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Objectives Vascular‐brain associations are well established in adults but neglected in youth and psychiatric populations, who are at greater cardiovascular risk. We therefore examined the association of retinal vascular caliber with regional brain structure in adolescents with and without bipolar disorder (BD). Methods One hundred and three adolescents (n = 51 BD, n = 52 healthy control [HC]) completed retinal fundus imaging, yielding arteriolar and venular diameters, followed by T1‐weighted 3‐Tesla MRI. Region of interest (ROI) analyses examined ventrolateral prefrontal cortex (vlPFC) and ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), amygdala, and hippocampus, complemented by vertex‐wise analyses. Linear regression assessed the association between retinal measures and brain structure, adjusting for covariates including age, sex, BMI, and intracranial volume (ICV). Results In the overall sample, arteriolar caliber was negatively associated with ACC volume (β = −0.20, puncorrected = .046) and surface area (β = −0.19, puncorrected = .049). There were no other significant ROI findings. Vertex‐wise analyses detected several significant positive bilateral associations of arteriovenous ratio (AVR) with volume and surface area in regions including rostral middle frontal gyrus (left p = .001; right p = .006), isthmus cingulate cortex (left and right p

Background Early-onset Bipolar Disorder (BD) is associated with a more severe illness as well as a number of clinical factors amongst adults. Early-onset can be categorised as childhood- (age

Premature cardiovascular disease, occurring over a decade earlier in bipolar disorder as compared with the general population, contributes significantly to early mortality. This association cannot be explained by medication use, lifestyle, or traditional cardiovascular risk factors alone. Negative clinical outcomes, including amount of time spent symptomatic, suicide risk, and number of psychiatric comorbidities, are all notably elevated in patients at higher cardiovascular risk. In spite of robust data that support significantly elevated risk and burden within bipolar disorder, clinical training still does not underscore this link, and little focus has been placed on intentionally targeting the vascular system to ameliorate psychiatric symptoms. Numerous emerging cardiovascular biomarkers may help to better explain this vascular-bipolar link and uncover underlying pathophysiology and new treatment targets.