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Brain Scans Explore ADHD, Bipolar Disorder

October 21, 2010
Written by: , Filed in: Diagnostic Imaging, Neuroradiology, Pediatric Radiology
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Brain imaging has allowed University of Illinois at Chicago researchers to learn more about the neurological origins of two somewhat similar childhood disorders that nevertheless call for very different treatments. The researchers hope to develop tests that can definitively differentiate between the two disorders.

The study explored the effects of emotion on working memory function in children with pediatric bipolar disorder (PBD) and attention deficit hyperactivity disorder (ADHD). Using functional MRI, the researchers scanned the brain activity of children ages 10 through 18 as they performed a working memory task while viewing faces that displayed various emotions.

Alessandra Passarotti, PhD, assistant professor of psychiatry at the university and the lead author of the study, said the working memory test showed how the children’s brains remembered such stimuli as faces and objects. “We also added in an emotional component—because both disorders show emotional deficits—to study how their working memory is affected by emotional challenge,” she said, as quoted in a university news release. Dr. Passarotti is associated with the Center for Cognitive Medicine and the Institute for Juvenile Research at the university.

Both disorders showed dysfunction in the prefrontal cortex, especially ADHD. The prefrontal cortex controls behavior, including impulsivity, and executive function, plus such complex cognitive processes as working memory, attention, and language. The bipolar group had greater dysfunction in regions of the brain involved in the processing and regulation of emotions.

Currently, the two disorders are diagnosed chiefly through observations of behavior, which can be imprecise. An incorrect diagnosis can make the disorders worse. Medications, such as Ritalin, Adderall, and other stimulants, that work for ADHD do not work for bipolar disorder.

“In fact,” said Dr. Passarotti, “if you give a stimulant to a child with bipolar disorder, they become more manic, and this makes their illness even worse, whereas if you give the mood-regulation medicine commonly prescribed for PBD to a child with ADHD, they still show a lot of attention deficits and do not show any improvement.”

So a brain imaging test that could diagnose the disorders neurologically would be tremendously helpful to PBD and ADHD patients—and  their parents. “Our hope is that by better differentiating between these two severe developmental illnesses, we can help develop more accurate diagnoses and more targeted treatments for PBD and ADHD,” said Dr. Passarotti.

The study has been published in the October issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

Related seminar: Pediatric Radiology Review

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