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The aim of this study was to provide preliminary evidence on temporal dynamics of resting-state brain networks in youth with anorexia nervosa (AN) using electroencephalography (EEG). Resting-state EEG data were collected in 18 young women with AN and 18 healthy controls (HC). Between-group differences in brain networks were assessed using microstates analyses. Five microstates were identified across all subjects (A, B, C, D, E). Using a single set of maps representative of the whole dataset, group differences were identified for microstates A, C, and E. A common-for-all template revealed a relatively high degree of consistency in results for reduced time coverage of microstate C, but also an increased presence of microstate class E. AN and HC had different microstate transition probabilities, largely involving microstate A. Using LORETA, for microstate D, we found that those with AN had augmented activations in the left frontal inferior operculum, left insula, and bilateral paracentral lobule, compared with HC. For microstate E, AN had augmented activations in the para-hippocampal gyrus, caudate, pallidum, cerebellum, and cerebellar vermis. Our findings suggest altered microstates in young women with AN associated with integration of sensory and bodily signals, monitoring of internal/external mental states, and self-referential processes. Future research should examine how EEG-derived microstates could be applied to develop diagnostic and prognostic models of AN.
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Anorexia Nerviosa , Adolescente , Humanos , Femenino , Electroencefalografía , Encéfalo , Mapeo Encefálico/métodos , CerebeloRESUMEN
Microstates represent brief periods of quasi-stable electroencephalography (EEG) scalp topography, offering insights into dynamic fluctuations in event-related potential (ERP) topographies. Despite this, there is a lack of a comprehensive systematic overview of microstate findings concerning cognitive face processing. This review aims to summarize ERP findings on face processing using microstate analyses and assess their effectiveness in characterizing face-related neural representations. A literature search was conducted for microstate ERP studies involving healthy individuals and psychiatric populations, utilizing PubMed, Google Scholar, Web of Science, PsychInfo, and Scopus databases. Twenty-two studies were identified, primarily focusing on healthy individuals (n = 16), with a smaller subset examining psychiatric populations (n = 6). The evidence reviewed in this study suggests that various microstates are consistently associated with distinct ERP stages involved in face processing, encompassing the processing of basic visual facial features to more complex functions such as analytical processing, facial recognition, and semantic representations. Furthermore, these studies shed light on atypical attentional neural mechanisms in Autism Spectrum Disorder (ASD), facial recognition deficits among emotional dysregulation disorders, and encoding and semantic dysfunctions in Post-Traumatic Stress Disorder (PTSD). In conclusion, this review underscores the practical utility of ERP microstate analyses in investigating face processing. Methodologies have evolved towards greater automation and data-driven approaches over time. Future research should aim to forecast clinical outcomes and conduct validation studies to directly demonstrate the efficacy of such analyses in inverse space.
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Encéfalo , Electroencefalografía , Potenciales Evocados , Reconocimiento Facial , Trastornos Mentales , Humanos , Potenciales Evocados/fisiología , Reconocimiento Facial/fisiología , Electroencefalografía/métodos , Trastornos Mentales/fisiopatología , Encéfalo/fisiopatología , Encéfalo/fisiologíaRESUMEN
Borderline personality disorder (BPD) is a debilitating psychiatric condition characterized by emotional dysregulation, unstable sense of self, and impulsive, potentially self-harming behavior. In order to provide new neurophysiological insights on BPD, we complemented resting-state EEG frequency spectrum analysis with EEG microstates (MS) analysis to capture the spatiotemporal dynamics of large-scale neural networks. High-density EEG was recorded at rest in 16 BPD patients and 16 age-matched neurotypical controls. The relative power spectrum and broadband MS spatiotemporal parameters were compared between groups and their inter-correlations were examined. Compared to controls, BPD patients showed similar global spectral power, but exploratory univariate analyses on single channels indicated reduced relative alpha power and enhanced relative delta power at parietal electrodes. In terms of EEG MS, BPD patients displayed similar MS topographies as controls, indicating comparable neural generators. However, the MS temporal dynamics were significantly altered in BPD patients, who demonstrated opposite prevalence of MS C (lower than controls) and MS E (higher than controls). Interestingly, MS C prevalence correlated positively with global alpha power and negatively with global delta power, while MS E did not correlate with any measures of spectral power. Taken together, these observations suggest that BPD patients exhibit a state of cortical hyperactivation, represented by decreased posterior alpha power, together with an elevated presence of MS E, consistent with symptoms of elevated arousal and/or vigilance. This is the first study to investigate resting-state MS patterns in BPD, with findings of elevated MS E and the suggestion of reduced posterior alpha power indicating a disorder-specific neurophysiological signature previously unreported in a psychiatric population.
