title: Explicit and implicit facial affect recognition in manic and depressed States of bipolar disorder: a functional magnetic resonance imaging study.
abstract: 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.
authors.affiliation: Brain Mapping Unit and Wolfson Brain Imaging Centre, Department of Psychiatry, University of Cambridge, UK.
authors.forename: Chi-Hua
authors.initials: CH
authors.lastname: Chen
authors.forename: Belinda
authors.initials: B
authors.lastname: Lennox
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jacob
authors.forename: Andrew
authors.initials: A
authors.lastname: Calder
authors.forename: Vicky
authors.initials: V
authors.lastname: Lupson
authors.forename: Ruth
authors.initials: R
authors.lastname: Bisbrown-Chippendale
authors.forename: John
authors.initials: J
authors.lastname: Suckling
authors.forename: Ed
authors.initials: E
authors.lastname: Bullmore
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000378:metabolism* / Q000503:physiopathology*; D001921:Brain / Q000098:blood supply; D001931:Brain Mapping; D005149:Facial Expression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010100:Oxygen / Q000097:blood; D021641:Recognition, Psychology / Q000502:physiology*
chemical_list: D010100:Oxygen