Distinct temporal brain dynamics in bipolar disorder and schizophrenia during emotion regulation

Liwen Zhang, Hui Ai, Esther M Opmeer, Jan-Bernard C Marsman, Lisette van der Meer, Henricus G Ruhé, André Aleman, Marie-José van Tol*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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BACKGROUND: Disturbances in emotion regulation (ER) are characteristic of both patients with bipolar disorder (BD) and schizophrenia (SZ). We investigated the temporal dynamics of brain activation during cognitive ER in BD and SZ to understand the contribution of temporal characteristics of disturbed ER to their unique and shared symptomatology.

METHOD: Forty-six participants performed an ER-task (BD, n = 15; SZ, n = 16; controls, n = 15) during functional magnetic resonance imaging, in which they were instructed to use cognitive reappraisal techniques to regulate their emotional responses. Finite impulse response modeling was applied to estimate the temporal dynamics of brain responses during cognitive reappraisal (v. passive attending) of negative pictures. Group, time, and group × time effects were tested using multivariate modeling.

RESULTS: We observed a group × time interaction during ER in the ventrolateral prefrontal cortex (VLPFC), supplementary motor area (SMA) and inferior occipital gyrus. Patients with SZ demonstrated initial hyper-activation of the VLPFC and SMA activation that was not sustained in later regulatory phases. Response profiles in the inferior occipital gyrus in SZ showed abnormal activation in the later phases of regulation. BD-patients showed general blunted responsivity in these regions.

CONCLUSIONS: These results suggest that ER-disturbances in SZ are characterized by an inefficient initialization and failure to sustain regulatory control, whereas in BD, a failure to recruit regulatory resources may represent initial deficits in formulating adequate representations of the regulatory needs. This may help to further understand how ER-disturbances give rise to symptomatology of BD and SZ.

Original languageEnglish
Pages (from-to)413-421
Number of pages9
JournalPsychological Medicine
Issue number3
Early online date18-Feb-2019
Publication statusPublished - Feb-2020


  • Bipolar disorder
  • cognitive reappraisal
  • emotion regulation
  • finite impulse response modeling
  • prefrontal cortex
  • schizophrenia

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