Prefrontal cortical and striatal activity to happy and fear faces in bipolar disorder is associated with comorbid substance abuse and eating disorder

Stefanie Hassel, Jorge R.C. Almeida, Ellen Frank, Amelia Versace, Sharon A. Nau, Crystal R. Klein, David J. Kupfer, Mary L. Phillips

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The spectrum approach was used to examine contributions of comorbid symptom dimensions of substance abuse and eating disorder to abnormal prefrontal-cortical and subcortical-striatal activity to happy and fear faces previously demonstrated in bipolar disorder (BD).
Method: Fourteen remitted BD-type I and sixteen healthy individuals viewed neutral, mild and intense happy and fear faces in two event-related fMRI experiments. All individuals completed Substance-Use and Eating-Disorder Spectrum measures. Region-of-Interest analyses for bilateral prefrontal and subcortical-striatal regions were performed.
Results: BD individuals scored significantly higher on these spectrum measures than healthy individuals (p < 0.05), and were distinguished by activity in prefrontal and subcortical-striatal regions. BD relative to healthy individuals showed reduced dorsal prefrontal-cortical activity to all faces. Only BD individuals showed greater subcortical-striatal activity to happy and neutral faces. In BD individuals, negative correlations were shown between substance use severity and right PFC activity to intense happy faces (p < 0.04), and between substance use severity and right caudate nucleus activity to neutral faces (p < 0.03). Positive correlations were shown between eating disorder and right ventral putamen activity to intense happy (p < 0.02) and neutral faces (p < 0.03). Exploratory analyses revealed few significant relationships between illness variables and medication upon neural activity in BD individuals.
Limitations: Small sample size of predominantly medicated BD individuals.
Conclusion: This study is the first to report relationships between comorbid symptom dimensions of substance abuse and eating disorder and prefrontal-cortical and subcortical-striatal activity to facial expressions in BD. Our findings suggest that these comorbid features may contribute to observed patterns of functional abnormalities in neural systems underlying mood regulation in BD.
Original languageEnglish
Pages (from-to)19-27
Number of pages9
JournalJournal of Affective Disorders
Volume118
Issue number1-3
DOIs
Publication statusPublished - Nov 2009

Bibliographical note

© 2009, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

  • magnetic resonance imaging
  • young adult
  • reference values
  • arousal
  • bipolar disorder
  • fear
  • humans
  • psychotropic drugs
  • corpus striatum
  • prefrontal cortex
  • cerebral dominance
  • happiness
  • nerve net
  • comorbidity
  • facial expression
  • binge-eating disorder
  • visual pattern recognition
  • adult
  • substance-related disorders
  • middle aged
  • adolescent
  • male
  • female
  • emotion processing
  • functional MRI
  • spectrum approach

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