Objective
Although previous neuroimaging studies suggest that adolescents with bipolar disorder exhibit smaller amygdala volumes compared with healthy adolescents, whether these abnormalities are present at illness onset or instead develop over time remains unclear. The aim of this study was to conduct a prospective longitudinal investigation comparing amygdala neurodevelopment among adolescents following their first manic episode, adolescents with attention deficit hyperactivity disorder (ADHD), and healthy adolescents.
Method
Thirty adolescents hospitalized for their first manic/mixed episode associated with bipolar disorder, twenty-nine adolescents with ADHD, and twenty-four demographically matched healthy teens underwent magnetic resonance imaging scans at index assessment and approximately 12 months later. Adolescents with bipolar disorder were prospectively evaluated using diagnostic interviews and symptom rating scales.
Results
Mixed models examining group-by-time effects for both left (p=0.005) and right (p=0.002) amygdala volumes were statistically significant. Change in left (p=0.01) and right (p=0.0008) amygdala volumes from baseline to 12 months were significantly different among groups. Specifically, left amygdala volumes increased over time in healthy adolescents (p=0.008) and adolescents with ADHD (p=0.0009), but not in adolescents with bipolar disorder (p=0.3). Right amygdala volume increased over time in adolescents with ADHD (p<0.001), but not in healthy adolescents nor in adolescents with bipolar disorder (p=0.1 and p=0.3, respectively). In adolescents with bipolar disorder, baseline total amygdala volume was significantly greater in those who subsequently achieved symptomatic recovery as compared to those who did not achieve recovery (p=0.02).
Conclusions
Adolescents with mania fail to exhibit normal increases in amygdala volume that occur during healthy adolescent neurodevelopment.