Foland Lara C, Altshuler Lori L, Bookheimer Susan Y, Eisenberger Naomi, Townsend Jennifer, Thompson Paul M
Laboratory of NeuroImaging, Department of Neurology, University of California, Los Angeles, CA, USA.
Psychiatry Res. 2008 Jan 15;162(1):27-37. doi: 10.1016/j.pscychresns.2007.04.007. Epub 2007 Dec 11.
Several studies have implicated the involvement of two major components of emotion regulatory networks, the ventrolateral prefrontal cortex (VLPFC) and amygdala, in the pathophysiology of bipolar disorder. In healthy subjects, the VLPFC has been shown to negatively modulate amygdala response when subjects cognitively evaluate an emotional face by identifying and labeling the emotion it expresses. The current study used such a paradigm to assess whether the strength of this modulation was altered in bipolar subjects when manic. During functional magnetic resonance imaging (fMRI), nine manic subjects with bipolar I disorder and nine healthy subjects either named the emotion shown in a face by identifying one of two words that correctly expressed the emotion (emotion labeling task) or matched the emotion shown in a face to one of two other faces (emotion perception task). The degree to which the VLPFC regulated amygdala response during these tasks was assessed using a psychophysiological interaction (PPI) analysis. Compared with healthy subjects, manic patients had a significantly reduced VLPFC regulation of amygdala response during the emotion labeling task. These findings, taken in context with previous fMRI studies of bipolar mania, suggest that reductions in inhibitory frontal activity in these patients may lead to an increased reactivity of the amygdala.
多项研究表明，情绪调节网络的两个主要组成部分，即腹外侧前额叶皮层（VLPFC）和杏仁核，参与了双相情感障碍的病理生理过程。在健康受试者中，当受试者通过识别和标记所表达的情绪来对情绪化面孔进行认知评估时，VLPFC已被证明对杏仁核反应具有负向调节作用。本研究采用这样一种范式来评估双相情感障碍患者躁狂发作时这种调节的强度是否发生改变。在功能磁共振成像（fMRI）过程中，9名患有双相I型障碍的躁狂受试者和9名健康受试者要么通过从两个正确表达情绪的单词中识别出一个来命名面孔中显示的情绪（情绪标记任务），要么将面孔中显示的情绪与另外两张面孔中的一张进行匹配（情绪感知任务）。使用心理生理交互作用（PPI）分析来评估在这些任务期间VLPFC对杏仁核反应的调节程度。与健康受试者相比，躁狂患者在情绪标记任务期间VLPFC对杏仁核反应的调节显著降低。结合先前关于双相躁狂的fMRI研究来看，这些发现表明，这些患者额叶抑制性活动的减少可能导致杏仁核反应性增加。
