Alteration of fronto-thalamic-striatal and visual network activity to positive emotional stimuli in adolescent patients with bipolar disorder during a Go/No-Go task-based functional brain MRI

Background: Adolescent patients with bipolar disorder (BD) tend to have abnormal neural activity to emotional stimuli. This study aimed to assess alterations of neural activity within the fronto-thalamic-striatal circuit, and the fusiform gyrus during positive stimuli processing in Go/No-Go task-based brain functional MRI (fMRI). Methods: This prospective study enrolled 43 adolescent patients with BD and 18 age- sex-matched healthy controls. All study participants underwent a task-based brain fMRI using a happy versus neutral Go/No-Go paradigm. All study participants also completed multiple affective and cognitive assessment questionnaire. Results: Enhanced activity was found in the fronto-thalamic-striatal circuit including the inferior frontal gyrus and the caudate, the fusiform gyrus, the left cerebellum crus I and the hippocampus in adolescent patients with BD, during response inhibition to happy versus neutral distractors in an emotional Go/No-Go fMRI task, compared with matched healthy controls (p<0.05). Moreover, the left inferior frontal gyrus, the right fusiform gyrus and the left cerebellum crus I responses to happy versus neutral distractors were positively associated with the differences in false response errors in the patients with BD (all p<0.05, FDR corrected). The enhanced activity of the caudate nucleus and that of the right hippocampus were negatively correlated with cognitive function (all p<0.05, FDR corrected). Conclusion: This study found significant brain functional alterations in the limbic system, the visual brain network and cerebellum, especially the fronto-thalamic-striatal track and fusiform gyrus, which was correlated with cognitive dysfunction in adolescent patients with BD. These changes may serve as potential neuroimaging correlates of BD in adolescent patients.