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Landin-Romero R, Kumfor F, Ys Lee A, Leyton C, Piguet O. Clinical and cortical trajectories in non-fluent primary progressive aphasia and Alzheimer's disease: A role for emotion processing. Brain Res 2024; 1829:148777. [PMID: 38286395 DOI: 10.1016/j.brainres.2024.148777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To examine the clinical trajectories and neural correlates of cognitive and emotion processing changes in the non-fluent/agrammatic (nfvPPA) and the logopenic (lvPPA) variants of primary progressive aphasia (PPA). DESIGN Observational case-control longitudinal cohort study. SETTING Research clinic of frontotemporal dementia. PARTICIPANTS This study recruited 29 non-semantic PPA patients (15 nfvPPA and 14 lvPPA) and compared them with 15 Alzheimer's disease (AD) patients and 14 healthy controls. MEASUREMENTS Participants completed an annual assessment (median = 2 years; range = 1-5 years) of general cognition, emotion processing and structural MRI. Linear mixed effects models investigated clinical and imaging trajectories between groups. RESULTS Over time, lvPPA showed the greatest cognitive deterioration. In contrast, nfvPPA showed significant decline in emotion recognition, whereas AD showed preserved emotion recognition, even with disease progression. Importantly, lvPPA also developed emotion processing impairments, with disease progression. Both nfvPPA and lvPPA showed continuing cortical atrophy in hallmark language-processing regions associated with these syndromes, together with progressive involvement of the right hemisphere regions, mirroring left hemisphere atrophy patterns at presentation. Decline in emotion processing was associated with bilateral frontal atrophy in nfvPPA and right temporal atrophy in lvPPA. CONCLUSIONS Our results show divergent clinical courses in nfvPPA and lvPPA, with rapid cognitive and neural deterioration in lvPPA and emotion processing decline in both groups and support the concurrent assessment of cognition and emotion processing in the clinic to inform diagnosis and monitoring in the non-semantic variants of PPA.
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Affiliation(s)
- Ramon Landin-Romero
- Sydney School of Health Sciences & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia.
| | - Fiona Kumfor
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Austin Ys Lee
- ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Cristian Leyton
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Olivier Piguet
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
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Brænden A, Coldevin M, Zeiner P, Stubberud J, Melinder A. Neuropsychological mechanisms of social difficulties in disruptive mood dysregulation disorder versus oppositional defiant disorder. Child Neuropsychol 2024; 30:402-424. [PMID: 37106502 DOI: 10.1080/09297049.2023.2205632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
Children with Disruptive Mood Dysregulation Disorder (DMDD) or Oppositional Defiant Disorder (ODD) are characterized by irritability and social difficulties. However, the mechanisms underlying these disorders could be different. This study explores differences in social cognition and executive function (EF) across DMDD and ODD and the influence of these factors and their interaction on social problems in both groups. Children with DMDD (n = 53, Mage = 9.3) or ODD (n = 39, Mage = 9.6) completed neuropsychological tasks measuring social cognition (Theory of Mind and Face-Emotion Recognition) and EF (cognitive flexibility, inhibition, and working memory). Parents reported social problems. More than one-third of the children with DMDD and almost two-thirds of those with ODD showed clear difficulties with Theory of Mind. Most children with DMDD (51-64%) or ODD (67-83%) showed difficulties with EF. In children with DMDD, worse EF (β = -.36) was associated with more social problems, whereas in children with ODD, better EF (β = .44) was associated with more social problems. In those with ODD, but not in those with DMDD, the interaction between social cognition and EF contributed to the explained variance of social problems (β = -1.97). Based on the observed interaction pattern, enhanced EF may lead to increased social problems among children with ODD who also exhibit social cognition difficulties. This study suggests the existence of distinct neuropsychological mechanisms underlying the social issues observed in children with DMDD versus those with ODD.
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Affiliation(s)
- Astrid Brænden
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marit Coldevin
- Lovisenberg Diaconal Hospital, Nic Waals Institute, Oslo, Norway
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Annika Melinder
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Qin K, Pan N, Lei D, Zhang F, Yu Y, Sweeney JA, DelBello MP, Gong Q. Common and distinct neural correlates of emotional processing in individuals at familial risk for major depressive disorder and bipolar disorder: A comparative meta-analysis. J Affect Disord 2024; 348:97-106. [PMID: 38113944 PMCID: PMC10846904 DOI: 10.1016/j.jad.2023.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
Individuals at familial risk for mood disorders exhibit deficits in emotional processing and associated brain dysfunction prior to illness onset. However, such brain-behavior abnormalities related to familial predisposition remain poorly understood. To investigate robust abnormal functional activation patterns during emotional processing in unaffected at-risk relatives of patients with major depressive disorder (UAR-MDD) and bipolar disorder (UAR-BD), we performed a meta-analysis of task-based functional magnetic resonance imaging studies using Seed-based d Mapping (SDM) toolbox. Common and distinct patterns of abnormal functional activation between UAR-MDD and UAR-BD were detected via conjunction and differential analyses. A total of 17 studies comparing 481 UAR and 670 healthy controls (HC) were included. Compared with HC, UAR-MDD exhibited hyperactivation in the parahippocampal gyrus, amygdala and cerebellum, while UAR-BD exhibited parahippocampal hyperactivation and hypoactivation in the striatum and middle occipital gyrus (MOG). Conjunction analysis revealed shared hyperactivated PHG in both groups. Differential analysis indicated that the activation patterns of amygdala and MOG significantly differed between UAR-MDD and UAR-BD. These findings provide novel insights into common and distinct neural phenotypes for familial risk and associated risk mechanisms in MDD and BD, which may have implications in guiding precise prevention strategies tailored to the family context.
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Affiliation(s)
- Kun Qin
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Radiology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, OH, United States of America
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, China
| | - Du Lei
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, OH, United States of America; College of Medical Informatics, Chongqing Medical University, Chongqing 400016, China
| | - Feifei Zhang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yifan Yu
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - John A Sweeney
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, OH, United States of America
| | - Melissa P DelBello
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, OH, United States of America
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China; Department of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen 361021, China.
