Elevated amygdala activity to sad facial expressions: a state marker of bipolar but not unipolar depression

Jorge R.C. Almeida, Amelia Versace, Stefanie Hassel, David J. Kupfer, Mary L. Phillips

Research output: Contribution to journalArticle

Abstract

Background - Difficulties in emotion processing and poor social function are common to bipolar disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated in processing emotionally salient stimuli, including emotional facial expressions. It is unclear, however, whether abnormal amygdala activity during positive and negative emotion processing represents a persistent marker of BD regardless of illness phase or a state marker of depression common or specific to BD and MDD depression.
Methods - Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects (HC). Groups were age- and gender ratio-matched; patient groups were matched for age of illness onset and illness duration; depressed groups were matched for depression severity. The BDd were taking more psychotropic medication than other patient groups. All individuals participated in three separate 3T neuroimaging event-related experiments, where they viewed mild and intense emotional and neutral faces of fear, happiness, or sadness from a standardized series.
Results - The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication. There were no other significant between-group differences in amygdala activity.
Conclusions - Abnormally elevated left amygdala activity to mild sad and neutral faces might be a depression-specific marker in BD but not MDD, suggesting different pathophysiologic processes for BD versus MDD depression.
Original languageEnglish
Pages (from-to)414-421
Number of pages8
JournalBiological Psychiatry
Volume67
Issue number5
DOIs
Publication statusPublished - 1 Mar 2010

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Facial Expression
Depressive Disorder
Amygdala
Bipolar Disorder
Major Depressive Disorder
Depression
Emotions
Diagnostic and Statistical Manual of Mental Disorders
Healthy Volunteers
Research Design
Happiness
Diagnostic Errors
Age of Onset
Neuroimaging
Fear
Age Groups
Interviews
Research

Keywords

  • facial expression
  • bipolar disorder
  • humans
  • adult
  • amygdala
  • affective commitment
  • depressive disorder
  • male
  • functional laterality
  • female
  • biological markers
  • emotional processing
  • fMRI
  • mood disorders

Cite this

Almeida, Jorge R.C. ; Versace, Amelia ; Hassel, Stefanie ; Kupfer, David J. ; Phillips, Mary L. / Elevated amygdala activity to sad facial expressions : a state marker of bipolar but not unipolar depression. In: Biological Psychiatry. 2010 ; Vol. 67, No. 5. pp. 414-421.
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abstract = "Background - Difficulties in emotion processing and poor social function are common to bipolar disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated in processing emotionally salient stimuli, including emotional facial expressions. It is unclear, however, whether abnormal amygdala activity during positive and negative emotion processing represents a persistent marker of BD regardless of illness phase or a state marker of depression common or specific to BD and MDD depression. Methods - Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects (HC). Groups were age- and gender ratio-matched; patient groups were matched for age of illness onset and illness duration; depressed groups were matched for depression severity. The BDd were taking more psychotropic medication than other patient groups. All individuals participated in three separate 3T neuroimaging event-related experiments, where they viewed mild and intense emotional and neutral faces of fear, happiness, or sadness from a standardized series. Results - The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication. There were no other significant between-group differences in amygdala activity. Conclusions - Abnormally elevated left amygdala activity to mild sad and neutral faces might be a depression-specific marker in BD but not MDD, suggesting different pathophysiologic processes for BD versus MDD depression.",
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Elevated amygdala activity to sad facial expressions : a state marker of bipolar but not unipolar depression. / Almeida, Jorge R.C.; Versace, Amelia; Hassel, Stefanie; Kupfer, David J.; Phillips, Mary L.

In: Biological Psychiatry, Vol. 67, No. 5, 01.03.2010, p. 414-421.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Elevated amygdala activity to sad facial expressions

T2 - a state marker of bipolar but not unipolar depression

AU - Almeida, Jorge R.C.

AU - Versace, Amelia

AU - Hassel, Stefanie

AU - Kupfer, David J.

AU - Phillips, Mary L.

PY - 2010/3/1

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N2 - Background - Difficulties in emotion processing and poor social function are common to bipolar disorder (BD) and major depressive disorder (MDD) depression, resulting in many BD depressed individuals being misdiagnosed with MDD. The amygdala is a key region implicated in processing emotionally salient stimuli, including emotional facial expressions. It is unclear, however, whether abnormal amygdala activity during positive and negative emotion processing represents a persistent marker of BD regardless of illness phase or a state marker of depression common or specific to BD and MDD depression. Methods - Sixty adults were recruited: 15 depressed with BD type 1 (BDd), 15 depressed with recurrent MDD, 15 with BD in remission (BDr), diagnosed with DSM-IV and Structured Clinical Interview for DSM-IV Research Version criteria; and 15 healthy control subjects (HC). Groups were age- and gender ratio-matched; patient groups were matched for age of illness onset and illness duration; depressed groups were matched for depression severity. The BDd were taking more psychotropic medication than other patient groups. All individuals participated in three separate 3T neuroimaging event-related experiments, where they viewed mild and intense emotional and neutral faces of fear, happiness, or sadness from a standardized series. Results - The BDd—relative to HC, BDr, and MDD—showed elevated left amygdala activity to mild and neutral facial expressions in the sad (p < .009) but not other emotion experiments that was not associated with medication. There were no other significant between-group differences in amygdala activity. Conclusions - Abnormally elevated left amygdala activity to mild sad and neutral faces might be a depression-specific marker in BD but not MDD, suggesting different pathophysiologic processes for BD versus MDD depression.

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KW - male

KW - functional laterality

KW - female

KW - biological markers

KW - emotional processing

KW - fMRI

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