Parametric Modulation of Neural Activity by Emotion in Youth With Bipolar Disorder, Youth With Severe Mood Dysregulation, and Healthy Volunteers

Abstract

Pediatric bipolar disorder (BD) is diagnosed with increasing frequency,¹ perhaps because some suggest that it presents as either severe nonepisodic irritability or episodic mania.² This suggestion raises questions about clinical and pathophysiologic differences between these 2 presentations. To evaluate this, the phenotype of severe, nonepisodic irritability was operationalized as severe mood dysregulation (SMD).² Family history³ and longitudinal data^4,5 suggest that BD and SMD are dissociable phenotypes, whereas behavioral data find similarities in facial information processing.^6-9 Imaging studies can elucidate similarities and differences in neural mediators of such information-processing findings.^10,11 In this study, we compared blood oxygenation level–dependent (BOLD) activation patterns during the presentation of parametrically morphed emotional faces in patients with BD or SMD and healthy volunteers (HVs).