Bipolar Disorder Clinical Trial
Official title:
Multimodal Neuroimaging of Treatment Effects in Adolescent Mania
Specific Aim 1: To determine the effects of treatment with quetiapine or lithium on brain
activation in adolescents. The investigators will use functional magnetic resonance imaging
(fMRI) to examine brain activation during an attentional task.
Specific Aim 2: To determine the effects of treatment with quetiapine or lithium on
neurometabolite measures, early in their illness course. The investigators will use 1H-MRS
to identify myo-inositol (mI), N-acetyl aspartate (NAA), and glutamate (Glu) levels in
prefrontal ALN regions.
Specific Aim 3: To determine the relationships among the changes in brain activation and
neurometabolite measures, as well as symptomatic improvement in manic adolescents.
Hypotheses 1 & 2 predict that following 6 weeks of treatment with lithium or quetiapine,
manic adolescents who demonstrate symptomatic improvement will exhibit normalized
(decreased) VLPFC and ACC activation and increased activation of compensatory posterior
attentional brain areas as well as normalization of VLPFC and ACC neurometabolite measures
(increased NAA and decreased Glu levels) compared with those who do not experience
symptomatic improvement and healthy adolescents.
Hypothesis 3 predicts significant associations between fMRI activation changes (i.e.
decreased activation in VLPFC and ACC ROIs and increased activation in the posterior
attention ROI) and MRS changes (increases in NAA and decreases in Glu levels in the VLPFC
and ACC) for patients who exhibit symptomatic improvement with either treatment.
Hypothesis 4 predicts that decreases in mI levels at 1 week will be associated with lithium,
but not quetiapine, response at endpoint.
In contrast, Hypothesis 5 predicts higher baseline Cho levels will be associated with
quetiapine, but not lithium, response at endpoint.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Diagnostic
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