PMID- 32745598
OWN - NLM
STAT- MEDLINE
DCOM- 20210419
LR  - 20220402
IS  - 1527-5418 (Electronic)
IS  - 0890-8567 (Print)
IS  - 0890-8567 (Linking)
VI  - 60
IP  - 4
DP  - 2021 Apr
TI  - Changes in Intrinsic Brain Connectivity in Family-Focused Therapy Versus Standard 
      Psychoeducation Among Youths at High Risk for Bipolar Disorder.
PG  - 458-469
LID - S0890-8567(20)31334-4 [pii]
LID - 10.1016/j.jaac.2020.07.892 [doi]
AB  - OBJECTIVE: We compared intrinsic network connectivity in symptomatic youths at 
      high risk (HR) for bipolar disorder (BD) and healthy comparison (HC) youths. In 
      HR youths, we also investigated treatment-related changes in intrinsic 
      connectivity after family-focused therapy for high-risk youths (FFT-HR) vs 
      standardized family psychoeducation. METHOD: HR youths (N = 34; age 9-17 years; 
      mean 14 years, 56% girls and 44% boys) with depressive and/or hypomanic symptoms 
      and at least 1 first- or second-degree relative with BD I or II were randomly 
      assigned to 4 months of FFT-HR (12 sessions of psychoeducation, communication, 
      and problem-solving skills training) or enhanced care (EC; 3 family and 3 
      individual psychoeducation sessions). Before and after 4 months of treatment, 
      participants underwent resting state functional magnetic resonance imaging 
      (rs-fMRI). A whole-brain independent component analysis compared rs-fMRI networks 
      in HR youths and 30 age-matched HC youths at a pretreatment baseline. Then we 
      identified pretreatment to posttreatment (4-month) changes in network 
      connectivity in HR youths receiving FFT-HR (n = 16) or EC (n = 18) and correlated 
      these changes with depression improvement. RESULTS: At baseline, HR youths had 
      greater connectivity between the ventrolateral prefrontal cortex (VLPFC) and the 
      anterior default mode network (aDMN) than did HCs (p = .004). Over 4 months of 
      treatment, FFT-HR-assigned HR youths had increased VLPFC-aDMN connectivity from 
      pre- to posttreatment (p = .003), whereas HR youths in EC showed no significant 
      change over time (p = .11) (treatment by time interaction, t(31) = 3.33, 95% CI = 
      0.27-1.14, p = .002]. Reduction in depression severity over 4 months inversely 
      correlated with enhanced anterior DMN (r = -0.71) connectivity in the FFT-HR but 
      not in the EC (r = -0.07) group (z = -2.17, p = .015). CONCLUSION: Compared to 
      standard psychoeducation, FFT-HR is associated with stronger connectivity between 
      the VLPFC and aDMN, suggesting possible enhancements of self-awareness, illness 
      awareness, and emotion regulation. CLINICAL TRIAL REGISTRATION INFORMATION: Early 
      Intervention for Youth at Risk for Bipolar Disorder; https://clinicaltrials.gov/; 
      NCT01483391.
CI  - Copyright (c) 2020 American Academy of Child and Adolescent Psychiatry. Published 
      by Elsevier Inc. All rights reserved.
FAU - Singh, Manpreet K
AU  - Singh MK
AD  - Stanford University School of Medicine, California. Electronic address: 
      mksingh@stanford.edu.
FAU - Nimarko, Akua F
AU  - Nimarko AF
AD  - Stanford University School of Medicine, California.
FAU - Garrett, Amy S
AU  - Garrett AS
AD  - University of Texas, Health Science Center at San Antonio.
FAU - Gorelik, Aaron J
AU  - Gorelik AJ
AD  - University of California, Davis.
FAU - Roybal, Donna J
AU  - Roybal DJ
AD  - University of Texas, Health Science Center at San Antonio.
FAU - Walshaw, Patricia D
AU  - Walshaw PD
AD  - University of California, Los Angeles School of Medicine.
FAU - Chang, Kiki D
AU  - Chang KD
AD  - private practice, Menlo Park, California.
FAU - Miklowitz, David J
AU  - Miklowitz DJ
AD  - University of California, Los Angeles School of Medicine.
LA  - eng
SI  - ClinicalTrials.gov/NCT01483391
GR  - R01 MH093666/MH/NIMH NIH HHS/United States
GR  - R01 MH093676/MH/NIMH NIH HHS/United States
GR  - R01 MH123575/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20200801
PL  - United States
TA  - J Am Acad Child Adolesc Psychiatry
JT  - Journal of the American Academy of Child and Adolescent Psychiatry
JID - 8704565
SB  - IM
MH  - Adolescent
MH  - *Bipolar Disorder/diagnostic imaging/therapy
MH  - Brain/diagnostic imaging
MH  - Child
MH  - Family Therapy
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Reference Standards
MH  - Treatment Outcome
PMC - PMC7854810
MID - NIHMS1618251
OTO - NOTNLM
OT  - bipolar disorder
OT  - depression
OT  - familial risk
OT  - family-focused therapy
OT  - resting state functional connectivity
EDAT- 2020/08/04 06:00
MHDA- 2021/04/20 06:00
PMCR- 2022/04/01
CRDT- 2020/08/04 06:00
PHST- 2019/11/27 00:00 [received]
PHST- 2020/04/22 00:00 [revised]
PHST- 2020/07/24 00:00 [accepted]
PHST- 2020/08/04 06:00 [pubmed]
PHST- 2021/04/20 06:00 [medline]
PHST- 2020/08/04 06:00 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - S0890-8567(20)31334-4 [pii]
AID - 10.1016/j.jaac.2020.07.892 [doi]
PST - ppublish
SO  - J Am Acad Child Adolesc Psychiatry. 2021 Apr;60(4):458-469. doi: 
      10.1016/j.jaac.2020.07.892. Epub 2020 Aug 1.