Bipolar Bozukluğu Olan Ötimik Hastalarda Emosyonel Tepkisellik ve İrkilme Yanıtının Afektif Düzenlenmesi

Abstract

Emotional reactivity (ER), which is a component of emotional processing, is a rapid and short-term response to an emotional stimulus. There are studies in which deviations in terms of quality and quantity in terms of startle responses and emotional responsiveness. These changes were observed in bipolar patients during disease and recovery periods. In this study euthymic bipolar patients without comorbid psychiatric disorders were evaluated in terms of affective modulation of startle reflex (AMSR). Which may be an important neurophysiological biomarker in BD. For this purpose, sample selected from patients and healthy participants was evaluated using ER measurements obtained by objective and subjective methods and the measurement results between the groups were compared. The patient’s diagnosis was confirmed with SCID 5 (Structured Interview for DSM 5 Disorders-Clinician Version) and psychiatric diseases were excluded in the control group. All participants evaluated with Beck Depression Scale (BDI), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Clinical Global Impression Scale, Young Mania Rating Scale (YMRS). Three emotional conditions (positive-neutral-negative) were created with 45 pictures selected from the International Affective Picture System (IAPS). The AMSR was evaluated by triggering startle with an acoustic stimulus. In addition, the patient’s valence and excitability scores for each picture and their subjective experiences were examined. 33 patients and 35 healthy controls were included in the study. No statistically significant difference was found between the groups in terms of HAM-D, HAM-A, YMRS scale scores. Both groups rated the pictures with positive, neutral and negative content in accordance with the normative values as expected. The patient group evaluated the pictures with a higher score compared the controls and this did not cause a significant difference. While the startle amplitude in different conditions showed the linear pattern in the control group, the linear pattern disappeared in the patient group. It has been shown that the startle reflex area changes according to emotional conditionsbut the group does not have a significant effect on area. In terms of latency, no statistically significant difference was observed between patients and controls and it was observed that they were not affected by emotional conditions. As a result, ER decreased and AMSR was suppresses in the euthymic period in BD, and this was demonstrated by startle response area and amplitude measurements.