Chen Chi-Hua, Lennox Belinda, Jacob Rebecca, Calder Andrew, Lupson Vicky, Bisbrown-Chippendale Ruth, Suckling John, Bullmore Ed
Brain Mapping Unit and Wolfson Brain Imaging Centre, Department of Psychiatry, University of Cambridge, UK.
Biol Psychiatry. 2006 Jan 1;59(1):31-9. doi: 10.1016/j.biopsych.2005.06.008. Epub 2005 Aug 22.
The pathophysiology of abnormal mood states-mania and depression-in patients with bipolar disorder remains unclear. Facial affect processing paradigms are an effective way of studying behavioral and functional magnetic resonance imaging (fMRI) correlates of affective disorders.
We used a factorial design to measure the neural correlates of tasks, tapping explicit and implicit recognition of sad, fearful, and happy facial expressions using event-related fMRI paradigms in three groups of participants: eight bipolar depressed patients, eight bipolar manic patients, and eight control subjects.
Depressed and manic patients exhibited overactivated responses to fearful faces, as well as to mood-incongruent facial expressions, with the depressed group exhibiting overactivity in fronto-striato-thalamic systems in response to happy faces and the manic group exhibiting overactivity in the fusiform gyrus in response to sad faces. For manic patients, task type also affected the neural response to sad faces, with the corticolimbic regions showing overactivation for implicit processing and underactivation for explicit processing.
Depressed and manic patients exhibited abnormal neural responses to sad, fearful, and happy facial expressions. Additionally, the attentional level of sad facial affect processing has important consequences for abnormalities of amygdala and cingulate activation in manic patients.
双相情感障碍患者躁狂和抑郁等异常情绪状态的病理生理学仍不清楚。面部情感加工范式是研究情感障碍行为和功能磁共振成像（fMRI）相关性的有效方法。
我们采用析因设计，通过事件相关fMRI范式，测量三组参与者（8名双相抑郁患者、8名双相躁狂患者和8名对照受试者）对悲伤、恐惧和快乐面部表情进行明确和隐含识别任务时的神经相关性。
抑郁和躁狂患者对恐惧面孔以及情绪不一致的面部表情表现出过度激活反应，抑郁组对快乐面孔反应时额-纹状体-丘脑系统表现为过度活跃，而躁狂组对悲伤面孔反应时梭状回表现为过度活跃。对于躁狂患者，任务类型也影响对悲伤面孔的神经反应，皮质边缘区域在隐含加工时表现为过度激活，在明确加工时表现为激活不足。
抑郁和躁狂患者对悲伤、恐惧和快乐面部表情表现出异常神经反应。此外，悲伤面部情感加工的注意水平对躁狂患者杏仁核和扣带回激活异常具有重要影响。