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Trastorno de Personalidad Limítrofe , Humanos , Vigilia , Nivel de Alerta/fisiología , ElectroencefalografíaRESUMEN
Microstates are transient scalp configurations of brain activity measured by electroencephalography (EEG). The application of microstate analysis in magnetoencephalography (MEG) data remains challenging. In one MEG dataset (N = 113), we aimed to identify MEG microstates at rest, explore their brain sources, and relate them to changes in brain activity during open-eyes (ROE) or closed-eyes resting state (RCE) and an auditory Mismatch Negativity (MMN) task. In another dataset of simultaneously recorded EEG-MEG data (N = 21), we investigated the association between MEG and EEG microstates. Six MEG microstates (mMS) provided the best clustering of resting-state activity, each linked to different brain sources: mMS 1-2: left/right occipito-parietal; mMS 3: fronto-temporal; mMS 4: centro-medial; mMS 5-6: left/right fronto-parietal. Increases in occipital alpha power in RCE relative to ROE correlated with greater mMS 1-2 time coverage (τbs < 0.20, ps > .002), while the lateralization of deviance detection in MMN was associated with mMS 5-6 time coverage (τbs < 0.16, ps > .012). No temporal correlation was found between EEG and MEG microstates (ps > .05), despite some overlap in brain sources and global explained variance between mMS 2-3 and EEG microstates B-C (rs > 0.60, ps < .002). Hence, the MEG signal can be decomposed into microstates, but mMS brain activity clustering captures phenomena different from EEG microstates. Source reconstruction and task-related modulations link mMS to large-scale networks and localized activities. Thus, mMSs offer insights into brain dynamics and task-specific processes, complementing EEG microstates in studying physiological and dysfunctional brain activity.
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Encéfalo , Electroencefalografía , Magnetoencefalografía , Humanos , Magnetoencefalografía/métodos , Electroencefalografía/métodos , Encéfalo/fisiología , Femenino , Masculino , Adulto , Adulto Joven , Mapeo Encefálico/métodos , Descanso/fisiología , Estimulación Acústica/métodosRESUMEN
OBJECTIVE: A deficit in interoception - the ability to perceive, interpret and integrate afferent signals about the physiological state of the body - has been shown in Anorexia Nervosa (AN), and linked to altered hunger sensations, body dysmorphia, and abnormal emotional awareness. The present high-density electroencephalography (hdEEG) study aims to assess cardiac interoception in AN and to investigate its neural correlates, using an objective neurophysiological measure. METHOD: Heartbeat-evoked potentials (HEPs) were computed from 5 min of resting-state EEG and electrocardiogram (ECG) data and compared between individuals with AN (N = 22) and healthy controls (HC) (N = 19) with waveform, topographic, and source imaging analyses. RESULTS: Differences in the cortical representation of heartbeats were present between AN and HC at a time window of 332-348 ms after the ECG R-peak. Source imaging analyses revealed a right-sided hypoactivation in AN of brain regions linked to interoceptive processing, such as the anterior cingulate and orbitofrontal areas. CONCLUSIONS: To the best of our knowledge, this is the first study using hdEEG to localise the underlying sources of HEPs in AN. Results point to altered interoceptive processing during resting-state in AN. As our participants had a short duration of illness, this might not be the consequence of prolonged starvation. Interventions targeted at interoception could provide an additional tool to facilitate recovery.
