Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-7057, USA.
Bipolar Disord. 2012 Jun;14(4):326-39. doi: 10.1111/j.1399-5618.2012.01021.x.
Bipolar disorder (BP) is characterized by a dysfunction of mood, alternating between states of mania/hypomania and depression. Thus, the primary abnormality appears to be an inability to regulate emotion, the result of which is emotional extremes. The purpose of this paper is to review the current functional magnetic resonance imaging (fMRI) literature on adult patients with BP using emotion processing or regulation paradigms.
A search was conducted on PubMed using the keywords: bipolar disorder, fMRI, mania, bipolar depression, bipolar euthymia, emotion, and amygdala. Only those studies that were conducted in adult patients using an emotion activation task were included in the final review.
Using tasks that assess neural functioning during emotion processing and emotion regulation, many fMRI studies have examined BP subjects during mania and euthymia. Fewer fMRI studies have been conducted during depression, and fewer still have included the same subjects in multiple mood states. Despite these limitations, these studies have demonstrated specific abnormalities in frontal-limbic regions. Using a variety of paradigms, investigators have specifically evaluated the amygdala (a structure within the limbic system known to be critical for emotion) and the prefrontal cortex (PFC) (a region known to have a regulatory function over the limbic system).
These investigations reveal that amygdala activation varies as a function of mood state, while the PFC remains persistently hypoactivated across mood states. Emotional dysregulation and lability in mania and depression may reflect disruption of a frontal-limbic functional neuroanatomical network.
双相情感障碍（BP）的特征是情绪功能障碍，在躁狂/轻躁狂和抑郁之间交替。因此，主要的异常似乎是无法调节情绪，其结果是情绪极端。本文的目的是使用情绪处理或调节范式综述成人 BP 患者的当前功能磁共振成像（fMRI）文献。
在 PubMed 上使用关键词：双相情感障碍、fMRI、躁狂、双相抑郁、双相轻躁狂、情绪和杏仁核进行搜索。只有使用情绪激活任务在成年患者中进行的研究才包括在最终综述中。
使用评估情绪处理和情绪调节期间神经功能的任务，许多 fMRI 研究在躁狂和轻躁狂期间检查了 BP 患者。在抑郁期间进行的 fMRI 研究较少，在多个情绪状态下包括相同患者的研究更少。尽管存在这些局限性，但这些研究表明额叶-边缘区域存在特定异常。使用各种范式，研究人员专门评估了杏仁核（已知对情绪至关重要的边缘系统结构）和前额叶皮层（PFC）（已知对边缘系统具有调节功能的区域）。
这些研究表明，杏仁核的激活随情绪状态而变化，而 PFC 在整个情绪状态下仍然持续低激活。躁狂和抑郁中的情绪失调和不稳定性可能反映了额叶-边缘功能神经解剖网络的中断。
