Differential engagement of cognitive and affective neural systems in pediatric bipolar disorder and attention deficit hyperactivity disorder

Center for Cognitive Medicine, University of Illinois Medical Center at Chicago, Chicago, IL 60612, USA.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 10/2009; 16(1):106-17. DOI: 10.1017/S1355617709991019
Source: PubMed

ABSTRACT This fMRI study investigates the neural bases of cognitive control of emotion processing in pediatric bipolar disorder (PBD) and attention deficit hyperactivity disorder (ADHD). Seventeen un-medicated PBD patients, 15 un-medicated ADHD patients, and 14 healthy controls (HC) (mean age = 13.78 +/- 2.47) performed an emotional valence Stroop Task, requiring them to match the color of an emotionally valenced word to the color of either of two adjacent circles. Both patient groups responded significantly slower than HC, but there were no group differences in accuracy. A voxel-wise analysis of variance on brain activation revealed a significant interaction of group by word valence [F(2,41) = 4.44; p = .02]. Similar group differences were found for negative and positive words. For negative versus neutral words, both patient groups exhibited greater activation in dorsolateral prefrontal cortex (DLPFC) and parietal cortex relative to HC. The PBD group exhibited greater activation in ventrolateral prefrontal cortex (VLPFC) and anterior cingulate cortex (ACC) relative to HC. The ADHD group exhibited decreased VLPFC activation relative to HC and the PBD group. During cognitive control of emotion processing, PBD patients deployed the VLPFC to a greater extent than HC. The ADHD patients showed decreased VLPFC engagement relative to both HC and PBD patients.

