de Almeida, Jorge R.C., Versace, Amelia, Mechelli, Andrea, Hassel, Stefanie, Quevedo, Karina, Kupfer, David J. and Phillips, Mary L. (2009). Abnormal amygdala-prefrontal effective connectivity to happy faces differentiates bipolar from major depression. Biological Psychiatry, 66 (5), pp. 451-459.
Abstract
Background - Bipolar disorder is frequently misdiagnosed as major depressive disorder, delaying appropriate treatment and worsening outcome for many bipolar individuals. Emotion dysregulation is a core feature of bipolar disorder. Measures of dysfunction in neural systems supporting emotion regulation might therefore help discriminate bipolar from major depressive disorder. Methods - Thirty-one depressed individuals—15 bipolar depressed (BD) and 16 major depressed (MDD), DSM-IV diagnostic criteria, ages 18–55 years, matched for age, age of illness onset, illness duration, and depression severity—and 16 age- and gender-matched healthy control subjects performed two event-related paradigms: labeling the emotional intensity of happy and sad faces, respectively. We employed dynamic causal modeling to examine significant among-group alterations in effective connectivity (EC) between right- and left-sided neural regions supporting emotion regulation: amygdala and orbitomedial prefrontal cortex (OMPFC). Results - During classification of happy faces, we found profound and asymmetrical differences in EC between the OMPFC and amygdala. Left-sided differences involved top-down connections and discriminated between depressed and control subjects. Furthermore, greater medication load was associated with an amelioration of this abnormal top-down EC. Conversely, on the right side the abnormality was in bottom-up EC that was specific to bipolar disorder. These effects replicated when we considered only female subjects. Conclusions - Abnormal, left-sided, top-down OMPFC–amygdala and right-sided, bottom-up, amygdala–OMPFC EC during happy labeling distinguish BD and MDD, suggesting different pathophysiological mechanisms associated with the two types of depression.
Publication DOI: | https://doi.org/10.1016/j.biopsych.2009.03.024 |
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Divisions: | College of Health & Life Sciences > School of Psychology College of Health & Life Sciences > Clinical and Systems Neuroscience College of Health & Life Sciences College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN) |
Additional Information: | © 2009, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
Uncontrolled Keywords: | emotions,differential diagnosis,bipolar disorder,humans,prefrontal cortex,major depressive disorder,facial expression,adult,neural pathways,case-control studies,amygdala,neurological models,female,male |
Publication ISSN: | 1873-2402 |
Last Modified: | 01 Oct 2024 07:18 |
Date Deposited: | 16 Jul 2013 13:33 |
Full Text Link: | |
Related URLs: |
https://www.sci ... 4272?via%3Dihub
(Publisher URL) |
PURE Output Type: | Article |
Published Date: | 2009-09-01 |
Authors: |
de Almeida, Jorge R.C.
Versace, Amelia Mechelli, Andrea Hassel, Stefanie ( 0000-0001-7240-1581) Quevedo, Karina Kupfer, David J. Phillips, Mary L. |