Search

Patients with mania show alterations of social behaviour. Neuropsychological studies in euthymic bipolar disorder (BD) have revealed deficits in cognitive, but not emotional aspects of social cognition (SC). Here, we studied the neural signature of social stimulus processing in mania. We expected alterations in regions associated with cognitive SC (dorsal-medial prefrontal cortex, dMPFC). Participants comprised 14 manic patients and 14 matched healthy controls who viewed standardized pictures with social and non-social content during functional magnetic resonance imaging (fMRI). Region-of-interest-analyses focused on areas related to SC (dorsal/ventral medial prefrontal cortex; temporo-parietal junction), determined by a quantitative meta-analysis. Between-group comparisons ('social>non-social') revealed reduced BOLD responses in the right dMPFC in manic patients, but no significant group difference in the ventral MPFC. In addition, manic patients showed elevated BOLD activation in the right temporo-parietal junction during perception of social stimuli, which was correlated with increased delusional ideation. Patients with mania show diminished BOLD responses to social stimuli in the right dMPFC, associated with cognitive SC and this may be related to reported deficits in understanding others' mental states. At the same time, manic patients show hyperactivation of the right temporo-parietal junction, likely related to exaggerated attribution of meaning to social stimuli., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Objectives: The present study in hypomanic and manic patients explored how amygdala responses to affective stimuli depend on the valence of the stimuli presented., Methods: We compared 10 patients with 10 matched healthy control subjects. We measured blood oxygen level-dependent (BOLD) responses in the amygdala while subjects passively viewed photographs taken from the International Affective Picture System. After the fMRI session, subjects saw the pictures again and subjectively rated the emotional valence and intensity of each picture., Results: Compared to healthy individuals, hypomanic or manic patients showed higher valence ratings in positive pictures and associated larger BOLD responses in the left amygdala during positive versus neutral picture viewing. This enhanced amygdala activation was correlated with Young Mania Rating Scale scores and with euphoric as opposed to irritable symptom presentation., Conclusions: Increased valence ratings and amygdala responses to positive affective stimuli may reflect a positive processing bias contributing to elevated mood states characteristic for euphoric mania.