Cognitive generation of affect in bipolar depression: an fMRI study
Cognitive generation of affect in bipolar depression: an fMRI study
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DOI：
10.1111/j.0953-816x.2003.03159.x
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发表时间：
2004-02-01
影响因子：
3.4
通讯作者：
Sachdev, P
中科院分区：
文献类型：
--
作者：
Malhi, GS;Lagopoulos, J;Sachdev, P
双相情感障碍患者表现出从抑郁到躁狂的全部情绪。为了了解情绪的功能基础，我们试图识别与双相抑郁症患者情感认知产生相关的大脑区域。因此，我们使用功能性磁共振成像（fMRI）检查了10名患有双相情感障碍的抑郁女性受试者和10名年龄匹配和性别匹配的健康对照受试者，同时观看了设计用于引起消极、积极或没有情感变化的字幕图片的交替块。激活范式包括在三个实验中交替呈现相同的视觉材料（实验1）否定和参考；（实验2）正面和参考图片（实验3）正面和负面图片。刺激在患者和对照组中都激活了先前涉及情感产生和调节的大脑区域，特别是前额叶和前扣带皮层。与健康受试者相比，患者的激活涉及更多的皮质下区域，特别是杏仁核、丘脑、下丘脑和内侧苍白球。患者和比较对象对消极（实验1）和积极（实验2）情感诱导产生相反激活模式的情感变化表现出不同的敏感性。我们得出结论，双相抑郁症患者可能需要额外的皮质下边缘系统来评估情绪，这可能反映了状态相关或特征相关的功能障碍。不同的激活模式告诉我们双相抑郁症，并有潜在的诊断和治疗意义。
Individuals with bipolar disorder manifest the full spectrum of emotions ranging from depression to mania. In attempting to understand the functional substrates of mood we attempted to identify brain regions associated with the cognitive generation of affect in bipolar depressed patients. We therefore examined ten depressed female subjects with bipolar affective disorder, and ten age-matched and sex-matched healthy comparison subjects using functional magnetic resonance imaging (fMRI) while viewing alternating blocks of captioned pictures designed to evoke negative, positive or no affective change. The activation paradigm involved the presentation of the same visual materials over three experiments alternating (experiment 1) negative and reference; (experiment 2) positive and reference and (experiment 3) positive and negative captioned pictures. The stimuli produced activation in both patients and comparison subjects in brain regions previously implicated in the generation and modulation of affect, in particular the prefrontal and anterior cingulate cortices. The activation in patients, when compared with healthy subjects, involved additional subcortical regions, in particular the amygdala, thalamus, hypothalamus and medial globus pallidus. Patients and comparison subjects displayed differential sensitivity to affective change with negative (experiment 1) and positive (experiment 2) affect induction producing converse patterns of activation. We conclude that bipolar depressed patients perhaps recruit additional subcortical limbic systems for emotional evaluation and this may reflect state-related or trait-related dysfunction. The differential patterns of activation inform us about bipolar depression and have potential diagnostic and therapeutic significance.