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Pentz AB, O'Connel KS, van Jole O, Timpe CMF, Slapø NB, Melle I, Lagerberg TV, Steen NE, Westlye LT, Haukvik UK, Moberget T, Jönsson EG, Andreassen OA, Elvsåshagen T. Mismatch negativity and polygenic risk scores for schizophrenia and bipolar disorder. Schizophr Res 2024; 264:314-326. [PMID: 38215567 DOI: 10.1016/j.schres.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE Auditory mismatch negativity (MMN) impairment is a candidate endophenotype in psychotic disorders, yet the genetic underpinnings remain to be clarified. Here, we examined the relationships between auditory MMN and polygenic risk scores (PRS) for individuals with psychotic disorders, including schizophrenia spectrum disorders (SSD) and bipolar disorder (BD) and in healthy controls (HC). METHODS Genotyped and clinically well-characterized individuals with psychotic disorders (n = 102), including SSD (n = 43) and BD (n = 59), and HC (n = 397) underwent a roving MMN paradigm. In addition MMN, we measured the memory traces of the repetition positivity (RP) and the deviant negativity (DN), which is believed to reflect prediction encoding and prediction error signals, respectively. SCZ and BD PRS were computed using summary statistics from the latest genome-wide association studies. The relationships between the MMN, RP, and DN and the PRSs were assessed with linear regressions. RESULTS We found no significant association between the SCZ or BD PRS and grand average MMN in the psychotic disorders group or in the HCs group (all p > 0.05). SCZ PRS and BD PRS were negatively associated with RP in the psychotic disorders group (β = -0.46, t = -2.86, p = 0.005 and β = -0.29, t = -0.21, p = 0.034, respectively). No significant associations were found between DN and PRS. CONCLUSION These findings suggest that genetic variants associated with SCZ and BD may be associated with MMN subcomponents linked to predictive coding among patients with psychotic disorders. Larger studies are needed to confirm these findings and further elucidate the genetic underpinnings of MMN impairment in psychotic disorders.
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Affiliation(s)
- Atle Bråthen Pentz
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway.
| | - Kevin Sean O'Connel
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Oda van Jole
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Clara Maria Fides Timpe
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Nora Berz Slapø
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Nils Eiel Steen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Unn K Haukvik
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Department of Adult Psychiatry, Institute of Clinical Medicine, University of Oslo, Norway; Department of Forensic Psychiatry Research, Oslo University Hospital, Norway
| | - Torgeir Moberget
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Department of Behavioral Sciences, Faculty of Health - Sciences, Oslo Metropolitan University - OsloMet, Oslo, Norway
| | - Erik G Jönsson
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Sciences, Stockholm Region, Stockholm, Sweden
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway
| | - Torbjørn Elvsåshagen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway; Department of Neurology, Oslo University Hospital, Oslo, Norway.
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Ewald VAM, Trapp NT, Sarrett ME, Pace BD, Wendt L, Richards JG, Gala IK, Miller JN, Wessel JR, Magnotta VA, Wemmie JA, Boes AD, Parker KL. Supra-second interval timing in bipolar disorder: examining the role of disorder sub-type, mood, and medication status. Int J Bipolar Disord 2023; 11:32. [PMID: 37779127 PMCID: PMC10542629 DOI: 10.1186/s40345-023-00312-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Widely reported by bipolar disorder (BD) patients, cognitive symptoms, including deficits in executive function, memory, attention, and timing are under-studied. Work suggests that individuals with BD show impairments in interval timing tasks, including supra-second, sub-second, and implicit motor timing compared to the neuronormative population. However, how time perception differs within individuals with BD based on disorder sub-type (BDI vs II), depressed mood, or antipsychotic medication-use has not been thoroughly investigated. The present work administered a supra-second interval timing task concurrent with electroencephalography (EEG) to patients with BD and a neuronormative comparison group. As this task is known to elicit frontal theta oscillations, signal from the frontal (Fz) lead was analyzed at rest and during the task. RESULTS Results suggest that individuals with BD show impairments in supra-second interval timing and reduced frontal theta power during the task compared to neuronormative controls. However, within BD sub-groups, neither time perception nor frontal theta differed in accordance with BD sub-type, depressed mood, or antipsychotic medication use. CONCLUSIONS This work suggests that BD sub-type, depressed mood status or antipsychotic medication use does not alter timing profile or frontal theta activity. Together with previous work, these findings point to timing impairments in BD patients across a wide range of modalities and durations indicating that an altered ability to assess the passage of time may be a fundamental cognitive abnormality in BD.
