Abnormal corticostriatal activity during fear perception in bipolar disorder.

The time course of responses to repeated presentations of affective stimuli is well characterized in healthy individuals but remains to be characterized in patients with bipolar disorder. Using functional magnetic resonance imaging, we compared early-stage and late-stage brain activation during a two-block fearful face perception task in 14 adult bipolar patients to that of 13 healthy controls. Whereas control participants showed increased orbitofrontal, anterior cingulate, and striatum activity during the late (vs. early) stage of the task, bipolar patients failed to show normal task-related activity in these regions. Results suggest that bipolar disorder may involve corticostriatal dysfunction.