Emotional processing in bipolar disorder: behavioural and neuroimaging findings

Existing studies revealed that bipolar patients show an altered identification of emotional stimuli (e.g. facial expressions), however, so far modifications in early emotional processes and the regulation of emotions are less clear. In response to emotional stimuli bipolar patients show a dysfunction in a ventral-limbic brain network including the amygdala, insula, striatum, subgenual cingulate cortex, ventrolateral prefrontal cortex and orbitofrontal cortex. In most studies, a relative hypoactivity of dorsal brain structures, including the dorsolateral prefrontal cortex, the dorsal anterior cingulate and the posterior cingulate cortex, has been reported in bipolar patients. This imbalance between the two networks has been proposed to underlie deficient emotion regulation in bipolar disorder.