Background
The pathophysiology of abnormal mood states–mania and depression–in patients with
bipolar disorder remains unclear. Facial affect processing paradigms are an effective
way of studying behavioral and functional magnetic resonance imaging (fMRI) correlates
of affective disorders.
Methods
We used a factorial design to measure the neural correlates of tasks, tapping explicit
and implicit recognition of sad, fearful, and happy facial expressions using event-related
fMRI paradigms in three groups of participants: eight bipolar depressed patients,
eight bipolar manic patients, and eight control subjects.
Results
Depressed and manic patients exhibited overactivated responses to fearful faces, as
well as to mood-incongruent facial expressions, with the depressed group exhibiting
overactivity in fronto-striato-thalamic systems in response to happy faces and the
manic group exhibiting overactivity in the fusiform gyrus in response to sad faces.
For manic patients, task type also affected the neural response to sad faces, with
the corticolimbic regions showing overactivation for implicit processing and underactivation
for explicit processing.
Conclusions
Depressed and manic patients exhibited abnormal neural responses to sad, fearful,
and happy facial expressions. Additionally, the attentional level of sad facial affect
processing has important consequences for abnormalities of amygdala and cingulate
activation in manic patients.
Key Words
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Article info
Publication history
Published online: August 22, 2005
Accepted:
June 7,
2005
Received in revised form:
May 12,
2005
Received:
February 25,
2005
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
