Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Acta Psychiatr Scand. 2018 Oct;138(4):336-347. doi: 10.1111/acps.12915. Epub 2018 Jun 7.
Bipolar disorder is associated with impairments in social cognition including the recognition of happy faces. This is accompanied by imbalanced cortico-limbic response to emotional faces. We found that EPO improved the recognition of happy faces in patients with bipolar disorder. This randomized, controlled, longitudinal fMRI study explores the neuronal underpinnings of this effect.
Forty-four patients with bipolar disorder in full or partial remission were randomized to eight weekly erythropoietin (EPO; 40 000 IU) or saline (NaCl 0.9%) infusions in a double-blind, parallel-group design. Participants underwent whole-brain fMRI at 3T, mood ratings and blood tests at baseline and week 14. During fMRI, participants viewed happy and fearful faces and performed a gender discrimination task.
Thirty-four patients had complete pre- and post-treatment fMRI data (EPO: N = 18, saline: N = 16). Erythropoietin vs. saline increased right superior frontal response to happy vs. fearful faces. This correlated with improved happiness recognition in the EPO group. Erythropoietin also enhanced gender discrimination accuracy for happy faces. These effects were not influenced by medication, mood, red blood cells or blood pressure.
Together with previous findings, the present observation suggests that increased dorsal prefrontal attention control is a common mechanism of EPO-associated improvements across several cognitive domains.
双相情感障碍与社会认知障碍有关，包括对快乐的面孔的识别。这伴随着情绪面孔的皮质-边缘反应不平衡。我们发现 EPO 改善了双相情感障碍患者对快乐的面孔的识别。这项随机、对照、纵向 fMRI 研究探讨了这种效应的神经基础。
44 名处于完全或部分缓解期的双相情感障碍患者被随机分为 8 周的红细胞生成素（EPO；40000IU）或生理盐水（NaCl 0.9%）输注的双盲、平行组设计。参与者在 3T 进行全脑 fMRI，在基线和第 14 周进行情绪评分和血液测试。在 fMRI 期间，参与者观看快乐和恐惧的面孔，并进行性别识别任务。
34 名患者有完整的治疗前后 fMRI 数据（EPO：N = 18，生理盐水：N = 16）。EPO 与生理盐水相比，右侧额上回对快乐与恐惧面孔的反应增强。这与 EPO 组的快乐识别能力提高有关。EPO 还提高了对快乐的面孔的性别识别准确性。这些效应不受药物、情绪、红细胞或血压的影响。
与以前的发现一起，本观察表明，背外侧前额叶注意力控制的增加是 EPO 相关改善几个认知领域的共同机制。
