Abstract
Background
Even in remission, patients with bipolar disorder (BD) remain sensitive to external
stressors that can trigger new episodes. Imitating such stressors by the controlled
transient exposure to an emotional stimulus may help to identify brain regions modulating
this sensitivity.
Methods
Transient sadness was induced in 9 euthymic and in 11 depressed subjects with BD.
Regional blood flow (rCBF) changes were measured using 15O-water positron emission tomography.
Results
Common changes in both groups were increased rCBF in anterior insula and cerebellum
and decreased rCBF in dorsal-ventral-medial frontal cortex, posterior cingulate, inferior
parietal, and temporal cortices. Decreases in dorsal ventral medial frontal cortices
occurred in both groups, but subjects in remission showed a greater magnitude of change.
Unique to remitted subjects with BD were rCBF increases in dorsal anterior cingulate
and in premotor cortex. Lateral prefrontal rCBF decreases were unique to depressed
subjects with BD. At baseline, remitted subjects showed a unique increase in dorsal
anterior cingulate and orbitofrontal cortex.
Conclusions
Common rCBF changes in remitted and depressed subjects identifies potential sites
of disease vulnerability. Unique cingulate and orbitofrontal changes both at baseline
and with induced sadness seen in the absence of prefrontal rCBF decreases may identify
regional interactions important to the euthymic state in this population.
Keywords
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Article info
Publication history
Accepted:
June 19,
2003
Received in revised form:
June 16,
2003
Received in revised form:
June 16,
2003
Received:
January 13,
2003
Identification
Copyright
© 2003 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