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Förster K, Maliske LZ, Schurz M, Henneberg PM, Dannlowski U, Kanske P. How do bipolar disease states affect positive and negative emotion processing? Insights from a meta-analysis on the neural fingerprints of emotional processing. Bipolar Disord 2023; 25:540-553. [PMID: 37248623 DOI: 10.1111/bdi.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Functional magnetic resonance imaging studies on emotion processing in patients with bipolar disorder (BD) show hyperactivity of limbic-striatal brain areas and hypoactivity in inferior frontal areas compared to healthy participants. However, heterogeneous results in patients with different disease states and different valences of emotional stimuli have been identified. METHODS To integrate previous results and elucidate the impact of disease state and stimulus valence, we conducted a systematic literature search for journal articles in the Web of Science Core Collection including MEDLINE databases and employed a coordinate-based-meta-analysis of functional-MRI studies comparing emotion processing in BD-patients with healthy participants using seed-based d mapping (SDM) to test for between-subjects-effects. We included 31 studies published before 11/2022 with a total of N = 766 BD-patients and N = 836 controls. RESULTS Patients with BD showed hyperactivated regions involved in salience processing of emotional stimuli (e.g., the bilateral insula) and hypoactivation of regions associated with emotion regulation (e.g., inferior frontal gyrus) during emotion processing, compared to healthy participants. A more detailed descriptive analysis revealed a hypoactive (anterior) insula in manic BD-patients specifically for negative in comparison to positive emotion processing. DISCUSSION This meta-analysis corroborates the overall tenor of existing literature that patients with BD show an increased emotional reactivity (hyperactivity of salience-processing regions) together with a lower (cognitive) control (hypoactivity of brain areas associated with emotion regulation) over emotional states. Our analysis suggests reduced interoceptive processing of negative stimuli in mania, pointing out the need for longitudinal within-subject analyses of emotion processing.
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Affiliation(s)
- Katharina Förster
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Lara Z Maliske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Matthias Schurz
- Institute of Psychology and Digital Science Center (DiSC), University of Innsbruck, Innsbruck, Austria
| | - Paula M Henneberg
- Clinic and Outpatient Clinic of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Philipp Kanske
- Clinical Psychology and Behavioral Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
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Del Giacco AC, Jones SA, Hernandez KO, Barnes SJ, Nagel BJ. Heightened adolescent emotional reactivity in the brain is associated with lower future distress tolerance and higher depressive symptoms. Psychiatry Res Neuroimaging 2023; 333:111659. [PMID: 37263126 PMCID: PMC10330591 DOI: 10.1016/j.pscychresns.2023.111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/26/2023] [Accepted: 05/18/2023] [Indexed: 06/03/2023]
Abstract
Distress tolerance, the ability to persist while experiencing negative psychological states, is essential for regulating emotions and is a transdiagnostic risk/resiliency trait for multiple psychopathologies. Studying distress tolerance during adolescence, a period when emotion regulation is still developing, may help identify early risk and/or protective factors. This study included 40 participants (mean scan age = 17.5 years) and using an emotional Go-NoGo functional magnetic resonance imaging task and voxel-wise regression analysis, examined the association between brain response during emotional face processing and future distress tolerance (two ± 0.5 years), controlling for sex assigned at birth, age, and time between visits. Post-hoc analyses tested the mediating role of distress tolerance on the emotional reactivity and depressive symptom relationship. Whole-brain analysis showed greater inferior occipital gyrus activation was associated with less distress tolerance at follow-up. The mediating role of distress tolerance demonstrated a trend-level indirect effect. Findings suggest that individuals who allocate greater visual resources to emotionally salient information tend to exhibit greater challenges in tolerating distress. Distress tolerance may help to link emotional reactivity neurobiology to future depressive symptoms. Building distress tolerance through emotion regulation strategies may be an appropriate strategy for decreasing depressive symptoms.
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Affiliation(s)
- Amanda C Del Giacco
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Scott A Jones
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Kristina O Hernandez
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Samantha J Barnes
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America
| | - Bonnie J Nagel
- Departments of Psychiatry, Oregon Health & Science University, Portland, OR, United States of America; Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, United States of America.
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Kim BH, Kim SH, Han C, Jeong HG, Lee MS, Kim J. Antidepressant-induced mania in panic disorder: a single-case study of clinical and functional connectivity characteristics. Front Psychiatry 2023; 14:1205126. [PMID: 37304446 PMCID: PMC10248065 DOI: 10.3389/fpsyt.2023.1205126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Mental health issues, including panic disorder (PD), are prevalent and often co-occur with anxiety and bipolar disorders. While panic disorder is characterized by unexpected panic attacks, and its treatment often involves antidepressants, there is a 20-40% risk of inducing mania (antidepressant-induced mania) during treatment, making it crucial to understand mania risk factors. However, research on clinical and neurological characteristics of patients with anxiety disorders who develop mania is limited. Methods In this single case study, we conducted a larger prospective study on panic disorder, comparing baseline data between one patient who developed mania (PD-manic) and others who did not (PD-NM group). We enrolled 27 patients with panic disorder and 30 healthy controls (HCs) and examined alterations in amygdala-based brain connectivity using a seed-based whole-brain approach. We also performed exploratory comparisons with healthy controls using ROI-to-ROI analyses and conducted statistical inferences at a threshold of cluster-level family-wise error-corrected p < 0.05, with the cluster-forming threshold at the voxel level of uncorrected p < 0.001. Results The patient with PD-mania showed lower connectivity in brain regions related to the default mode network (left precuneous cortex, maximum z-value within the cluster = -6.99) and frontoparietal network (right middle frontal gyrus, maximum z-value within the cluster = -7.38; two regions in left supramarginal gyrus, maximum z-value within the cluster = -5.02 and -5.86), and higher in brain regions associated with visual processing network (right lingual gyrus, maximum z-value within the cluster = 7.86; right lateral occipital cortex, maximum z-value within the cluster = 8.09; right medial temporal gyrus, maximum z-value within the cluster = 8.16) in the patient with PD-mania compared to the PD-NM group. One significantly identified cluster, the left medial temporal gyrus (maximum z-value within the cluster = 5.82), presented higher resting-state functional connectivity with the right amygdala. Additionally, ROI-to-ROI analysis revealed that significant clusters between PD-manic and PD-NM groups differed from HCs in the PD-manic group but not in the PD-NM group. Conclusion Here, we demonstrate altered amygdala-DMN and amygdala-FPN connectivity in the PD-manic patient, as reported in bipolar disorder (hypo) manic episodes. Our study suggests that amygdala-based resting-state functional connectivity could serve as a potential biomarker for antidepressant-induced mania in panic disorder patients. Our findings provide an advance in understanding the neurological basis of antidepressant-induced mania, but further research with larger cohorts and more cases is necessary for a broader perspective on this issue.
