Archer Camille, Milewski Amy, Jeong Hee Jung, Reimann Gabrielle E, Durham E Leighton, Kaczkurkin Antonia N
Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA.
Department of Psychology, Sogang University, Seoul, South Korea.
Brain Behav. 2025 Sep;15(9):e70894. doi: 10.1002/brb3.70894.
Prodromal symptoms of mania in children are predictive of the later development of bipolar disorder; yet, the neurostructural correlates of these early symptoms remain poorly understood. This study aimed to investigate the association between prodromal mania symptoms and brain structure in a large cohort of children.
We analyzed data from 10,662 nine- to 10-year-old children from the Adolescent Brain Cognitive Development (ABCD) Study, employing structural equation modeling to examine the concurrent and longitudinal associations between prodromal mania symptoms and cortical and subcortical gray matter volume.
After adjusting for multiple comparisons and controlling for age, sex, scanner model, socioeconomic status, and medication use, we found that baseline mania symptoms were associated with reduced gray matter volume across both cortical and subcortical areas, suggesting a global effect. These findings were further supported by the loss of these effects when total intracranial volume was included as an additional covariate, suggesting that smaller overall brain size, rather than specific regional effects, is related to prodromal mania symptoms. Lastly, longitudinal analyses revealed that brain volume at baseline did not predict prodromal mania symptoms at the second-year follow-up.
Our results support the structural differences observed in adults with bipolar disorder in prior work and refine our understanding of the neurostructural correlates of prodromal mania symptoms in children. These findings could enhance early identification and intervention efforts for youth at risk of developing bipolar disorder.
儿童躁狂发作的前驱症状可预测双相情感障碍的后期发展；然而，这些早期症状的神经结构相关性仍知之甚少。本研究旨在调查一大群儿童前驱躁狂症状与脑结构之间的关联。
我们分析了青少年大脑认知发展（ABCD）研究中10662名9至10岁儿童的数据，采用结构方程模型来检验前驱躁狂症状与皮质和皮质下灰质体积之间的同时性和纵向关联。
在对多重比较进行校正并控制年龄、性别、扫描仪型号、社会经济地位和药物使用后，我们发现基线躁狂症状与皮质和皮质下区域灰质体积减少有关，提示存在整体效应。当将总颅内体积作为额外协变量纳入时，这些效应消失，进一步支持了这些发现，表明整体脑容量较小而非特定区域效应与前驱躁狂症状有关。最后，纵向分析显示，基线时的脑容量并不能预测第二年随访时的前驱躁狂症状。
我们的结果支持了先前研究中在双相情感障碍成人患者中观察到的结构差异，并完善了我们对儿童前驱躁狂症状神经结构相关性的理解。这些发现可能会加强对有患双相情感障碍风险的青少年的早期识别和干预工作。
