Jessica Kalmar, M.D., Ph.D.

Fellow in Child & Adolescent Depression

Project Details

PROJECT title

Developing Neurobehavioral Endophenotypes to Dissociate Pediatric Major Depressive and Bipolar Disorders

PROJECT SUMMARY

Pediatric major depressive disorder (MDD) is difficult to distinguish from bipolar disorder (BD) as depression frequently presents first in children with BD. Methods to dissociate MDD from BD in youth are needed critically in order to prevent the severe consequences of misdiagnosis. Identifying childhood markers of MDD and BD would help guide early detection and development of more targeted treatments.

Potential differences between MDD and BD in emotional processing and the functioning of the brain system that supports emotional processing are emerging. While abnormalities in the amygdala, a brain structure which processes responses to emotional stimuli, have been detected in youth with MDD and BD, preliminary evidence from adult research suggests that these abnormalities may be found in different brain hemispheres in the two disorders.

Our pilot data indicate that lateralized differences are present in the amygdala during processing of emotional stimuli in adolescents with MDD and BD. Our pilot data also suggest that the neurocognitive dysfunction associated with these regional brain abnormalities may be detected using outside of scanner cognitive and behavioral testing, as adolescents with MDD and BD differ in the biases they exhibit when processing emotional stimuli. This raises the exciting potential of developing minimally invasive measures to assist in differentiation of pediatric MDD and BD.

This project aims to implement a novel and interdisciplinary approach to directly compare adolescents with MDD and BD using functional neuroimaging and cognitive/behavioral assessment to develop measures that would identify neurobehavioral endophenotypes that dissociate between the two disorders in youth.

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