Emotion regulation in bipolar disorder type I: an fMRI study

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Bipolar I disorder (BD-I) is linked to emotion dysregulation.
• Experimental studies on emotion regulation (ER) in BD-I are limited and yield inconsistent findings.
• Brain correlates of ER deficits in BD-I require further investigation.

Purpose of the Study:

• To investigate brain activity during emotion regulation in euthymic BD-I patients compared to healthy controls (HC).
• To examine the neural underpinnings of successful and unsuccessful emotion regulation strategies in BD-I.

Main Methods:

• Functional magnetic resonance imaging (fMRI) was used in 19 euthymic BD-I patients and 17 HC.
• Participants performed a visual emotion regulation task involving 'Look' and 'Decrease' instructions with 'Negative' and 'Neutral' valences.
• Emotional ratings assessed regulation success post-picture presentation.

Main Results:

• BD-I patients demonstrated successful emotion downregulation, albeit less effectively than HC.
• Both groups activated known ER brain regions, but BD-I patients showed increased activation in areas like the ventrolateral prefrontal cortex (VLPFC) under specific conditions.
• Unlike HC, BD-I patients did not exhibit reduced amygdala activation during emotion downregulation of negative stimuli.

Conclusions:

• BD-I patients can employ emotion downregulation strategies when instructed.
• Increased engagement of the ER network, particularly the VLPFC, even when not explicitly required, may characterize BD-I.
• These neural differences may underlie the persistent challenges in everyday emotion regulation reported by individuals with BD-I.