Evaluating the neuroimaging findings in high risk off-springs of bipolar parents: A DTİ study

Aim: Primary objective of this study is; to distinguish the children with parents who are diagnosed with Bipolar Disorder (BD) as affected and un-affected via semi-structured clinical interviews, then to compare the neuroimaging features and to determine the differences between both groups and healthy controls. Secondary objective is to assess the usage potential of neuroimaging techniques as a bio-markers which would enable the disorder to be diagnosed at an early period. Method: Children and adolescents of ages 13 to 18 are included in our study. Un-affected high risk group consists of 12 children and adolescents whose parents are diagnosed with BD and who don't meet any diagnostic criteria in K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School Aged Children Kiddie-SADS-lifetime Version) now and/or in the past. Affected high risk group consists of 7 children and adolescents whose parents are diagnosed with BD and have a psychiatric symptom or diagnosis in the last 6 months other than Substance/Alcohol Dependance or Abuse, Bipolar Disorder Type I or II, Schzophrenia, Delusional Disorder, Schizoaffective Disorder, Schizophreniform Disorder and Autistic Disorder and in remission period for minimum 3 months (for Major Depressive Disorder CDRS-R≤54, Anxiety Disorder STAI<39 and Bipolar Disorder NOS CDRS-R≤54 and YMRS≤7). Healthy control group consists of 13 children and adolescents whose parents don't have any psychiatric disorder dignose and who don't meet any diagnostic criteria in K-SADS-PL now and/or in the past. Neuro-imaging features will be gathered from both groups using DTI method. In diffusion tensor imaging; mean diffusivity (MD) and fractional anisotropy (FA) values will be measured using region of interest (ROI) method from identified white matter areas on MD and FA maps. Regions we are planning to measure are; frontal cortex, genu - splenium of corpus callosum, anterior cingulate cortex and uncinate fasciculus. Results: CGAS scores in affected high risk group were found lower compared to un-affected high risk group and healthy control group. No difference of fractional anisotropy (FA) or mean diffusivity (MD) values were found in Corpus Callosum Genu and Splenium area, Frontal Cortex area and Uncinate Fasciculus between groups; but MD values of Anterior Cingulate Cortex were significantly higher in high risk group compared to healthy control group. Conclusion: Higher OD values found in the Anterior Cingulate Cortex area of high risk group may represent a possible cellulare damage in that brain region. Results found in our study may be candidates to predict a possible Bipolar Prodromal phase; but it is really difficult to determine the potential of neuro-imaging findings as bio-markers. In order to be able to generalize this situation, there is a need for longitudinal researches with larger sample sizes.