Prefrontal cortical and striatal activity to happy and fear faces in bipolar disorder is associated with comorbid substance abuse and eating disorder.
BACKGROUND
The spectrum approach was used to examine contributions of comorbid symptom dimensions of substance abuse and eating disorder to abnormal prefrontal-cortical and subcortical-striatal activity to happy and fear faces previously demonstrated in bipolar disorder (BD).


METHODS
Fourteen remitted BD-type I and sixteen healthy individuals viewed neutral, mild and intense happy and fear faces in two event-related fMRI experiments. All individuals completed Substance-Use and Eating-Disorder Spectrum measures. Region-of-Interest analyses for bilateral prefrontal and subcortical-striatal regions were performed.


RESULTS
BD individuals scored significantly higher on these spectrum measures than healthy individuals (p<0.05), and were distinguished by activity in prefrontal and subcortical-striatal regions. BD relative to healthy individuals showed reduced dorsal prefrontal-cortical activity to all faces. Only BD individuals showed greater subcortical-striatal activity to happy and neutral faces. In BD individuals, negative correlations were shown between substance use severity and right PFC activity to intense happy faces (p<0.04), and between substance use severity and right caudate nucleus activity to neutral faces (p<0.03). Positive correlations were shown between eating disorder and right ventral putamen activity to intense happy (p<0.02) and neutral faces (p<0.03). Exploratory analyses revealed few significant relationships between illness variables and medication upon neural activity in BD individuals.


CONCLUSIONS
Small sample size of predominantly medicated BD individuals.


CONCLUSIONS
This study is the first to report relationships between comorbid symptom dimensions of substance abuse and eating disorder and prefrontal-cortical and subcortical-striatal activity to facial expressions in BD. Our findings suggest that these comorbid features may contribute to observed patterns of functional abnormalities in neural systems underlying mood regulation in BD.
Hassel
Stefanie
S
University of Pittsburgh, School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA. hassels@upmc.edu
Almeida
Jorge R
JR
Frank
Ellen
E
Versace
Amelia
A
Nau
Sharon A
SA
Klein
Crystal R
CR
Kupfer
David J
DJ
Phillips
Mary L
ML
D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D056912:Binge-Eating Disorder / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D015897:Comorbidity; D003342:Corpus Striatum / Q000187:drug effects / Q000503:physiopathology*; D004292:Dominance, Cerebral / Q000502:physiology; D005149:Facial Expression; D005239:Fear / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006240:Happiness; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000187:drug effects / Q000503:physiopathology; D010364:Pattern Recognition, Visual / Q000187:drug effects / Q000502:physiology*; D017397:Prefrontal Cortex / Q000187:drug effects / Q000503:physiopathology*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012016:Reference Values; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
D011619:Psychotropic Drugs