Spectroscopy in Children and Adolescents With Bipolar Disorder
Condition: Bipolar Disorder; ADHD
MeSH terms: Bipolar Disorder
Study type: Observational

Summary: 
      The primary aim of this study is to use proton magnetic resonance spectroscopy to look at
      myo-Inositol containing compounds (Ino) and creatine + phosphocreatine (Cr) in the anterior
      cingulate of 20 children with bipolar disorder between the ages of 6-17 years old free of
      risperidone treatment and 20 children with bipolar disorder after an eight-week or longer
      treatment with risperidone. For comparison, results will also be obtained from 20 controls
      (without bipolar disorder or ADHD) of the same age and gender as well as from 20 children or
      adolescents with a diagnosis of Attention Deficit Hyperactivity Disorder. We hypothesize that
      Ino/Cr levels in the anterior cingulate will correlate positively with manic symptoms using
      the Young mania rating scale (YMRS). Ino/Cr levels in the anterior cingulate in the anterior
      cingular gyrus will be lower in subjects who have received eight weeks or longer of
      risperidone
    

Detailed description: 
      Choline containing compound (Cho) and creatine + phosphocreatine (Cr) have been found to be
      greater in the orbitofrontal cortex of depressed adolescents. In addition, Cho/Cr has been
      found to increase in the anterior cingulate in depressed patients with bipolar affective
      disorder (BPD) compared with comparison subjects. Also, BPD subjects not taking
      antidepressants had a significantly higher anterior cingulate Cho/Cr compared with subjects
      taking antidepressants or comparison subjects. Therefore it would appear the frontal lobe
      Cho/Cr is increased in depression. Given these findings, we are interested in looking at
      subjects with mania to investigate if there may also be a biological marker for mania and
      drug response. Mania measured using the YMRS have been associated with an increase in the
      anterior cingulate Ino/Cr in manic children, adolescents, and adults with bipolar affective
      disorder. In addition, children and adolescents who were responsive to lithium showed a
      decrease in Ino/Cr levels after acute lithium treatment. We will test whether Ino/Cr levels
      will correlate positively with manic symptoms using the YMRS, as well as whether overall
      Ino/Cr levels will be lower for children and adolescents receiving risperidone.

      The primary aim of this study is to use proton magnetic resonance spectroscopy to look at
      myo-Inositol containing compounds (Ino) and creatine + phosphocreatine (Cr) in the anterior
      cingulate of 20 children with bipolar disorder between the ages of 6-17 years old free of
      risperidone treatment and 20 children with bipolar disorder after an eight-week or longer
      treatment with risperidone. For comparison, results will also be obtained from 20 controls
      (without bipolar disorder or ADHD) of the same age and gender as well as from 20 children or
      adolescents with a diagnosis of Attention Deficit Hyperactivity Disorder. We hypothesize that
      Ino/Cr levels in the anterior cingulate will correlate positively with manic symptoms using
      the Young mania rating scale (YMRS). Ino/Cr levels in the anterior cingulate in the anterior
      cingular gyrus will be lower in subjects who have received eight weeks or longer of
      risperidone
    

Intervention name(s): Proton Magnetic Resonance Spectroscopy
Intervention type(s): Device
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        20 children with bipolar disorder between the ages of 6-17 years old free of risperidone
        treatment and 20 children with bipolar disorder after an eight-week or longer treatment
        with risperidone.
      
Keywords: SPECT; bipolar disorder; ADHD; children