A preliminary study of the neural mechanisms of frustration in pediatric bipolar disorder using magnetoencephalography

Department of Psychology, The Catholic University of America, 4001 Harewood Road NE, Washington, DC 20064, USA.
Depression and Anxiety (Impact Factor: 4.41). 03/2010; 27(3):276-86. DOI: 10.1002/da.20649
Source: PubMed


Irritability is prevalent and impairing in pediatric bipolar disorder (BD) but has been minimally studied using neuroimaging techniques. We used magnetoencephalography (MEG) to study theta band oscillations in the anterior cingulate cortex (ACC) during frustration in BD youth. ACC theta power is associated with attention to emotional stimuli, and the ACC may mediate responses to frustrating stimuli.
We used the affective Posner task, an attention paradigm that uses rigged feedback to induce frustration, to compare 20 medicated BD youth (14.9+/-2.0 years; 45% male) and 20 healthy controls (14.7+/-1.7 years; 45% male). MEG measured neuronal activity after negative and positive feedback; we also compared groups on reaction time, response accuracy, and self-reported affect. Patients met strict DSM-IV BD criteria and were euthymic. Controls had no psychiatric history.
BD youth reported more negative affective responses than controls. After negative feedback, BD subjects, relative to controls, displayed greater theta power in the right ACC and bilateral parietal lobe. After positive feedback, BD subjects displayed lower theta power in the left ACC than did controls. Correlations between MEG, behavior, and affect were nonsignificant.
In this first MEG study of BD youth, BD youth displayed patterns of theta oscillations in the ACC and parietal lobe in response to frustration-inducing negative feedback that differed from healthy controls. These data suggest that BD youth may display heightened processing of negative feedback and exaggerated self-monitoring after frustrating emotional stimuli. Future studies are needed with unmedicated bipolar youth, and comparison ADHD and anxiety groups.

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    • "One prominent model integrates these findings with a large body of work on at-risk individuals to indicate that heightened positive affectivity may be core to the etiology of BD (Gruber, 2011a). Other findings, however, suggest that this could be part of a broader profile of emotional reactivity, in that researchers have also observed greater reactivity among those with BD to both success and failure experiences (Pavlova, Uher, Dennington, Wright, & Donaldson, 2011; Gruber et al., 2009; Rich et al., 2010). Other studies, however, have failed to identify significant group differences in reactivity to standardized stimuli. "
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    • "The results provide novel evidence for the role of negative affect and impaired attentional resources in a high-risk population of toddlers of mothers with BD. Specifically, pediatric BD studies have shown that emotionally demanding environments, in particular those characterized by frustration (Rich et al. 2005), are a critical factor in eliciting attentional deficits and that compared with controls, BD youth were more upset by frustrationinducing conditions and exhibited greater emotional reactivity (Rich et al. 2010). Attentional performance in children with BD was impaired only in the setting of negative emotions (Rich et al. 2005). "
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