Jiawei Wang

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

BackgroundBipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions.MethodsThis study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness.ResultsThe scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I.ConclusionsThe cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient’s ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.

Blink reflex under external emotional-stimuli in bipolar I and II disorders

Bipolar disorder types I (BD I) and II (BD II) might present different cortico-brainstem circuit dysfunctions under external emotions, which might be reflected by the blink reflex. We therefore invited 32 BD I and 23 BD II patients, and 46 healthy volunteers to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik - van Praag Depression inventory, and to undergo the blink reflex test under external emotions (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. Compared to healthy controls, BD I showed prolonged R2/R2 latencies under most emotions, and their PVP scores were negatively correlated with the areas under curve (AUCs) of R2 and R2 under Erotica; and BD II showed reduced R2/R2 AUCs under all emotions. Moreover, R2 AUCs under Disgust, Fear, and Happiness were significantly reduced in BD II than those in BD I. Our results have shown that, irrespective of patients on-going affective states, the R2/R2 components were delayed in BD I but suppressed in BD II under most external emotions. Our study provides some hints to distinguish the two types of bipolar disorder, referring to the cortico-brainstem circuit dysfunctions under external emotions.

Intensity Dependence of Auditory Evoked Potentials in Primary Dysmenorrhea

Some studies suggest that women with primary dysmenorrhea have distinct emotional or personality features. For example, they might exaggerate their responses to external stimuli, such as to intensity-increasing auditory stimuli. Fifteen women with primary dysmenorrhea and 15 healthy women were invited to undergo tests of the intensity dependence of auditory evoked potentials (IDAEP), the Functional and Emotional Measure of Dysmenorrhea, and the Plutchik-van Praag Depression Inventory. Study participants with dysmenorrhea showed higher Functional and Emotional scale scores and stronger IDAEP. Regarding the IDAEP generation, the source inversion of N1 and P2 disclosed the activated bilateral superior temporal gyri, medial and superior prefrontal gyri in all participants, and additionally, the middle frontal gyri in dysmenorrhea patients. We report a pronounced IDAEP in primary dysmenorrhea, which indicates the decreased cerebral serotonergic innervations and points to increased activations in the prefrontal and frontal areas in the disorder.nnnPERSPECTIVEnUsing an IDAEP technique, the authors found decreased serotonergic innervation and altered cerebral activation in women with primary dysmenorrhea, which might offer some pharmacotherapeutic clues for the disorder.

Headache symptoms from migraine patients with and without aura through structure-validated self-reports

BackgroundHeadache symptoms self-reported by migraine patients are largely congruent with the clinician-used diagnostic criteria, but not always so. Patients’ self-reports of headache symptoms might offer additional clues to characterize migraine with (MA) and without (MO) aura more precisely.MethodsFirstly, we invited 324 participants with a life-long headache attack to answer an item-matrix measuring symptoms of primary headaches, then we performed both exploratory and confirmatory factor analyses to their answers and refined a headache symptom questionnaire. Secondly, we applied this questionnaire to 28 MA and 52 MO patients.ResultsIn participants with a life-long headache, we refined a 27-item, structure-validated headache symptom questionnaire, with four factors (scales) namely the Somatic /Aura Symptoms, Gastrointestinal and Autonomic Symptoms, Tightness and Location Features, and Prodromal/Aggravating Symptoms. Further, we found that MA patients reported higher than did MO patients on the Somatic/Aura Symptoms and Tightness and Location Features scales.ConclusionsCompared to MO, MA was conferred with more prominent tightness and location features besides its higher somatic or aura symptoms. Patients’ self-reports of headache symptoms might offer more clues to distinguish two types of migraine besides their clinician-defined criteria.

Cerebral processing of facial emotions in bipolar I and II disorders: An event-related potential study

BACKGROUNDnBehavioral results have shown that bipolar disorder patients have impaired recognition of facial emotions, but the detailed information processing of facial emotions in patients with bipolar I (BD I) and II (BD II) disorders remain unknown.nnnMETHODSnWe tested the cerebral event-related potentials to the static facial expressions of Neutral, Happiness, Anger and Sadness in 39 adult patients with BD I, 22 BD II, and 54 healthy volunteers. Participants affective states were measured with the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression Inventory.nnnRESULTSnOver-processed right occipitotemporal cortex during N1 time window to Neutral and Happiness, and during P3b window to Sadness were found in BD I; prolonged N1 latencies to Neutral and Happiness, declined P3b amplitude to Sadness, negative correlation between P3b latency to Sadness and depression, and attenuated superior frontal activity during P3b window to Sadness were found in BD II; and the right-side dominance during facial emotion processing were found in both BD I and BD II.nnnLIMITATIONSnWe didnt record the personality traits or medication used in patients, nor included other facial emotions such as fear and disgust.nnnCONCLUSIONSnWhen responding to facial emotions, both BD I and BD II showed a right-side processing dominance; BD I displayed enhanced processing in the right occipitotemporal cortex during structural encoding and categorical processing of facial emotions; while BD II displayed generalized impairments, less involvement of superior frontal cortex to negative emotions, and reduced ability to process negative emotions which was associated with depression.

