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Colic L, Sankar A, Goldman DA, Kim JA, Blumberg HP. Towards a neurodevelopmental model of bipolar disorder: a critical review of trait- and state-related functional neuroimaging in adolescents and young adults. Mol Psychiatry 2025; 30:1089-1101. [PMID: 39333385 PMCID: PMC11835756 DOI: 10.1038/s41380-024-02758-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/12/2024] [Accepted: 09/18/2024] [Indexed: 09/29/2024]
Abstract
Neurodevelopmental mechanisms are increasingly implicated in bipolar disorder (BD), highlighting the importance of their study in young persons. Neuroimaging studies have demonstrated a central role for frontotemporal corticolimbic brain systems that subserve processing and regulation of emotions, and processing of reward in adults with BD. As adolescence and young adulthood (AYA) is a time when fully syndromal BD often emerges, and when these brain systems undergo dynamic maturational changes, the AYA epoch is implicated as a critical period in the neurodevelopment of BD. Functional magnetic resonance imaging (fMRI) studies can be especially informative in identifying the functional neuroanatomy in adolescents and young adults with BD (BDAYA) and at high risk for BD (HR-BDAYA) that is related to acute mood states and trait vulnerability to the disorder. The identification of early emerging brain differences, trait- and state-based, can contribute to the elucidation of the developmental neuropathophysiology of BD, and to the generation of treatment and prevention targets. In this critical review, fMRI studies of BDAYA and HR-BDAYA are discussed, and a preliminary neurodevelopmental model is presented based on a convergence of literature that suggests early emerging dysfunction in subcortical (e.g., amygdalar, striatal, thalamic) and caudal and ventral cortical regions, especially ventral prefrontal cortex (vPFC) and insula, and connections among them, persisting as trait-related features. More rostral and dorsal cortical alterations, and bilaterality progress later, with lateralization, and direction of functional imaging findings differing by mood state. Altered functioning of these brain regions, and regions they are strongly connected to, are implicated in the range of symptoms seen in BD, such as the insula in interoception, precentral gyrus in motor changes, and prefrontal cortex in cognition. Current limitations, and outlook on the future use of neuroimaging evidence to inform interventions and prevent the onset of mood episodes in BDAYA, are outlined.
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Affiliation(s)
- Lejla Colic
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
- German Center for Mental Health, partner site Halle-Jena-Magdeburg, Jena, Germany
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Anjali Sankar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Neurobiology Research Unit, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Danielle A Goldman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, USA
| | - Jihoon A Kim
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.
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Wedasingha N, Samarasinghe P, Senevirathna L, Papandrea M, Puiatti A. Autoencoder based data clustering for identifying anomalous repetitive hand movements, and behavioral transition patterns in children. Phys Eng Sci Med 2025; 48:221-238. [PMID: 39836324 DOI: 10.1007/s13246-024-01507-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 12/04/2024] [Indexed: 01/22/2025]
Abstract
The analysis of repetitive hand movements and behavioral transition patterns holds particular significance in detecting atypical behaviors in early child development. Early recognition of these behaviors holds immense promise for timely interventions, which can profoundly impact a child's well-being and future prospects. However, the scarcity of specialized medical professionals and limited facilities has made detecting these behaviors and unique patterns challenging using traditional manual methods. This highlights the necessity for automated tools to identify anomalous repetitive hand movements and behavioral transition patterns in children. Our study aimed to develop an automated model for the early identification of anomalous repetitive hand movements and the detection of unique behavioral patterns. Utilizing autoencoders, self-similarity matrices, and unsupervised clustering algorithms, we analyzed skeleton and image-based features, repetition count, and frequency of repetitive child hand movements. This approach aimed to distinguish between typical and atypical repetitive hand movements of varying speeds, addressing data limitations through dimension reduction. Additionally, we aimed to categorize behaviors into clusters beyond binary classification. Through experimentation on three datasets (Hand Movements in Wild, Updated Self-Stimulatory Behaviours, Autism Spectrum Disorder), our model effectively differentiated between typical and atypical hand movements, providing insights into behavioral transitional patterns. This aids the medical community in understanding the evolving behaviors in children. In conclusion, our research addresses the need for early detection of atypical behaviors through an automated model capable of discerning repetitive hand movement patterns. This innovation contributes to early intervention strategies for neurological conditions.
