The longitudinal trajectory of emotion regulation and associated neural activity in patients with bipolar disorder: A prospective fMRI study
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The longitudinal trajectory of emotion regulation and associated neural activity in patients with bipolar disorder : A prospective fMRI study. / Kjærstad, Hanne Lie; de Siqueira Rotenberg, Luisa; Knudsen, Gitte Moos; Vinberg, Maj; Kessing, Lars Vedel; Macoveanu, Julian; Lafer, Beny; Miskowiak, Kamilla Woznica.
In: Acta Psychiatrica Scandinavica, Vol. 146, No. 6, 2022, p. 568-582.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The longitudinal trajectory of emotion regulation and associated neural activity in patients with bipolar disorder
T2 - A prospective fMRI study
AU - Kjærstad, Hanne Lie
AU - de Siqueira Rotenberg, Luisa
AU - Knudsen, Gitte Moos
AU - Vinberg, Maj
AU - Kessing, Lars Vedel
AU - Macoveanu, Julian
AU - Lafer, Beny
AU - Miskowiak, Kamilla Woznica
N1 - Publisher Copyright: © 2022 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
PY - 2022
Y1 - 2022
N2 - Objectives: Impaired emotion regulation is a key feature of bipolar disorder (BD) that presents during acute mood episodes and in remission. The neural correlates of voluntary emotion regulation seem to involve deficient prefrontal top-down regulation already at BD illness onset. However, the trajectory of aberrant neuronal activity during emotion regulation in BD is unclear. Methods: We investigated neural activity during emotion regulation in response to aversive pictures from the International Affective Picture System in patients with recently diagnosed BD (n = 43) in full or partial remission and in healthy controls (HC) (n = 38) longitudinally at baseline and 16 months later. Results: Patients with BD exhibited stable hypo-activity in the left dorsomedial prefrontal cortex (DMPFC) and right dorsolateral prefrontal cortex (DLPFC) and impaired emotion regulation compared to HC over the 16 months follow-up time. More DLPFC hypo-activity during emotion regulation correlated with less successful down-regulation (r = 0.16, p = 0.045), more subsyndromal depression (r = −0.18, p = 0.02) and more functional impairment (r = −0.24, p = 0.002), while more DMPFC hypo-activity correlated with less efficient emotion regulation (r = 0.16, p = 0.048). Finally, more DMPFC hypo-activity during emotion regulation at baseline was associated with an increased likelihood of subsequent relapse during the 16 months follow-up time (β = −2.26, 95% CI [0.01; 0.99], p = 0.048). Conclusion: The stable DLPFC and DMPFC hypo-activity during emotion regulation represents a neuronal trait-marker of persistent emotion regulation difficulties in BD. Hypo-activity in the DMPFC may contribute to greater risk of relapse.
AB - Objectives: Impaired emotion regulation is a key feature of bipolar disorder (BD) that presents during acute mood episodes and in remission. The neural correlates of voluntary emotion regulation seem to involve deficient prefrontal top-down regulation already at BD illness onset. However, the trajectory of aberrant neuronal activity during emotion regulation in BD is unclear. Methods: We investigated neural activity during emotion regulation in response to aversive pictures from the International Affective Picture System in patients with recently diagnosed BD (n = 43) in full or partial remission and in healthy controls (HC) (n = 38) longitudinally at baseline and 16 months later. Results: Patients with BD exhibited stable hypo-activity in the left dorsomedial prefrontal cortex (DMPFC) and right dorsolateral prefrontal cortex (DLPFC) and impaired emotion regulation compared to HC over the 16 months follow-up time. More DLPFC hypo-activity during emotion regulation correlated with less successful down-regulation (r = 0.16, p = 0.045), more subsyndromal depression (r = −0.18, p = 0.02) and more functional impairment (r = −0.24, p = 0.002), while more DMPFC hypo-activity correlated with less efficient emotion regulation (r = 0.16, p = 0.048). Finally, more DMPFC hypo-activity during emotion regulation at baseline was associated with an increased likelihood of subsequent relapse during the 16 months follow-up time (β = −2.26, 95% CI [0.01; 0.99], p = 0.048). Conclusion: The stable DLPFC and DMPFC hypo-activity during emotion regulation represents a neuronal trait-marker of persistent emotion regulation difficulties in BD. Hypo-activity in the DMPFC may contribute to greater risk of relapse.
KW - bipolar disorder
KW - emotion regulation
KW - functional neuroimaging
KW - longitudinal
KW - neurobiology
U2 - 10.1111/acps.13488
DO - 10.1111/acps.13488
M3 - Journal article
C2 - 36054343
AN - SCOPUS:85137322080
VL - 146
SP - 568
EP - 582
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
SN - 0001-690X
IS - 6
ER -
ID: 323988756