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Anorexia Nerviosa , Interocepción , Humanos , Interocepción/fisiología , Frecuencia Cardíaca/fisiología , Electroencefalografía , Potenciales Evocados/fisiología , Concienciación/fisiologíaRESUMEN
Impairment in cognitive flexibility is a core symptom of anorexia nervosa (AN) and is associated with treatment resistance. Nevertheless, studies on the neural basis of cognitive flexibility in adolescent AN are rare. This study aimed to investigate brain networks underlying cognitive flexibility in adolescents with AN. To address this aim, participants performed a Dimensional Change Card Sorting task during high-density electroencephalography (EEG) recording. Anxiety was measured with the State-Trait Anxiety Inventory. Data were collected on 22 girls with AN and 23 controls. Evoked responses were investigated using global-spatial analysis. Adolescents with AN showed greater overall accuracy, fewer switch trial errors and reduced inverse efficiency switch cost relative to controls, although these effects disappeared after adjusting for trait and state anxiety. EEG results indicated augmented early visual orienting processing (P100) and subsequent impaired attentional mechanisms to task switching (P300b) in subjects with AN. During task switching, diminished activations in subjects with AN were identified in the posterior cingulate, calcarine sulcus and cerebellum, and task repetitions induced diminished activations in a network involving the medial prefrontal cortex, and several posterior regions, compared with controls. No significant associations were found between measures of cognitive flexibility and anxiety in the AN group. Findings of this study suggest atypical neural mechanisms underlying cognitive flexibility in adolescents with AN. More importantly, our findings suggest that different behavioural profiles in AN could relate to differences in anxiety levels. Future research should investigate the efficacy of cognitive training to rebalance brain networks of cognitive flexibility in AN.
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Anorexia Nerviosa , Femenino , Humanos , Adolescente , Imagen por Resonancia Magnética , Encéfalo/fisiología , Cognición/fisiología , ElectroencefalografíaRESUMEN
Several studies showed that in the human brain specific premotor and parietal areas are activated during the execution and observation of motor acts. The activation of this premotor-parietal network displaying the so-called Mirror Mechanism (MM) was proposed to underpin basic forms of action understanding. However, the functional properties of the MM in children are still largely unknown. In order to address this issue, we recorded high-density EEG from 12 children (6 female, 6 male; average age 10.5, SD ±2.15). Data were collected when children observed video clips showing hands grasping objects in two different experimental conditions: (1) Full Vision, in which the motor act was fully visible; (2) Hidden, in which the interaction between the hand and the object was not visible. Event-related potentials (ERPs) and topographic map analyses were used to investigate the temporal pattern of the ERPs and their brain source of localization, employing a children template of the Montreal Neurological Institute. Results showed that two different parieto-premotor circuits are activated by the observation of object-related hand reaching-to-grasping motor acts in children. The first circuit comprises the ventral premotor and the inferior parietal cortices. The second one comprises the dorsal premotor and superior parietal cortices. The activation of both circuits is differently lateralized and modulated in time, and influenced by the amount of visual information available about the hand grasping-related portion of the observed motor acts.
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Potenciales Evocados Visuales , Lóbulo Frontal/fisiología , Actividad Motora , Lóbulo Parietal/fisiología , Niño , Electroencefalografía , Femenino , Humanos , MasculinoRESUMEN
The mirror mechanism allows the direct translation of a perceived (seen, felt, heard) action into the same motor representation of its related goal. This mechanism allows a direct comprehension of others' goals and motor intentions, enabling an embodied link between individuals. Because the mirror mechanism is a functional expression of the motor system, these findings suggest the relevance of the motor system to social cognition. It has been hypothesized that the impaired understanding of others' intentions, sensations, and emotions reported in autism spectrum disorder (ASD) could be linked to an alteration of the mirror mechanism in all of these domains. In this review, we address the theoretical issues underlying the social impairments in ASD and discuss them in relation to the cognitive role of the mirror mechanism.
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Trastornos Generalizados del Desarrollo Infantil/complicaciones , Trastornos Generalizados del Desarrollo Infantil/psicología , Conducta Imitativa/fisiología , Niño , Preescolar , Trastornos del Conocimiento/etiología , Trastornos de la Comunicación/etiología , Comprensión , Emociones , Humanos , Intención , Actividad Motora , Trastorno de la Conducta Social/etiologíaRESUMEN
Event related potentials (ERPs) represent powerful tools to investigate cognitive functioning in child and adolescent psychiatry. So far, the available body of research has largely focused on advancements in analysis methods, with little attention given to the perspective of assessment. The aim of this brief report is to provide recommendations for cognitive ERPs assessment that can be applied across diagnostic categories in child and adolescent psychiatry research. First, we discuss major issues for ERPs testing using examples from common psychiatric disorders. We conclude by summing up our recommendations for methodological standards and highlighting the potential role of ERPs in the field.
