title: Emotional face processing in pediatric bipolar disorder: evidence for functional impairments in the fusiform gyrus.
abstract: OBJECTIVE
  Pediatric bipolar disorder involves poor social functioning, but the neural mechanisms underlying these deficits are not well understood. Previous neuroimaging studies have found deficits in emotional face processing localized to emotional brain regions. However, few studies have examined dysfunction in other regions of the face processing circuit. This study assessed hypoactivation in key face processing regions of the brain in pediatric bipolar disorder.
  
  
  METHODS
  Youth with a bipolar spectrum diagnosis (n = 20) were matched to a nonbipolar clinical group (n = 20), with similar demographics and comorbid diagnoses, and a healthy control group (n = 20). Youth participated in a functional magnetic resonance imaging (fMRI) scanning which employed a task-irrelevant emotion processing design in which processing of facial emotions was not germane to task performance.
  
  
  RESULTS
  Hypoactivation, isolated to the fusiform gyrus, was found when viewing animated, emerging facial expressions of happiness, sadness, fearfulness, and especially anger in pediatric bipolar participants relative to matched clinical and healthy control groups.
  
  
  CONCLUSIONS
  The results of the study imply that differences exist in visual regions of the brain's face processing system and are not solely isolated to emotional brain regions such as the amygdala. Findings are discussed in relation to facial emotion recognition and fusiform gyrus deficits previously reported in the autism literature. Behavioral interventions targeting attention to facial stimuli might be explored as possible treatments for bipolar disorder in youth.
authors.affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, University of Pittsburgh. Electronic address: perlmansb2@upmc.edu.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Perlman
authors.forename: Jay C
authors.initials: JC
authors.lastname: Fournier
authors.forename: Genna
authors.initials: G
authors.lastname: Bebko
authors.forename: Michele A
authors.initials: MA
authors.lastname: Bertocci
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Hinze
authors.forename: Lisa
authors.initials: L
authors.lastname: Bonar
authors.forename: Jorge R C
authors.initials: JR
authors.lastname: Almeida
authors.forename: Amelia
authors.initials: A
authors.lastname: Versace
authors.forename: Claudiu
authors.initials: C
authors.lastname: Schirda
authors.forename: Michael
authors.initials: M
authors.lastname: Travis
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Gill
authors.forename: Christine
authors.initials: C
authors.lastname: Demeter
authors.forename: Vaibhav A
authors.initials: VA
authors.lastname: Diwadkar
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Sunshine
authors.forename: Scott K
authors.initials: SK
authors.lastname: Holland
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kowatch
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: David
authors.initials: D
authors.lastname: Axelson
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Horwitz
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.forename: Mary A
authors.initials: MA
authors.lastname: Fristad
authors.forename: Eric A
authors.initials: EA
authors.lastname: Youngstrom
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
authors.forename: Mary L
authors.initials: ML
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D004644:Emotions / Q000502:physiology*; D005145:Face; D005149:Facial Expression; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015337:Multicenter Studies as Topic; D009778:Occipital Lobe / Q000503:physiopathology; D013702:Temporal Lobe / Q000503:physiopathology
keywords: emotion; face processing; functional magnetic resonance imaging (fMRI); fusiform gyrus; pediatric bipolar disorder