Frontostriatal neuroimaging findings differ in patients with bipolar disorder who have or do not have ADHD comorbidity

JOURNAL OF AFFECTIVE DISORDERS

卷:147

Article

Townsend, Jennifer D.¹  Sugar, Catherine A.^1,2,3  Walshaw, Patricia D.¹  Vasquez, Roxanne E.¹  Foland-Ross, Lara C.⁴  Moody, Teena D.^1,2  Bookheimer, Susan Y.¹  McGough, James J.^1,2  Altshuler, Lori L.^1,5 

[1] Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA

[2] Univ Calif Los Angeles, Jane & Terry Semel Inst Neurosci & Human Behav, Los Angeles, CA 90024 USA

[3] Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90095 USA

[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Lab Neuroimaging, Los Angeles, CA 90095 USA

[5] West Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA

关键词: Bipolar disorder;    Euthymia;    fMRI;    ADHD;    Response inhibition;    Inferior frontal cortex;   

DOI  :  10.1016/j.jad.2012.08.019

来源: Elsevier

【 摘 要 】

Background: The inferior frontal cortical (IFC)-striatal network plays an integral role in response inhibition and is compromised in patients with Bipolar Disorder (BP) or Attention-Deficit/Hyperactivity Disorder (ADHD). Prior BP functional neuroimaging studies have not accounted for ADHD comorbidity despite its high prevalence. Methods: The authors conducted an fMRI study using a response inhibition task (Go-NoGo) in 32 euthymic adults with BP, half with comorbid ADHD (BP/ADHD); 16 adults with ADHD alone; and 30 healthy controls. Within- and between-group whole-brain analyses were performed to assess for significant neural function differences. Results: All groups activated frontal and striatal regions involved in response inhibition. ANOVA results demonstrated significant interaction effects of BP and ADHD in the anterior and posterior cingulate, left superior and middle frontal gyri and left inferior parietal lobule. Follow-up comparisons showed significant differences between BP subjects with and without ADHD. Other regions demonstrated main effects of BP (left inferior frontal gyms, left middle frontal gyms, right superior frontal gyrus and left insula) and ADHD (left inferior frontal gyms, left precentral gyrus and right anterior cingulate). Limitations: This study, as the first of its kind, requires replication using large sample sizes and controlling for potential effects of medication. Conclusions: Euthymic bipolar adults with comorbid ADHD have significantly different neural activation patterns from BP patients without this comorbidity. If understanding of the neurobiology of bipolar disorder is to be achieved, it is critical to control for this potential confound, something not done by most prior fMRI studies of adults with BP. Published by Elsevier B.V.

【 授权许可】

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