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Psiquiatría del Adolescente , Trastornos Mentales , Adolescente , Atención , Niño , Cognición , Potenciales Evocados , Humanos , Trastornos Mentales/diagnósticoRESUMEN
Introduction: Electroencephalography (EEG) represents a powerful tool to detect abnormal neural dynamics in child and adolescent psychiatry. Feeding and Eating Disorders (FEDs), such as anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and avoidant restrictive food intake disorder (ARFID) onset in childhood and adolescence. EEG has rarely been used to examine cortical brain activity in children and adolescents with FEDs. This review aims to summarize EEG findings in FEDs amongst children and adolescents, and to highlight areas deserving further research. Methods: We searched the literature for EEG studies on children and adolescents with FEDs using Google Scholar, PsycINFO, Medline, and PubMed. Results: Twelve studies were identified, the majority focusing on AN (N = 10). The identified studies suggest reduced action monitoring control (preparatory waves, N200, P300), specific perceptual-cognitive styles to body/face perception (late positive potentials/early posterior negativity), as well as fundamental changes in posterior theta oscillations in AN. Behavioral traits of BN/BED (i.e., loss of control eating, emotional eating), and AN seem to be associated with an increased attentional reactivity (P300) to visual food stimuli. Conclusion: Electroencephalography research in children and adolescents with FEDs is limited and mostly focused on AN. While EEG abnormalities seem consistent with a reduced top-down control and attentional allocation deficits in AN, altered attention specific to food cues emerges across FEDs. Overcoming conventional EEG analyses, and investigating spatial properties (i.e., electrical neuroimaging), will enhance our understanding of FEDs neurobiology.
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ADHD has been associated with social cognitive impairments across the lifespan, but no studies have specifically addressed the presence of abnormalities in eye-gaze processing in the adult brain. This study investigated the neural basis of eye-gaze perception in adults with ADHD using event-related potentials (ERP). Twenty-three ADHD and 23 controls performed a delayed face-matching task with neutral faces that had either direct or averted gaze. ERPs were classified using microstate analyses. ADHD and controls displayed similar P100 and N170 microstates. ADHD was associated with cluster abnormalities in the attention-sensitive P200 to direct gaze, and in the N250 related to facial recognition. For direct gaze, source localization revealed reduced activity in ADHD for the P200 in the left/midline cerebellum, as well as in a cingulate-occipital network at the N250. These results suggest brain impairments involving eye-gaze decoding in adults with ADHD, suggestive of neural signatures associated with this disorder in adulthood.
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Trastorno por Déficit de Atención con Hiperactividad , Reconocimiento Facial , Adulto , Electroencefalografía/métodos , Potenciales Evocados , Expresión Facial , Fijación Ocular , Humanos , Percepción VisualRESUMEN
The main aim of the present study was to explore, by means of high-density EEG, the intensity and the temporal pattern of event-related sensory-motor alpha desynchronization (ERD) during the observation of different types of hand motor acts and gestures. In particular, we aimed to investigate whether the sensory-motor ERD would show a specific modulation during the observation of hand behaviors differing for goal-relatedness (hand grasping of an object and meaningless hand movements) and social relevance (communicative hand gestures and grasping within a social context). Time course analysis of alpha suppression showed that all types of hand behaviors were effective in triggering sensory-motor alpha ERD, but to a different degree depending on the category of observed hand motor acts and gestures. Meaningless gestures and hand grasping were the most effective stimuli, resulting in the strongest ERD. The observation of social hand behaviors such as social grasping and communicative gestures, triggered a more dynamic time course of ERD compared to that driven by the observation of simple grasping and meaningless gestures. These findings indicate that the observation of hand motor acts and gestures evoke the activation of a motor resonance mechanism that differs on the basis of the goal-relatedness and the social relevance of the observed hand behavior.
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Ritmo alfa/fisiología , Electroencefalografía , Mano/fisiología , Destreza Motora/fisiología , Adulto , Femenino , Fuerza de la Mano/fisiología , Humanos , Masculino , Corteza Motora/fisiología , Red Nerviosa/fisiología , Lóbulo Parietal/fisiología , Estimulación Luminosa , Desempeño Psicomotor/fisiologíaRESUMEN
Trait anxiety is an important phenotype in the prediction of stress-induced neuropsychiatric disorders. While the role of trait anxiety in mental effort and cognitive impairment is well documented, much less is known about its influence on motivated behaviors and physical effort. Here, we investigated trait anxiety-related differences in behavioral and neural responses in an effort-related monetary incentive delay task. Participants prompted with different incentive levels could exert handgrip responses to earn monetary rewards while a 256-channel electroencephalography (EEG) was recorded. Participants' performance was linearly dependent on incentive level, with higher stakes prompting better accuracy and higher grip force. Importantly, we found a striking association between trait anxiety and incentive-related grip force; effort exertion was related to incentive level only in high-anxious individuals. In analyses of neural efficiency associated with effort preparation involving Contingent-negative variation (CNV), we found that the CNV amplitude was sensitive to monetary incentive levels. Source imaging analyses of CNV indicated increased activity in the anterior cingulate cortex (ACC) for the highest incentive level. Importantly, we found a significant interaction between trait anxiety and incentive level on CNV modulation at the interval ranging from -2610 to -2510 ms, with greater CNV responses to the lower monetary incentive sizes in high anxiety. Subsequent mediation analyses supported a mediation of the ACC activation on the association between trait anxiety and incentive-selective grip force. Our study reveals a role for ACC in trait anxiety-related differences on incentive processing, when rewards are dependent on effortful performance.
