Intrinsic functional connectivity during continuous maintenance and suppression of emotion in bipolar disorder
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ORIGINAL RESEARCH
Intrinsic functional connectivity during continuous maintenance and suppression of emotion in bipolar disorder Amit Anand 1 & Jaykumar Grandhi 1 & Harish Karne 1 & Jeffrey M. Spielberg 2
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Resting-state connectivity studies, which examine unconstrained low frequency BOLD fluctuations, have reported inconsistent abnormalities in bipolar disorder (BP). In this study, we investigated intrinsic brain connectivity under the constraints of a Continuous Emotion Regulation Task (CERT) in BP patients in depressed (BPD) and manic (BPM) states, along with healthy control participants. Medication-free participants, with either a diagnosis of BP (BPD = 27, BPM = 30) or healthy controls (N = 33) were included. We collected 2 fMRI scans using the CERT paradigm, in which participants continuously watched negative pictures and either maintained emotions (MAINTAIN) or suppressed emotion using reappraisal techniques (SUPPRESS). Network-based statistic and graph theory analyses were examined for (i) the main effect of condition (within-group) and (ii) group and condition interactions. In healthy participants, MAINTAIN largely involved occipital and parietal cortices (p < .001), whereas SUPPRESS also recruited the frontal and cingulate cortices (p = .023). The interaction between group (BPD vs. BPM) and condition revealed a network involving the inferior frontal lobe which was stronger during MAINTAIN for BPD and during SUPPRESS for BPM (p = .037). Graph theory properties (i.e., clustering coefficient) for key nodes also evidenced significant group by condition interactions. We observed BP-related changes in network properties involved in normal and abnormal emotion regulation, which provide insights into the neural bases for affective disturbances in BP. Keywords Bipolar disorder . Emotion regulation . Mania . Depression . Brain network
Introduction Bipolar disorder (BP) is a chronic condition that remains one of the most debilitating forms of mental illness (Ormel et al. 2008). BP is characterized by shifts into states of seemingly opposing affective valence – episodes of (hypo)mania and depression. Thus, understanding BP-related neural circuitry requires identifying disturbances characteristic of each of these states, potentially providing insight into the mechanisms by which each mood state is triggered. Amit Anand and Jeffrey M. Spielberg contributed equally to this work. * Amit Anand [email protected] * Jeffrey M. Spielberg [email protected] 1
Center for Behavioral Health, Cleveland Clinic Main Campus, Mail Code P57, 9500 Euclid Avenue, Cleveland, OH 44195, USA
2
Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE 19176, USA
BP research implicates dysfunction in brain networks supporting affect regulation (Strakowski et al. 2005; Brady et al. 2014; Wessa et al. 2014). For example, mounting evidence supports the existence of BP-related disturbances in functional networks (mapped via fMRI) (Va
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