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Abstract

Objective:

Child and adult bipolar patients show both behavioral deficits in face emotion processing and abnormal amygdala activation. However, amygdala function in pediatric relative to adult bipolar patients has not been compared directly. The authors used functional MRI to compare amygdala activity during a face processing task in children and adults with bipolar disorder and in healthy comparison subjects.

Method:

Amygdala responses to emotional facial expressions were examined in pediatric (N=18) and adult (N=17) bipolar patients and in healthy child (N=15) and adult (N=22) volunteers. Participants performed a gender identification task while viewing fearful, angry, and neutral faces.

Results:

In response to fearful faces, bipolar patients across age groups exhibited right amygdala hyperactivity relative to healthy volunteers. However, when responses to all facial expressions were combined, pediatric patients exhibited greater right amygdala activation than bipolar adults and healthy children.

Conclusions:

Amygdala hyperactivity in response to fearful faces is present in both youths and adults with bipolar disorder. However, compared with bipolar adults and healthy child volunteers, pediatric bipolar patients showed amygdala hyperactivity in response to a broad array of emotional faces. Thus, abnormal amygdala activation during face processing appears to be more pervasive in children than in adults with bipolar disorder. Longitudinal studies are needed to elucidate the mechanisms of this developmental difference, thus facilitating developmentally sensitive diagnosis and treatment.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 642 - 649
PubMed: 22535257

History

Received: 16 August 2011
Revision received: 25 October 2011
Accepted: 13 January 2012
Published online: 1 June 2012
Published in print: June 2012

Authors

Details

Pilyoung Kim, Ph.D.
From NIMH, Bethesda, Md.
Laura A. Thomas, Ph.D.
From NIMH, Bethesda, Md.
Brooke H. Rosen, B.A.
From NIMH, Bethesda, Md.
Alexander M. Moscicki, B.A.
From NIMH, Bethesda, Md.
Melissa A. Brotman, Ph.D.
From NIMH, Bethesda, Md.
Carlos A. Zarate, Jr., M.D.
From NIMH, Bethesda, Md.
R. James R. Blair, Ph.D.
From NIMH, Bethesda, Md.
Daniel S. Pine, M.D.
From NIMH, Bethesda, Md.
Ellen Leibenluft, M.D.
From NIMH, Bethesda, Md.

Notes

Address correspondence to Dr. Kim ([email protected]).

Funding Information

Dr. Zarate is listed as a co-inventor on a patent application for the use of ketamine in major depression; he has assigned his rights in the patent to the U.S. government but will share a percentage of any royalties that may be received by the government. All other authors report no financial relationships with commercial interests.Supported by the Intramural Research Program of NIMH and NIH.

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