Reward/behavioral approach system hypersensitivity is implicated in bipolar disorders (BD) and in normative
development during adolescence. Pediatric onset of BD is associatedwith a more severe illness course. However,
little is known about neural processing of rewards in adolescents with BD or developmental (i.e., age) associations
with activation of these neural systems. The present study aims to address this knowledge gap. The present
sample included 21 adolescents with BD and 26 healthy adolescents, ages 13 to 19. Participants completed a
functional magnetic resonance imaging (fMRI) protocol using the Monetary Incentive Delay (MID) task. Behavioral
performance was similar between groups. Group differences in BOLD activation during target anticipation
and feedback anticipation periods of the task were examined using whole-brain analyses, as were group differences
in age effects. During both target anticipation and feedback anticipation, adolescents with BD, compared
to adolescents without psychopathology, exhibited decreased engagement of frontal regions involved in cognitive
control (i.e., dorsolateral prefrontal cortex). Healthy adolescents exhibited age-related decreases, while adolescents
with BD exhibited age-related increases, in activity of other cognitive control frontal areas (i.e., right
inferior frontal gyrus), suggesting altered development in the BD group. Longitudinal research is needed to examine
potentially abnormal development of cognitive control during reward pursuit in adolescent BD and whether
early therapeutic interventions can prevent these potential deviations from normative development.