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Certain neural circuitries during emotional processing may predict bipolar disorder

Greater activity and functional connectivity during emotion regulation tasks in the anterior cingulate cortex may be specific markers of bipolar disorder risk in youth, according to findings published in JAMA Psychiatry.

In children of parents with bipolar disorder, the researchers observed increased right rostral anterior cingulate cortices activity to happy faces and greater amygdala to left caudal anterior cingulate cortices functional connectivity to fearful faces during attentional task performance, which have significant ties to affective lability — a precursor of bipolar disorder, according to the researchers.

“More studies are needed to identify abnormalities in emotion processing and regulation neural circuitries specific to [offspring of parents with bipolar disorder],” Heather E. Acuff, PhD, from the University of Pittsburgh, and colleagues wrote. “Examining these relationships can improve understanding of [bipolar disorder] development in youth and may enhance early identification of [bipolar disorder] risk in, and guide novel interventions for, [offspring of parents with bipolar disorder].”

To identify neural markers of future bipolar disorder risk in 31 youth born to parents with bipolar disorder, the researchers assessed measures of activity and functional connectivity in amygdala to ventrolateral prefrontal cortices circuitry during emotion processing and regulation. They compared the brain activity of these at-risk offspring with that of 28 children of comparison parents with non-bipolar disorder psychopathologies and 21 children of healthy parents. They also examined the extent to which these measures were tied to symptom severity in this cross-sectional and longitudinal neuroimaging study.

While the participants performed in an emotional face processing and n-back task, the investigators examined group differences in amygdala, dorsolateral and ventrolateral prefrontal cortices (PFC), caudal anterior cingulate cortices (cACC) and rostral anterior cingulate cortices (rACC) neuroimaging measures. They also assessed associations between neuroimaging and symptom changes over follow-up (average 2.9 years) in a subset of 30 participants.

The results demonstrated that offspring of parents with bipolar disorder had greater right rACC activity when regulating attention to happy faces during the emotional processing task compared with offspring of comparison parents, and this was positively correlated with affective lability symptom severity (P = .006). Furthermore, offspring of parents with bipolar disorder and of comparison parents demonstrated lower rACC activity than those born to healthy parents when participants saw happy faces during the n-back task performance.

In addition, children of parents with bipolar disorder had greater amygdala to left cACC functional connectivity when seeing fearful, happy and neutral faces compared with offspring of comparison parents. Over the follow-up period, changes in amygdala to left cACC functional connectivity to fearful faces were tied to changes in affective lability severity (P = .003).

“We conclude that greater right rACC activity and greater amygdala to left cACC functional connectivity during emotional regulation are candidate objective markers of [bipolar disorder] risk in youth,” Acuff and colleagues wrote. “Our findings are important steps toward identifying neural markers of [bipolar disorder] risk to aid in enhanced early identification and guide interventions for [bipolar disorder] at-risk youth.” – by Savannah Demko

Disclosure: Acuff reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.