Pediatric Psychiatry Hospitalized Patients’ Amygdala Basal Activity Varies from Control
Keywords:
Psychosis, Amygdala, Resting state-functional magnetic resonance imaging (rs-fMRI), Magnetic resonance imaging (MRI), Independent component analysis (ICA), Default mode, Connectivity, EpilepsyAbstract
Introduction
Patients with psychiatric disorders needing inpatient care often display aggression, fear, anxiety. These emotional proccesses are typically ascribed to the amygdala, as indicated by multiple publications. However, very few of these studies have been done with patients of the pediatric or adolescent population. The goal of our research was to analyze a hypothesized increase on the activity of the amygdala in patients being admitted for a psychiatric reason.
Method
We retrospectively analyzed a group of 168 patients with a primary psychiatric diagnosis that were hospitalized at Nicklaus Children’s Hospital, Miami, Florida between the years 2010 and 2017 and who had a resting state functional magnetic resonance imaging (fMRI) as part of the neuroimage work-up for psychiatric symptoms. Primary diagnosis included major depressive disorder, bipolar disorder and schizophrenia. The comparison group consisted of 75 hospitalized pediatric patients with intractable epilepsy and no past psychiatric history. This comparison group was chosen due to the large number of imaging studies available done in an identical hospital setting.
Results
The results of our study showed a considerable increase in the frequency of identified networks in the amygdala in psychotic patients vs comparison group with intractable epilepsy. The percentage of patients with identified networks that show an increase in amygdala activation in the epileptic group was 10.7%. The percentage of patients that showed an increase in amygdala network activation in the psychiatric group was 50.0%.
Discussion
This study suggests that children with severe psychiatric conditions requiring in-patient care have a statistically significant increase in basal amygdala activation compared to a control group with intractable epilepsy. Our findings require further development and refinement to ascertain which specific etiologies or symptoms are more related to the finding. This may ultimately evolve into a radiological biomarker for a specific psychiatric condition with potential to guide future treatment.
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