在内隐情绪加工过程中，杏仁核-前额叶皮质功能连接可区分双相谱系青少年与外化性障碍青少年。
Amygdala-prefrontal cortical functional connectivity during implicit emotion processing differentiates youth with bipolar spectrum from youth with externalizing disorders.
作者信息
Hafeman Danella, Bebko Genna, Bertocci Michele A, Fournier Jay C, Chase Henry W, Bonar Lisa, Perlman Susan B, Travis Michael, Gill Mary Kay, Diwadkar Vaibhav A, Sunshine Jeffrey L, Holland Scott K, Kowatch Robert A, Birmaher Boris, Axelson David, Horwitz Sarah M, Arnold L Eugene, Fristad Mary A, Frazier Thomas W, Youngstrom Eric A, Findling Robert L, Phillips Mary L
机构信息
Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, USA.
Psychiatry and Behavioral Neuroscience, Wayne State University, USA.
出版信息
J Affect Disord. 2017 Jan 15;208:94-100. doi: 10.1016/j.jad.2016.09.064. Epub 2016 Oct 11.
OBJECTIVE
Both bipolar spectrum disorders (BPSD) and attention deficit hyperactivity disorder (ADHD) present with emotion-regulation deficits, but require different clinical management. We examined how the neurobiological underpinnings of emotion regulation might differentiate youth with BPSD versus ADHD (and healthy controls, HCs), specifically assessing functional connectivity (FxC) of amygdala-prefrontal circuitry during an implicit emotion processing task.
METHODS
We scanned a subset of the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a clinically recruited cohort with elevated behavioral and emotional dysregulation, and age/sex-ratio matched HCs. Our sample consisted of 22 youth with BPSD, 30 youth with ADHD/no BPSD, and 26 HCs. We used generalized psychophysiological interaction (gPPI) to calculate group differences to emerging emotional faces vs. morphing shapes in FxC between bilateral amygdala and ventral prefrontal cortex/anterior cingulate cortex.
RESULTS
FxC between amygdala and left ventrolateral prefrontal cortex (VLPFC) in response to emotions vs. shapes differed by group (p=.05): while BPSD showed positive FxC (emotions>shapes), HC and ADHD showed inverse FxC (emotions<shapes). A group x emotion interaction was found in amygdala-subgenual cingulate FxC (p=.025), explained by differences in FxC in response to negative emotions. While BPSD showed positive FxC, HC showed inverse FxC; ADHD were intermediate. Amygdala-subgenual FxC was also positively associated with depressive symptoms and stimulant medication.
LIMITATIONS
Co-morbidity and relatively small sample size.
CONCLUSIONS
Youth with BPSD showed abnormally positive FxC between amygdala and regions in the ventral prefrontal cortex during emotion processing. In particular, the amygdala-VLPFC finding was specific to BPSD, and not influenced by other diagnoses or medications.
目的
双相谱系障碍（BPSD）和注意力缺陷多动障碍（ADHD）均存在情绪调节缺陷，但需要不同的临床管理。我们研究了情绪调节的神经生物学基础如何区分患有BPSD的青少年与患有ADHD的青少年（以及健康对照，HCs），具体评估了在一项内隐情绪处理任务中杏仁核 - 前额叶回路的功能连接（FxC）。
方法
我们对躁狂症状纵向评估（LAMS）样本的一个子集进行了扫描，该样本是一个临床招募的队列，行为和情绪失调程度较高，以及年龄/性别比例匹配的HCs。我们的样本包括22名患有BPSD的青少年、30名患有ADHD/无BPSD的青少年和26名HCs。我们使用广义心理生理相互作用（gPPI）来计算双侧杏仁核与腹侧前额叶皮质/前扣带回皮质之间在对出现的情绪化面孔与变形形状的FxC方面的组间差异。
结果
杏仁核与左腹外侧前额叶皮质（VLPFC）之间对情绪与形状的FxC因组而异（p = 0.05）：BPSD表现出正FxC（情绪>形状），而HC和ADHD表现出相反的FxC（情绪<形状）。在杏仁核 - 膝下扣带回FxC中发现了组×情绪相互作用（p = 0.025），这可以通过对负面情绪的FxC差异来解释。BPSD表现出正FxC，HC表现出相反的FxC；ADHD处于中间状态。杏仁核 - 膝下FxC也与抑郁症状和兴奋剂药物呈正相关。
局限性
共病情况和样本量相对较小。
结论
患有BPSD的青少年在情绪处理过程中杏仁核与腹侧前额叶皮质区域之间表现出异常的正FxC。特别是，杏仁核 - VLPFC的发现是BPSD所特有的，不受其他诊断或药物的影响。
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