title: Prolonged hemodynamic response during incidental facial emotion processing in inter-episode bipolar I disorder.
abstract: This fMRI study examined whether hemodynamic responses to affectively-salient stimuli were abnormally prolonged in remitted bipolar disorder, possibly representing a novel illness biomarker. A group of 18 DSM-IV bipolar I-diagnosed adults in remission and a demographically-matched control group performed an event-related fMRI gender-discrimination task in which face stimuli had task-irrelevant neutral, happy or angry expressions designed to elicit incidental emotional processing. Participants' brain activation was modeled using a "fully informed" SPM5 basis set. Mixed-model ANOVA tested for diagnostic group differences in BOLD response amplitude and shape within brain regions-of-interest selected from ALE meta-analysis of previous comparable fMRI studies. Bipolar-diagnosed patients had a generally longer duration and/or later-peaking hemodynamic response in amygdala and numerous prefrontal cortex brain regions. Data are consistent with existing models of bipolar limbic hyperactivity, but the prolonged frontolimbic response more precisely details abnormalities recognized in previous studies. Prolonged hemodynamic responses were unrelated to stimulus type, task performance, or degree of residual mood symptoms, suggesting an important novel trait vulnerability brain dysfunction in bipolar disorder. Bipolar patients also failed to engage pregenual cingulate and left orbitofrontal cortex-regions important to models of automatic emotion regulation-while engaging a delayed dorsolateral prefrontal cortex response not seen in controls. These results raise questions about whether there are meaningful relationships between bipolar dysfunction of specific ventromedial prefrontal cortex regions believed to automatically regulate emotional reactions and the prolonged responses in more lateral aspects of prefrontal cortex.
authors: Olin Neuropsychiatry Research Center, The Institute of Living/Hartford Hospital, 200 Retreat Ave, Whitehall Building, Hartford, CT, 06106, USA.
authors: Ethan S
authors: ES
authors: Rosenfeld
authors: Godfrey D
authors: GD
authors: Pearlson
authors: John A
authors: JA
authors: Sweeney
authors: Carol A
authors: CA
authors: Tamminga
authors: Matcheri S
authors: MS
authors: Keshavan
authors: Camilla
authors: C
authors: Nonterah
authors: Michael C
authors: MC
authors: Stevens
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001714:Bipolar Disorder / Q000503:physiopathology* / Q000523:psychology; D001931:Brain Mapping; D002560:Cerebrovascular Circulation; D004644:Emotions; D005145:Face; D005149:Facial Expression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010100:Oxygen / Q000378:metabolism*; D010775:Photic Stimulation; D013997:Time Factors; D014796:Visual Perception
chemical_list: D010100:Oxygen
references: Harv Rev Psychiatry. 2006 Mar-Apr;14(2):47-63
references: 16603472
references: Trends Cogn Sci. 2005 May;9(5):242-9
references: 15866151
references: J Affect Disord. 2007 Nov;103(1-3):29-42
references: 17328959
references: Bipolar Disord. 2004 Jun;6(3):171-82
references: 15117396
references: J Psychiatry Neurosci. 2009 Nov;34(6):418-32
references: 19949718
references: Psychiatry Res. 2008 May 30;159(1-2):1-6
references: 18295902
references: Am J Psychiatry. 2008 Mar;165(3):313-20
references: 18245175
references: Neuroimage. 2002 Jun;16(2):331-48
references: 12030820
references: Neuroimage. 2012 Aug 15;62(2):1017-23
references: 22366081
references: IEEE Trans Med Imaging. 2002 May;21(5):470-84
references: 12071618
references: Mol Psychiatry. 2008 Sep;13(9):829, 833-57
references: 18574483
