Pilot investigation of the changes in cortical activation during facial affect recognition with lamotrigine monotherapy in bipolar disorder.
BACKGROUND
Bipolar disorder is associated with dysfunction in prefrontal and limbic areas implicated in emotional processing.


OBJECTIVE
To explore whether lamotrigine monotherapy may exert its action by improving the function of the neural network involved in emotional processing.


METHODS
We used functional magnetic resonance imaging to examine changes in brain activation during a sad facial affect recognition task in 12 stable patients with bipolar disorder when medication-free compared with healthy controls and after 12 weeks of lamotrigine monotherapy.


RESULTS
At baseline, compared with controls, patients with bipolar disorder showed overactivity in temporal regions and underactivity in the dorsal medial and right ventrolateral prefrontal cortex, and the dorsal cingulate gyrus. Following lamotrigine monotherapy, patients demonstrated reduced temporal and increased prefrontal activation.


CONCLUSIONS
This preliminary evidence suggests that lamotrigine may enhance the function of the neural circuitry involved in affect recognition.
Jogia
Jigar
J
Section of Neurobiology of Psychosis, Institute of Psychiatry, King's College London, PO66, De Crespigny Park, London, SE5 8AF, UK.
Haldane
Morgan
M
Cobb
Annabel
A
Kumari
Veena
V
Frangou
Sophia
S
D000293:Adolescent; D000328:Adult; D000339:Affect; D018692:Antimanic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D001931:Brain Mapping / Q000379:methods; D002540:Cerebral Cortex / Q000187:drug effects* / Q000503:physiopathology; D005149:Facial Expression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D000077213:Lamotrigine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000187:drug effects / Q000503:physiopathology; D010364:Pattern Recognition, Visual; D010865:Pilot Projects; D021641:Recognition, Psychology; D014227:Triazines / Q000494:pharmacology* / Q000627:therapeutic use
D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine