Background
Studies incorporating direct comparisons across all phases of bipolar (BP) disorder
are needed to elucidate the pathophysiology of bipolar disorder. However, functional
neuroimaging studies that differentiate bipolar mood states from each other and from
healthy subjects are few and have yielded inconsistent findings.
Methods
One hundred five unmedicated adults were recruited: 30 with current bipolar depression
(BPD), 30 with current bipolar hypomania or mania (BPM), 15 bipolar euthymic (BPE),
and 30 healthy control subjects (HC). All subjects were diagnosed with DSM-IV BP (type
I or II) using a structured clinical interview. Groups were age- and gender-ratio
matched. In 3T functional magnetic resonance imaging experiments, subjects completed
a negative facial emotion matching task.
Results
Bipolar euthymic and BPD groups exhibited increased amygdala activation compared with
HCs in response to the negative faces; however, in the BPM group, this increase was
not seen. Conversely, both BPE and BPM groups had increased activation in the insula
relative to HCs, but in the BPD group, this effect was not seen. All three BP groups
exhibited increased activation of the putamen compared with HCs. In the cortical areas,
the BPM group exhibited decreased left lateral orbitofrontal cortex activation compared
with both BPEs and HCs, increased dorsal anterior cingulate cortex activation compared
with the BPD group, and increased dorsolateral prefrontal cortical activation compared
with all other groups.
Conclusions
Both state- and trait-related abnormalities in corticolimbic activation were seen
in response to the negative facial emotion processing in a large sample of unmedicated
adults across BP mood states.
Key Words
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References
- Elevated amygdala activity to sad facial expressions: A state marker of bipolar but not unipolar depression.Biol Psychiatry. 2010; 67: 414-421
- Subgenual prefrontal cortex abnormalities in mood disorders.Nature. 1997; 386: 824-827
- Neurobiology of emotion perception II: Implications for major psychiatric disorders.Biol Psychiatry. 2003; 54: 515-528
- Anomalous prefrontal-subcortical activation in familial pediatric bipolar disorder: A functional magnetic resonance imaging investigation.Arch Gen Psychiatry. 2004; 61: 781-792
- Regional brain changes in bipolar I depression: A functional magnetic resonance imaging study.Bipolar Disord. 2008; 10: 708-717
- fMRI during affect discrimination in bipolar affective disorder.Bipolar Disord. 2000; 2: 237-248
- Abnormal left and right amygdala-orbitofrontal cortical functional connectivity to emotional faces: State versus trait vulnerability markers of depression in bipolar disorder.Biol Psychiatry. 2010; 67: 422-431
- Abnormal ventral frontal response during performance of an affective go/no go task in patients with mania.Biol Psychiatry. 2004; 55: 1163-1170
- Increased anterior cingulate and caudate activity in bipolar mania.Biol Psychiatry. 2000; 48: 1045-1052
- Behavioural and neurocognitive responses to sad facial affect are attenuated in patients with mania.Psychol Med. 2004; 34: 795-802
- Explicit and implicit facial affect recognition in manic and depressed states of bipolar disorder: A functional magnetic resonance imaging study.Biol Psychiatry. 2006; 59: 31-39
- Evidence for deficient modulation of amygdala response by prefrontal cortex in bipolar mania.Psychiatry Res. 2008; 162: 27-37
- A functional magnetic resonance imaging study of bipolar disorder: State- and trait-related dysfunction in ventral prefrontal cortices.Arch Gen Psychiatry. 2003; 60: 601-609
- Decision-making in mania: A PET study.Brain. 2001; 124: 2550-2563
- Cognitive generation of affect in hypomania: An fMRI study.Bipolar Disord. 2004; 6: 271-285
- A longitudinal fMRI study of the manic and euthymic states of bipolar disorder.Bipolar Disord. 2010; 12: 344-347
- Increased amygdala activation during mania: A functional magnetic resonance imaging study.Am J Psychiatry. 2005; 162: 1211-1213