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Ansiedad/fisiopatología , Potenciales Evocados/fisiología , Giro del Cíngulo/fisiología , Motivación/fisiología , Personalidad/fisiología , Desempeño Psicomotor/fisiología , Recompensa , Adulto , Electroencefalografía , Giro del Cíngulo/diagnóstico por imagen , Humanos , Masculino , Adulto JovenRESUMEN
Previous studies have documented atypical brain responses to faces in individuals with bipolar disorder (BD) and in their relatives. In view of previous findings of atypical face processing in youths at risk for BD, the aim of this study was to examine whether BD patients and offspring would show differential activation in networks of the social brain when processing eye-gaze. Data from 18 euthymic BD patients and 18 offspring, as well as 36 age-matched healthy controls, were collected using a delayed face-matching paradigm, event related potentials and electrical neuroimaging methods. The P200 component, which is implicated in facial cues decoding, differentiated the BD groups from their age-matched controls. P200 source reconstruction indicates impairments conveyed by eye-contact in a network involved in experiencing others' social intentions in BD patients (supplementary motor cortex, precentral gyrus, inferior parietal lobe), and the engagement of compensatory prefrontal mechanisms for modulating these functions in BD offspring. When viewing faces that had an averted gaze, BD patients and offspring showed a hypo-activation, compared to controls, particularly in regions involved in experiencing others' feelings (post-central gyrus in BD patients / ventral premotor cortex in offspring). Therefore, the neural mechanism for decoding shifts in eye-gaze may be a familial characteristic of BD.
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Trastorno Bipolar/diagnóstico por imagen , Trastorno Bipolar/fisiopatología , Encéfalo/diagnóstico por imagen , Fijación Ocular , Neuroimagen , Adulto , Afecto , Encéfalo/fisiopatología , Potenciales Evocados , Femenino , Lóbulo Frontal , Humanos , Masculino , Corteza Motora , Lóbulo Parietal , Fenotipo , Adulto JovenRESUMEN
Background: Neuroimaging studies provided evidence for disrupted resting-state functional brain network activity in bipolar disorder (BD). Electroencephalographic (EEG) studies found altered temporal characteristics of functional EEG microstates during depressive episode within different affective disorders. Here we investigated whether euthymic patients with BD show deviant resting-state large-scale brain network dynamics as reflected by altered temporal characteristics of EEG microstates. Methods: We used high-density EEG to explore between-group differences in duration, coverage, and occurrence of the resting-state functional EEG microstates in 17 euthymic adults with BD in on-medication state and 17 age- and gender-matched healthy controls. Two types of anxiety, state and trait, were assessed separately with scores ranging from 20 to 80. Results: Microstate analysis revealed five microstates (A-E) in global clustering across all subjects. In patients compared to controls, we found increased occurrence and coverage of microstate A that did not significantly correlate with anxiety scores. Conclusion: Our results provide neurophysiological evidence for altered large-scale brain network dynamics in BD patients and suggest the increased presence of A microstate to be an electrophysiological trait characteristic of BD.
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The aim of this study was to examine the effects of maternal interpersonal violence-related posttraumatic disorder (IPV-PTSD) on child appraisal of emotion, as measured by high-density electroencephalography (HD-EEG) during an Emotional Face-matching Task (EFMT). We recorded HD-EEG in 47 children of mothers with and without IPV-PTSD during an Emotional Face-matching Task (EFMT). Mothers and children each performed the EFMT. Behavioral results demonstrated that both mothers who were directly exposed to violent events, and their children, presented attentional bias toward negative emotions when processing facial stimuli. EEG findings confirmed differences in emotion appraisal between children of IPV-PTSD mothers and non-PTSD controls at scalp-level and in terms of source localization upon which children of IPV-PTSD mothers demonstrated decreased activation of the right dorsolateral prefrontal cortex (dlPFC) in response to angry and fearful faces as compared to non-PTSD children with respect to the N170 component. Our study, to our knowledge, is the first to show that maternal IPV-PTSD significantly affects a mother's own and her child's neural activity in response to facial expressions of negative emotion. These findings are potentially important to the development and study of effective interventions to interrupt intergenerational cycles of violence and trauma.