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Affiliation(s)
- Byung-Hoon Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Department of Life Sciences, Korea University, Seoul, Republic of Korea
| | - Junhyung Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Lee KS, Hagan CN, Hughes M, Cotter G, McAdam Freud E, Kircanski K, Leibenluft E, Brotman MA, Tseng WL. Systematic Review and Meta-analysis: Task-based fMRI Studies in Youths With Irritability. J Am Acad Child Adolesc Psychiatry 2023; 62:208-229. [PMID: 35944754 PMCID: PMC9892288 DOI: 10.1016/j.jaac.2022.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/22/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Childhood irritability, operationalized as disproportionate and frequent temper tantrums and low frustration tolerance relative to peers, is a transdiagnostic symptom across many pediatric disorders. Studies using task-dependent functional magnetic resonance imaging (fMRI) to probe neural dysfunction in irritability have increased. However, an integrated review summarizing the published methods and synthesized fMRI results remains lacking. METHOD We conducted a systematic search using irritability terms and task functional neuroimaging in key databases in March 2021, and identified 30 studies for our systematic review. Sample characteristics and fMRI methods were summarized. A subset of 28 studies met the criteria for extracting coordinate-based data for quantitative meta-analysis. Ten activation-likelihood estimations were performed to examine neural convergence across irritability measures and fMRI task domains. RESULTS Systematic review revealed small sample sizes (median = 58, mean age range = 8-16 years) with heterogeneous sample characteristics, irritability measures, tasks, and analytical procedures. Meta-analyses found no evidence for neural activation convergence of irritability across neurocognitive functions related to emotional reactivity, cognitive control, and reward processing, or within each domain. Sensitivity analyses partialing out variances driven by heterogeneous tasks, irritability measures, stimulus types, and developmental ages all yielded null findings. Results were compared with a review on irritability-related structural anomalies from 11 studies. CONCLUSION The lack of neural convergence suggests a need for common, standardized irritability assessments and more homogeneous fMRI tasks. Thoughtfully designed fMRI studies probing commonly defined neurocognitive functions may be more fruitful to elucidate the neural mechanisms of irritability. Open science practices, data mining in large neuroscience databases, and standardized analytical methods promote meaningful collaboration in irritability research.
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Affiliation(s)
- Ka Shu Lee
- Yale School of Medicine, New Haven, Connecticut; University of Oxford, United Kingdom.
| | | | - Mina Hughes
- Yale School of Medicine, New Haven, Connecticut
| | | | - Eva McAdam Freud
- Yale School of Medicine, New Haven, Connecticut.,University College London, United Kingdom, and Anna Freud National
Centre for Children and Families, London, United Kingdom
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Cattarinussi G, Bellani M, Maggioni E, Sambataro F, Brambilla P, Delvecchio G. Resting-state functional connectivity and spontaneous brain activity in early-onset bipolar disorder: A review of functional Magnetic Resonance Imaging studies. J Affect Disord 2022; 311:463-471. [PMID: 35580695 DOI: 10.1016/j.jad.2022.05.055] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Early-onset bipolar disorder (BD) is a complex psychiatric illness characterized by mood swings, irritability and functional impairments. To improve our understanding of the pathophysiology of the disorder, we collected the existing resting-state functional Magnetic Resonance Imaging (rs-fMRI) studies exploring resting-state functional connectivity (rs-FC) and spontaneous activity alterations in children and adolescents with BD. METHODS A search on PubMed, Web of Science and Scopus was conducted to identify all the relevant rs-fMRI investigations conducted in early-onset BD. A total of 14 studies employing different methodological approaches to explore rs-FC and spontaneous activity in early-onset BD were included (independent component analysis, n = 1; seed-based analysis, n = 7; amplitude of low frequency fluctuations analysis, n = 2; regional homogeneity analysis, n = 4). RESULTS Overall, the studies showed abnormalities within the Default Mode Network (DMN) and between the DMN and the Salience Network (SN). Moreover, widespread alterations in rs-FC and spontaneous brain activity within and between cortico-limbic structures, involving primarily the occipital and frontal lobes, amygdala, hippocampus, insula, thalamus and striatum were also reported. LIMITATIONS The small sample sizes, the use of medications, the presence of comorbidities and the heterogeneity in methods hamper the integration of the study findings. CONCLUSIONS Early-onset BD seems to be characterized by selective rs-FC and spontaneous activity dysfunctions in DMN and SN as well as in the cortico-limbic and cortico-striatal circuits, which could explain the emotive and cognitive deficits observed in this disabling psychiatric illness.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Electronics Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Brænden A, Zeiner P, Coldevin M, Stubberud J, Melinder A. Underlying mechanisms of disruptive mood dysregulation disorder in children: A systematic review by means of research domain criteria. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Astrid Brænden
- Department of Child and Adolescent Psychiatry Oslo University Hospital Oslo Norway
| | - Pål Zeiner
- Child and Adolescent Mental Health Research Unit, Department of Research and Innovation Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Marit Coldevin
- Nic Waals Institute Lovisenberg Diaconal Hospital Oslo Norway
- Department of Research Lovisenberg Diaconal Hospital Oslo Norway
| | - Jan Stubberud
- Department of Research Lovisenberg Diaconal Hospital Oslo Norway
- Department of Psychology University of Oslo Oslo Norway
| | - Annika Melinder
- Department of Child and Adolescent Psychiatry Oslo University Hospital Oslo Norway
- Department of Psychology University of Oslo Oslo Norway
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Elucidating the neural correlates of emotion recognition in children with sub-clinical anxiety. J Psychiatr Res 2021; 143:75-83. [PMID: 34461352 DOI: 10.1016/j.jpsychires.2021.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/31/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The pervasiveness of subclinical anxiety in children, highlights the need to identify its neurobiological underpinnings to better inform interventions. Given the now well-established link between aberrant emotion processing and anxiety disorders and yet limited neurobiologically-informed research in this area, this study examined the neural correlates of emotion recognition (ER) in children with sub-clinical anxiety. METHOD Ninety children (aged 9-11 years) with sub-clinical anxiety, completed an emotion recognition task whilst undergoing functional magnetic resonance imaging. The ER task required participants to match shapes and match emotional faces in the context of shape distractors. Participants also completed the Spence Children's Anxiety Scale (SCAS). RESULTS Greater blood oxygenation level dependent (BOLD) changes associated with ER were observed in the lateral occipital cortex, middle frontal gyrus, superior middle frontal gyrus, inferior frontal gyrus, superior parietal lobule, inferior parietal lobule, superior temporal gyrus, and middle temporal gyrus symmetrically. The clusters also included posterior cingulate cortex, insula, hippocampus, amygdala and cerebellum during matching emotions than those matching shapes. Females showed greater BOLD changes associated with ER than males in the right middle frontal gyrus. The BOLD changes associated with ER in the right middle frontal gyrus and right insula were greater in children with SCAS subscale (physical injury fear) scores in the normal range than those with elevated scores. DISCUSSION The findings in this study implicate the right middle frontal gyrus and insula as key regions in the neurobiological underpinnings of sub-clinical anxiety as they relate to attention impairments in anxious children. CONCLUSION The results of this study indicate there are gender differences in young participants during emotion processing and provides a neurobiological target for attention impairments in anxious children.
