Elsevier

Biological Psychiatry

Volume 66, Issue 5, 1 September 2009, Pages 516-521
Biological Psychiatry

Research Report
Functional and Structural Connectivity Between the Perigenual Anterior Cingulate and Amygdala in Bipolar Disorder

https://doi.org/10.1016/j.biopsych.2009.03.023Get rights and content

Objective

Abnormalities in the morphology and function of two gray matter structures central to emotional processing, the perigenual anterior cingulate cortex (pACC) and amygdala, have consistently been reported in bipolar disorder (BD). Evidence implicates abnormalities in their connectivity in BD. This study investigates the potential disruptions in pACC-amygdala functional connectivity and associated abnormalities in white matter that provides structural connections between the two brain regions in BD.

Methods

Thirty-three individuals with BD and 31 healthy comparison subjects (HC) participated in a scanning session during which functional magnetic resonance imaging (fMRI) during processing of face stimuli and diffusion tensor imaging (DTI) were performed. The strength of pACC-amygdala functional connections was compared between BD and HC groups, and associations between these functional connectivity measures from the fMRI scans and regional fractional anisotropy (FA) from the DTI scans were assessed.

Results

Functional connectivity was decreased between the pACC and amygdala in the BD group compared with HC group, during the processing of fearful and happy faces (p < .005). Moreover, a significant positive association between pACC-amygdala functional coupling and FA in ventrofrontal white matter, including the region of the uncinate fasciculus, was identified (p < .005).

Conclusion

This study provides evidence for abnormalities in pACC-amygdala functional connectivity during emotional processing in BD. The significant association between pACC-amygdala functional connectivity and the structural integrity of white matter that contains pACC-amygdala connections suggest that disruptions in white matter connectivity may contribute to disturbances in the coordinated responses of the pACC and amygdala during emotional processing in BD.

Section snippets

Subjects

The Structured Clinical Interview for DSM-IV Axis I Disorders Version 2.0 (27) confirmed the presence or absence of Axis I Disorders and mood state at scanning for the 33 BD and 31 healthy comparison (HC) participants. Symptoms were assessed using the Hamilton Depression Rating Scale (28) and Clinician-Administered Rating Scale for Mania (29). No subject had a history of neurologic illness, head trauma with loss of consciousness over 5 min, or major medical disorder with the exception of three

Results

There were no significant group differences in mean reaction time or response accuracy to the different face types (Table 1). We observed decreased pACC-amygdala functional connectivity in the BD group, compared with the HC group (p < .005), during fearful (Figure 1A and 1C) and happy (Figure 1B and 1D) face processing. No significant group differences in functional connectivity were detected during neutral face processing. Whole-brain analyses revealed additional group differences in

Discussion

We detected disturbances in pACC-amygdala functional connectivity during the processing of faces depicting positive and negative emotions in BD. Moreover, we found an association between pACC-amygdala functional connectivity measurements and the structural integrity of ventrofrontal white matter, including the uncinate fasciculus where FA was also significantly decreased in the BD group. Taken together, these data provide some of the first evidence that abnormalities in the structural integrity

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