Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Transl Psychiatry. 2024 May 27;14(1):211. doi: 10.1038/s41398-024-02944-6.
Lamotrigine is an effective mood stabiliser, largely used for the management and prevention of depression in bipolar disorder. The neuropsychological mechanisms by which lamotrigine acts to relieve symptoms as well as its neural effects on emotional processing remain unclear. The primary objective of this current study was to investigate the impact of an acute dose of lamotrigine on the neural response to a well-characterised fMRI task probing implicit emotional processing relevant to negative bias. 31 healthy participants were administered either a single dose of lamotrigine (300 mg, n = 14) or placebo (n = 17) in a randomized, double-blind design. Inside the 3 T MRI scanner, participants completed a covert emotional faces gender discrimination task. Brain activations showing significant group differences were identified using voxel-wise general linear model (GLM) nonparametric permutation testing, with threshold free cluster enhancement (TFCE) and a family wise error (FWE)-corrected cluster significance threshold of p < 0.05. Participants receiving lamotrigine were more accurate at identifying the gender of fearful (but not happy or angry) faces. A network of regions associated with emotional processing, including amygdala, insula, and the anterior cingulate cortex (ACC), was significantly less activated in the lamotrigine group compared to the placebo group across emotional facial expressions. A single dose of lamotrigine reduced activation in limbic areas in response to faces with both positive and negative expressions, suggesting a valence-independent effect. However, at a behavioural level lamotrigine appeared to reduce the distracting effect of fear on face discrimination. Such effects may be relevant to the mood stabilisation effects of lamotrigine.
拉莫三嗪是一种有效的情绪稳定剂，主要用于治疗和预防双相情感障碍的抑郁。拉莫三嗪缓解症状的神经心理学机制及其对情绪处理的神经影响仍不清楚。本研究的主要目的是研究单次剂量的拉莫三嗪对一项针对与负性偏向相关的内隐情绪处理的特征明确的 fMRI 任务的神经反应的影响。31 名健康参与者以随机、双盲设计接受单剂量拉莫三嗪（300mg，n=14）或安慰剂（n=17）。在 3T MRI 扫描仪内，参与者完成了一项隐蔽的情绪面孔性别辨别任务。使用基于体素的广义线性模型（GLM）非参数置换检验识别显示出显著组间差异的脑激活，采用无阈值聚类增强（TFCE）和经家族性错误（FWE）校正的簇显著性阈值 p<0.05。服用拉莫三嗪的参与者在识别恐惧（但不是快乐或愤怒）面孔的性别时更准确。与安慰剂组相比，在情绪面孔表情中，与情绪处理相关的区域网络（包括杏仁核、岛叶和前扣带皮层（ACC））的激活显著降低。单次剂量的拉莫三嗪降低了对具有正性和负性表达的面孔的边缘区域的激活，表明存在与效价无关的效应。然而，在行为水平上，拉莫三嗪似乎减轻了恐惧对面孔辨别力的干扰效应。这些影响可能与拉莫三嗪的情绪稳定作用有关。
