Fournier Jay C, Chase Henry W, Almeida Jorge, Phillips Mary L
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2016 Nov;1(6):518-527. doi: 10.1016/j.bpsc.2016.03.005.
Bipolar disorder (BD) and unipolar depression (UD) can be difficult to distinguish clinically, particularly during episodes of depression. In this study we test for differences between BD, UD, and healthy control (HC) adults regarding within- and between-session changes in BOLD response during implicit emotional processing.
During fMRI, HC adults (N=19) and depressed adults with UD (N=19) and BD (N=16) performed an implicit emotion-processing task. Each participant was scanned twice, separated by 6-months, resulting in 108 scans. BOLD response and linear change in BOLD response were examined within and between sessions.
We observed within-session linear decreases in BOLD signal (irrespective of group, condition, or session) in the left amygdala, a right-sided temporo-parietal region, and a right-sided fronto-insular region. Furthermore, we observed group differences in within-session BOLD signal change (p<0.05, FWE corrected) in a left-sided striatal-insular-thalamic region. Individuals with BD demonstrated a linear decrease in BOLD signal compared to HC (p<0.008, FWE corrected) across this region and compared to UD in the posterior insula portion of the region (p<0.008, FWE corrected). Finally, we observed main effects of emotional valence in bilateral visuo-spatial processing regions as well as in the left and right amygdala.
Individuals with BD demonstrated linear attenuation of BOLD response to emotional stimuli within left-sided striatal-insular-thalamic regions. Individuals with BD may either have experienced abnormal habituation in this region or disengaged quickly from processing the emotional stimuli, despite comparable task performance. This pattern may represent an underlying pathophysiological process associated with BD that differs from UD.
双相情感障碍（BD）和单相抑郁症（UD）在临床上可能难以区分，尤其是在抑郁发作期间。在本研究中，我们测试了BD、UD和健康对照（HC）成年人在隐式情绪处理过程中，脑血氧水平依赖（BOLD）反应在会话内和会话间变化的差异。
在功能磁共振成像（fMRI）期间，HC成年人（N = 19）、患有UD的抑郁成年人（N = 19）和BD成年人（N = 16）执行一项隐式情绪处理任务。每位参与者被扫描两次，间隔6个月，共进行了108次扫描。在会话内和会话间检查BOLD反应以及BOLD反应的线性变化。
我们观察到左侧杏仁核、右侧颞顶叶区域和右侧额岛叶区域的BOLD信号在会话内呈线性下降（与组别、条件或会话无关）。此外，我们观察到左侧纹状体 - 岛叶 - 丘脑区域在会话内BOLD信号变化存在组间差异（p < 0.05，家族误差率校正）。与HC相比，BD个体在该区域的BOLD信号呈线性下降（p < 0.008，家族误差率校正），并且在该区域的后岛叶部分与UD相比也呈线性下降（p < 0.008，家族误差率校正）。最后，我们观察到情绪效价在双侧视觉空间处理区域以及左右杏仁核中的主效应。
BD个体在左侧纹状体 - 岛叶 - 丘脑区域对情绪刺激的BOLD反应呈线性衰减。尽管任务表现相当，但BD个体在该区域可能经历了异常的习惯化，或者很快停止处理情绪刺激。这种模式可能代表了与BD相关的潜在病理生理过程，与UD不同。