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Available from: Mani N Pavuluri, Nov 03, 2014
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    • "BDII Mixture of mood states Yes Not an exclusion, but details not provided Not provided Yes, current AAO 19.6 (4.0) 8 [4e99] GNG Comparable Welander-Vatn et al., 2013 24 (14) 24 (11) 35.6 (11.3) 34.5 (9.4) BDI Mixture of mood states Yes Yes Not provided Yes, current AAO 23.8 (9.5) Median 6.5 GNG Slower response times and more errors in BD Wessa et al., 2007 17 (7) 17 (6) 44.9 (12.7) 44.9 (11.4) BDI, II Euthymic Yes Yes Not provided No current 21.9 (12.7) Not provided GNG Comparable T. Hajek et al. / Journal of Psychiatric Research 47 (2013) 1955e1966 2003b; Cerullo et al., 2009; Deveney et al., 2012a; Diler et al., 2013; Elliott et al., 2004; Fleck et al., 2011; Frangou, 2012; Hummer et al., 2013; Kaladjian et al., 2009b; Kronhaus et al., 2006; Lagopoulos and Malhi, 2007; Malhi et al., 2005; Mazzola- Pomietto et al., 2009; McIntosh et al., 2008b; Nelson et al., 2007; Passarotti et al., 2010a, 2010b; Pavuluri et al., 2010; Roberts et al., 2013; Roth et al., 2006; Singh et al., 2010; Strakowski et al., 2005, 2008; Townsend et al., 2012; Weathers et al., 2012; Welander-Vatn et al., 2009, 2013; Wessa et al., 2007 "
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    ABSTRACT: Impaired response inhibition underlies symptoms and altered functioning in patients with bipolar disorders (BD). The interpretation of fMRI studies requires an accurate estimation of neurocognitive performance, for which individual studies are typically underpowered. Thus, we performed the first combined meta-analysis of fMRI activations and neurocognitive performance in studies investigating response inhibition in BD. We used signed differential mapping to combine anatomical coordinates of activation and standardized differences between means to evaluate neurocognitive performance in 30 fMRI studies of response inhibition comparing controls (n = 667) and patients with BD (n = 635). Relative to controls, BD patients underactivated the right inferior frontal gyrus (rIFG) regardless of current mood state and behavioral performance. Unique to euthymia were cortical hyperactivations (left superior temporal, right middle frontal gyri) combined with subcortical hypoactivations (basal ganglia), whereas unique to mania were subcortical hyperactivations (bilateral basal ganglia), combined with cortical hypoactivations (right inferior and medial frontal gyri). The fMRI changes in euthymia were associated with normal cognitive performance, whereas manic patients committed more errors during response inhibition. The rIFG hypoactivations were congruent with a BD trait, which may underlie the impaired response inhibition in mania. Euthymic BD subjects may compensate for the rIFG hypoactivations by hyperactivations of adjacent cortical areas, yielding comparable performance in inhibitory functions and suggesting possibilities for neuromodulation treatment of these cognitive impairments. The reversal of the activation pattern between mania and euthymia has implications for monitoring of treatment response and identification of imminent relapse.
    Journal of Psychiatric Research 09/2013; 47(12). DOI:10.1016/j.jpsychires.2013.08.015 · 3.96 Impact Factor
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    • "Regarding comparisons among groups, for ADHD adults and schizophrenic patients there are few studies that have investigated emotional processing, although impairments in both facial recognition and emotional processing have been proposed as possible biomarkers of these conditions (Marsh and Williams, 2006). Some studies have compared emotional impairment in children with ADHD and BD and have shown that both groups of children have deficits (Brotman et al., 2010; Passarotti et al., 2010a,b "
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    ABSTRACT: t is commonly assumed thatearly emotional signals provide relevant informationfor social cognition tasks. The goal of this study was to test the association between (a) cortical markers of face emotional processing and (b) social-cognitive measures,and also to build a model which can predictthis association (a & b) in healthy volunteers as well as in different groups of psychiatric patients. Thus, we investigated the early cortical processing of emotional stimuli (N170, using a face and word valence task) and their relationship with the social-cognitive profiles (SCPs, indexed by measures of theory of mind, fluid intelligence, speed processing, and executive functions). Group comparisons and individual differences were assessed among schizophrenia (SCZ) patients and their relatives, individuals with attention deficit hyperactivity disorder (ADHD), individuals with euthymic bipolar disorder (BD) and healthy participants (educational level, handedness, age and gendermatched). Our results provide evidence of emotional N170 impairments in the affected groups (SCZ and relatives, ADHD and BD) as well as subtle group differences. Importantly, cortical processing of emotional stimuli predicted the social cognition profile (SCP), as evidenced by a structural equation model (SEM) analysis. This is the first study to report anassociation model of brain markers of emotional processing and SCP.
    Social Cognitive and Affective Neuroscience 05/2013; 9(7). DOI:10.1093/scan/nst067 · 7.37 Impact Factor
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    • "In response to angry and fearful expressions, both BD and SMD patients exhibited decreased activation compared to HV youth.. †p b.10, *b.05, **b.01. Passarotti et al., 2010a, b; Thomas et al., 2012). Regarding SMD, the rate of ADHD is high by definition. "
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    ABSTRACT: A major controversy in child psychiatry is whether bipolar disorder (BD) presents in children as severe, non-episodic irritability (operationalized here as severe mood dysregulation, SMD), rather than with manic episodes as in adults. Both classic, episodic BD and SMD are severe mood disorders characterized by deficits in processing emotional stimuli. Neuroimaging techniques can be used to test whether the pathophysiology mediating these deficits are similar across the two phenotypes. Amygdala dysfunction during face emotion processing is well-documented in BD, but little is known about amygdala dysfunction in chronically irritable youth. We compared neural activation in SMD (n=19), BD (n=19), and healthy volunteer (HV; n=15) youths during an implicit face-emotion processing task with angry, fearful and neutral expressions. In the right amygdala, both SMD and BD exhibited greater activity across all expressions than HV. However, SMD and BD differed from each other and HV in posterior cingulate cortex, posterior insula, and inferior parietal lobe. In these regions, only SMD showed deactivation in response to fearful expressions, whereas only BD showed deactivation in response to angry expressions. Thus, during implicit face emotion processing, youth with BD and those with SMD exhibit similar amygdala dysfunction but different abnormalities in regions involved in information monitoring and integration.
    Clinical neuroimaging 04/2013; 2(1):637-645. DOI:10.1016/j.nicl.2013.04.007 · 2.53 Impact Factor
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