Cited by 277Bipolar Disorder and TreatmentSchizophrenia research and treatmentNeural and Behavioral Psychology Studies

Elevated striatal and decreased dorsolateral prefrontal cortical activity in response to emotional stimuli in euthymic bipolar disorder: no associations with psychotropic medication load

Open access
Hassel, Stefanie, Almeida, Jorge RC, Kerr, Natalie, Nau, Sharon, Ladouceur, Cecile D, Fissell, Kate, Kupfer, David J, Phillips, Mary L·2008·Bipolar Disorders

Abstract

Objective: To examine abnormal patterns of frontal cortical‐subcortical activity in response to emotional stimuli in euthymic individuals with bipolar disorder type I in order to identify trait‐like, pathophysiologic mechanisms of the disorder. We examined potential confounding effects of total psychotropic medication load and illness variables upon neural abnormalities. Method: We analyzed neural activity in 19 euthymic bipolar and 24 healthy individuals to mild and intense happy, fearful and neutral faces. Results: Relative to healthy individuals, bipolar subjects had significantly increased left striatal activity in response to mild happy faces (p < 0.05, corrected), decreased right dorsolateral prefrontal cortical (DLPFC) activity in response to neutral, mild and intense happy faces, and decreased left DLPFC activity in response to neutral, mild and intense fearful faces (p < 0.05, corrected). Bipolar and healthy individuals did not differ in amygdala activity in response to either emotion. In bipolar individuals, there was no significant association between medication load and abnormal activity in these regions, but a negative relationship between age of illness onset and amygdala activity in response to mild fearful faces (p = 0.007). Relative to those without comorbidities, bipolar individuals with comorbidities showed a trend increase in left striatal activity in response to mild happy faces. Conclusions: Abnormally increased striatal activity in response to potentially rewarding stimuli and decreased DLPFC activity in response to other emotionally salient stimuli may underlie mood instabilities in euthymic bipolar individuals, and are more apparent in those with comorbid diagnoses. No relationship between medication load and abnormal neural activity in bipolar individuals suggests that our findings may reflect pathophysiologic mechanisms of the illness rather than medication confounds. Future studies should examine whether this pattern of abnormal neural activity could distinguish bipolar from unipolar depression.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/j.1399-5618.2008.00641.x

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Recent work has demonstrated significant associations between an earlier illness onset and both amygdala hyperactivity and decreased activity within the DLPFC in bipolar disorder.

    “Recent work has demonstrated significant associations between an earlier illness onset and both amygdala hyperactivity 86 and decreased activity within the DLPFC.”
  • In euthymic patients with bipolar disorder compared with healthy controls, studies have demonstrated increased hippocampal activity along with enhanced amygdala activity and diminished DLPFC activation when viewing fearful faces.

    “In euthymic patients with bipolar disorder compared with healthy controls, studies have demonstrated increased hippocampal activity 82 along with enhanced amygdala activity 76 and diminished DLPFC activation when viewing fearful faces 76,82,86”
  • Preliminary evidence indicates that comorbid symptoms, particularly anxiety, eating or substance abuse disorder, may alter patterns of neuronal activation during recognition of emotional faces in patients with bipolar disorder.

    “Preliminary evidence indicates that comorbid symptoms, and in particular the presence of an anxiety, eating or substance abuse disorder, may alter patterns of neuronal activation during recognition of emotional faces in patients with bipolar disorder”
  • These findings were not consistently observed in euthymic patients with bipolar disorder.

    “These findings, however, were not consistently observed in euthymic patients with bipolar disorder.”
  • Patients with bipolar disorder do not show normalization of function despite recovery, with exceptions following treatment with a mood stabilizer.

    “patients with bipolar disorder do not show this normalization of function despite recovery (for exceptions following treatment with a mood stabilizer, see Hassel and colleagues 86 and Robinson and colleagues 90”

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [4]Goodwin FK Jamison KR Manic-Depressive Illness: Bipolar Disorder and Recurrent Depression 2007 Oxford University Press New York 2nd edn.

Cited by

Sorted by citations

Authors
Hassel, S., Almeida, J. R., Kerr, N., Nau, S., Ladouceur, C. D., Fissell, K., Kupfer, D. J., & Phillips, M. L.
Affiliations
University of Pittsburgh (US)
Corresponding author
Phillips, Mary L
Venue
Bipolar Disorders
Publisher
Wiley
Published
2008-11-18
Volume
10
Issue
8
Pages
916-927
ISSN
  • 1398-5647 (ISSN-L)
  • 1399-5618
OpenAlex
W2010891863
Cited by
277
References
56
Citations by year
2026: 6 · 2025: 26 · 2024: 12 · 2023: 10 · 2022: 16 · 2021: 13 · 2020: 11 · 2019: 8 · 2018: 13 · 2017: 14 · 2016: 15 · 2015: 19 · 2014: 18 · 2013: 26 · 2012: 26
FWCI
10.07
Type
journal article
Language
en
Open access
Locations
  • Bipolar Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Scientific Electronic Library Online (São Paulo Research Foundation, Latin American and Caribbean Center on Health Sciences Information, Conselho Nacional de Desenvolvimento Científico e Tecnológico) (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders
  • National Institutes of Health (5r01mh076971-05)
  • National Institute of Mental Health (R01-MH076971)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
bipolar I disorder, euthymia, dorsolateral prefrontal cortex, amygdala, emotional face processing, emotional stimuli, comorbidities, mood instability, pathophysiology, major depressive disorder
MeSH terms
Adult, Amygdala, Arousal, Bipolar Disorder, Brain Mapping, Cerebral Cortex, Corpus Striatum, Dominance, Cerebral, Drug Therapy, Combination, Emotions, Facial Expression, Female, Humans, Image Interpretation, Computer-Assisted, Limbic System, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Net, Oxygen, Pattern Recognition, Visual, Psychotropic Drugs, Comorbidity, Prefrontal Cortex

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review