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Wang YL, Jiang ML, Huang LX, Meng X, Li S, Pang XQ, Zeng ZS. Disrupted resting-state interhemispheric functional connectivity in systemic lupus erythematosus patients with and without neuropsychiatric lupus. Neuroradiology 2021; 64:129-140. [PMID: 34379142 DOI: 10.1007/s00234-021-02750-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study is to explore interhemispheric homotopic functional connectivity alterations in systemic lupus erythematosus (SLE) patients with and without neuropsychiatric lupus (NPSLE and non-NPSLE, respectively) and their potential correlations with clinical characteristics and neuropsychological performance. METHODS Based on resting-state functional MRI (rs-fMRI) data collected from SLE patients and matched healthy controls (HCs), the voxel-mirrored homotopic connectivity (VMHC) analysis was conducted to measure functional homotopy. Subsequently, correlations between altered functional homotopy and clinical/neuropsychological data were analyzed. RESULTS Compared with the HC group, both NPSLE and non-NPSLE groups showed attenuated homotopic connectivity in middle temporal gyrus (MTG), cuneus (CUN), middle occipital gyrus (MOG), angular gyrus (ANG), and postcentral gyrus (PoCG). NPSLE patients also exhibited decreased homotopic connectivity in inferior parietal gyrus (IPG) and middle frontal gyrus (MFG). Compared with non-NPSLE patients, NPSLE patients showed weaker interhemispheric homotopic functional connectivity in MOG. Decreased homotopic functional connectivity in PoCG, IPG, and MOG were associated with the anxiety state of SLE patients. CONCLUSIONS Our findings revealed attenuated functional homotopy in both NPSLE and non-NPSLE groups compared to the HC group, which appeared to be more severe in patients with comorbid neuropsychiatric lupus. Interhemispheric homotopy dysconnectivity may participate in the neuropathology of anxiety symptoms in SLE.
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Affiliation(s)
- Yi-Ling Wang
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Mu-Liang Jiang
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Li-Xuan Huang
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Xia Meng
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Shu Li
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Xiao-Qi Pang
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China
| | - Zi-San Zeng
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, Zhuang Autonomous Region, China.
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Altered Functional Integration in the Salience and Default Mode Networks in Euthymic Pediatric Bipolar Disorder. Neural Plast 2020; 2020:5853701. [PMID: 33133177 PMCID: PMC7568799 DOI: 10.1155/2020/5853701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/28/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022] Open
Abstract
Accumulating studies demonstrate emotional and cognitive dysregulation in the euthymic period of pediatric bipolar disorder (PBD). However, the relative contribution of functional integration in human brain to disturbed emotion and cognitive function in the euthymic PBD patients remains unclear. In this study, 16 euthymic PBD patients and 16 healthy controls underwent resting-state functional magnetic resonance imaging. A data-driven functional connectivity analysis was used to investigate functional connectivity changes of the euthymic PBD. Compared with healthy controls, the euthymic PBD exhibited greater global functional connectivity density in the left anterior insula and lower global functional connectivity density in the right temporoparietal junction, the left angular gyrus, and the bilateral occipital lobule. A distant functional connectivity analysis demonstrated altered integration within the salience and default mode networks in euthymic PBD. Correlation analysis found that altered functional connectivity of the salience network was related to the reduced performance in the backward digit span test, and altered functional connectivity of the default mode network was related to the Young Mania Rating Scale in euthymic PBD patients. Our findings indicated that disturbed functional integration in salience and default mode networks might shed light on the physiopathology associated with emotional and cognitive dysregulation in PBD.
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Shan X, Qiu Y, Pan P, Teng Z, Li S, Tang H, Xiang H, Wu C, Tan Y, Chen J, Guo W, Wang B, Wu H. Disrupted Regional Homogeneity in Drug-Naive Patients With Bipolar Disorder. Front Psychiatry 2020; 11:825. [PMID: 32922322 PMCID: PMC7456987 DOI: 10.3389/fpsyt.2020.00825] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Studies on alterations in the regional neural activity in the brain of patients with bipolar disorder (BD) have provided conflicting results because of different medications used and study designs. A low bone mineral density (BMD) is also observed in patients with BD. This study aimed to further explore regional neural activities in unmedicated patients with BD and their association with BMD. METHODS In this study, 40 patients with BD and 42 healthy controls were scanned through resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with regional homogeneity (ReHo) and pattern classification. Pearson's correlation analyses were performed to explore the correlations between abnormal ReHo and BMD. RESULTS A significant increase in ReHo values in the left inferior frontal gyrus (IFG)/temporal pole, left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem, and right superior temporal gyrus (STG) and a decrease in ReHo in the occipital gyrus (OG; left middle OG/superior OG/bilateral cuneus) were found in the patients with BD (p < 0.05) compared with those in the healthy controls. No significant correlation was observed between the abnormal ReHo values in any of the brain regions of the patients with BMD.Support vector machine (SVM) analyses revealed that the ReHo values in the right STG for distinguishing patients from healthy controls showed an accuracy of 91.89%, a sensitivity of 75.68%, and a specificity of 83.78%. The ReHo values in the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem indicated an accuracy of 78.38%, a sensitivity of 75.68%, and a specificity of 81.08%. CONCLUSION This study further confirms the abnormal brain activities in extensive regions, and these brain regions are primarily located in the fronto-temporal-occipital circuit and the cerebellum vermis of patients with BD. The regional neural activity in the right STG and the left cerebellum vermis I/vermis II/parahippocampal gyrus/brainstem may serve as potential imaging markers to distinguish patients with BD from healthy controls.
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Affiliation(s)
- Xiaoxiao Shan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yan Qiu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pan Pan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ziwei Teng
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Sujuan Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Tang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hui Xiang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chujun Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuxi Tan
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jindong Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, The Third People’s Hospital of Foshan, Foshan, China
| | - Bolun Wang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haishan Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China
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Song H, Chon MW, Ryu V, Yu R, Lee DK, Lee H, Lee W, Lee JH, Park DY. Cortical Volumetric Correlates of Childhood Trauma, Anxiety, and Impulsivity in Bipolar Disorder. Psychiatry Investig 2020; 17:627-635. [PMID: 32571005 PMCID: PMC7385221 DOI: 10.30773/pi.2019.0305] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE More recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD. METHODS We studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group. RESULTS Childhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores. CONCLUSION The present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.
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Affiliation(s)
- Hyehyun Song
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Myong-Wuk Chon
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Vin Ryu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Rina Yu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong-Kyun Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Wonhye Lee
- Department of Clinical Psychology, National Center for Mental Health, Seoul, Republic of Korea
| | - Jung Hyun Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong Yeon Park
- Department of Mood Disorders, National Center for Mental Health, Seoul, Republic of Korea
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Qiu S, Chen F, Chen G, Jia Y, Gong J, Luo X, Zhong S, Zhao L, Lai S, Qi Z, Huang L, Wang Y. Abnormal resting-state regional homogeneity in unmedicated bipolar II disorder. J Affect Disord 2019; 256:604-610. [PMID: 31299441 DOI: 10.1016/j.jad.2019.06.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/06/2019] [Accepted: 06/29/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies demonstrated that patients with bipolar disorder (BD) exhibited abnormal neural activity in multiple brain regions. However, no study has been conducted to identify regional intrinsic neural activity changes in BD II. In the present study, we used the regional homogeneity (ReHo) approach to explore the regional abnormal neural activity in bipolar II disorder METHODS: One hundred unmedicated patients with BD II depression and 100 healthy controls (HC) underwent the resting-state functional magnetic resonance imaging. The ReHo values of each voxel was calculated in the whole brain. The two-sample t-test and threshold-free cluster enhancement (TFCE) correction were applied for the ReHo analysis. RESULTS Compared with the HC group, the BD II group showed significantly decreased ReHo in the left orbitofrontal cortex, and increased ReHo in the right precentral gyrus, right supplementary motor area and bilateral middle occipital gyrus (P < .05, TFCE corrected). LIMITATIONS This study lacks the evidence of brain structural changes, and used the cross-sectional design which did not explore local alterations of remitted and manic patients. CONCLUSION Our findings revealed abnormal local intrinsic neural activity during resting state which may contribute to the pathophysiology of bipolar II disorder. Particularly the disrupted balance between the prefrontal cortex and primary sensorimotor regions provides evidence for the unique pathological mechanism underlying BD.
