title: Differential Abnormal Pattern of Anterior Cingulate Gyrus Activation in Unipolar and Bipolar Depression: an fMRI and Pattern Classification Approach.
abstract: Distinguishing bipolar disorder from major depressive disorder is a major challenge in psychiatric treatment. Consequently, there has been growing interest in identifying neuronal biomarkers of disorder-specific pathophysiological processes to differentiate affective disorders. Thirty-six depressed bipolar patients, 36 depressed unipolar patients, and 36 matched healthy controls (HCs) participated in an fMRI experiment. Emotional faces served as stimuli in a matching task. We investigated neural activation towards angry, fearful, and happy faces focusing on prototypical regions related to emotion processing, ie, the amygdala and the anterior cingulate gyrus (ACG). Furthermore, we employed a whole-brain and a multivariate pattern classification analysis. Unipolar patients showed abnormally reduced ACG activation toward happy and fearful faces compared with bipolar patients and HCs respectively. Furthermore, the whole-brain analysis revealed significantly increased activation in bipolar patients compared with unipolar patients in the fearful condition in the right frontal and parietal cortex. Moreover, the multivariate pattern classification analysis yielded significant classification rates of up to 72% based on ACG activation elicited by fearful faces. Our results question the rather 'amygdalocentric' neurobiological models of mood disorders. We observed patterns of abnormally reduced ventral and supragenual ACG activation, potentially indicating impaired bottom-up emotion processing and automatic emotion regulation specifically in unipolar but not in bipolar individuals.
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Bürger
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Ronny
authors.initials: R
authors.lastname: Redlich
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Grotegerd
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Meinert
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Dohm
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Ilona
authors.initials: I
authors.lastname: Schneider
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Dario
authors.initials: D
authors.lastname: Zaremba
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Förster
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.|Cluster of Excellence EXC 1003, Cells in Motion, University of Münster, Münster, Germany.
authors.forename: Judith
authors.initials: J
authors.lastname: Alferink
authors.affiliation: Institute of Psychology, University of Münster, Münster, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Bölte
authors.affiliation: Department of Clinical Radiology, University of Münster, Münster, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Heindel
authors.affiliation: Department of Clinical Radiology, University of Münster, Münster, Germany.
authors.forename: Harald
authors.identifier: http://orcid.org/0000-0002-4349-1984
authors.initials: H
authors.lastname: Kugel
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Arolt
authors.affiliation: Department of Psychiatry, University of Münster, Münster, Germany.|Department of Psychiatry, University of Marburg, Marburg, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Dannlowski
mesh_terms: D001714:Bipolar Disorder / Q000145:classification / Q000000981:diagnostic imaging* / Q000378:metabolism; D003866:Depressive Disorder / Q000145:classification* / Q000000981:diagnostic imaging* / Q000378:metabolism; D005149:Facial Expression; D005260:Female; D006179:Gyrus Cinguli / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000145:classification* / Q000379:methods; D008297:Male; D010775:Photic Stimulation / Q000379:methods; D011897:Random Allocation