Working memory training in adolescents with pediatric bipolar disorder

Institution: University of Illinois, Chicago Investigator(s): A. M. Passarotti, Ph.D., M.N. Pavuluri, M.D., Ph.D. Program: Cogmed RM Background & Aim: Severe WM deficits can co-exist with affective dysregulation in pediatric bipolar disorder (PBD) and, if left untreated, contribute to difficulties and delays in a cluster of cognitive areas including learning, concentration, academic performance, and frustration tolerance. The vast majority of current interventions for PBD focus on affect dysregulation, viewing cognitive problems as secondary issues that may improve with mood stabilization. However, cognitive problems often persist during inter-episodic periods, despite successful treatments for mania or depression. Additionally, these cognitive deficits persist over a three-year longitudinal study, with children suffering from PBD lagging behind and substantially increasing the gap in performance relative to healthy peers (HC). To complicate matters, medications that remediate affect dysfunction fail to fully address cognitive deficits in PBD and some patients worsen with stimulants prescribed for cognitive deficits. Hence, a non-pharmacological intervention approach to cognitive remediation appears as a promising alternative. The aim of this study is to use the Cogmed for school-age children to target neuroplastic brain functional changes in adolescents with pediatric bipolar disorder (PBD) who also have working memory deficits. Using fMRI methods, researchers will map WM functions onto discrete biological circuits, and then elucidate how the WM intervention relates to changes in these circuits in PBD. Participants will train using Cogmed RM in combination with an affective module has been added to go along with the cognitive module, which provides words of encouragement to the participants. Population & Sample Size: N = 60 (n = 30 stimulant naïve adolescents with PDB (Type I & II) ages 10 -16 years old and n = 30 typically functioning adolescents, ages 10-16 years old) Design: Age-matched healthy no-contact controlled, Test-retest, 4 Month Follow Up, fMRI