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

Published online by Cambridge University Press:  31 August 2021

Hanne Lie Kjærstad Open the ORCID record for Hanne Lie Kjærstad [Opens in a new window] ,
Julian Macoveanu Open the ORCID record for Julian Macoveanu [Opens in a new window] ,
Gitte Moos Knudsen Open the ORCID record for Gitte Moos Knudsen [Opens in a new window] ,
Sophia Frangou Open the ORCID record for Sophia Frangou [Opens in a new window] ,
K. Luan Phan ,
Maj Vinberg Open the ORCID record for Maj Vinberg [Opens in a new window] ,
Lars Vedel Kessing Open the ORCID record for Lars Vedel Kessing [Opens in a new window]  and
Kamilla Woznica Miskowiak Open the ORCID record for Kamilla Woznica Miskowiak [Opens in a new window]
Hanne Lie Kjærstad*
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Julian Macoveanu
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Gitte Moos Knudsen
Affiliation:
Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, Denmark
Sophia Frangou
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
K. Luan Phan
Affiliation:
Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, USA
Maj Vinberg
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark Psychiatric Research Unit, Psychiatric Centre North Zealand, Hillerød, Denmark
Lars Vedel Kessing
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark
Kamilla Woznica Miskowiak
Affiliation:
Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Denmark Department of Psychology, University of Copenhagen, Copenhagen, Denmark
*
Author for correspondence: Hanne Lie Kjærstad, E-mail: hanne.lie.kjaerstad@regionh.dk
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Abstract

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.

Keywords

Emotion regulationbipolar disorderhigh-riskrelativesfMRIfunctional connectivitychildhood trauma
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 4 , March 2023 , pp. 1254 - 1265
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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