Wessa M, Linke J. Emotional processing in bipolar disorder: behavioural and neuroimaging findings. Int Rev Psychiatry 21: 357-367

Department of Cognitive and Clinical Neuroscience, Research Group Emotional Processing in Bipolar Disorder, Central Institute of Mental Health, 68159 Mannheim, Germany.
International Review of Psychiatry (Impact Factor: 1.8). 01/2009; 21(4):357-67. DOI: 10.1080/09540260902962156
Source: PubMed


Existing studies revealed that bipolar patients show an altered identification of emotional stimuli (e.g. facial expressions), however, so far modifications in early emotional processes and the regulation of emotions are less clear. In response to emotional stimuli bipolar patients show a dysfunction in a ventral-limbic brain network including the amygdala, insula, striatum, subgenual cingulate cortex, ventrolateral prefrontal cortex and orbitofrontal cortex. In most studies, a relative hypoactivity of dorsal brain structures, including the dorsolateral prefrontal cortex, the dorsal anterior cingulate and the posterior cingulate cortex, has been reported in bipolar patients. This imbalance between the two networks has been proposed to underlie deficient emotion regulation in bipolar disorder.

21 Reads
  • Source
    • "Cette distinction renvoie à l'opposition entre mécanismes de type bottom-up, suscités par une réactivité émotionnelle accrue, et mécanismes top-down relevant de capacités de régulation émotionnelle altérées [26] [27]. Ces mécanismes sont indistincts lorsqu'ils sont examinés à travers le comportement d'un individu, mais ils relèvent pourtant de processus différents au niveau neuronal [28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Le trouble déficit d’attention/hyperactivité (TDA/H) est le trouble neurodéveloppemental le plus fréquent chez l’enfant et l’adolescent. Son diagnostic repose sur trois ensembles de symptômes : inattention, impulsivité et hyperactivité ; mais des études mobilisant des méthodologies variées mettent également en évidence des symptômes de labilité émotionnelle chez les patients présentant un TDA/H. Ces symptômes ne sont pas seulement une conséquence secondaire de déficits des fonctions exécutives : la dysrégulation émotionnelle semble être une composante indépendante du trouble, contribuant de manière significative à sa symptomatologie. Les modèles étiopathogéniques actuels reflètent l’hétérogénéité clinique du TDA/H, en identifiant de multiples voies cérébrales pouvant sous-tendre un même ensemble de symptômes. Aux côtés des atteintes des voies fronto-corticales impliquées dans les déficits des fonctions exécutives, des études de neuro-imagerie récentes reportent des altérations fonctionnelles des voies fronto-limbiques impliquées dans la régulation émotionnelle chez des patients présentant un TDA/H. Cet ensemble de données récentes nous éloigne d’une conception purement cognitive du trouble, et est donc d’une grande importance pour la pratique clinique.
    L Encéphale 04/2014; 41(2). DOI:10.1016/j.encep.2013.12.004 · 0.70 Impact Factor
  • Source
    • "Emotional processing is a dynamic phenomenon composed of several successive stages (Gross, 2007; Wessa and Linke, 2009) that each may be targeted by multiple kinds of interventions to control emotional experiences. These active attempts to modify emotional states are referred to as emotion regulation (ER) strategies and include all 'extrinsic and intrinsic processes responsible for monitoring, evaluating, and modifying emotional reactions, especially their intensive and temporal features' (Thompson, 1994, pp. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Theoretical accounts of emotion regulation (ER) discriminate various cognitive strategies to voluntarily modify emotional states. Amongst these, attentional deployment (i.e., distraction) and cognitive change (i.e., reappraisal), have been shown to successfully down-regulate emotions. Neuroimaging studies found that both strategies differentially engage neural structures associated with selective attention, working memory and cognitive control. The aim of this study was to further delineate similarities and differences between the ER strategies reappraisal and distraction by investigating their temporal brain dynamics using event-related potentials (ERPs) and their patterns of facial expressive behavior. Twenty-one participants completed an ER experiment in which they had to either passively view positive, neutral and negative pictures, reinterpret them to down-regulate affective responses (reappraisal), or solve a concurrently presented mathematical equation (distraction). Results demonstrate the efficacy of both strategies in the subjective control of emotion, accompanied by reductions of facial expressive activity (corrugator supercilii, zygomaticus major). ERP results indicated that distraction, compared to reappraisal, yielded a stronger and earlier attenuation of the LPP magnitude for negative pictures. For positive pictures only distraction but not reappraisal had significant effect on LPP attenuation. The results support the process model of ER, separating subtypes of cognitive strategies based on their specific time course.
    Social Cognitive and Affective Neuroscience 08/2013; 9(9). DOI:10.1093/scan/nst116 · 7.37 Impact Factor
  • Source
    • "Thus, deficiencies in cognitive measures should be recognized as a major element in social and vocational integration of schizophrenia patients, and should become a standardized assessment approach in clinical trials [48]. As discussed above, overlapping disordered cognitive behavioral profiles of EDs patients with patients who have major psychiatric disorders [27–31] are compelling and support equivalent dysregulation of convergent frontal cortical cognitive and reward neural circuits. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A substantive literature has drawn a compelling case for the functional involvement of mesolimbic/prefrontal cortical neural reward systems in normative control of eating and in the etiology and persistence of severe eating disorders that affect diverse human populations. Presently, we provide a short review that develops an equally compelling case for the importance of dysregulated frontal cortical cognitive neural networks acting in concert with regional reward systems in the regulation of complex eating behaviors and in the presentation of complex pathophysiological symptoms associated with major eating disorders. Our goal is to highlight working models of major eating disorders that incorporate complementary approaches to elucidate functionally interactive neural circuits defined by their regulatory neurochemical phenotypes. Importantly, we also review evidence-based linkages between widely studied psychiatric and neurodegenerative syndromes (e.g., autism spectrum disorders and Parkinson's disease) and co-morbid eating disorders to elucidate basic mechanisms involving dopaminergic transmission and its regulation by endogenously expressed morphine in these same cortical regions.
    Medical science monitor: international medical journal of experimental and clinical research 05/2013; 19(1):353-8. DOI:10.12659/MSM.889133 · 1.43 Impact Factor
Show more