Danella Hafeman1, Genna Bebko1, Michele A Bertocci1, Jay C Fournier1, Henry W Chase1, Lisa Bonar1, Susan B Perlman1, Michael Travis1, Mary Kay Gill1, Vaibhav A Diwadkar2, Jeffrey L Sunshine3, Scott K Holland4, Robert A Kowatch5, Boris Birmaher1, David Axelson6, Sarah M Horwitz7, L Eugene Arnold6, Mary A Fristad6, Thomas W Frazier8, Eric A Youngstrom9, Robert L Findling10, Mary L Phillips11. 1. Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, USA. 2. Psychiatry and Behavioral Neuroscience, Wayne State University, USA. 3. University Hospitals Case Medical Center/Case Western Reserve University, USA. 4. Cincinnati Children's Hospital Medical Center, University of Cincinnati, USA. 5. The Research Institute at Nationwide Children's Hospital, USA. 6. Psychiatry and Behavioral Health, Ohio State University, USA. 7. Child Psychiatry, New York University School of Medicine, USA. 8. Cleveland Clinic, Center for Pediatric Behavioral Health, USA. 9. Psychology, University of North Carolina at Chapel Hill, USA. 10. University Hospitals Case Medical Center/Case Western Reserve University, USA; Psychiatry, Johns Hopkins University, USA. 11. Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, USA; Psychological Medicine, Cardiff University, United Kingdom.
Abstract
OBJECTIVE: Both bipolar spectrum disorders (BPSD) and attention deficit hyperactivity disorder (ADHD) present with emotion-regulation deficits, but require different clinical management. We examined how the neurobiological underpinnings of emotion regulation might differentiate youth with BPSD versus ADHD (and healthy controls, HCs), specifically assessing functional connectivity (FxC) of amygdala-prefrontal circuitry during an implicit emotion processing task. METHODS: We scanned a subset of the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a clinically recruited cohort with elevated behavioral and emotional dysregulation, and age/sex-ratio matched HCs. Our sample consisted of 22 youth with BPSD, 30 youth with ADHD/no BPSD, and 26 HCs. We used generalized psychophysiological interaction (gPPI) to calculate group differences to emerging emotional faces vs. morphing shapes in FxC between bilateral amygdala and ventral prefrontal cortex/anterior cingulate cortex. RESULTS: FxC between amygdala and left ventrolateral prefrontal cortex (VLPFC) in response to emotions vs. shapes differed by group (p=.05): while BPSD showed positive FxC (emotions>shapes), HC and ADHD showed inverse FxC (emotions<shapes). A group x emotion interaction was found in amygdala-subgenual cingulate FxC (p=.025), explained by differences in FxC in response to negative emotions. While BPSD showed positive FxC, HC showed inverse FxC; ADHD were intermediate. Amygdala-subgenual FxC was also positively associated with depressive symptoms and stimulant medication. LIMITATIONS: Co-morbidity and relatively small sample size. CONCLUSIONS: Youth with BPSD showed abnormally positive FxC between amygdala and regions in the ventral prefrontal cortex during emotion processing. In particular, the amygdala-VLPFC finding was specific to BPSD, and not influenced by other diagnoses or medications.
OBJECTIVE: Both bipolar spectrum disorders (BPSD) and attention deficit hyperactivity disorder (ADHD) present with emotion-regulation deficits, but require different clinical management. We examined how the neurobiological underpinnings of emotion regulation might differentiate youth with BPSD versus ADHD (and healthy controls, HCs), specifically assessing functional connectivity (FxC) of amygdala-prefrontal circuitry during an implicit emotion processing task. METHODS: We scanned a subset of the Longitudinal Assessment of Manic Symptoms (LAMS) sample, a clinically recruited cohort with elevated behavioral and emotional dysregulation, and age/sex-ratio matched HCs. Our sample consisted of 22 youth with BPSD, 30 youth with ADHD/no BPSD, and 26 HCs. We used generalized psychophysiological interaction (gPPI) to calculate group differences to emerging emotional faces vs. morphing shapes in FxC between bilateral amygdala and ventral prefrontal cortex/anterior cingulate cortex. RESULTS: FxC between amygdala and left ventrolateral prefrontal cortex (VLPFC) in response to emotions vs. shapes differed by group (p=.05): while BPSD showed positive FxC (emotions>shapes), HC and ADHD showed inverse FxC (emotions<shapes). A group x emotion interaction was found in amygdala-subgenual cingulate FxC (p=.025), explained by differences in FxC in response to negative emotions. While BPSD showed positive FxC, HC showed inverse FxC; ADHD were intermediate. Amygdala-subgenual FxC was also positively associated with depressive symptoms and stimulant medication. LIMITATIONS: Co-morbidity and relatively small sample size. CONCLUSIONS: Youth with BPSD showed abnormally positive FxC between amygdala and regions in the ventral prefrontal cortex during emotion processing. In particular, the amygdala-VLPFC finding was specific to BPSD, and not influenced by other diagnoses or medications.
Authors: Sarah McCue Horwitz; Christine A Demeter; Maria E Pagano; Eric A Youngstrom; Mary A Fristad; L Eugene Arnold; Boris Birmaher; Mary Kay Gill; David Axelson; Robert A Kowatch; Thomas W Frazier; Robert L Findling Journal: J Clin Psychiatry Date: 2010-10-05 Impact factor: 4.384
Authors: Helen S Mayberg; Andres M Lozano; Valerie Voon; Heather E McNeely; David Seminowicz; Clement Hamani; Jason M Schwalb; Sidney H Kennedy Journal: Neuron Date: 2005-03-03 Impact factor: 17.173
Authors: B Birmaher; D A Brent; L Chiappetta; J Bridge; S Monga; M Baugher Journal: J Am Acad Child Adolesc Psychiatry Date: 1999-10 Impact factor: 8.829
Authors: Dylan E Kirsch; Alex Preston; Valeria Tretyak; Vanessa Le; Wade Weber; Stephen M Strakowski; Elizabeth T C Lippard Journal: Bipolar Disord Date: 2021-09-24 Impact factor: 5.345
Authors: Amy S Garrett; Kiki D Chang; Manpreet K Singh; Casey C Armstrong; Patricia D Walshaw; David J Miklowitz Journal: Bipolar Disord Date: 2021-01-26 Impact factor: 5.345
Authors: Ting Xiao; Sheng Zhang; Lue-En Lee; Herta H Chao; Christopher van Dyck; Chiang-Shan R Li Journal: Front Aging Neurosci Date: 2018-07-16 Impact factor: 5.750
Authors: Olga Tymofiyeva; Vivian X Zhou; Chuan-Mei Lee; Duan Xu; Christopher P Hess; Tony T Yang Journal: Front Hum Neurosci Date: 2020-07-07 Impact factor: 3.169