UIC Logo Doctors treating patients with serious conditions such as pediatric bipolar disorder (PBD) or attention deficit hyperactivity disorder (ADHD) can possibly benefit from the following article. Investigators from the University of Illinois at Chicago claim that brain imaging helps analyze effects of emotion on working memory function in children with PBD or ADHD. These severe developmental disorders are known to have common behavioral characteristics like impulsivity, irritability and attention problems.

Having employed fMRI, authors seemingly scrutinized the brain activity of children who were made to perform a working memory task on viewing faces with different emotions, namely angry, happy or neutral expressions. Study volunteers aged 10 to 18 years had to recall the faces and press a button in the MR-scanner whenever the same face presented in earlier two trials appeared. 23 non-medicated children with bipolar disorder, 14 non-medicated children with ADHD and 19 healthy controls were included in the investigation.

Alessandra Passarotti, assistant professor of psychiatry at UIC and lead author of the study, alleged, “In fact, 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. 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.”

It was observed that both disorders reveal dysfunction in the prefrontal cortex as compared to healthy controls. The ADHD group apparently showed most severe dysfunction in this region. It is known that behavior such as impulsivity, and executive function as well as complex cognitive processes namely working memory, attention and language are regulated by the prefrontal cortex. Additional investigations are being initiated for helping individuals use their prefrontal cortex. Greater dysfunction in working memory circuits of the brain appeared among the ADHD group. On the other hand, more deficits in regions of the brain controlling emotion-processing and regulation were seemingly noted.

Passarotti remarked, “It’s a simple yet elegant working memory test that tells us a lot about how their brain remembers stimuli like faces or 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.”

At present, authors are trying to introduce novel diagnostic tests based on neurological and behavioral markers of illness that can be used in a clinical setting. Patients are usually diagnosed by clinical measures, questionnaires, behavior scales and interviews with parents. Differentiating between both the disorders behaviorally seems to be an extremely difficult task for physicians. This inability to ascertain the accurate disorder may heighten chances of an incorrect diagnosis and wrong medications, which further worsens symptoms and develops greater frustration for children and parents. Though all neurological deficits of ADHD and PBD are not known, it was claimed that dissimilar medications treat both the conditions.

The study is published in the October issue of the Journal of the American Academy of Child and Adolescent Psychiatry.