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Affiliation(s)
- Shaojuan Qiu
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiaying Gong
- Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Xiaomei Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Lianping Zhao
- Department of Radiology, Gansu Provincial Hospital, Gansu 730000, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Zhong S, Chen G, Zhao L, Jia Y, Chen F, Qi Z, Huang L, Wang Y. Correlation between Intrinsic Brain Activity and Thyroid-Stimulating Hormone Level in Unmedicated Bipolar II Depression. Neuroendocrinology 2019; 108:232-243. [PMID: 30673659 DOI: 10.1159/000497182] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/21/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Although abnormalities of amplitude of low-frequency fluctuations (ALFF) and hormone levels of hypothalamus-pituitary-thyroid axis have been reported in patients with bipolar disorder (BD), the association between abnormal ALFF and serum thyroid hormone levels remains unknown. METHOD A total of 90 patients with unmedicated BD II depression and 100 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging, and then routine band (0.01-0.1 Hz), slow-5 band (0.01-0.027 Hz), and slow-4 band (0.027-0.073 Hz) ALFF analysis were performed. Additionally, serum thyroid hormone levels including free tri-iodothyronine (FT3), total tri-iodothyronine (TT3), free thyroxin (FT4), total thyroxin (TT4), and thyroid-stimulating hormone (TSH) were detected. The correlation between abnormal serum thyroid hormone levels and ALFF values in patients with BD II depression was calculated. RESULTS Compared with the HCs, patients with BD II depression showed decreased ALFF in bilateral precuneus (PCu)/posterior cingulate cortex (PCC) in routine and slow-4 frequency bands, decreased ALFF in the right PCu, and increased ALFF in the right middle occipital gyrus (MOG) in the slow-5 frequency band. Additionally, patients with BD II depression showed lower TSH level than HCs, and TSH level was positively correlated with ALFF values in the bilateral PCu/PCC in the routine frequency band. CONCLUSIONS These findings suggest that patients with BD II depression display intrinsic activity abnormalities, mainly in the PCu/PCC and MOG, which are associated with specific frequency bands. Moreover, altered intrinsic activity in the PCu/PCC may be related to TSH levels in bipolar II depression.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Radiology, Gansu Provincial Hospital, Gansu, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Feng Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China,
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China,
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17
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Rappaport LM, Carney DM, Verhulst B, Neale MC, Blair J, Brotman MA, Pine DS, Leibenluft E, Hettema JM, Roberson-Nay R. A Developmental Twin Study of Emotion Recognition and Its Negative Affective Clinical Correlates. J Am Acad Child Adolesc Psychiatry 2018; 57:925-933.e3. [PMID: 30522738 PMCID: PMC7036262 DOI: 10.1016/j.jaac.2018.05.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 05/16/2018] [Accepted: 06/14/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Youth with psychiatric disorders distinguished by irritability, including depression and associated trait neuroticism, show deficits in the ability to recognize facial expressions of emotion, particularly happiness. However, the contribution of genetic and environmental factors to this ability remains unknown. The present study examined this trait in twins to assess the genetic and environmental influences on face-emotion recognition abilities and their association with irritability, neuroticism, and depression. METHOD Child and adolescent twins (N = 957 from 496 families) 9 to 17 years old rated their irritability (on the Affective Reactivity Index), neuroticism (on the Junior Eysenck Personality Questionnaire), and depression (on the Short Mood and Feelings Questionnaire) and completed a face-emotion labeling task. Faces depicting anger, disgust, fear, happiness, sadness, and surprise were morphed with a neutral face, yielding 10 levels of increasing emotional expressivity. Biometrical twin analyses evaluated contributions of genetic and environmental factors to the etiology of face-emotion recognition and its association with irritability, neuroticism, and depression. RESULTS Recognition of each emotion was heritable; common and specific sets of genetic factors influenced all emotions and individual emotions, respectively. Irritability, neuroticism, and depression were modestly and negatively correlated with emotion recognition, particularly the recognition of happiness. For irritability and neuroticism, this correlation appeared largely due to genetic factors. CONCLUSION This study maps genetic and environmental contributions to face-emotion recognition and its association with irritability, neuroticism, and depression. Findings implicate common genetic factors in deficits regarding the recognition of happiness associated with irritability and neuroticism in childhood and adolescence.
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Affiliation(s)
| | | | | | | | - James Blair
- National Institute of Mental Health, Bethesda, MD
| | | | | | | | - John M Hettema
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond
| | - Roxann Roberson-Nay
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond
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Kessel EM, Kujawa A, Dougherty LR, Hajcak G, Carlson GA, Klein DN. Neurophysiological Processing of Emotion in Children of Mothers with a History of Depression: the Moderating Role of Preschool Persistent Irritability. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1599-1608. [PMID: 28138807 DOI: 10.1007/s10802-017-0272-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Research on emotion-processing biases in offspring of depressed parents has produced a variety of findings. Child persistent irritability may be a useful clinical feature that demarcates subgroups of offspring with distinct patterns of emotion processing. The present study examined whether early persistent irritability moderated the relationship between maternal lifetime history of a depressive disorder and appetitive- and aversive-emotion processing in 338 never-depressed pre-adolescent children (43.8% female). When children were 3, mothers were interviewed about children's persistent irritability. Six years later, EEG was recorded while children completed a task in which the late positive potential (LPP), a neural index of emotional reactivity, was measured in response to appetitive, aversive, and neutral images. At both assessments, mothers were interviewed about their own psychopathology. Among offspring of depressed mothers, children characterized by high levels of early persistent irritability showed an enhanced LPP to appetitive and aversive compared to neutral images (i.e., ΔLPP), whereas children with low levels of early irritability showed attenuated ΔLPPs. In offspring of mothers with no history of depression, there was no association between irritability and emotion processing. Findings suggest that persistent irritability influences the pattern of emotion-processing aberrations in offspring of depressed mothers.
