title: Modulation of fronto-limbic activity by the psychoeducation in euthymic bipolar patients. A functional MRI study.
abstract: Bipolar disorders (BD) are mainly characterized by emotional and cognitive processing impairment. The cerebral substrate explaining BD impairment and the action mechanisms of therapies are not completely understood, especially for psychosocial interventions. This fMRI study aims at assessing cerebral correlates of euthymic bipolar patients (EBP) before and after psychoeducation therapy. Sixteen EBP and 16 matched healthy subjects (HS) performed a word-face emotional Stroop task in two separate fMRI sessions at 3-month interval. Between fMRI sessions, EBP underwent psychoeducation. Before psychoeducation, the comparison of EBP vs. HS in fMRI data revealed (a) significant decreased activity of cognitive control regions such as bilateral inferior and left superior frontal gyri, right insula, right fusiform gyrus and bilateral occipital gyri and (b) significant increased activity of emotion-related processing regions such as bilateral hippocampus, parahippocampal gyri and the left middle temporal gyrus. After psychoeducation, EBP showed significant clinical improvement, increased activity of inferior frontal gyri and a tendency toward decreased activity of right hippocampus and parahippocampal gyrus. These results suggest that the imbalance between cognitive control and emotion processing systems characterizing BD acute episodes may persist during euthymic periods. Moreover, this imbalance may be improved by psychoeducation, which enhances the cognitive control and modulates emotional fluctuations in EBP.
authors.affiliation: Université Grenoble Alpes, LPNC, CNRS, LPNC UMR 5105, F-38040 Grenoble, France; Université Grenoble Alpes, SFR Santé et Société, F-38040 Grenoble, France. Electronic address: pauline.favre@upmf-grenoble.fr.
authors.forename: Pauline
authors.initials: P
authors.lastname: Favre
authors.forename: Monica
authors.initials: M
authors.lastname: Baciu
authors.forename: Cédric
authors.initials: C
authors.lastname: Pichat
authors.forename: Marie-Atéa
authors.initials: MA
authors.lastname: De Pourtalès
authors.forename: Benjamin
authors.initials: B
authors.lastname: Fredembach
authors.forename: Sabrina
authors.initials: S
authors.lastname: Garçon
authors.forename: Thierry
authors.initials: T
authors.lastname: Bougerol
authors.forename: Mircea
authors.initials: M
authors.lastname: Polosan
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D001931:Brain Mapping; D016022:Case-Control Studies; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D004644:Emotions; D005149:Facial Expression; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D007802:Language; D008032:Limbic System / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010353:Patient Education as Topic; D057190:Stroop Test
keywords: Bipolar disorders; Cognitive control; Emotional processing; Word-face emotional Stroop; fMRI