Grant: Project Grant

An American Heart Association Scientific Statement positioned bipolar disorder (BD) as a condition that predisposes youth to excessive and premature heart disease. Importantly, the increased risk of heart disease in BD is above-and-beyond what can be explained by traditional heart disease risk factors (e.g. high blood pressure, obesity), diet, physical activity, or medications. We will measure the function and structure of small blood-vessels in the brain, heart, retina, and finger in order to better understand how they relate to BD, heart disease risk, and cognition. This study will enroll 300 teens: 240 at high-risk for heart disease due to having BD (n=120), having a parent with BD (n=60), or having a parent with heart disease (n=60), and 60 healthy comparison teens. Small-vessels will be measured using MRI of the brain and the heart, photographs of retinal vessels in the eyes, and blood vessel functioning in the fingers. Cardiovascular risk factors will be measured according to International Diabetes Federation criteria. Inflammation will be measured using standard scientific protocols. Cognition will be measured using a computerized touch-screen program. This study will look at factors that predict small-vessel problems, such as inflammation, exercise, diet, and use of substances. Participants will return after 2-years to measure changes in these variables. This study will examine differences between groups in regards to the above variables, and will determine how these variables change over 2-years. We predict that teens with BD will have poorer traits than healthy comparison teens in several areas. The investigative team includes experts in all study areas, including psychiatry, ophthalmology, cardiology, MRI, neurocognition, and inflammation. Once completed, this study will advance the perspective that BD is in part a disease of problematic small blood-vessels. This in turn will lead to new approaches to diagnosis, monitoring, and treatment.