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Affiliation(s)
- Nushara Wedasingha
- Faculty of Engineering, Sri Lanka Institute of Information Technology, New Kandy Rd, Malabe, Colombo, 10115, Sri Lanka.
| | - Pradeepa Samarasinghe
- Faculty of Computing, Sri Lanka Institute of Information Technology, New Kandy Rd, Malabe, Colombo, 10115, Sri Lanka
| | - Lasantha Senevirathna
- Faculty of Engineering, Sri Lanka Institute of Information Technology, New Kandy Rd, Malabe, Colombo, 10115, Sri Lanka
| | - Michela Papandrea
- Information Systems and Networking Institute (ISIN), University of Applied Sciences and Arts of Southern Switzerland, Via Pobiette, Manno, 6928, Manno, Switzerland
| | - Alessandro Puiatti
- Institute of Digital Technologies for Personalized Healthcare (MeDiTech), University of Applied Sciences and Arts of Southern Switzerland, Via Pobiette, Manno, 6928, Manno, Switzerland
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Betz AK, Cetin-Karayumak S, Bonke EM, Seitz-Holland J, Zhang F, Pieper S, O'Donnell LJ, Tripodis Y, Rathi Y, Shenton ME, Koerte IK. Executive functioning, behavior, and white matter microstructure in the chronic phase after pediatric mild traumatic brain injury: results from the adolescent brain cognitive development study. Psychol Med 2024; 54:2133-2143. [PMID: 38497117 DOI: 10.1017/s0033291724000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Mild traumatic brain injury (mTBI) is common in children. Long-term cognitive and behavioral outcomes as well as underlying structural brain alterations following pediatric mTBI have yet to be determined. In addition, the effect of age-at-injury on long-term outcomes is largely unknown. METHODS Children with a history of mTBI (n = 406; Mage = 10 years, SDage = 0.63 years) who participated in the Adolescent Brain Cognitive Development (ABCD) study were matched (1:2 ratio) with typically developing children (TDC; n = 812) and orthopedic injury (OI) controls (n = 812). Task-based executive functioning, parent-rated executive functioning and emotion-regulation, and self-reported impulsivity were assessed cross-sectionally. Regression models were used to examine the effect of mTBI on these domains. The effect of age-at-injury was assessed by comparing children with their first mTBI at either 0-3, 4-7, or 8-10 years to the respective matched TDC controls. Fractional anisotropy (FA) and mean diffusivity (MD), both MRI-based measures of white matter microstructure, were compared between children with mTBI and controls. RESULTS Children with a history of mTBI displayed higher parent-rated executive dysfunction, higher impulsivity, and poorer self-regulation compared to both control groups. At closer investigation, these differences to TDC were only present in one respective age-at-injury group. No alterations were found in task-based executive functioning or white matter microstructure. CONCLUSIONS Findings suggest that everyday executive function, impulsivity, and emotion-regulation are affected years after pediatric mTBI. Outcomes were specific to the age at which the injury occurred, suggesting that functioning is differently affected by pediatric mTBI during vulnerable periods. Groups did not differ in white matter microstructure.
