ABSTRACT
Objectives: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. Methods: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). Results: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. Conclusion: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.
ABSTRACT
OBJECTIVES: Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. METHODS: Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. RESULTS: The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. CONCLUSIONS: Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.
Subject(s)
Humans , Bipolar Disorder , Brain , Broca Area , Endophenotypes , Gyrus Cinguli , Magnetic Resonance Imaging , Prefrontal CortexABSTRACT
Objective: To analyze the recognition, identification, and discrimination of facial emotions in a sample of outpatients with bipolar disorder (BD). Methods: Forty-four outpatients with diagnosis of BD and 48 matched control subjects were selected. Both groups were assessed with tests for recognition (Emotion Recognition-40 - ER40), identification (Facial Emotion Identification Test - FEIT), and discrimination (Facial Emotion Discrimination Test - FEDT) of facial emotions, as well as a theory of mind (ToM) verbal test (Hinting Task). Differences between groups were analyzed, controlling the influence of mild depressive and manic symptoms. Results: Patients with BD scored significantly lower than controls on recognition (ER40), identification (FEIT), and discrimination (FEDT) of emotions. Regarding the verbal measure of ToM, a lower score was also observed in patients compared to controls. Patients with mild syndromal depressive symptoms obtained outcomes similar to patients in euthymia. A significant correlation between FEDT scores and global functioning (measured by the Functioning Assessment Short Test, FAST) was found. Conclusions: These results suggest that, even in euthymia, patients with BD experience deficits in recognition, identification, and discrimination of facial emotions, with potential functional implications. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Bipolar Disorder/psychology , Expressed Emotion , Facial Expression , Recognition, Psychology , Educational StatusABSTRACT
OBJECTIVE: Semantic dementia, a subtype of frontotemporal lobar degeneration, is characterised by cross-modal loss of conceptual knowledge attributable to progressive degeneration of the left anterior temporal lobe. Much less is known regarding the clinical presentation of SD patients with predominantly right-lateralised atrophy. Recent reports emphasise marked socioemotional and behavioural disturbances in such cases. Given the importance of the right anterior temporal lobes in social cognition, we hypothesised that socioemotional functioning would be disproportionately affected in right versus left-lateralised SD cases. METHODS: We assessed well-characterised cases of predominantly right (n=10) and left (n=12) SD and 20 matched healthy controls on tests of emotion processing and interpersonal functioning. RESULTS: Right SD cases showed disproportionate difficulties in the recognition of positive and negative facial emotions, specifically happiness and anger, compared with left SD cases. Deficits in anger recognition persisted in right SD despite covarying for facial and semantic processing. On a contextually rich task of emotion recognition using multimodal videos, no subgroup differences were evident. Finally, empathic concern was rated as significantly lower by caregivers of right versus left SD cases. Overall, the extent of socioemotional disturbance was associated with the degree of behavioural changes in SD. CONCLUSION: Our results reveal considerable overlap in the extent to which socioemotional processes are disrupted in left and right-lateralised cases of SD. Notably, however, right SD cases show disproportionate deficits for recognition of facial emotions and the capacity for empathic concern, supporting a specialised role for the right anterior temporal lobes in mediating these cognitive functions.
OBJETIVO: A demência semântica (DS), um subtipo de degeneração lobar frontotemporal, é caracterizada por perda multimodal do conhecimento conceitual atribuída à degeneração progressiva do região anterior do lobo temporal esquerdo. Sabe-se menos sobre o quadro clínico de pacientes com DS em que a atrofia é localizada predominantemente à direita. Relatos recentes têm enfatizado marcantes distúrbios socioemocionais e comportamentais em tais casos. Dada a importância da região anterior do lobo temporal direito na cognição social, aventamos a hipótese de que o funcionamento socioemocional seria desproporcionalmente afetado nos casos de DS com atrofia lateralizada à direita. MÉTODOS: Foram avaliados os desempenhos de casos bem caracterizados de DS com atrofia do lobo temporal predominantemente à direita (n=10) e à esquerda (n=12) e 20 controles saudáveis em testes de processamento de emoções e funcionamento interpessoal. RESULTADOS: Casos de DS com atrofia predominante à direita apresentaram dificuldades desproporcionadas no reconhecimento de emoções faciais positivas e negativas, especificamente expressões de felicidade e raiva, em comparação com os casos de atrofia à esquerda. Os déficits no reconhecimento de raiva persistiram depois de excluídas as covariações com processamento facial e semântico. Em uma tarefa contextualmente rica de reconhecimento de emoções através de vídeos multimodais, não houve diferenças entre os subgrupos. Por fim, preocupação empática foi classificada por cuidadores como significativamente menor nos casos com atrofia à direita. Em geral, o grau de perturbação socioemocional foi associado com o grau de alterações comportamentais na DS. CONCLUSÃO: Nossos resultados revelam uma considerável sobreposição na medida em que os processos socioemocionais são rompidos tanto em casos com atrofia predominante à direita como à esquerda. Notavelmente, entretanto, os casos com DS com atrofia predominante à direita apresentam déficits desproporcionais no reconhecimento de emoções faciais e na capacidade de preocupação empática, dando suporte à hipótese de um papel especializado das regiões anteriores do lobo temporal direito na mediação dessas funções cognitivas.