Altered baseline brain activity in children with bipolar disorder during mania state: a resting-state study

Figures & data

Table 1 Participant demographic data in PBD (n=18) versus typically HC (n=18) subjects

Characteristics	PBD	HC	t/χ^2	P
Age, years	15.1±1.81	14.13±1.61	1.75	0.09
Full-Scale IQ	98.5±13.51	105.00±7.72	−1.87	0.07
Education (years)	8.17±1.69	7.44±2.28	1.08	0.29
Sex (male/female), n	6/12	6/12	0	1
YMRS scores	33.40±6.09	3.67±2.11	19.56	0.00
MFQ scores	6.89±2.59	6.39±3.36	0.50	0.62
K-SADS-PL current comorbidity diagnoses, n (%)
ADHD	1 (5.56)
OCD	2 (11.12)
Anxiety	1 (5.56)
Medications, n (%)
Lithium	7 (38.9)
Valproate	8 (44.4)
Atypical antipsychotics	13 (72.2)
Antidepressants	3 (16.7)
None	2 (11.1)
Onset age, years	13.6±1.7
Illness duration, months	15.6±13.0
Family BD history (yes/no), n	5/13
Psychotic symptoms (yes/no), n	9/9
BP-I/BP-II, n	14/4

Notes: All patients were of Han Chinese ethnicity/race. Data are presented as mean ± standard deviation, except where indicated otherwise.

Abbreviations: PBD, pediatric bipolar disorder; HC, healthy control; IQ, intelligence quotient; YMRS, Young Mania Rating Scale; MFQ, Mood and Feelings Questionnaire; K-SADS-PL, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version; ADHD, attention-deficit/hyperactivity disorder; OCD, obsessive–compulsive disorder; BD, bipolar disorder; BP-I, bipolar disorder type I; BP-II, bipolar disorder type II.

Figure 1 Brain regions with increased/decreased amplitude of low-frequency fluctuation (ALFF) in pediatric bipolar disorder patients are superimposed on a T1 template.

Notes: The ALFF showed a decrease (cold colors) in the left precuneus (d), left superior parietal lobule (e), and bilateral inferior occipital gyrus (c1 and c2), and an increase (hot colors) in bilateral caudate (b1 and b2) and left pallidum (a). The voxels with P=0.001 and a cluster size of 6 were used to identify the clusters with significant differences between the pediatric bipolar disorder and healthy control groups (P<0.05, corrected). Patients versus controls; two-sample t-test; P<0.05, corrected.
Abbreviations: L, left; R, Right.

Table 2 Brain regions showing increased/decreased ALFF in PBD versus HC subjects

Brain regions of ALFF	Side	BA	Talairach coordinates (MNI)			t-statistic	K
PBD vs HC			X	Y	Z
PBD > HC
Caudate	Left		−15.00	6.00	15.00	4.18	42
Caudate	Right		12.00	6.00	15.00	4.05	55
Pallidum	Left		−15.00	6.00	−3.00	3.52	10
PBD < HC
Precuneus	Left	7	−18.00	−63.00	57.00	−5.78	10
Superior parietal lobule	Left	7	−24.00	−69.00	45.00	−4.02	37
Inferior occipital gyrus	Left	18	−30.00	−87.00	−15.00	−3.55	18
Inferior occipital gyrus	Right	18	42.00	−84.00	−15.00	−3.35	13

Abbreviations: ALFF, amplitude of low-frequency fluctuation; BA, Brodmann area; HC, healthy controls; PBD, pediatric bipolar disorder; K, cluster size in 3 × 3 × 3 mm³ voxels; MNI, Montreal Neurological Institute.

Figure 2 Scatter plots showing significant positive correlation between total Young Mania Rating Scale scores and regional amplitude of low-frequency fluctuation (ALFF) values in the left pallidum in pediatric bipolar disorder patients (P<0.05).

Table 3 Brain regions with significant between-group differences in ALFF and YMRS

Brain region	Side	YMRS (r, P)
Caudate	Left	0.40, 0.10
Caudate	Right	0.11, 0.69
Pallidum	Left	0.52, 0.03*
Precuneus	Left	0.17, 0.51
Superior parietal lobule	Left	−0.06, 0.82
Inferior occipital gyrus	Left	0.02, 0.93
Inferior occipital gyrus	Right	0.01, 0.96

Note:

* P<0.05.

Abbreviations: ALFF, amplitude of low-frequency fluctuation; YMRS, Young Mania Rating Scale.