021

Insights

Pediatric bipolar disorder (PBD) patients with psychotic symptoms show distinct brain activity patterns compared to those without. These findings highlight segregated neural differences underlying varied clinical outcomes in PBD.

Area of Science:

Neuroscience
Psychiatry
Pediatric Mental Health

Background:

Psychotic symptoms are common in pediatric bipolar disorder (PBD) and influence prognosis.
Understanding the neural mechanisms of psychosis in PBD is crucial for targeted treatments.

Purpose of the Study:

To investigate functional brain differences between PBD patients with and without psychotic symptoms using fMRI.
To elucidate the neurobiological underpinnings of psychosis in pediatric bipolar disorder.

Main Methods:

Recruited 71 participants: 27 psychotic PBD (P-PBD), 25 nonpsychotic PBD (NP-PBD), and 19 healthy controls.
Utilized 3.0 Tesla functional magnetic resonance imaging (fMRI).
Applied Four-dimensional (spatiotemporal) Consistency of local Neural Activities (FOCA) analysis and ANOVA for group comparisons.

Main Results:

Significant FOCA differences were found in frontal, motor, and occipital regions across groups.
P-PBD group showed decreased FOCA in supplementary motor area and superior frontal gyrus, increased in inferior frontal gyrus compared to controls.
NP-PBD group exhibited decreased FOCA in superior occipital gyrus and postcentral gyrus, increased in inferior frontal gyrus compared to controls.

Conclusions:

PBD patients with and without psychotic symptoms display distinct brain functional patterns.
These findings provide empirical evidence for the biological basis of differing clinical outcomes in PBD.
Highlights segregated neural activity in pediatric bipolar disorder with and without psychosis.

Read full analysis

Abstract

Objective:

Psychotic symptoms are quite common in patients with pediatric bipolar disorder (PBD) and may affect the symptom severity and prognosis of PBD. However, the potential mechanisms are less well elucidated until now. Thus, the purpose of this study was to investigate the brain functional differences between PBD patients with and without psychotic symptoms.

Method:

A total of 71 individuals including: 27 psychotic PBD (P-PBD), 25 nonpsychotic PBD (NP-PBD), and 19 healthy controls were recruited in the present study. Each subject underwent 3.0 Tesla functional magnetic resonance imaging scan. Four-dimensional (spatiotemporal) Consistency of local neural Activities (FOCA) was employed to detect the local brain activity changes. Analyses of variance (ANOVA) were used to reveal brain regions with significant differences among three groups groups of individuals, and inter-group comparisons were assessed using post hoc tests.

Results:

The ANOVA obtained significant among-group FOCA differences in the left triangular inferior frontal gyrus, left supplementary motor area, left precentral gyrus, right postcentral gyrus, right superior occipital gyrus, and right superior frontal gyrus. Compared with the control group, the P-PBD group showed decreased FOCA in the left supplementary motor area and bilateral superior frontal gyrus and showed increased FOCA in the left triangular inferior frontal gyrus. In contrast, the NP-PBD group exhibited decreased FOCA in the right superior occipital gyrus and right postcentral gyrus and showed increased FOCA in the left orbital inferior frontal gyrus. Compared to the NP-PBD group, the P-PBD group showed decreased FOCA in the right superior frontal gyrus.

Conclusion:

The present findings demonstrated that the two groups of PBD patients exhibited segregated brain functional patterns, providing empirical evidence for the biological basis of different clinical outcomes between PBD patients with and without psychotic symptoms.

Keywords:

FOCA Pediatric bipolar disorder Psychotic symptom

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