Cortical source localization during facial emotion recognition in bipolar mania: An ERP study

Facial emotion recognition has enormous value for humans in social cognition and thereby day to day functioning. Disturbances in the processing of emotional cues are seen in all the three phases of bipolar disorder and have been proposed as an etiology in the development of bipolar disorder. 30 consented patients with bipolar mania with psychotic symptoms and 30 age and sex matched healthy controls were taken for the study. Facial emotion ecognition task containing four basic emotions namely happy, sad, anger and fear were used. Sixty four (64) channel ERP recordings were done for all the subjects. Source localization was done using sLORETA selecting the window for late positive potentials (LPP). Statistically significant and reduced cortical sources were noted in the right insula (p = 0.004) at the peak of LPP during response to anger facial emotions in bipolar mania patients. Hypoactivation of right insular cortex during response to anger emotion may be due to the aberrant activation and possible failure of interoceptive prediction system during acute manic phase are discussed.