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Affiliation(s)
- Anja K Betz
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Suheyla Cetin-Karayumak
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Elena M Bonke
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Inga K Koerte
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Alamr F, Alzahrani HMA, Alghamdi AMA, Alzhrani ASA, Alzahrani FAA, Alkhediwi LMA, Alghamdi MAA, Alhomrani MAM, Aburaida OM. Prevalence and Risk Factors of Home Accidents Among Children Under Five Years of Age in Al-Baha, Saudi Arabia. Cureus 2023; 15:e46846. [PMID: 37954756 PMCID: PMC10637285 DOI: 10.7759/cureus.46846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
INTRODUCTION Internationally, home accidents are the main cause of preventable debilities and death among children and young persons. Many times, children survive accidents with physical or mental damage that curtails their activities in the long term. The most commonly reported accidental injuries include head injuries, open wounds, and poisoning. This study aims to assess the prevalence and factors associated with home accidents among children under five years old in the Al-Baha region, Saudi Arabia. METHODS A descriptive cross-sectional study was conducted among the community population in the Al-Baha region, Saudi Arabia, targeting all accessible parents who have children under five years old. A convenience sampling technique was used for sample collection during the period of three months (May 2023 to July 2023), where all accessible parents who fulfilled the inclusion criteria and agreed to participate were invited to fill out the received online study questionnaire. Section 1 covered the participants' demographic data. The second section covered the children's data and the third section included questions about home accident types, frequency, severity, and causes. Results: The findings showed that 205 (58.2%) study parents reported a history of home accidents among their children. As for accident data, about 122 (59.5%) of the injured children were males. The most reported home accidents among children were fall/impact with hard objects (58.2%), burn (30.7%), asphyxia (27.6%), and poisoning (24.4%). Families with more than seven members and those with four or more siblings significantly experienced higher home accidents than others (p<0.001). CONCLUSION In conclusion, the current study showed that home accidents among children under five years of age were mainly falls and burns; they were mainly found among male children and children in families with highly educated mothers and many kids. A majority of the reported cases of home accidents were less severe and the hospitalization rates with complications were very few.
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Affiliation(s)
- Fahad Alamr
- College of Medicine, Al-Baha University, Al-Baha, SAU
| | | | | | | | | | | | | | | | - Omer M Aburaida
- Paediatrics and Child Health, College of Medicine, Al-Baha University, Al-Baha, SAU
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Chang MC. Pediatric Physical Medicine and Rehabilitation. CHILDREN (BASEL, SWITZERLAND) 2022; 9:954. [PMID: 35883938 PMCID: PMC9323241 DOI: 10.3390/children9070954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/22/2022]
Abstract
Pediatric rehabilitation medicine is a discipline that enables children with acquired or congenital disabilities to reach their maximum physical, mental, social, occupational, and educational potential [...].
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu 38541, Korea
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Sutapa P, Pratama KW, Rosly MM, Ali SKS, Karakauki M. Improving Motor Skills in Early Childhood through Goal-Oriented Play Activity. CHILDREN (BASEL, SWITZERLAND) 2021; 8:994. [PMID: 34828707 PMCID: PMC8625902 DOI: 10.3390/children8110994] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. PURPOSE The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. METHODS Forty children aged 4.5-6 years old were recruited and took part in a set of training activities divided into Posts 1-5. To pass each post, a child had to run, walk on a balance beam, move sticks, throw and catch the ball, and arrange blocks. Training was given three times every week for 12 weeks. Data collected consisted of running 25 m, walking on the balance beam, throwing the ball as far as possible, locomotor movement, arranging cans, and bouncing the ball. Paired t and Wilcoxon signed-rank tests were used for analysis. RESULTS The results showed that there were significant differences in the motor skills evaluated pre- and post-training with p < 0.05. Conclusion: All six training activities conducted for 12 weeks provided significant improvements in the motor skills areas in children aged 4.5-6 years old.
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Affiliation(s)
- Panggung Sutapa
- Department of Sport Science, Faculty of Sport Science, Yogyakarta State University, Yogyakarta 55281, Indonesia
| | - Kukuh Wahyudin Pratama
- Department of Sport Science Research and Development, Institute of Advanced Science, Engineering, and Education (IASEE), Shah Alam 40150, Malaysia;
| | - Maziah Mat Rosly
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Syed Kamaruzaman Syed Ali
- Department of Physical Education and Health, Faculty of Education, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.K.S.A.); (M.K.)
| | - Manil Karakauki
- Department of Physical Education and Health, Faculty of Education, University of Malaya, Kuala Lumpur 50603, Malaysia; (S.K.S.A.); (M.K.)
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