Background: Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and\nbrainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under\ndifferent stimuli of external emotions.\nMethods: This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited\nto answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression\ninventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of\nDisgust, Erotica, Fear, Happiness, and Sadness.\nResults: The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters.\nCompared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness\nand sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged\nES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness.\nMoreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I.\nConclusions: The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was\nindependent of the patient�s ongoing emotions. Our study thus provides some hints to distinguish the two types\nof bipolar disorders.
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