OBJECTIVES:To determine the neural responses invoked in the recognition of facial fear and disgust in euthymic bipolar patients as compared with healthy subjects. METHODS:This study examined 10 female euthymic bipolar patients, and 10 suitably matched healthy subjects using functional magnetic resonance imaging (fMRI) while subjects were engaged in an explicit facial emotion recognition task involving fear, disgust and neutral expressions. The activation paradigm involved nominating the facial expression using specified response keys. Behavioural data were collected and analysed and both within-group (Fear versus Neutral; Disgust versus Neutral) and random-effects between-group analyses were performed on fMRI data using BrainVoyager (Brain Innovations, Maastricht, the Netherlands). RESULTS:Patients were equally accurate in identifying facial expressions as healthy subjects but were slower to respond, especially with respect to fear and disgust. Responses to fear and disgust (within-group analyses) resulted in activation of anticipated brain regions such as amygdala and insula, respectively. However, between-group random effects analysis revealed differential responses to both disgust and fear in both healthy subjects and euthymic bipolar patients such that euthymic bipolar patients responded largely to fear and healthy subjects responded more so to disgust. This partitioning of responsiveness was reflected by differential activation involving the hippocampus and amygdala. CONCLUSIONS:Greater responsiveness to fear with hippocampal activation in patients perhaps reflects recollection of traumatic events associated with past experiences of illness or simply the use of a more mnemonic (hippocampal) as opposed to affective (amygdala) approach when performing the task. It is possible that in bipolar disorder, prefrontal-subcortical network dysfunction that relegates neural processing to limbic regions is impaired and that clinically euthymic bipolar patients, although able to accurately and effectively identify emotions such as fear and disgust, are limited in their ability to interpret their salience. The implications of these findings are discussed.

译文

目的:确定与健康受试者相比,在正常人双相情感障碍患者中识别面部恐惧和厌恶时所引起的神经反应。
方法:本研究使用功能性磁共振成像(fMRI)检查了10名女性常态性双相情感障碍患者和10名适当匹配的健康受试者,而受试者则参与了涉及恐惧,厌恶和中性表情的明确面部情绪识别任务。激活范例涉及使用指定的响应键来提名面部表情。收集并分析行为数据,并使用BrainVoyager(Brain Innovations,马斯特里赫特,荷兰)对fMRI数据进行组内(恐惧与中性;厌恶与中性)和组间随机影响分析。
结果:患者在识别面部表情方面与健康受试者一样准确,但反应较慢,尤其是在恐惧和厌恶方面。对恐惧和厌恶的反应(组内分析)分别激活了预期的大脑区域,如杏仁核和岛状脑岛。但是,组间随机效应分析显示,健康受试者和正常人双相情感障碍患者对厌恶和恐惧的反应不同,因此,正常人双相情感障碍患者对恐惧的反应很大,而健康受试者对厌恶的反应则更大。反应的这种划分通过涉及海马和杏仁核的差异激活来反映。
结论:患者对海马激活后恐惧的反应性增强,可能反映出与过去疾病经历相关的创伤事件的回忆,或者在执行任务时仅使用记忆法(海马法)而不是情感法(扁桃体法)。在双相情感障碍中,将神经处理降级到边缘区域的额叶前皮质下网络功能障碍可能会受到损害,尽管临床上有幸福感的双相情感障碍患者虽然能够准确有效地识别出恐惧和厌恶之类的情绪,但其解释能力却受到限制。他们的显着性。讨论了这些发现的含义。

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