Deficits in frontoparietal activation and anterior insula functional connectivity during regulation of cognitive‐affective interference in bipolar disorder

Abstract

Objectives: Bipolar disorders (BD) are characterized by emotion and cognitive dysregulation. Mapping deficits in the neurocircuitry of cognitive-affective regulation allows for potential identification of intervention targets. This study used functional MRI data in BD patients and healthy controls during performance on a task requiring cognitive and inhibitory control superimposed on affective images, assessing cognitive and affective interference. Methods: Functional MRI data were collected from 39 BD patients and 36 healthy controls during performance on the Multi-Source Interference Task overlaid on images from the International Affective Picture System (MSIT-IAPS). Analyses examined patterns of activation in a priori regions implicated in cognitive and emotional processing. Functional connectivity to the anterior insula during task performance was also examined, given this region's role in emotion-cognition integration. Results: BD patients showed significantly less activation during cognitive interference trials in inferior parietal lobule, dorsomedial prefrontal cortex, anterior insula, mid-cingulate, and ventrolateral prefrontal cortex regardless of affective valence. BD patients showed deviations in functional connectivity with anterior insula in regions of the default mode and frontoparietal control networks during negatively valenced cognitive interference trials. Conclusions: Our findings show disruptions in cognitive regulation and inhibitory control in BD patients in the presence of irrelevant affective distractors. Results of this study suggest one pathway to dysregulation in BD is through inefficient integration of affective and cognitive information, and highlight the importance of developing interventions that target emotion-cognition integration in BD. K E Y W O R D S bipolar disorder, cognition, emotion regulation, fMRI, Multi Source Interference Task | 245 ELLARD Et AL.

Altered functional activity in bipolar disorder: A comprehensive review from a large‐scale network perspective

“…For ROI‐based studies, findings indicated reduced intranetwork functional connectivity at rest for networks belonging to the 3 major large‐scale RSNs, which are the DMN (Anticevic et al., 2013; Ellard et al., 2019; Gong et al., 2019; Liu et al., 2019; Magioncalda et al., 2015), CEN (Baker et al., 2014), and SAN (Gong et al., 2019; Karcher et al., 2019; Magioncalda et al., 2015; Mamah et al., 2013; Pang et al., 2018; Sheffield et al., 2017). In addition, the intranetwork functional connectivity of the LIM (Dvorak et al., 2019) was also decreased as compared to the respective control group.…”

“…In addition, the intranetwork functional connectivity of the LIM (Dvorak et al., 2019) was also decreased as compared to the respective control group. Interestingly, in the case of the CEN and DMN, the functional connectivity within the network during a task‐based stimuli such as emotion recognition or cognitive tasks were opposite in polarity with respect to at rest, with increased intranetwork functional connectivity of the CEN (Dell'Osso et al, 2015; Ellard et al., 2019) and DMN (Marchand et al., 2014) in individuals with bipolar disorder compared to their respective healthy control groups. A visual representation of the intranetwork functional connectivity alterations of the 3 major large‐scale RSNs at rest for individuals with bipolar disorder, compared to the respective healthy control group, is shown in Figure 2.…”

“…Among the large‐scale networks, the functional alteration of regions that make up the DMN were the most prevalent across studies. Specifically, some of the key regions that demonstrated significantly altered functional connectivity were the medial prefrontal cortex (mPFC) (Chai et al., 2011; Anticevic et al., 2013; Favre et al., 2014; Rey et al., 2016; Rodríguez‐Cano et al, 2017; Chen et al., 2019; Gong et al., 2019; Luo et al., 2018), posterior cingulate cortex (PCC) (Townsend et al., 2013; Magioncalda et al., 2015; Rey et al., 2016; Wang, Zhong, et al, 2018; Ellard et al., 2019; Gong et al., 2019), precuneus (Pang et al., 2018; Wang, Zhong, et al, 2018; He et al., 2019; Liu et al., 2019), and superior frontal gyrus (SFG) (Marchand et al., 2014; Rodríguez‐Cano et al, 2017; Karcher et al., 2019). Studies that selected the mPFC as one of the ROIs found reduced global brain connectivity of the mPFC with respect to the rest of the frontal cortex (Anticevic et al., 2013), as well as reduced functional connectivity between the mPFC and other regions of the DMN such as the PCC (Gong et al., 2019).…”

Altered Functional Integration in the Salience and Default Mode Networks in Euthymic Pediatric Bipolar Disorder

“…The TPJ, which is located at the ventral-anterior section of the inferior parietal lobule and the posterior end of the superior temporal sulcus, is thought to either shift attention to goal-directed cognitive processing or understand others' mental state [ 24 – 26 ]. A recent task fMRI study had suggested that BD patients showed less activation and altered FC in regions within the salience network during an emotion-cognition integration task [ 7 ]. Our further voxel-based whole FC analysis showed enhanced FC between the left insula and the TPJ and decreased FC between the bilateral insula in the euthymic PBD patients.…”

“…Functional magnetic resonance imaging (fMRI) has been broadly used to investigate euthymic PBD [ 5 , 6 ]. Many studies have provided evidence for changes of brain function in BD, such as changes in the corticolimbic pathways during mood episode [ 7 , 8 ]. Recently, intrinsic functional connectivity (FC) based on resting-state fMRI has been employed to reveal stable and reliable functional brain networks, such as the default mode network (DMN), and the salience network (SN), which are associated with cognition and emotion [ 9 , 10 ].…”