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Affiliation(s)
- Ellen M Kessel
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Autumn Kujawa
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Lea R Dougherty
- Department of Psychology, University of Maryland-College Park, College Park, USA
| | - Greg Hajcak
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Gabrielle A Carlson
- Department of Psychiatry, Stony Brook University School of Medicine, New York, USA
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.,Department of Psychiatry, Stony Brook University School of Medicine, New York, USA
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Altered interhemispheric functional connectivity in remitted bipolar disorder: A Resting State fMRI Study. Sci Rep 2017; 7:4698. [PMID: 28680123 PMCID: PMC5498592 DOI: 10.1038/s41598-017-04937-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 05/23/2017] [Indexed: 01/10/2023] Open
Abstract
Abnormalities in structural and functional brain connectivity have been increasingly reported in patients with bipolar disorder (BD). However, alterations of remitted BD (RBD) in functional connectivity between the cerebral hemispheres are still not well understood. This study was designed to analyze the pattern of the interhemispheric functional connectivity of the whole brain in patients with remitted BD during resting state. Twenty patients with RBD and 38 healthy controls (HC) underwent the resting-state functional magnetic resonance imaging. The functional connectivity between any pair of symmetrical interhemispheric voxels (i.e., functional homotopy) was measured by voxel-mirrored homotopic connectivity (VMHC). The patients with RBD showed lower VMHC than HC in the middle frontal gyrus and precentral gyrus. No regions of increased VMHC were detected in the RBD patients. There were no significant correlations between the VMHC values in these regions and the clinical variables. These findings suggest substantial impairment of interhemispheric coordination in RBD and they may represent trait, rather than state, neurobiological feature of brain function in BD.
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20
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Defining and measuring irritability: Construct clarification and differentiation. Clin Psychol Rev 2017; 53:93-108. [DOI: 10.1016/j.cpr.2017.01.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/23/2016] [Accepted: 01/30/2017] [Indexed: 11/22/2022]
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Irritability in child and adolescent psychopathology: An integrative review for ICD-11. Clin Psychol Rev 2017; 53:29-45. [PMID: 28192774 DOI: 10.1016/j.cpr.2017.01.004] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 01/02/2017] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
In preparation for the World Health Organization's development of the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11) chapter on Mental and Behavioral Disorders, this article reviews the literature pertaining to severe irritability in child and adolescent psychopathology. First, research on severe mood dysregulation suggests that youth with irritability and temper outbursts, among other features of hyperactivity and arousal, demonstrate cross-sectional correlates and developmental outcomes that distinguish them from youth with bipolar disorder. Second, other evidence points to an irritable dimension of Oppositional Defiant Disorder symptomatology, which is uniquely associated with concurrent and subsequent internalizing problems. In contrast to the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Disruptive Mood Dysregulation Disorder, our review of the literature supports a different solution: a subtype, Oppositional Defiant Disorder with chronic irritability/anger (proposal included in Appendix). This solution is more consistent with the available evidence and is a better fit with global public health considerations such as harm/benefit potential, clinical utility, and cross-cultural applicability. Implications for assessment, treatment, and research are discussed.
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Stoddard J, Tseng WL, Kim P, Chen G, Yi J, Donahue L, Brotman MA, Towbin KE, Pine DS, Leibenluft E. Association of Irritability and Anxiety With the Neural Mechanisms of Implicit Face Emotion Processing in Youths With Psychopathology. JAMA Psychiatry 2017; 74:95-103. [PMID: 27902832 PMCID: PMC6309540 DOI: 10.1001/jamapsychiatry.2016.3282] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
IMPORTANCE Psychiatric comorbidity complicates clinical care and confounds efforts to elucidate the pathophysiology of commonly occurring symptoms in youths. To our knowledge, few studies have simultaneously assessed the effect of 2 continuously distributed traits on brain-behavior relationships in children with psychopathology. OBJECTIVE To determine shared and unique effects of 2 major dimensions of child psychopathology, irritability and anxiety, on neural responses to facial emotions during functional magnetic resonance imaging. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional functional magnetic resonance imaging study in a large, well-characterized clinical sample at a research clinic at the National Institute of Mental Health. The referred sample included youths ages 8 to 17 years, 93 youths with anxiety, disruptive mood dysregulation, and/or attention-deficit/hyperactivity disorders and 22 healthy youths. MAIN OUTCOMES AND MEASURES The child's irritability and anxiety were rated by both parent and child on the Affective Reactivity Index and Screen for Child Anxiety Related Disorders, respectively. Using functional magnetic resonance imaging, neural response was measured across the brain during gender labeling of varying intensities of angry, happy, or fearful face emotions. In mixed-effects analyses, the shared and unique effects of irritability and anxiety were tested on amygdala functional connectivity and activation to face emotions. RESULTS The mean (SD) age of participants was 13.2 (2.6) years; of the 115 included, 64 were male. Irritability and/or anxiety influenced amygdala connectivity to the prefrontal and temporal cortex. Specifically, irritability and anxiety jointly influenced left amygdala to left medial prefrontal cortex connectivity during face emotion viewing (F4,888 = 9.20; P < .001 for mixed model term). During viewing of intensely angry faces, decreased connectivity was associated with high levels of both anxiety and irritability, whereas increased connectivity was associated with high levels of anxiety but low levels of irritability (Wald χ21 = 21.3; P < .001 for contrast). Irritability was associated with differences in neural response to face emotions in several areas (F2, 888 ≥ 13.45; all P < .001). This primarily occurred in the ventral visual areas, with a positive association to angry and happy faces relative to fearful faces. CONCLUSIONS AND RELEVANCE These data extend prior work conducted in youths with irritability or anxiety alone and suggest that research may miss important findings if the pathophysiology of irritability and anxiety are studied in isolation. Decreased amygdala-medial prefrontal cortex connectivity may mediate emotion dysregulation when very anxious and irritable youth process threat-related faces. Activation in the ventral visual circuitry suggests a mechanism through which signals of social approach (ie, happy and angry expressions) may capture attention in irritable youth.
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Affiliation(s)
- Joel Stoddard
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Colorado, Anshutz Medical Campus, Aurora, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Wan-Ling Tseng
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Pilyoung Kim
- Department of Psychology, University of Denver, Denver, Colorado
| | - Gang Chen
- Scientific and Statistical Computing Core, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Jennifer Yi
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Laura Donahue
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Melissa A. Brotman
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Kenneth E. Towbin
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Ellen Leibenluft
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
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Tseng WL, Thomas LA, Harkins E, Stoddard J, Zarate CA, Pine DS, Leibenluft E, Brotman MA. Functional connectivity during masked and unmasked face emotion processing in bipolar disorder. Psychiatry Res 2016; 258:1-9. [PMID: 27814457 PMCID: PMC5135603 DOI: 10.1016/j.pscychresns.2016.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 09/22/2016] [Accepted: 10/21/2016] [Indexed: 12/19/2022]
Abstract
Little is known regarding the neural connectivity and correlates during automatic, unconscious face emotion processing in individuals with bipolar disorder (BD). In this study, 14 adults with BD and 14 healthy volunteers (HV) underwent fMRI scanning while completing an affective priming task with unconsciously perceived and consciously perceived faces (angry, happy, neutral, blank oval). We found that, regardless of awareness level and emotion types, BD patients exhibited diminished functional connectivity between amygdala and ventromedial prefrontal cortex (vmPFC) compared to HV. This connectivity finding is present in the absence of activation differences in amygdala. In addition, in medial frontal gyrus, BD patients displayed greater activation while HV displayed less activation to angry and neutral faces compared to blank ovals. These results suggest that aberrant amygdala-vmPFC connectivity and neural dysfunction in areas implicated in appraisal and expression of emotions (medial frontal gyrus) may be the pathophysiological correlates of emotional processing in BD regardless of awareness level.
