# Course and Outcome of Bipolar Disorder in Youth - Supplement

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2021 · $64,312

## Abstract

Project Summary/Abstract - no change from original
The Course and Outcome of Bipolar Disorders in Youth (COBY) study has comprehensively characterized the
clinical course of a large sample of youth with bipolar disorder (BD), and has identified demographic and
clinical factors that are associated with different illness courses. To date, however, COBY has not included
neuroimaging assessments. Including such assessments now will allow, for the first time, an evaluation of the
impact of 13-year course of BD and treatment upon neural circuitry function and structure. Furthermore, the
majority of COBY participants are currently between 18-30 years old, when the brain, and prefrontal cortex in
particular, continues to develop. Including neuroimaging assessments in COBY participants now can thus take
advantage of the neurodevelopmental processes occurring between 18-30 years where there are unique
opportunities to intervene therapeutically to help normalize abnormalities in neural functioning and structure.
Focusing on this age range will also provide a critically important opportunity to determine the extent to which
neuroimaging measures predict future clinical course in adulthood. Having normal prefrontal cortical function
and structure may predict better clinical course in adulthood, even in COBY participants with poor clinical
course in youth, and may lead to decisions to reduce, or even stop, specific treatments in these individuals. In
the proposed study, we will determine how previous BD clinical course (e.g., % time with mood symptoms vs.
euthymic; % time with comorbid disorders) and treatment exposure from childhood into adulthood impacts
neural circuitry functioning and structure supporting key NIMH RDoC information processing domains, and
compare neuroimaging findings in COBY participants with those of demographically-matched healthy controls
(Aim 1). We will also determine whether neuroimaging measures predict illness course in adulthood, beyond
demographic and clinical factors, and previous clinical course in youth (Aim 2). We will use machine learning
to explore patterns of wholebrain functioning, white and gray matter structure, and clinical and demographic
measures, that most accurately predict future clinical course at the individual subject level. The proposed study
also provides a valuable opportunity to inform the field regarding the clinical and functional course and
outcome from youth into adulthood in a large, well-characterized sample of people with BD. This is important
because the clinical outcome of BD youth in adulthood remains uncertain, as only two studies with a total of 72
subjects followed BD youth into their early twenties. Structural and functional neuroimaging techniques will be
employed in a representative subsample of COBY participants (n=120), and healthy controls (n=50).
Comprehensive assessments of psychopathology and functioning will be collected at the time of neuroimaging,
and twice more during the proposed ...

## Key facts

- **NIH application ID:** 10397801
- **Project number:** 3R01MH059929-20S1
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** BORIS BIRMAHER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $64,312
- **Award type:** 3
- **Project period:** 2021-07-19 → 2022-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10397801

## Citation

> US National Institutes of Health, RePORTER application 10397801, Course and Outcome of Bipolar Disorder in Youth - Supplement (3R01MH059929-20S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10397801. Licensed CC0.

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