An fMRI study of the neural correlates of incidental versus directed emotion processing in pediatric bipolar disorder.
An fMRI study of the neural correlates of incidental versus directed emotion processing in pediatric bipolar disorder.
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DOI：
10.1097/chi.0b013e3181948fc7
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发表时间：
2009-03
影响因子：
13.3
通讯作者：
Sweeney JA
中科院分区：
文献类型：
--
作者：
Pavuluri MN;Passarotti AM;Harral EM;Sweeney JA
应用功能神经影像学技术探讨儿童双相情感障碍患者情绪加工和情绪反应障碍背后的情感回路功能障碍。在年龄、性别、种族、社会经济地位和智商方面，将同等数量的对照组（HC）和未接受药物治疗的心境愉悦和PBD患者进行匹配（每组n = 10，平均年龄14.2岁[SD 2.0岁]）。这项任务包括一个“定向的”情绪处理条件，在这个条件下，受试者判断面部表情中的情绪是积极的还是消极的，以及一个“附带的”条件，在这个条件下，受试者判断表达类似情绪的面孔是年龄大于还是小于35岁。相对于直接条件，附带条件引起PBD患者右侧杏仁核和右侧岛、左侧额叶中回和左侧后扣带皮层的更大激活，而HC则显示右侧额叶上回的更大激活。在偶发和定向两种情况下，与注视相比，PBD患者的右侧前额叶皮层（额上回、额中回和额下回）和前扣带皮层的激活程度较低，而后视觉和面部处理区域（即右侧楔前叶、梭状回）的激活程度较高。相对于定向情绪加工，偶然情绪加工诱发PBD患者杏仁核激活增加可能表明更强烈的自动情绪反应。此外，无论情绪处理是偶然的还是直接的，被认为调节情绪的右侧前额叶系统似乎在PBD患者中较少参与，这可能表明PBD患者对情绪反应的自上而下控制减少。
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.