These results contribute to a growing literature implicating a role for the genu of the CC in BPD and are the first to report WM variations in the AC of children with BPD. Taken together with the correlational data for aggression and the role of the AC in emotional processing, our data provide preliminary evidence for a possible association between the structural integrity of the WM of the AC and aggression in pediatric BPD.

Barnett [6] in a case series (n=4;7-16 years), and Biederman et al. [7] in an eight-week, open-label trial with 21 children and adolescents (6-17 years) studied the effects of ziprasidone monotherapy in improving bipolar symptomatology in youths with bipolar disorder. In both studies, treatment with ziprasidone showed clinical improvement in the children/adolescents' bipolar symptomatology, with no significant increase in body weight.To determine the appropriate dose and titration schedule for ziprasidone in children and adolescents with bipolar disorder type 1, schizophrenia, or schizoaffective disorder, Delbello et al. [8] conducted AbstractObjective: This open-label clinical trial evaluated the dosing, safety, and effectiveness of rapid vs. slow titration of ziprasidone in pediatric bipolar disorder over a period of 6 weeks. Methods:Study participants (aged 10-17 years) were diagnosed with bipolar disorder using standardized diagnostic instruments. Additionally, standardized rating scales were used to assess changes in mood, adverse effects, and overall functioning. Twenty-eight participants were randomly assigned to either the rapid-or slow-dose titration of ziprasidone. Linear mixed model analyses of repeated measures-adjusting for the age and respective baseline clinical scorewere used to evaluate the main effects and the 2-way interaction effect (incorporating titration group and time). Cox Proportional Hazards Regression, adjusting for age, compared the time-to-treatment response for the rapid-vs. the slow-dose titration of ziprasidone. Treatment response was defined as ≥ 50% reduction from baseline on the Young Mania Rating Scale total scores for at least two sustained periods. Results:Irrespective of titration group assignment, mean YMRS total scores decreased significantly across the 6 weeks of treatment for the combined groups (p=.008). The median time to response was 2 weeks for the rapid titration group and 3 weeks for the slow group, but the two survival curves of treatment response did not differ significantly between the two titration groups (p=0.92). Overall, ziprasidone was tolerated well by the study participants in both groups (slow and rapid titration). Conclusions:No significant difference emerged between the rapid-and slow-titration groups over the 6 weeks of ziprasidone treatment on severity of manic symptoms or time-to-response. There was a reduction in manic symptoms in both the rapid and slow titration groups over the 6 week period. A much larger sample is required to test for meaningful differences between the two titration groups, in regards to improving clinical symptoms and minimizing adverse effects from ziprasidone.