references: Biol Psychiatry. 2007 Jul 15;62(2):158-67
references: 17097071
references: Neurosci Biobehav Rev. 2009 May;33(5):699-771
references: 19428491
references: Biol Psychiatry. 2002 May 1;51(9):693-707
references: 11983183
references: Neuroimage. 2002 Apr;15(4):870-8
references: 11906227
references: Psychopharmacology (Berl). 2005 Dec;183(3):308-13
references: 16249909
references: J Clin Psychiatry. 2012 Apr;73(4):451-9
references: 21903032
references: Bipolar Disord. 2009 Feb;11(1):63-9
references: 19133967
references: Neuroimage. 2009 Mar;45(1 Suppl):S187-98
references: 19084070
references: Cogn Affect Behav Neurosci. 2003 Sep;3(3):207-33
references: 14672157
references: J Affect Disord. 2013 May;147(1-3):304-11
references: 23261134
references: Mol Psychiatry. 2005 Jan;10(1):105-16
references: 15340357
references: Neuroimage. 2011 Feb 14;54(4):2571-81
references: 21073967
references: J Affect Disord. 2010 Dec;127(1-3):1-9
references: 20231037
references: Semin Clin Neuropsychiatry. 2002 Oct;7(4):243-54
references: 12382207
references: J Int Neuropsychol Soc. 2003 May;9(4):623-32
references: 12755174
references: Neuroimage. 2004 Apr;21(4):1748-61
references: 15050595
references: Int Rev Psychiatry. 2009;21(4):357-67
references: 20374149
references: Neuroimage. 2010 Jan 15;49(2):1699-707
references: 19833213
references: J Affect Disord. 2006 Mar;91(1):53-6
references: 16413611
references: PLoS One. 2009;4(1):e4257
references: 19165335
references: Am J Psychiatry. 2002 Feb;159(2):302-4
references: 11823275
references: Arch Gen Psychiatry. 2003 Jun;60(6):601-9
references: 12796223
references: BMC Psychiatry. 2008 Sep 19;8:82
references: 18803831
references: J Affect Disord. 2007 Jan;97(1-3):109-22
references: 16837058
references: J Nerv Ment Dis. 2007 Oct;195(10):830-6
references: 18043523
references: Biol Psychiatry. 2006 Jan 1;59(1):31-9
references: 16112653
references: Neuroimage. 2010 Oct 15;53(1):58-64
references: 20595014
references: Acta Psychiatr Scand. 2010 Jun;121(6):404-14
references: 19958306
references: Neuroreport. 2007 Oct 8;18(15):1583-7
references: 17885606
references: Biol Psychiatry. 2003 Sep 1;54(5):504-14
references: 12946879
references: Neuroimage. 2002 Jan;15(1):83-97
references: 11771976
references: Science. 2002 Nov 8;298(5596):1191-4
references: 12424363
references: Psychiatry Res. 2008 Apr 15;162(3):244-55
references: 18294820
references: Int Rev Psychiatry. 2009;21(4):314-22
references: 20374146
references: Biol Psychiatry. 2004 Mar 15;55(6):578-87
references: 15013826
references: Am J Psychiatry. 2007 Apr;164(4):638-46
references: 17403978
references: Behav Brain Sci. 2000 Apr;23(2):177-91; discussion 192-233
references: 11301577
references: Acta Psychiatr Scand. 2003 Feb;107(2):124-31
references: 12534438
references: J Am Acad Child Adolesc Psychiatry. 2009 Mar;48(3):308-319
references: 19242292
references: J Affect Disord. 2008 Apr;107(1-3):63-75
references: 17884175
references: Nature. 1996 Oct 31;383(6603):812-5
references: 8893004
references: Neuroimage. 1998 Jan;7(1):30-40
references: 9500830
references: Neuroimage. 2001 Jan;13(1):218-29
references: 11133324
references: Hum Brain Mapp. 2005 May;25(1):155-64
references: 15846811
references: Behav Ther. 2008 Jun;39(2):107-16
references: 18502244
references: Bipolar Disord. 2008 Dec;10(8):916-27
references: 19594507
references: J Affect Disord. 2012 Feb;136(3):294-303
references: 22166398
references: Neuroimage. 2004 May;22(1):252-7
references: 15110015
references: Am J Psychiatry. 2003 Jun;160(6):1172-4
references: 12777278
references: Acta Neuropsychiatr. 2009 Sep 23;21(6):228-238
references: 20676360
references: Annu Rev Neurosci. 2010;33:173-202
references: 20331363