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Preliminary evidence for progressive prefrontal abnormalities in adolescents and young adults with bipolar disorder

  • JESSICA H. KALMAR (a1) (a2), FEI WANG (a1) (a2), LINDA SPENCER (a1) (a2), ERIN EDMISTON (a1) (a2), CHERYL M. LACADIE (a3), ANDRÉS MARTIN (a1) (a4), R. TODD CONSTABLE (a3) (a5) (a6), JAMES S. DUNCAN (a3) (a5) (a7), LAWRENCE H. STAIB (a3) (a5) (a7), XENOPHON PAPADEMETRIS (a3) (a5) and HILARY P. BLUMBERG (a1) (a2) (a3) (a4)...

Previous cross-sectional study of ventral prefrontal cortex (VPFC) implicated progressive volume abnormalities during adolescence in bipolar disorder (BD). In the present study, a within-subject, longitudinal design was implemented to examine brain volume changes during adolescence/young adulthood. We hypothesized that VPFC volume decreases over time would be greater in adolescents/young adults with BD than in healthy comparison adolescents/young adults. Eighteen adolescents/young adults (10 with BD I and 8 healthy comparison participants) underwent two high-resolution magnetic resonance imaging scans over approximately 2 years. Regional volume changes over time were measured. Adolescents/young adults with BD displayed significantly greater volume loss over time, compared to healthy comparison participants, in a region encompassing VPFC and rostral PFC and extending to rostral anterior cingulate cortex (p < .05). Additional areas where volume change differed between groups were observed. While data should be interpreted cautiously due to modest sample size, this study provides preliminary evidence to support the presence of accelerated loss in VPFC and rostral PFC volume in adolescents/young adults with BD. (JINS, 2009, 15, 476–481.)

Corresponding author
*Correspondence and reprint requests to: Jessica H. Kalmar, Mood Disorders Research Program, Department of Psychiatry, Yale School of Medicine, 300 George Street, Suite 901, New Haven, Connecticut 06511. E-mail:
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