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Dysfunction of emotional brain systems in individuals at high risk of mood disorder with depression and predictive features prior to illness

Published online by Cambridge University Press:  17 September 2014

H. C. Whalley ,
J. E. Sussmann ,
L. Romaniuk ,
T. Stewart ,
S. Kielty ,
S. M. Lawrie ,
J. Hall  and
A. M. McIntosh
H. C. Whalley*
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
J. E. Sussmann
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
L. Romaniuk
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
T. Stewart
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
S. Kielty
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
S. M. Lawrie
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
J. Hall
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
A. M. McIntosh
Affiliation:
Division of Psychiatry, University of Edinburgh, Edinburgh, UK
*
*Address for correspondence: Dr H. C. Whalley, Ph.D., University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, UK. (Email: heather.whalley@ed.ac.uk)
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Abstract

Background.

Abnormalities of emotion-related brain circuitry, including cortico-thalamic-limbic regions underpin core symptoms of bipolar disorder (BD) and major depressive disorder (MDD). It is unclear whether these abnormalities relate to symptoms of the disorder, are present in unaffected relatives, or whether they can predict future illness.

Method.

The Bipolar Family Study (BFS) is a prospective longitudinal study that has examined individuals at familial risk of mood disorder and healthy controls on three occasions, 2 years apart. The current study concerns imaging data from the second assessment; 51 controls and 81 high-risk (HR) individuals performing an emotional memory task. The latter group was divided into 61 HR individuals who were well, and 20 who met diagnostic criteria for MDD. At the time of the third assessment a further 11 HR individuals (from the Well group) had developed MDD. The current analyses focused on (i) differences between groups based on diagnostic status at the time of the scan, and (ii) predictors of future illness, comparing the 11 HR individuals who became unwell after the second scanning assessment to those who remained well.

Results.

All groups demonstrated typical emotional modulation of memory and associated brain activations. For analysis (i) the HR MDD group demonstrated increased thalamic activation v. HR Well. (ii) HR Well individuals who subsequently became ill showed increased activation of thalamus, insula and anterior cingulate compared to those who remained well.

Conclusions.

These findings suggest evidence for specific changes related to the presence of illness and evidence that changes in brain function in cortico-thalamic-limbic regions precede clinical illness.

Keywords

Bipolar disorderfMRIinsulamajor depressive disorderthalamus
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1207 - 1218
Copyright
Copyright © Cambridge University Press 2014 

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