Laboratory of NeuroImaging, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90095, USA.
Neuroimage. 2012 Jan 2;59(1):738-44. doi: 10.1016/j.neuroimage.2011.07.054. Epub 2011 Aug 10.
Functional neuroimaging studies have implicated the involvement of the amygdala and ventrolateral prefrontal cortex (vlPFC) in the pathophysiology of bipolar disorder. Hyperactivity in the amygdala and hypoactivity in the vlPFC have been reported in manic bipolar patients scanned during the performance of an affective faces task. Whether this pattern of dysfunction persists during euthymia is unclear. Using functional magnetic resonance imaging (fMRI), 24 euthymic bipolar and 26 demographically matched healthy control subjects were scanned while performing an affective task paradigm involving the matching and labeling of emotional facial expressions. Neuroimaging results showed that, while amygdala activation did not differ significantly between groups, euthymic patients showed a significant decrease in activation of the right vlPFC (BA47) compared to healthy controls during emotion labeling. Additionally, significant decreases in activation of the right insula, putamen, thalamus and lingual gyrus were observed in euthymic bipolar relative to healthy control subjects during the emotion labeling condition. These data, taken in context with prior studies of bipolar mania using the same emotion recognition task, could suggest that amygdala dysfunction may be a state-related abnormality in bipolar disorder, whereas vlPFC dysfunction may represent a trait-related abnormality of the illness. Characterizing these patterns of activation is likely to help in understanding the neural changes related to the different mood states in bipolar disorder, as well as changes that represent more sustained abnormalities. Future studies that assess mood-state related changes in brain activation in longitudinal bipolar samples would be of interest.
功能神经影像学研究表明，杏仁核和腹外侧前额叶皮层（vlPFC）参与了双相情感障碍的病理生理学。在进行情感面孔任务时，扫描躁狂双相情感障碍患者发现杏仁核活动过度，而 vlPFC 活动不足。在病情稳定期这种功能障碍模式是否持续存在尚不清楚。使用功能磁共振成像（fMRI），对 24 名病情稳定的双相情感障碍患者和 26 名年龄匹配的健康对照者进行扫描，这些患者在进行涉及情绪面部表情匹配和标记的情感任务范式时接受扫描。神经影像学结果显示，尽管两组之间杏仁核激活没有显著差异，但在进行情绪标记时，与健康对照组相比，病情稳定的患者右侧 vlPFC（BA47）的激活显著降低。此外，在进行情绪标记时，与健康对照组相比，病情稳定的双相情感障碍患者右侧岛叶、壳核、丘脑和舌回的激活也显著降低。结合之前使用相同情绪识别任务的躁狂双相情感障碍研究，这些数据表明，杏仁核功能障碍可能是双相情感障碍的一种与状态相关的异常，而 vlPFC 功能障碍可能代表疾病的一种与特质相关的异常。对这些激活模式进行特征描述可能有助于理解双相情感障碍不同情绪状态相关的神经变化，以及代表更持久异常的变化。评估纵向双相情感障碍样本中与情绪状态相关的大脑激活变化的未来研究将是有趣的。
