Background
Difficulties in emotion processing and poor social function are common to bipolar
disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD
depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated
in processing emotionally salient stimuli, including emotional facial expressions.
It is unclear, however, whether abnormal amygdala activity during positive and negative
emotion processing represents a persistent marker of BD regardless of illness phase
or a state marker of depression common or specific to BD and MDD depression.
Methods
Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with
recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured
Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects
(HC). Groups were age- and gender ratio-matched; patient groups were matched for age
of illness onset and illness duration; depressed groups were matched for depression
severity. The BDd were taking more psychotropic medication than other patient groups.
All individuals participated in three separate 3T neuroimaging event-related experiments,
where they viewed mild and intense emotional and neutral faces of fear, happiness,
or sadness from a standardized series.
Results
The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild
and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication.
There were no other significant between-group differences in amygdala activity.
Conclusions
Abnormally elevated left amygdala activity to mild sad and neutral faces might be
a depression-specific marker in BD but not MDD, suggesting different pathophysiologic
processes for BD versus MDD depression.
Key Words
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Article info
Publication history
Published online: November 23, 2009
Accepted:
September 23,
2009
Received in revised form:
August 26,
2009
Received:
June 5,
2009
Identification
Copyright
© 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
