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An fMRI study of the neural correlates of incidental versus directed emotion processing in pediatric bipolar disorder.

Authors
  • Pavuluri, Mani N1
  • Passarotti, Alessandra M2
  • Harral, Erin M2
  • Sweeney, John A2
  • 1 All of the authors are with the Center for Cognitive Medicine, University of Illinois at Chicago. Drs. Pavuluri and Passarotti are also with the Institute for Juvenile Research. Electronic address: [email protected].
  • 2 All of the authors are with the Center for Cognitive Medicine, University of Illinois at Chicago. Drs. Pavuluri and Passarotti are also with the Institute for Juvenile Research.
Type
Published Article
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
Publication Date
Mar 01, 2009
Volume
48
Issue
3
Pages
308–319
Identifiers
DOI: 10.1097/CHI.0b013e3181948fc7
PMID: 19242292
Source
Medline
Language
English
License
Unknown

Abstract

To use functional neuroimaging to probe the affective circuitry dysfunctions underlying disturbances in emotion processing and emotional reactivity in pediatric bipolar disorder (PBD). Equal numbers of controls (HC) and unmedicated patients with euthymia and PBD were matched for age, sex, race, socioeconomic status, and IQ (n = 10 per group; mean age 14.2 years [SD 2.0 years]). The task consisted of a "directed" emotion processing condition where subjects judged whether emotion in facial expression was positive or negative and an "incidental" condition where subjects judged whether faces expressing similar affect were older or younger than 35 years. Relative to the directed condition, the incidental condition elicited greater activation in the right amygdala and the right insula, the left middle frontal gyrus, and the left posterior cingulate cortex in patients with PBD, in contrast to the HC that showed greater activation in the right superior frontal gyrus. In both incidental and directed conditions, relative to visual fixation, patients with PBD showed less activation in the right prefrontal cortex (superior, middle, and inferior frontal gyri) and the pregenual anterior cingulate cortex and greater activation in the posterior visual and face-processing regions (i.e., right precuneus/cuneus, fusiform gyrus). Increased amygdala activation observed in patients with PBD elicited by incidental emotional processing relative to directed emotional processing may indicate more intense automatic emotional reactivity. Furthermore, the right prefrontal systems that are believed to modulate affect seem to be less engaged in patients with PBD regardless of whether the emotion processing is incidental or directed, which may signify reduced top-down control of emotional reactivity in PBD.

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