{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:33:34Z","timestamp":1791916414694,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,2,11]],"date-time":"2018-02-11T00:00:00Z","timestamp":1518307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000782","name":"European Science Foundation","doi-asserted-by":"publisher","award":["044.035.001"],"award-info":[{"award-number":["044.035.001"]}],"id":[{"id":"10.13039\/501100000782","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Objectives<\/jats:title>Sufficient prefrontal top\u2010down control of limbic affective areas, especially the amygdala, is essential for successful effortful emotion regulation (ER<\/jats:styled-content>). Difficulties in effortful ER<\/jats:styled-content> have been seen in patients with bipolar disorder (BD<\/jats:styled-content>), which could be suggestive of a disturbed prefrontal\u2010amygdala regulation circuit. The aim of this study was to investigate whether BD<\/jats:styled-content> patients show abnormal effective connectivity from the prefrontal areas to the amygdala during effortful ER<\/jats:styled-content> (reappraisal).<\/jats:p><\/jats:sec>Methods<\/jats:title>Forty participants (23 BD<\/jats:styled-content> patients and 17 healthy controls [HC<\/jats:styled-content>]) performed an ER<\/jats:styled-content> task during functional magnetic resonance imaging. Using dynamic causal modeling, we investigated effective connectivity from the dorsolateral prefrontal cortex (DLPFC<\/jats:styled-content>) and ventrolateral prefrontal cortex (VLPFC<\/jats:styled-content>) to the amygdala, as well as connectivity between the DLPFC<\/jats:styled-content> and VLPFC<\/jats:styled-content> during reappraisal.<\/jats:p><\/jats:sec>Results<\/jats:title>Both BD<\/jats:styled-content> patients and HC<\/jats:styled-content> showed decreased negative affect ratings following reappraisal compared to attending negative pictures (P\u00a0<\/jats:italic><\u00a0<\/jats:italic>.001). There were no group differences (P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>.10). There was a differential modulatory effect of reappraisal on the connectivity from the DLPFC<\/jats:styled-content> to amygdala between BD<\/jats:styled-content> patients and HC<\/jats:styled-content> (P\u00a0<\/jats:italic>=\u00a0<\/jats:italic>.04), with BD<\/jats:styled-content> patients showing a weaker modulatory effect on this connectivity compared to HC<\/jats:styled-content>. There were no other group differences.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The disturbance in BD <\/jats:styled-content>patients in effective connectivity from the DLPFC<\/jats:styled-content> to the amygdala while reappraising is indicative of insufficient prefrontal control. This impairment should be studied further in relation to cycling frequency and polarity of switches in BD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12611","type":"journal-article","created":{"date-parts":[[2018,2,12]],"date-time":"2018-02-12T04:32:50Z","timestamp":1518409970000},"page":"349-358","source":"Crossref","is-referenced-by-count":43,"title":["Altered frontal\u2010amygdala effective connectivity during effortful emotion regulation in bipolar disorder"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8533-9075","authenticated-orcid":false,"given":"Liwen","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neuroscience NeuroImaging Center University Medical Center Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther M","family":"Opmeer","sequence":"additional","affiliation":[{"name":"Department of Neuroscience 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