Distinguishing Remitted Bipolar Disorder from Remitted Unipolar Depression in Pre-Adolescent Children: A Neural Reward Processing Perspective

Bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), highlighting the need to identify clinically useful markers to differentiate them. To provide insights into this endeavor, the current study will employ functional magnetic resonance imaging and conduct region-of-interest (ROI; ventral striatum and orbitofrontal cortex), whole-brain, and connectivity analyses to examine the similarities and differences between children with BD, children with UD, and healthy controls (HCs) in brain activation patterns and functional coupling between brain regions within the context of reward processing, as evoked by the Monetary Incentive Delay task. The current study represents the first examination of neural reward processing in preadolescent children with remitted BD or UD. We aim to (a) test whether preadolescent children with remitted BD or UD display abnormal patterns of neural activation and connectivity in response to reward, relative to HCs and (b) compare remitted UD and BD directly with each other to evaluate whether they can be distinguished by neural activation and connectivity during reward processing