This article is more than 5 years old. Information may no longer be current.

Bipolar disorder affects brains of children, adults differently

Greater activation in the right amygdala is more common among bipolar children, compared with adults, when viewing emotional faces, according to recent study findings published in JAMA Psychiatry.

“Bipolar disorder is among the most debilitating psychiatric illnesses affecting adults worldwide, with an estimated prevalence of 1% to 4% of the adult population, but more than 40% of adults report their bipolar disorder started in childhood rather than adulthood,” Ezra Wegbreit, PhD, a postdoctoral research fellow at Bradley Hospital in East Providence, R.I., said in a press release. “Despite this, very few studies have examined whether brain or behavioral changes exist that are specific to children with bipolar disorder vs. adults with bipolar disorder.”

Ezra Wegbreit

Wegbreit and colleagues conducted a meta-analysis of 21 pediatric studies, 73 adult studies and two studies containing both children and adults to determine if children with bipolar disorder (BD) have greater convergence of amygdala hyperactivation and prefrontal cortical hypoactivation compared with adults with BD. The studies all used functional magnetic resonance imaging (fMRI).

“Our meta-analysis has located different regions of the brain that are either hyperactive or under-active in children with bipolar disorder,” Wegbreit said. “These point us to the targeted areas of the brain that relate to emotional dysfunction and cognitive deficits for children with bipolar disorder.”

Researchers found that children with BD showed greater amygdala activity when analyzing emotional face recognition compared with adults with BD. Children also had greater activation in the inferior frontal gyrus and precuneus areas of the brain when emotional stimuli were used. However, when studies used non-emotional cognitive tasks, children with BD showed significantly lower activation in the anterior cingulate cortex, compared with adults with BD.

“Understanding more about the brains of children and adults with mental illness is very important because, ultimately, all mental illnesses are reflected in changes in brain activity,” study researcher Daniel Dickstein, MD, director of the PediMIND Program at Bradley Hospital, said in the release. “Locating the underlying brain change in bipolar youths could lead us to new, brain-based ways to improve how we diagnose and treat this disorder.”

Disclosure: See the full study for a complete list of relevant financial disclosures.