TY - JOUR

T1 - Neural responses during down-regulation of negative emotion in patients with recently diagnosed bipolar disorder and their unaffected relatives

AU - Kjærstad, Hanne Lie

AU - Macoveanu, Julian

AU - Knudsen, Gitte Moos

AU - Frangou, Sophia

AU - Phan, K. Luan

AU - Vinberg, Maj

AU - Kessing, Lars Vedel

AU - Miskowiak, Kamilla Woznica

N1 - Publisher Copyright: © The Author(s), 2021. Published by Cambridge University Press.

PY - 2023

Y1 - 2023

N2 - Background Aberrant emotion regulation has been posited as a putative endophenotype of bipolar disorder (BD). We therefore aimed to compare the neural responses during voluntary down-regulation of negative emotions in a large functional magnetic resonance imaging study of BD, patients' unaffected first-degree relatives (URs), and healthy controls (HCs). Methods We compared neural activity and fronto-limbic functional connectivity during emotion regulation in response to aversive v. neutral pictures in patients recently diagnosed with BD (n = 78) in full/partial remission, their URs (n = 35), and HCs (n = 56). Results Patients showed hypo-activity in the left dorsomedial, dorsolateral, and ventrolateral prefrontal cortex (DMPFC and DLPFC) during emotion regulation while viewing aversive pictures compared to HCs, with URs displaying intermediate neural activity in these regions. There were no significant differences between patients with BD and HCs in functional connectivity from the amygdala during emotion regulation. However, exploratory analysis indicated that URs displayed more negative amygdala-DMPFC coupling compared with HCs and more negative amygdala-cingulate DLPFC coupling compared to patients with BD. At a behavioral level, patients and their URs were less able to dampen negative emotions in response aversive pictures. Conclusions The findings point to deficient recruitment of prefrontal resources and more negative fronto-amygdala coupling as neural markers of impaired emotion regulation in recently diagnosed remitted patients with BD and their URs, respectively.

AB - Background Aberrant emotion regulation has been posited as a putative endophenotype of bipolar disorder (BD). We therefore aimed to compare the neural responses during voluntary down-regulation of negative emotions in a large functional magnetic resonance imaging study of BD, patients' unaffected first-degree relatives (URs), and healthy controls (HCs). Methods We compared neural activity and fronto-limbic functional connectivity during emotion regulation in response to aversive v. neutral pictures in patients recently diagnosed with BD (n = 78) in full/partial remission, their URs (n = 35), and HCs (n = 56). Results Patients showed hypo-activity in the left dorsomedial, dorsolateral, and ventrolateral prefrontal cortex (DMPFC and DLPFC) during emotion regulation while viewing aversive pictures compared to HCs, with URs displaying intermediate neural activity in these regions. There were no significant differences between patients with BD and HCs in functional connectivity from the amygdala during emotion regulation. However, exploratory analysis indicated that URs displayed more negative amygdala-DMPFC coupling compared with HCs and more negative amygdala-cingulate DLPFC coupling compared to patients with BD. At a behavioral level, patients and their URs were less able to dampen negative emotions in response aversive pictures. Conclusions The findings point to deficient recruitment of prefrontal resources and more negative fronto-amygdala coupling as neural markers of impaired emotion regulation in recently diagnosed remitted patients with BD and their URs, respectively.

KW - bipolar disorder

KW - childhood trauma

KW - Emotion regulation

KW - fMRI

KW - functional connectivity

KW - high-risk

KW - relatives

U2 - 10.1017/S0033291721002737

DO - 10.1017/S0033291721002737

M3 - Journal article

C2 - 37010225

AN - SCOPUS:85114088104

VL - 53

SP - 1254

EP - 1265

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 4

ER -