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Preliminary evidence for medication effects on functional abnormalities in the amygdala and anterior cingulate in bipolar disorder

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Abstract

Rationale

Abnormal amygdala and frontocortical responses to emotional stimuli are implicated in bipolar disorder (BD) and have been proposed as potential treatment targets.

Objectives

The aim of this study was to investigate amygdala and frontocortical responses to emotional face stimuli in BD and the influences of mood-stabilizing medications on these responses.

Methods

Functional magnetic resonance imaging was performed while 17 BD participants (5 unmedicated) and 17 healthy comparison (HC) participants viewed faces with happy, sad, fearful, or neutral expressions.

Results

The group by stimulus-condition interaction was significant (p<0.01) for amygdala activation, with the greatest effects in the happy face condition. Relative to HC, amygdala increases were greater in unmedicated BD, but lower in medicated BD. Rostral anterior cingulate (rAC) activation was decreased in unmedicated BD compared to HC; however, BD participants taking medication demonstrated rAC activation similar to HC participants.

Conclusions

Although the sample sizes were small, these preliminary results suggest that BD is associated with increased amygdala and decreased rAC response to emotional faces. The findings also provide preliminary evidence that mood-stabilizing medications may reverse abnormalities in BD in the response of an amygdala–frontal neural system to emotional stimuli.

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Acknowledgements

The authors thank Kathleen Colonese, BA, for her expert care in coordinating the research; Hedy Sarofin, RTRMR, and Terry Hickey, RTRMRN, for their technical expertise; and the research subjects for their participation.

The authors were supported by research grants from the National Alliance for Research in Affective Disorders and Schizophrenia (Great Neck, NY) (HPB), The Ethel F. Donaghue Women's Investigator Program at Yale (New Haven, CT) (HPB), the Borderline Personality Disorder Research Foundation (NHD, CAS, THM), the Department of Veterans Affairs Research Career Development (HPB), Merit Review (HPB) and Research Enhancement Award Program (REAP) (HPB, JHK) Awards, Alcohol Research Center (JHK) and Clinical Neurosciences Division of the National Center for PTSD (JHK) (Washington, DC) and the National Institute of Mental Health R01MH69747 and R01MH070902 (HPB), National Institute on Alcohol Abuse and Alcoholism K05 AA 14906-01 (JHK) and NIH/NIMH K05-01654 (THM) (Bethesda, MD).

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Authors and Affiliations

  1. Mood Disorders Research Program, Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT, 06511, USA

    Hilary P. Blumberg, Nelson H. Donegan, Charles A. Sanislow, Susan Collins, Thomas H. McGlashan & John H. Krystal

  2. Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, 06519, USA

    Hilary P. Blumberg, Cheryl Lacadie, Pawel Skudlarski & Robert K. Fulbright

  3. Depression Research Center (REAP), Department of Veterans Affairs, VA CT Healthcare System, West Haven, CT, 06516, USA

    Hilary P. Blumberg & John H. Krystal

  4. Department of Epidemiology and Public Health, Yale University, New Haven, CT, 06520, USA

    Ralitza Gueorguieva

  5. Department of Radiology, Vanderbilt University, Nashville, TN, 37232, USA

    John C. Gore

Authors
  1. Hilary P. Blumberg
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  2. Nelson H. Donegan
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  3. Charles A. Sanislow
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  4. Susan Collins
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  5. Cheryl Lacadie
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  6. Pawel Skudlarski
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  7. Ralitza Gueorguieva
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  8. Robert K. Fulbright
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  9. Thomas H. McGlashan
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  10. John C. Gore
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  11. John H. Krystal
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Correspondence to Hilary P. Blumberg.

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Blumberg, H.P., Donegan, N.H., Sanislow, C.A. et al. Preliminary evidence for medication effects on functional abnormalities in the amygdala and anterior cingulate in bipolar disorder. Psychopharmacology 183, 308–313 (2005). https://doi.org/10.1007/s00213-005-0156-7

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  • DOI: https://doi.org/10.1007/s00213-005-0156-7

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