Cerebral Correlates of Abnormal Emotion Conflict Processing in Euthymic Bipolar Patients: A Functional MRI Study

PLoS One. 2015 Aug 5;10(8):e0134961. doi: 10.1371/journal.pone.0134961. eCollection 2015.


Background: Patients with bipolar disorder experience cognitive and emotional impairment that may persist even during the euthymic state of the disease. These persistent symptoms in bipolar patients (BP) may be characterized by disturbances of emotion regulation and related fronto-limbic brain circuitry. The present study aims to investigate the modulation of fronto-limbic activity and connectivity in BP by the processing of emotional conflict.

Methods: Fourteen euthymic BP and 13 matched healthy subjects (HS) underwent functional magnetic resonance imaging (fMRI) while performing a word-face emotional Stroop task designed to dissociate the monitoring/generation of emotional conflict from its resolution. Functional connectivity was determined by means of psychophysiological interaction (PPI) approach.

Results: Relative to HS, BP were slower to process incongruent stimuli, reflecting higher amount of behavioral interference during emotional Stroop. Furthermore, BP showed decreased activation of the right dorsolateral prefrontal cortex (DLPFC) during the monitoring and a lack of bilateral amygdala deactivation during the resolution of the emotional conflict. In addition, during conflict monitoring, BP showed abnormal positive connectivity between the right DLPFC and several regions of the default mode network.

Conclusions: Overall, our results highlighted dysfunctional processing of the emotion conflict in euthymic BP that may be subtended by abnormal activity and connectivity of the DLPFC during the conflict monitoring, which, in turn, leads to failure of amygdala deactivation during the resolution of the conflict. Emotional dysregulation in BP may be underpinned by a lack of top-down cognitive control and a difficulty to focus on the task due to persistent self-oriented attention.

Trial registration: ClinicalTrials.gov NCT01821469.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amygdala / physiopathology
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / physiopathology*
  • Bipolar Disorder / psychology
  • Brain / physiopathology*
  • Conflict, Psychological*
  • Emotions / physiology*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Prefrontal Cortex / physiopathology
  • Psychomotor Performance / physiology
  • Psychophysiology / methods
  • Stroop Test

Associated data

  • ClinicalTrials.gov/NCT01821469

Grants and funding

This work has been supported by research grants from: Grenoble University Hospital, http://www.chu-grenoble.fr/; “the French University Institute”, http://iuf.amue.fr/; “Grenoble Cognition Center”, http://www.grenoblecognition.fr/ and “Health and Society Research Network” from Pierre Mendès France University (Grenoble) http://www.sfr-sante-societe.net/fr/. Grenoble MRI facility IRMaGE was partly funded by the French program "Investissement d'avenir" run by the "Agence Nationale pour la Recherche" http://www.agence-nationale-recherche.fr/; grant "Infrastructure d'avenir en Biologie Santé" - ANR-11-INBS-0006. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.