Electrocardiographic and Electrooculographic Responses to External Emotions and Their Transitions in Bipolar I and II Disorders

Bipolar disorder has two main types, bipolar I (BD I) and II (BD II), which present different affective states and personality characteristics, they might present different modes of emotional regulation. We hypothesized that the electrocardiogram and electrooculogram to external emotions are different in BD I and BD II. We asked 69 BD I and 54 BD II patients, and 139 healthy volunteers to undergo these tests in response to disgust, erotica, fear, happiness, neutral, and sadness, and their transitions. Their affective states were also measured. The heart rate in BD I was significantly higher under background fear after target neutral. The eyeball movement was quicker in BD I under target happiness after background disgust; in BD I under target sadness after background disgust; and in BD I under background disgust after target neutral. Some electrocardiographic and electrooculographic changes were correlated with affective states in patients. BD I and BD II had different physiological responses to external emotions and their transitions, indicating different pathophysiologies and suggesting different emotional-therapies for BD I and BD II.

Nightmare experience in bipolar I and II disorders.

Some patients with bipolar disorder have traumatic experience, sleep disturbance, and emotional variations, which are related to nightmare reports in clinics. We hypothesized that the nightmare experience might present some uniqueness in different types of bipolar disorder. We invited 200 healthy volunteers and 141 bipolar disorder I (BD I) and 78 bipolar disorder II (BD II) patients who had at least one nightmare lifelong to undergo tests of the Nightmare Experience Questionnaire (NEQ) and the questionnaires measuring mania, hypomania, and depression. Compared with healthy controls, both BD I and BD II patients displayed their abnormal affective states and scored significantly higher on NEQ Meaning Interpretation; BD I patients, in addition, scored higher on NEQ Horrible Stimulation. Hypomania was correlated with Horrible Simulation in BD II patients, and depression was correlated with Physical Effect and Horrible Stimulation in healthy controls. We found some NEQ scales were elevated in bipolar disorder, but these abnormalities failed to differentiate BD I from BD II. However, these results help explain the cognitive and emotional disturbances of bipolar disorder in general.

Relationship between hypnosis and personality trait in participants with high or low hypnotic susceptibility

Background The relationship between normal personality and hypnotic susceptibility is important for understanding mental processing and mental disorders, but it is less consistent in normal people or in patients with a psychiatric disorder. We have hypothesized that the correlation exists but varies in individuals with different levels of hypnotizability. Participants and methods We invited 72 individuals with high (HIGH group) and 47 individuals with low (LOW group) hypnotic susceptibilities to undertake tests of NEO-PI-R and the Stanford Hypnotic Susceptibility Scale, Form C (SHSSC). Results The HIGH group scored significantly higher than the LOW group did on openness to experience and its facet openness to feelings. In the LOW group, SHSSC total was positively predicted by openness to ideas; age regression was positively predicted by openness to experience and negatively predicted by extraversion; anosmia to ammonia was negatively predicted by agreeableness; and negative visual hallucination was positively predicted by openness to experience. In the HIGH group, hallucinated voice was positively predicted by openness to experience and negatively predicted by agreeableness, and posthypnotic amnesia was positively predicted by extraversion and negatively predicted by openness to experience. Conclusion The associations between normal personality traits and hypnotic susceptibility items were weak and different in the two groups, which imply that managing mental or somatoform disorders might be through adjusting hypnotizability and mobilizing personality functions.

Hypnotic susceptibility and affective states in bipolar I and II disorders

BackgroundHighly hypnotizable individuals have impaired executive function, elevated motor impulsivity and increased emotional sensitivity, which are sometimes found in bipolar disorder patients. It is then reasonable to assume that certain aspects of hypnotic susceptibility differ with the types of bipolar disorder.MethodsThe Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C) test, the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32) and the Plutchick-van Praag Depression Inventory (PVP) were applied to 62 patients with bipolar I disorder, 33 bipolar II disorder, and 120 healthy volunteers.ResultsThe passing rate of the SHSS:C ‘Moving hands apart’ item was higher in bipolar I patients than in controls, whereas for ‘Mosquito hallucination’ the rate was lower. Bipolar I and II patients scored significantly higher on MDQ, HCL-32 and PVP scales than controls. The passing rates of ‘Mosquito hallucination’ in controls, ‘Arm rigidity’ in bipolar I, and ‘Age regression’ in bipolar II predicted the respective MDQ scores.ConclusionIn contrast to cognitive suggestions, bipolar I patients followed motor suggestions more often under hypnosis. Furthermore, both bipolar disorder patients and healthy volunteers demonstrated associations between mania levels and certain hypnotic susceptibility features. Our study aids in better understanding the altered conscious states in bipolar disorders, and encourages the use of related psychotherapy for these patients.

Waking‐hour cerebral activations in nightmare disorder: A resting‐state functional magnetic resonance imaging study

The purpose of the current study was to explore the cerebral areas involved in nightmare disorder.