- Elevated striatal and decreased dorsolateral prefrontal cortical activity in response to emotional stimuli in euthymic bipolar disorder: No associations with psychotropic medication load.Bipolar Disord. 2008; 10: 916-927
- Role of variation in the serotonin transporter protein gene (SLC6A4) in trait disturbances in the ventral anterior cingulate in bipolar disorder.Neuropsychopharmacology. 2009; 34: 1301-1310
- Fronto-limbic circuitry in euthymic bipolar disorder: Evidence for prefrontal hyperactivation.Psychiatry Res. 2008; 164: 106-113
- Trait and state dependent functional impairments in bipolar disorder.Psychiatry Res. 2010; 184: 135-142
- The functional neuroanatomy of bipolar disorder: A review of neuroimaging findings.Mol Psychiatry. 2005; 10: 105-116
- A rating scale for depression.J Neurol Neurosurg Psychiatry. 1960; 23: 56-62
- A rating scale for mania: Reliability, validity and sensitivity.Br J Psychiatry. 1978; 133: 429-435
- Serotonin transporter genetic variation and the response of the human amygdala.Science. 2002; 297: 400-403
- The NimStim set of facial expressions: Judgments from untrained research participants.Psychiatry Res. 2009; 168: 242-249
- A default mode of brain function.Proc Natl Acad Sci U S A. 2001; 98: 676-682
- Frontostriatal abnormalities in adolescents with bipolar disorder: Preliminary observations from functional MRI.Am J Psychiatry. 2003; 160: 1345-1347
- Neuroimaging in bipolar disorder.Bipolar Disord. 2000; 2: 148-164
- Striatal structure and function in mood disorders: A comprehensive review.Bipolar Disord. 2010; 12: 764-785
- Basal ganglia-thalamocortical circuits: Parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions.Prog Brain Res. 1990; 85: 119-146
- How do you feel - now?.Nat Rev Neurosci. 2009; 10: 59-70
- Circuitry and functional aspects of the insular lobe in primates including humans.Brain Res Rev. 1996; 22: 229-244
- Selective attention to emotional stimuli in a verbal go/no-go task: An fMRI study.Neuroreport. 2000; 11: 1739-1744
- Fronto-striatal overactivation in euthymic bipolar patients during an emotional go/nogo task.Am J Psychiatry. 2007; 164: 638-646
- Abnormal facial emotion recognition in depression: Serial testing in an ultra-rapid-cycling patient.Behav Modif. 1998; 22: 192-204
- Resolving emotional conflict: A role for the rostral anterior cingulate cortex in modulating activity in the amygdala.Neuron. 2006; 51: 871-882
- Impaired recognition of affect in facial expression in depressed patients.Biol Psychiatry. 1992; 31: 947-953
- Serial pathways from primate prefrontal cortex to autonomic areas may influence emotional expression.BMC Neurosci. 2003; 4: 25
- Sequence of information processing for emotions based on the anatomic dialogue between prefrontal cortex and amygdala.Neuroimage. 2007; 34: 905-923
- The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans.Cereb Cortex. 2000; 10: 206-219
- Prevalence and correlates of bipolar spectrum disorder in the World Mental Health Survey Initiative.Arch Gen Psychiatry. 2011; 68: 241-251
- The amygdala response to emotional stimuli: A comparison of faces and scenes.Neuroimage. 2002; 17: 317-323
- Modulating emotional responses: Effects of a neocortical network on the limbic system.Neuroreport. 2000; 11: 43-48
- A susceptibility gene for affective disorders and the response of the human amygdala.Arch Gen Psychiatry. 2005; 62: 146-152
- Neutral faces activate the amygdala during identity matching.Neuroimage. 2006; 29: 628-636
- Subcortical and ventral prefrontal cortical neural responses to facial expressions distinguish patients with bipolar disorder and major depression.Biol Psychiatry. 2004; 55: 578-587
Article info
Publication history
Published online: December 30, 2011
Accepted:
October 29,
2011
Received in revised form:
October 10,
2011
Received:
July 25,
2011
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
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