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Electroencefalografía/métodos , Emociones/fisiología , Expresión Facial , Relaciones Madre-Hijo/psicología , Trastornos por Estrés Postraumático/psicología , Violencia/psicología , Adulto , Niño , Preescolar , Femenino , Humanos , Relaciones Interpersonales , Masculino , Madres/psicología , Estimulación Luminosa/métodos , Corteza Prefrontal/fisiopatología , Tiempo de Reacción/fisiología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/fisiopatologíaRESUMEN
Sensitivity to canons of beauty as represented in the human body-and as typically defined in the Western Culture-has been poorly studied in children. Current literature shows that infants as young as about three months are sensitive to the human body structure and its parts. Using a sample of 54 three- to five-year-old children, the present study investigated preference for drawings representing the "canonical" body structure, contrasting these with drawings showing the same bodies, but where the relation between trunk and legs was modified. It was hypothesized that preference for the canonical body structures would emerge as early as three years, increasing with age. Results only partially supported the hypothesis: while three-year-olds showed a significant preference for the canonical body structures as predicted, a significant preference reversal was found for the four-year-olds, with a tendency to return to preferring the canonical body at five years. The results are discussed in light of research findings associated with developmental theories hallmarking visual art perception in children.
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Belleza , Desarrollo Infantil/fisiología , Conducta de Elección , Cuerpo Humano , Percepción Visual/fisiología , Preescolar , Femenino , Humanos , Masculino , AutoimagenRESUMEN
Gaze conveys emotional information, and humans present sensitivity to its direction from the earliest days of life. Bipolar disorder is a disease characterized by fluctuating states of emotional and cognitive dysregulation. To explore the role of attentional control on face processing in bipolar patients (BP) we used gaze direction as an emotion modulation parameter in a two-back Working Memory (WM) task while high-density EEG data were acquired. Since gaze direction influences emotional attributions to faces with neutral expressions as well, we presented neutral faces with direct and averted gaze. Nineteen euthymic BP and a sample of age- and gender-matched controls were examined. In BP we observed diminished P200 and augmented P300 evoked responses, differentially modulated by non-repeated or repeated faces, as well as by gaze direction. BP showed a reduced P200 amplitude, significantly stronger for faces with direct gaze than averted gaze. Source localization of P200 indicated decreased activity in sensory-motor regions and frontal areas suggestive of abnormal affective processing of neutral faces. The present study provides neurophysiological evidence for abnormal gaze processing in BP and suggests dysfunctional processing of direct eye contact as a prominent characteristic of bipolar disorder.
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Trastorno Bipolar/fisiopatología , Encéfalo/fisiopatología , Fijación Ocular/fisiología , Adulto , Atención/fisiología , Electroencefalografía , Emociones/fisiología , Potenciales Evocados Visuales/fisiología , Expresión Facial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Percepción Visual/fisiologíaRESUMEN
Humans are sensitive to gaze direction from early life, and gaze has social and affective values. Borderline personality disorder (BPD) is a clinical condition characterized by emotional dysregulation and enhanced sensitivity to affective and social cues. In this study we wanted to investigate the temporal-spatial dynamics of spontaneous gaze processing in BPD. We used a 2-back-working-memory task, in which neutral faces with direct and averted gaze were presented. Gaze was used as an emotional modulator of event-related-potentials to faces. High density EEG data were acquired in 19 females with BPD and 19 healthy women, and analyzed with a spatio-temporal microstates analysis approach. Independently of gaze direction, BPD patients showed altered N170 and P200 topographies for neutral faces. Source localization revealed that the anterior cingulate and other prefrontal regions were abnormally activated during the N170 component related to face encoding, while middle temporal deactivations were observed during the P200 component. Post-task affective ratings showed that BPD patients had difficulty to disambiguate neutral gaze. This study provides first evidence for an early neural bias toward neutral faces in BPD independent of gaze direction and also suggests the importance of considering basic aspects of social cognition in identifying biological risk factors of BPD.