Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India.
J Affect Disord. 2021 Mar 1;282:869-875. doi: 10.1016/j.jad.2020.12.153. Epub 2020 Dec 30.
Facial emotion recognition (FER) deficit is documented in many psychiatric disorders, including bipolar disorder (BD). However, its role as a risk-marker in BD is not well researched. In the present study, we investigated the role of FER and the corresponding prefrontal neurohemodynamic changes (PNHC) with functional near infra-red spectroscopy (fNIRS) in patients with BD and subjects at high risk for BD compared to healthy subject.
Using a cross-sectional case-control design we compared 14 patients with first episode mania (FEM) in remission (BD group), 14 healthy siblings of BD patients (HR group), and 13 matched healthy subjects (HC group). FER was assessed using a computer-based task called Tool for Recognition of Emotions in Neuropsychiatric Disorders (TRENDS). Simultaneously, the corresponding PNHC was recorded with fNIRS. Kruskal Wallis H test was used to analyze between-group differences and Spearman's rho for correlation analysis.
The three groups were comparable on socio-demographics (all p>0.09) except education (p = 0.03). HR group had the most hyper-activation in the bilateral DLPFC during the TRENDS task (all p<0.05). There was no significant between-group differences in the FER performance and no significant correlation between the FER performance and the PNHC in the HR and BD groups (all p>0.35).
The potential confounding effect of medications in the BD group.
The hyper-activation of the DLPCF in HR group during FER could indicate an increased risk for BD. However, the lack of similar findings in the BD group might reflect a possible normalizing effect of medications. It is equally likely that differences in the PNHC are detectable earlier than the differences in FER task performance during the course of the illness. This requires further exploration.
面部情绪识别（FER）缺陷在许多精神疾病中都有记录，包括双相情感障碍（BD）。然而，其作为 BD 的风险标志物的作用尚未得到充分研究。在本研究中，我们使用功能近红外光谱（fNIRS）比较了 BD 患者、BD 患者高风险亲属（HR 组）和健康对照者（HC 组）的 FER 和相应的前额神经血液动力学变化（PNHC）。
我们采用横断面病例对照设计，比较了 14 例缓解期首发躁狂（FEM）患者（BD 组）、14 例 BD 患者健康同胞（HR 组）和 13 例匹配的健康对照者（HC 组）。使用称为神经精神障碍情绪识别工具（TRENDS）的计算机任务评估 FER。同时，使用 fNIRS 记录相应的 PNHC。采用 Kruskal Wallis H 检验分析组间差异，Spearman 相关系数分析相关性。
三组在社会人口统计学方面无差异（均 P>0.09），除教育程度（P=0.03）。在 TRENDS 任务中，HR 组双侧背外侧前额叶皮质（DLPFC）的激活最明显（均 P<0.05）。HR 组和 BD 组 FER 表现无显著组间差异，HR 组和 BD 组 FER 表现与 PNHC 无显著相关性（均 P>0.35）。
BD 组药物治疗的潜在混杂效应。
HR 组在 FER 期间 DLPFC 的过度激活可能表明 BD 风险增加。然而，BD 组中没有类似的发现可能反映了药物治疗的可能的正常化作用。同样可能的是，PNHC 的差异在疾病过程中比 FER 任务表现的差异更早被检测到。这需要进一步探索。
