Objective
Despite increased interest in the developmental trajectory of the pathophysiology mediating bipolar disorder (BD), few studies compare adults and youths with BD. Deficits in motor inhibition are thought to play an important role in the pathophysiology of BD across the age spectrum. Here we compare neural circuitry mediating this process in youths vs. adults with BD and healthy volunteers.
Method
fMRI data from 89 subjects (16 BD youth, 23 BD adults, 21 healthy children, 29 healthy adults) were acquired while subjects performed the stop-signal task.
Results
During failed inhibition, an age group x diagnosis interaction manifested in the anterior cingulate cortex (ACC), with child BD participants showing hypoactivation relative to healthy children and adult BD, and adult BD showing hyperactivation relative to healthy adults. During successful inhibition, a main effect of diagnosis emerged in the right nucleus accumbens and left ventral prefrontal cortex, with bipolar individuals, irrespective of age, showing less activation than healthy participants.
Conclusions
Child BD and adult BD both show ACC dysfunction during failed motor inhibition, although the nature of that dysfunction differs between groups. Adults and youth with BD show similar deficits in nucleus accumbens and ventral prefrontal cortex activation during successful inhibition. Therefore, while subcortical and VPFC hypoactivation is present in BD across the lifespan, ACC dysfunction varies developmentally, with reduced ACC activation in child BD and increased activation in adult BD during failed inhibition. Longitudinal fMRI studies on the developmental trajectory of the neural circuitry mediating motor inhibition in BD are warranted.