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Affiliation(s)
- Wan-Ling Tseng
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - Laura A Thomas
- War Related Illness and Injury Study Center, Veterans Affairs Medical Center, Washington, DC, USA
| | - Elizabeth Harkins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Joel Stoddard
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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25
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Wiggins JL, Brotman MA, Adleman NE, Kim P, Oakes AH, Reynolds RC, Chen G, Pine DS, Leibenluft E. Neural Correlates of Irritability in Disruptive Mood Dysregulation and Bipolar Disorders. Am J Psychiatry 2016; 173:722-30. [PMID: 26892942 PMCID: PMC11193882 DOI: 10.1176/appi.ajp.2015.15060833] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Bipolar disorder and disruptive mood dysregulation disorder (DMDD) are clinically and pathophysiologically distinct, yet irritability can be a clinical feature of both illnesses. The authors examine whether the neural mechanisms mediating irritability differ between bipolar disorder and DMDD, using a face emotion labeling paradigm because such labeling is deficient in both patient groups. The authors hypothesized that during face emotion labeling, irritability would be associated with dysfunctional activation in the amygdala and other temporal and prefrontal regions in both disorders, but that the nature of these associations would differ between DMDD and bipolar disorder. METHOD During functional MRI acquisition, 71 youths (25 with DMDD, 24 with bipolar disorder, and 22 healthy youths) performed a labeling task with happy, fearful, and angry faces of varying emotional intensity. RESULTS Participants with DMDD and bipolar disorder showed similar levels of irritability and did not differ from each other or from healthy youths in face emotion labeling accuracy. Irritability correlated with amygdala activity across all intensities for all emotions in the DMDD group; such correlation was present in the bipolar disorder group only for fearful faces. In the ventral visual stream, associations between neural activity and irritability were found more consistently in the DMDD group than in the bipolar disorder group, especially in response to ambiguous angry faces. CONCLUSIONS These results suggest diagnostic specificity in the neural correlates of irritability, a symptom of both DMDD and bipolar disorder. Such evidence of distinct neural correlates suggests the need to evaluate different approaches to treating irritability in the two disorders.
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Affiliation(s)
- Jillian Lee Wiggins
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Melissa A Brotman
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Nancy E Adleman
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Pilyoung Kim
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Allison H Oakes
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Richard C Reynolds
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Gang Chen
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Daniel S Pine
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
| | - Ellen Leibenluft
- From the Emotion and Development Branch and the Scientific and Statistical Computing Core, NIMH, Bethesda, Md.; the Department of Psychology, San Diego State University, San Diego; the Department of Psychology, Catholic University of America, Washington, D.C.; and the Department of Psychology, University of Denver, Denver
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26
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Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A. The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review. J Am Acad Child Adolesc Psychiatry 2016; 55:556-70. [PMID: 27343883 PMCID: PMC4927461 DOI: 10.1016/j.jaac.2016.04.014] [Citation(s) in RCA: 298] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/27/2016] [Accepted: 04/29/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Research and clinical interest in irritability have been on the rise in recent years. Yet several questions remain about the status of irritability in psychiatry, including whether irritability can be differentiated from other symptoms, whether it forms a distinct disorder, and whether it is a meaningful predictor of clinical outcomes. In this article, we try to answer these questions by reviewing the evidence on how reliably irritability can be measured and its validity. METHOD We combine a narrative and systematic review and meta-analysis of studies. For the systematic review and meta-analysis, we searched studies in PubMed and Web of Science based on preselected criteria. A total of 163 articles were reviewed, and 24 were included. RESULTS We found that irritability forms a distinct dimension with substantial stability across time, and that it is specifically associated with depression and anxiety in longitudinal studies. Evidence from genetic studies reveals that irritability is moderately heritable, and its overlap with depression is explained mainly by genetic factors. Behavioral and neuroimaging studies show that youth with persistent irritability exhibit altered activations in the amygdala, striatum, and frontal regions compared with age-matched healthy volunteers. Most knowledge about the treatment of irritability is based on effects of treatment on related conditions or post hoc analyses of trial data. CONCLUSION We identify a number of research priorities including innovative experimental designs and priorities for treatment studies, and conclude with recommendations for the assessment of irritability for researchers and clinicians.
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Affiliation(s)
- Pablo Vidal-Ribas
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Melissa A Brotman
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Isabel Valdivieso
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ellen Leibenluft
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Argyris Stringaris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
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27
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Kerestes R, Segreti AM, Pan LA, Phillips ML, Birmaher B, Brent DA, Ladouceur CD. Altered neural function to happy faces in adolescents with and at risk for depression. J Affect Disord 2016; 192:143-52. [PMID: 26724693 PMCID: PMC4837954 DOI: 10.1016/j.jad.2015.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/24/2015] [Accepted: 12/11/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is accumulating evidence of alterations in neural circuitry underlying the processing of social-affective information in adolescent Major Depressive Disorder (MDD). However the extent to which such alterations are present in youth at risk for mood disorders remains unclear. METHOD Whole-brain blood oxygenation level-dependent task responses and functional connectivity using generalized psychophysiological interaction (gPPI) analyses to mild and intense happy face stimuli was examined in 29 adolescents with MDD (MDD; M age, 16.0, S.D. 1.2 years), 38 healthy adolescents at risk of a mood disorder, by virtue of having a parent diagnosed with either Bipolar Disorder (BD) or MDD (Mood-risk; M age 13.4, S.D. 2.5 years) and 43 healthy control adolescents, having parents with no psychiatric disorder (HC; M age 14.6, S.D. 2.2 years). RESULTS Relative to HC adolescents, Mood-risk adolescents showed elevated right dorsolateral prefrontal cortex (DLPFC) activation to 100% intensity happy (vs. neutral) faces and concomitant lowered ventral putamen activity to 50% intensity happy (vs. neutral) faces. gPPI analyses revealed that MDD adolescents showed significantly lower right DLPFC functional connectivity with the ventrolateral PFC (VLPFC) compared to HC to all happy faces. LIMITATIONS The current study is limited by the smaller number of healthy offspring at risk for MDD compared to BD. CONCLUSIONS Because Mood-risk adolescents were healthy at the time of the scan, elevated DLPFC and lowered ventral striatal activity in Mood-risk adolescents may be associated with risk or resiliency. In contrast, altered DLPFC-VLPFC functional connectivity in MDD adolescents may be associated with depressed mood state. Such alterations may affect social-affective development and progression to a mood disorder in Mood-risk adolescents. Future longitudinal follow-up studies are needed to directly answer this research question.
