Elevated amygdala activity to sad facial expressions: a state marker of bipolar but not unipolar depression.
Elevated amygdala activity to sad facial expressions: a state marker of bipolar but not unipolar depression.
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DOI：
10.1016/j.biopsych.2009.09.027
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发表时间：
2010-03-01
影响因子：
10.6
通讯作者：
Phillips, Mary L.
中科院分区：
文献类型：
--
作者：
Almeida, Jorge R. C.;Versace, Amelia;Hassel, Stefanie;Kupfer, David J.;Phillips, Mary L.
双相情感障碍（bipolar disorder，BD）和重性抑郁障碍（major depression disorder，MDD）的抑郁症患者普遍存在情绪处理困难和社会功能差的问题，导致BD抑郁症患者被误诊为MDD。杏仁核是处理情绪显著刺激的关键区域，包括情绪面部表情。然而，目前尚不清楚，是否异常杏仁核活动在积极和消极的情绪处理代表一个持久的标志，BD无论疾病阶段或抑郁症的状态标志，共同或特定的BD和MDD抑郁症。招募了60名成年人：15名患有BD 1型（BDd）的抑郁症患者，15名患有复发性MDD的抑郁症患者，15名患有BD缓解期（BDr）的抑郁症患者，根据DSM-IV和DSM-IV研究版标准的结构化临床访谈进行诊断;以及15名健康对照受试者（HC）。组的年龄和性别比例相匹配;患者组的发病年龄和疾病持续时间相匹配;抑郁症组的抑郁症严重程度相匹配。BDd比其他患者组服用更多的精神药物。所有人都参与了三个独立的3 T神经成像事件相关实验，在这些实验中，他们从标准化系列中看到了恐惧，快乐或悲伤的温和和强烈的情绪和中性面孔。BD-相对于HC，BDr和MDD-在悲伤中表现出左杏仁核活动升高，以产生轻度和中性的面部表情（p <0.009），但在其他与药物无关的情绪实验中则没有。杏仁核活动没有其他显著的组间差异。异常升高的左杏仁核活动，轻度悲伤和中性的面孔可能是抑郁症的特异性标志物，在BD，但不是MDD，这表明不同的病理生理过程，BD与MDD抑郁症。
Difficulties in emotion processing and poor social function are common to bipolar disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated in processing emotionally salient stimuli, including emotional facial expressions. It is unclear, however, whether abnormal amygdala activity during positive and negative emotion processing represents a persistent marker of BD regardless of illness phase or a state marker of depression common or specific to BD and MDD depression. Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects (HC). Groups were age- and gender ratio-matched; patient groups were matched for age of illness onset and illness duration; depressed groups were matched for depression severity. The BDd were taking more psychotropic medication than other patient groups. All individuals participated in three separate 3T neuroimaging event-related experiments, where they viewed mild and intense emotional and neutral faces of fear, happiness, or sadness from a standardized series. The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication. There were no other significant between-group differences in amygdala activity. Abnormally elevated left amygdala activity to mild sad and neutral faces might be a depression-specific marker in BD but not MDD, suggesting different pathophysiologic processes for BD versus MDD depression.
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