Neural Activation During Facial Emotion Processing in Unmedicated Bipolar Depression, Euthymia, and Mania

Abstract

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.

Altered amygdala-prefrontal response to facial emotion in offspring of parents with bipolar disorder

“…The amygdala is a key region for processing of emotional faces and emotions in general Glä scher et al, 2004;Sabatinelli et al, 2011). Our finding of abnormally elevated right amygdala activation to all emotional faces in BO and NBO taken together with previous findings of abnormally increased amygdala activation in individuals with established bipolar disorder (Lawrence et al, 2004;Blumberg et al, 2005;Pavuluri et al, 2007Pavuluri et al, , 2009Ladouceur et al, 2011;Hulvershorn et al, 2012;Brotman et al, 2014b), in individuals at-risk for bipolar disorder (Olsavsky et al, 2012), and also in those at-risk for major depressive disorder (Monk et al, 2008), suggest that elevated right amygdala activation may be a risk marker for psychiatric disorders in general, rather than for BO specifically. Interestingly, we did not show a pattern of abnormally reduced prefrontal cortical activation to emotional faces in BO relative to the other groups.…”

Differential Resting-State Functional Connectivity of Striatal Subregions in Bipolar Depression and Hypomania

“…Therefore, these abnormalities could either be interpreted as being trait related or mood state nonspecific, that is, these abnormalities are related to an abnormal mood state regardless of valence. A number of previous studies, which have examined activation and connectivity abnormalities concurrently in mania and depression, have also uncovered many similar findings in both BPM and BPD (Anand et al, 2009;Chen et al, 2006;Hulvershorn et al, 2012;Hummer et al, 2013;Marchand et al, 2007a;Phillips and Swartz, 2014;Wessa et al, 2007). To definitely ascertain that these abnormalities are trait related, they need to be investigated in medication-free euthymic subjects in future studies.…”

Hyperthymic temperament and rapid reaction time in brightness preference

“…For example, manic patients have been reported to show increasing activations in the left lateral orbitofrontal cortex (BA11 and BA47) during expectation of increasing gain and decreasing responses during expectation of increasing loss (Bermpohl et al, 2010) whilst decreased the left lateral orbitofrontal cortex activation during facial emotion processing has also been reported in manic patients (Hulvershorn et al, 2012). Also, euthymic patients with bipolar I disorder have been reported to display elevated the left lateral orbitofrontal cortex (BA 47) activity during reward anticipation (Nusslock et al, 2012).…”