双相情感障情绪影响工作记忆

nullnullDr. Alessandra M. Passarotti, Ph.D., Dr. John A. Sweeney, Ph.D., Dr. Mani N. Pavuluri, M.D., Ph.D.Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2010 October ; 49(10): 1064–1080. doi:10.1016/j.jaac.2010.07.009nullIntroduction—PBD: emotional dysregulation ,rapid mood cycling with mixed episodes ADHD: hyperactivity, distractibility, irritability The interaction between cognitive and affective functions results from synergistic neural mechanisms of the ventral affect processing system and the dorsal executive control system Objective—Objective—This fMRI study examined how working memory circuits are affected by face emotion processing in pediatric bipolar disorder (PBD) and attention-deficit hyperactivity disorder (ADHD).Methods— Methods— Participants： 23 patients with bipolar disorder, 14 patients with ADHD 19 healthy controls (HC) (mean age = 13.36 ± 2.55) nullClinical Assessment: the DSM IV diagnoses of PBD or ADHD Parent ADHD Rating Scale IV Revised a handedness questionnaire Young Mania Rating Scale Child Depression Rating Scale-RevisedMethods—nullfMRI session and n-back task with emotional faces a block design 2-back working memory task with emotional faces a block(10 trials), each trial 3 sec first run：angry and neutral faces; second run：happy and neutral faces pressing a response key if they saw the same face as the one presented two trials earlier Methods—nullFigure 1. Illustration of match trials in the 2-back working memory task, with happy, neutral and angry faces.nullMRI Protocol Gradient-echo echo-planar functional imaging and structural acquisitions were performed with a 3.0 Tesla whole body scanner twenty-five slices in the axial plane anatomical images were also acquired in the axial planeMethods—nullImage Processing and Data Analysis used FIASCO software for head motion correction A Fisher z transform was also applied, voxel by voxel, to normalize the effect size maps (zr) The zr-maps and SPGR anatomical images were imported in AFNI (Analysis of Functional Neuroimages) and warped into Talairach space using AFNI’s auto-talairaching proceduresnull Demographic and Clinical DataResults— null Demographic and Clinical DataResults— nullBehavioral Performance Results RT: angry faces significantly slower than neutral faces Accuracy : the PBD group was significantly lower than HC The PBD and ADHD groups did not differ from each otherResults— null Table 2nullBetween-group differences in significant clusters of brain activation for the Angry vs.Neutral face contrast. Note: Red indicates greater activation in the first group compared to the second group. Blue indicates greater activation in the second group compared to the first group.nullBetween-group differences in significant clusters of brain activation for the Happy vs. Neutral face contrast. Red indicates greater activation in the first group compared to the second group. Blue indicates greater activation in the second group compared to the first groupnullfMRI ResultsnullDifferential Involvement of Affective and Cognitive Circuitry in PBD and ADHD Specific Dysfunction of the Neural Interface of Affective and Cognitive Circuitry in PBD relative to HC VLPFC and ACC Dysfunction in ADHD relative to HCDiscussion—Conclusions—Conclusions—Relative to the ADHD group the PBD group exhibited greater deployment of the emotion processing circuitry and reduced deployment of working memory circuitry. Commonalities across PBD and ADHD patients, relative to HC, entailed cortico-subcortical activity that is reduced under negative emotional challenge, and increased under positive emotional challenge.null谢谢聆听！THANK YOU VERY MUCH!