Altered Reward Processing Can Signal Onset of Bipolar Symptoms

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Children who have a parent with bipolar disorder show altered functioning in a part of the brain associated with the processing of rewards, which could make them less likely to be motivated and pursue goals later in life.

Manpreet K. Singh of the Stanford University School of Medicine, Stanford, California, and colleagues, evaluated 20 children of bipolar parents along with 25 children of parents without the disease. The two groups were similar in terms of expressions of anxiety, depression or mania.

Children of parents who are bipolar had significantly lower Children’s Global Assessment Scale compared to the control group, as well as higher levels of novelty seeking, the researchers reported in JAMA Psychiatry.

On functional MRIs, the control group children had more activity in the pregenual cingulate when anticipating a loss than when anticipating a reward. That region of the brain is involved in the regulation of emotion and weighing cost against benefit in situations that require decision making, the researchers wrote.

However, the opposite was true among children of bipolar patients, who had the greatest activation when anticipating a reward.

The results show “early vulnerabilities for developing dysfunctional regulation of goal pursuit and motivation in children at high risk for mania,” researchers concluded. “Longitudinal studies are needed to examine whether these patterns of neural activation predict the onset of mania and other mood disorders in high-risk children."

Autism and Pediatric Bipolar Disorder
Altered Reward Processing in Brain Can Signal Bipolar Onset

Healthy children who have a parent with bipolar disorder show altered brain activation during reward processing, research shows. Compared with children with no Axis I psychiatric disorders among their first- or second-degree relatives, children of bipolar patients had altered function in the pregenual cingulate when anticipating a reward and in the orbitofrontal cortex (OFC) when gaining or failing to gain a reward.

Children of bipolar patients had significantly lower Children's Global Assessment Scale scores than a demographically matched group of low-risk children, as well as higher levels of novelty seeking.

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