Amygdala Activation During Emotion Processing of Neutral Faces in Children With Severe Mood Dysregulation Versus ADHD or Bipolar Disorder

Abstract

Objective To understand disorder-unique and common pathophysiology, studies in multiple patient groups with overlapping symptoms are needed. Deficits in emotion processing and hyperarousal symptoms are prominent features of bipolar disorder, attention deficit hyperactivity disorder (ADHD), and severe mood dysregulation. The authors compared amygdala response during emotional and nonemotional ratings of neutral faces in youths with these disorders as well as a group of healthy comparison youths. Method Blood-oxygen-level-dependent (BOLD) signal in the amygdala was examined in children with bipolar disorder (N=43), ADHD (N=18), and severe mood dysregulation (N=29) and healthy comparison subjects (N=37). During functional magnetic resonance imaging (fMRI), participants attended to emotional and nonemotional aspects of neutral faces. Results While rating subjective fear of neutral faces, youths with ADHD demonstrated left amygdala hyperactivity relative to the other three groups, whereas youths with severe mood dysregulation demonstrated hypoactivity. Conclusions These findings support the role of unique neural correlates in face-emotion processing among youths with bipolar disorder, ADHD, and severe mood dysregulation.

Similarities between emotional dysregulation in adults suffering from ADHD and bipolar patients

“…In a study by Posner et al, (2011), subjects suffering from ADHD show a left amygdala hyperactivity that is more important than control subjects. Brotman et al, (2010) have demonstrated that, faced with emotional stimuli, children suffering from ADHD have greater amygdala hyperactivity than children suffering from bipolar disorder. In BD, there are an increased right parahippocampal gyrus and subgenual cingulate gyrus effective connectivity (Houenou et al, 2011) and reduced activation of the parahippocampal gyrus in response to emotional stimuli (Almeida et al, 2009).…”

ADHD and DMDD Comorbidities, Similarities and Distinctions

“…In pedopsychiatric population, comorbid disorders with DMDD were particularly frequent: 93.8% of ADHD, 84.4% of ODD and 46.9% of anxiety disorders. Also, according to Brotman and al [19], diagnoses of Axis I most associated with DMDD are ADHD (26.9%), ODD (24.5%), anxiety disorders (14.7%) and depressive disorders (13.7%) [9].…”

“…Pathophysiologycally, the study of amygdala activation during emotion processing of neutral faces in children with DMDD versus ADHD suggested the role of unique neural correlates in face emotion processing [19]. It showed a double dissociation in amygdala activity in youths with DMMD and ADHD when completing fear (emotional) versus non emotional ratings of neural faces.…”

Developments and challenges in the diagnosis and treatment of ADHD

“…35 The neuroimaging literature has shown that ADHD is related to alterations in several brain systems, including systems involved in attention, cognitive control, emotional, sensorimotor, and reward processes. 12,[40][41][42][43][44][45][46][47] . Most of those studies have focused on single process hypotheses and have not addressed the multiple pathways model.…”