Functional cerebral asymmetries of emotional processes in the healthy and bipolar brain

The perception and processing of emotions are of primary importance for social interaction, which confers faculties such as inferring what another person’s feels. Brain organisation of emotion perception has shown to primarily involve right hemisphere functioning. However, the brain may be functionally organised according to fundamental aspects of emotion such as valence, rather than involving processing of emotions in general. It should be noted, however, that emotion perception is not merely a perceptual process consisting in the input of emotional information, but also involves one’s emotional response. Therefore, the functional brain organisation of emotional processing may also be influenced by emotional experience. An experimental model for testing functional cerebral asymmetries (FCAs) of valenced emotional experience is uniquely found in bipolar disorder (BD) involving impaired ability to regulate emotions and eventually leading to depressive or manic episodes. Previous models have only explained hemispheric asymmetries for manic and depressive mood episodes, but not for BD euthymia. The present thesis sought to investigate FCAs in emotional processing in two major ways. First, FCAs underlying facial emotion perception under normal functioning was examined in healthy controls. Secondly, functional brain organisation in emotional processing was further investigated by assessing FCAs in the bipolarity continuum, used as an experimental model for studying the processing of emotions. In contrast with previous asymmetry models, results suggested a right hemisphere involvement in emotional experience regardless of valence. Atypical FCAs were found in euthymic BD patients reflecting inherent aspects of BD functional brain organisation that are free of symptomatic influence. Also, BD patients exhibited atypical connectivity in a default amygdala network particularly affecting the right hemisphere, suggesting intrinsic mechanisms associated with internal emotional states. Last, BD patients were associated with a reduced right hemisphere specialisation in visuospatial attention, therefore suggesting that right hemisphere dysfunction can also affect non-emotional processes. Taken together, the findings emphasize a BD continuum model relying on euthymia as a bridging state between usual mood and acute mood phases