title: Amygdala and whole-brain activity to emotional faces distinguishes major depressive disorder and bipolar disorder.
abstract: OBJECTIVE
  It can be clinically difficult to distinguish depressed individuals with bipolar disorder (BD) and major depressive disorder (MDD). To examine potential biomarkers of difference between the two disorders, the current study examined differences in the functioning of emotion-processing neural regions during a dynamic emotional faces task.
  
  
  METHODS
  During functional magnetic resonance imaging, healthy control adults (HC) (n = 29) and depressed adults with MDD (n = 30) and BD (n = 22) performed an implicit emotional-faces task in which they identified a color label superimposed on neutral faces that dynamically morphed into one of four emotional faces (angry, fearful, sad, happy). We compared neural activation between the groups in an amygdala region-of-interest and at the whole-brain level.
  
  
  RESULTS
  Adults with MDD showed significantly greater activity than adults with BD in the left amygdala to the anger condition (p = 0.01). Results of whole-brain analyses (at p < 0.005, k ≥ 20) revealed that adults with BD showed greater activity to sad faces in temporoparietal regions, primarily in the left hemisphere, whereas individuals with MDD demonstrated greater activity than those with BD to displays of anger, fear, and happiness. Many of the observed BD-MDD differences represented abnormalities in functioning compared to HC.
  
  
  CONCLUSIONS
  We observed a dissociation between depressed adults with BD and MDD in the processing of emerging emotional faces. Those with BD showed greater activity during mood-congruent (i.e., sad) faces, whereas those with MDD showed greater activity for mood-incongruent (i.e., fear, anger, and happy) faces. Such findings may reflect markers of differences between BD and MDD depression in underlying pathophysiological processes.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Jay C
authors.initials: JC
authors.lastname: Fournier
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Keener
authors.forename: Jorge
authors.initials: J
authors.lastname: Almeida
authors.forename: Dina M
authors.initials: DM
authors.lastname: Kronhaus
authors.forename: Mary L
authors.initials: ML
authors.lastname: Phillips
mesh_terms: D000328:Adult; D000679:Amygdala / Q000098:blood supply* / Q000473:pathology; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000175:diagnosis*; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D003865:Major Depressive Disorder / Q000175:diagnosis*; D004644:Emotions / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D010364:Pattern Recognition, Visual; D010775:Photic Stimulation; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: amygdala; bipolar disorder; brain imaging; emotion processing; major depressive disorder; whole brain
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