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Affiliation(s)
- Rebecca Kerestes
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Anna Maria Segreti
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Lisa A Pan
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Mary L Phillips
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA; Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Boris Birmaher
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - David A Brent
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
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28
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Kessel EM, Dougherty LR, Kujawa A, Hajcak G, Carlson GA, Klein DN. Longitudinal Associations Between Preschool Disruptive Mood Dysregulation Disorder Symptoms and Neural Reactivity to Monetary Reward During Preadolescence. J Child Adolesc Psychopharmacol 2016; 26:131-7. [PMID: 26771832 PMCID: PMC4800388 DOI: 10.1089/cap.2015.0071] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Reward-processing abnormalities are thought to be a key feature of various psychiatric disorders and may also play a role in disruptive mood dysregulation disorder (DMDD), a new diagnosis in DSM-5. In the current study, we used event-related potentials (ERP) sensitive to monetary gains (i.e., the reward positivity [RewP]) and losses (i.e., the N200) to examine associations between symptoms of DMDD during early childhood and later reward processing during preadolescence. METHODS To assess early emerging DMDD symptoms in a large longitudinal community sample (n=373) of 3-year old children, we administered a diagnostic interview, Preschool Age Psychiatric Assessment (PAPA) with parents. At a later assessment, ∼6 years later, children completed a monetary reward task while an electroencephalogram (EEG) was recorded. Children's lifetime history of psychopathology was also assessed at that time using Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) with the child and parent. RESULTS Multiple regression analyses revealed that age 3 DMDD symptoms predicted an enhanced RewP to monetary rewards in preadolescence. This association is independent of demographics and lifetime history of symptoms of depression, any anxiety disorder, attention-deficit disorder, oppositional defiant disorder, or conduct disorder Conclusions: Early manifestations of DMDD in children as young as 3 years old predicted enhanced reward processing later in development. These findings add to the growing corpus of literature on the pathophysiology of DMDD, and underscore the predictive validity of preschool DMDD on a neural level.
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Affiliation(s)
- Ellen M. Kessel
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Lea R. Dougherty
- Department of Psychology, University of Maryland, College Park, Maryland
| | - Autumn Kujawa
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Greg Hajcak
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | | | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, New York.,Department of Psychiatry, Stony Brook School of Medicine, Stony Brook, New York
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29
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Lee SA, Kim CY, Lee SH. Non-Conscious Perception of Emotions in Psychiatric Disorders: The Unsolved Puzzle of Psychopathology. Psychiatry Investig 2016; 13:165-73. [PMID: 27081376 PMCID: PMC4823191 DOI: 10.4306/pi.2016.13.2.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/13/2015] [Accepted: 05/29/2015] [Indexed: 11/19/2022] Open
Abstract
Psychophysiological and functional neuroimaging studies have frequently and consistently shown that emotional information can be processed outside of the conscious awareness. Non-conscious processing comprises automatic, uncontrolled, and fast processing that occurs without subjective awareness. However, how such non-conscious emotional processing occurs in patients with various psychiatric disorders requires further examination. In this article, we reviewed and discussed previous studies on the non-conscious emotional processing in patients diagnosed with anxiety disorder, schizophrenia, bipolar disorder, and depression, to further understand how non-conscious emotional processing varies across these psychiatric disorders. Although the symptom profile of each disorder does not often overlap with one another, these patients commonly show abnormal emotional processing based on the pathology of their mood and cognitive function. This indicates that the observed abnormalities of emotional processing in certain social interactions may derive from a biased mood or cognition process that precedes consciously controlled and voluntary processes. Since preconscious forms of emotional processing appear to have a major effect on behaviour and cognition in patients with these disorders, further investigation is required to understand these processes and their impact on patient pathology.
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Affiliation(s)
- Seung A Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Chai-Youn Kim
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
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30
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Tseng WL, Thomas LA, Harkins E, Pine DS, Leibenluft E, Brotman MA. Neural correlates of masked and unmasked face emotion processing in youth with severe mood dysregulation. Soc Cogn Affect Neurosci 2015; 11:78-88. [PMID: 26137973 DOI: 10.1093/scan/nsv087] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/26/2015] [Indexed: 01/29/2023] Open
Abstract
Reproducibility of results is important in improving the robustness of conclusions drawn from research, particularly in functional magnetic resonance imaging (fMRI). In this study, we aim to replicate a previous study on the neural correlates of face emotion processing above and below awareness level using an independent sample of youth with severe mood dysregulation (SMD) and healthy volunteers (HV). We collected fMRI data in 17 SMD and 20 HV, using an affective priming paradigm with masked (17 ms) and unmasked (187 ms) faces (angry, happy, neutral, blank oval). When processing masked and unmasked angry faces, SMD patients exhibited increased activation in the parahippocampal gyrus (PHG) and superior temporal gyrus relative to HV. When processing masked and unmasked happy faces, SMD patients showed decreased activation in the insula, PHG and thalamus compared with HV. During masked face processing in general across emotions, youth with SMD showed greater ventromedial prefrontal cortex (vmPFC) activation relative to HV. Perturbed activation in emotion processing areas (e.g. insula, PHG, superior temporal gyrus and thalamus) manifests as hyper-sensitivity toward negative emotions and hypo-sensitivity toward positive emotions may be important in the etiology and maintenance of irritability, aggression and depressive symptoms in SMD. vmPFC dysfunction may mediate over-reactivity to face emotions associated with irritability.
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Affiliation(s)
- Wan-Ling Tseng
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA and
| | - Laura A Thomas
- War Related Illness and Injury Study Center, Veterans Affairs Medical Center, Washington, DC, USA
| | - Elizabeth Harkins
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA and
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA and
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA and
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA and
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31
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Tseng WL, Bones BL, Kayser RR, Olsavsky AK, Fromm SJ, Pine DS, Leibenluft E, Brotman MA. An fMRI study of emotional face encoding in youth at risk for bipolar disorder. Eur Psychiatry 2015; 30:94-8. [PMID: 25172156 PMCID: PMC10656053 DOI: 10.1016/j.eurpsy.2014.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/09/2014] [Accepted: 05/20/2014] [Indexed: 11/30/2022] Open
Abstract
Face memory deficits may be a bipolar disorder (BD) endophenotype. BD (n=27) and unaffected youth at risk (n=13) exhibited middle frontal gyrus hypoactivation during successful vs. unsuccessful encoding. Parahippocampal gyrus dysfunction was found in BD and at-risk youth (vs. low-risk, n=37). Middle occipital gyrus hypoactivation was only present in BD.
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Affiliation(s)
- W-L Tseng
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
| | - B L Bones
- Georgetown University School of Medicine, Washington, DC, USA
| | - R R Kayser
- Georgetown University School of Medicine, Washington, DC, USA
| | - A K Olsavsky
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - S J Fromm
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - D S Pine
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - E Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - M A Brotman
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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