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Neural correlates of irritability differ between disruptive mood dysregulation disorder, bipolar disorder

Recent findings indicated different neural mechanisms associated with irritability between youth with disruptive mood dysregulation disorder and peers with bipolar disorder.

“While the clinical presentation of irritability differs between [disruptive mood dysregulation disorder] and bipolar disorder, the symptom is important in both disorders. However, it is unknown whether the neural mechanisms mediating irritability differ between [disruptive mood dysregulation disorder and bipolar disorder; the question has potential treatment implications,” Jillian Lee Wiggins, PhD, of the Emotion and Development Branch and the Scientific and

Statistical Computing Core, NIMH, Bethesda, Maryland, and colleagues wrote.

To determine if neural mechanisms mediating irritability differ between bipolar disorder and disruptive mood dysregulation disorder (DMDD), researchers conducted functional MRI while 25 youths with DMDD and 24 with bipolar disorder performed a labeling task with happy, fearful and angry faces of varying emotional intensity.

Study participants with DMDD and bipolar disorder exhibited similar levels of irritability and did not differ from each other or healthy youth in face emotion labeling accuracy.

Irritability was associated with amygdala activity across all intensities for all emotions among youth with DMDD. This association was found in youth with bipolar disorder, but only for fearful faces.

Associations between neural activity and irritability in the ventral visual stream were more common in participants with DMDD than those with bipolar disorder, particularly in response to ambiguous angry faces.

“The results support different neural correlates of irritability in DMDD and bipolar disorder and have implications for treatment. Future studies investigating other transdiagnostic symptom dimensions, such as anxiety or depression symptoms, could use this integrated approach to better identify mechanisms of symptoms,” the researchers concluded. – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.