Singh Manpreet K, Chang Kiki D, Mazaika Paul, Garrett Amy, Adleman Nancy, Kelley Ryan, Howe Meghan, Reiss Allan
Pediatric Bipolar Disorders Program, Stanford University School of Medicine, Stanford, California 94305-5719, USA.
J Child Adolesc Psychopharmacol. 2010 Feb;20(1):15-24. doi: 10.1089/cap.2009.0004.
Pediatric bipolar disorder is characterized by core deficits in mood and executive function and commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD). We aimed to examine response inhibition in this population, as an element of executive function, which, if aberrant, may interfere with learning and information processing.
Children (9-18 years) with bipolar I or II disorder (BD, n = 26) and age, gender, and intelligence quotient (IQ) comparable healthy children (HC, n = 22) without any psychopathology were given a standardized Go/NoGo computerized task measuring response inhibition. A whole-brain functional magnetic resonance imaging (MRI) group analysis was performed using statistical parametric mapping software (SPM2) for comparing NoGo to Go epochs.
There were no statistically significant group differences between groups in age, gender, or ethnicity. The BD group had high rates of co-morbid disorders, including 81% with ADHD, 62% with oppositional defiant disorder (ODD), and 46% with anxiety disorders. This BD group had fewer correct responses on Go (84% vs. 96%, T[46] = 3.35, p = 0.002) and overall (85% vs. 94%, T[46] = 4.12, p = 0.0002) trials as compared to the HC group. However, there were no statistically significant group differences in response inhibition on NoGo trials (p = 0.11). In the NoGo-Go contrast, the BD group showed increased neural activation in the right dorsolateral prefrontal cortex (DLPFC) compared to HC (T[46] = 4.21, p < 0.001).
During accurate NoGo but impaired Go trial performance, children with BD showed increased right DLPFC activation versus controls, suggesting increased recruitment of executive control regions for accurate response inhibition. Studies relating these results to mood regulation in pediatric BD are warranted.
儿童双相情感障碍的特征是情绪和执行功能存在核心缺陷，且常与注意力缺陷多动障碍（ADHD）共病。我们旨在研究该人群的反应抑制能力，作为执行功能的一个要素，若其异常，可能会干扰学习和信息处理。
选取患有双相I型或II型障碍（BD，n = 26）的9至18岁儿童，以及年龄、性别和智商（IQ）与之匹配且无任何精神病理学问题的健康儿童（HC，n = 22），让他们完成一项测量反应抑制能力的标准化Go/NoGo计算机任务。使用统计参数映射软件（SPM2）进行全脑功能磁共振成像（MRI）组分析，以比较NoGo期和Go期。
两组在年龄、性别或种族方面无统计学显著差异。BD组共病率较高，包括81%患有ADHD，62%患有对立违抗障碍（ODD），46%患有焦虑症。与HC组相比，BD组在Go试验（84%对96%，T[46] = 3.35，p = 0.002）和总体试验（85%对94%，T[46] = 4.12，p = 0.0002）中的正确反应较少。然而，在NoGo试验的反应抑制方面，两组无统计学显著差异（p = 0.11）。在NoGo - Go对比中，与HC组相比，BD组右侧背外侧前额叶皮质（DLPFC）的神经激活增加（T[46] = 4.21，p < 0.001）。
在准确的NoGo试验但Go试验表现受损的情况下，BD儿童与对照组相比，右侧DLPFC激活增加，这表明为了准确的反应抑制，执行控制区域的募集增加。有必要开展将这些结果与儿童BD情绪调节相关联的研究。
