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Is a lack of disgust something to fear? A functional magnetic resonance imaging facial emotion recognition study in euthymic bipolar disorder patients.
Bipolar Disord. 2007 Jun; 9(4):345-57.BD

Abstract

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.

Authors+Show Affiliations

CADE Clinic, Royal North Shore Hospital, University of Sydney, Australia. gmalhi@med.usyd.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17547581

Citation

Malhi, Gin S., et al. "Is a Lack of Disgust Something to Fear? a Functional Magnetic Resonance Imaging Facial Emotion Recognition Study in Euthymic Bipolar Disorder Patients." Bipolar Disorders, vol. 9, no. 4, 2007, pp. 345-57.
Malhi GS, Lagopoulos J, Sachdev PS, et al. Is a lack of disgust something to fear? A functional magnetic resonance imaging facial emotion recognition study in euthymic bipolar disorder patients. Bipolar Disord. 2007;9(4):345-57.
Malhi, G. S., Lagopoulos, J., Sachdev, P. S., Ivanovski, B., Shnier, R., & Ketter, T. (2007). Is a lack of disgust something to fear? A functional magnetic resonance imaging facial emotion recognition study in euthymic bipolar disorder patients. Bipolar Disorders, 9(4), 345-57.
Malhi GS, et al. Is a Lack of Disgust Something to Fear? a Functional Magnetic Resonance Imaging Facial Emotion Recognition Study in Euthymic Bipolar Disorder Patients. Bipolar Disord. 2007;9(4):345-57. PubMed PMID: 17547581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is a lack of disgust something to fear? A functional magnetic resonance imaging facial emotion recognition study in euthymic bipolar disorder patients. AU - Malhi,Gin S, AU - Lagopoulos,Jim, AU - Sachdev,Perminder S, AU - Ivanovski,Belinda, AU - Shnier,Ron, AU - Ketter,Terence, PY - 2007/6/6/pubmed PY - 2007/10/16/medline PY - 2007/6/6/entrez SP - 345 EP - 57 JF - Bipolar disorders JO - Bipolar Disord VL - 9 IS - 4 N2 - 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. SN - 1398-5647 UR - https://www.unboundmedicine.com/medline/citation/17547581/Is_a_lack_of_disgust_something_to_fear_A_functional_magnetic_resonance_imaging_facial_emotion_recognition_study_in_euthymic_bipolar_disorder_patients_ L2 - https://doi.org/10.1111/j.1399-5618.2007.00485.x DB - PRIME DP - Unbound Medicine ER -