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Affiliation(s)
| | - Nicholas T Trapp
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | | | - Benjamin D Pace
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
| | - Linder Wendt
- Institute for Clinical and Translational Science, The University of Iowa, Iowa City, IA, USA
| | - Jenny G Richards
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
| | - Ilisa K Gala
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
| | | | - Jan R Wessel
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, USA
- Department of Neurology, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Vincent A Magnotta
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Radiology, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - John A Wemmie
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Molecular Physiology and Biophysics, The University of Iowa, Iowa City, IA, USA
- Department of Neurosurgery, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Aaron D Boes
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA
- Department of Pediatrics, The University of Iowa, Iowa City, IA, USA
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA
| | - Krystal L Parker
- Department of Psychiatry, The University of Iowa, 200 Hawkins Drive W276GH, Iowa City, IA, 52242-1057, USA.
- Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA, USA.
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Visual electrophysiology and neuropsychology in bipolar disorders: a review on current state and perspectives. Neurosci Biobehav Rev 2022; 140:104764. [DOI: 10.1016/j.neubiorev.2022.104764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/21/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022]
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Raggi A, Lanza G, Ferri R. Auditory mismatch negativity in bipolar disorder: a focused review. Rev Neurosci 2022; 33:17-30. [PMID: 33837681 DOI: 10.1515/revneuro-2021-0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Abstract
The auditory mismatch negativity, a component of the event-related potential elicited by an unexpected stimulus in a sequence of acoustic stimuli, provides an objective measure of the accuracy of the echoic information processing of the human brain in vivo. Auditory mismatch negativity is also a useful probe of cortical glutamatergic N-methyl-d-aspartate receptor activity and disturbance. Notably, auditory mismatch negativity is consistently impaired in schizophrenia. Because of the wide spectrum extending from bipolar affective illness and schizoaffective psychosis to typical schizophrenia, we examined the literature on auditory mismatch negativity in bipolar disorder with the aim to find any neurophysiological dysfunction concerning pre-attentive information processing shared by these clinical conditions. This focused review includes 26 original articles published in peer-reviewed journals and indexed in the National Institutes of Health National Library of Medicine (PubMed) search system. Overall, evidence is consistent with the finding that auditory mismatch negativity is impaired in bipolar disorder with psychotic features, even though to a lesser extent than in schizophrenia. It must be acknowledged that, in a few twin and family studies, mismatch negativity abnormalities were not specifically associated with bipolar disorder. In conclusion, auditory mismatch negativity research supports the involvement of the N-methyl-d-aspartate system in the pathophysiology of bipolar disorder, as previously assessed for schizophrenia, thus creating an intriguing trait d'union between these two mental illnesses and stimulating the development of novel therapeutic agents. With additional replication and validation, auditory mismatch negativity may be further considered as a correlate of a common psychopathology of schizophrenia and bipolar spectrum illnesses.
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Affiliation(s)
- Alberto Raggi
- Unit of Neurology, G.B. Morgagni - L. Pierantoni Hospital, Via Carlo Forlanini 34, 47121 Forlì, Italy
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
| | - Raffaele Ferri
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy
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Mismatch Negativity and Loudness Dependence of Auditory Evoked Potentials among Patients with Major Depressive Disorder, Bipolar II Disorder, and Bipolar I Disorder. Brain Sci 2020; 10:brainsci10110789. [PMID: 33126640 PMCID: PMC7692302 DOI: 10.3390/brainsci10110789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022] Open
Abstract
Mismatch negativity (MMN) and loudness dependence of auditory evoked potentials (LDAEP), which are event-related potentials, have been investigated as biomarkers. MMN indicates the pre-attentive function, while LDAEP may be an index of central serotonergic activity. This study aimed to test whether MMN and LDAEP are useful biological markers for distinguishing patients with bipolar disorder (BD) and major depressive disorder (MDD), as well as the relationship between MMN and LDAEP. Fifty-five patients with major depressive episodes, aged 20 to 65 years, who had MDD (n = 17), BD type II (BIID) (n = 27), and BD type I (BID) (n = 11), were included based on medical records. Patients with MDD had a higher MMN amplitude than those with BID. In addition, the MMN amplitude in F4 positively correlated with the Korean version of mood disorder questionnaire scores (r = 0.37, p = 0.014), while the MMN amplitude in F3 correlated negatively with LDAEP (r = −0.30, p = 0.024). The odds ratios for the BID group and some variables were compared with those for the MDD group using multinomial logistic regression analysis. As a result, a significant reduction of MMN amplitude was found under BID diagnosis compared to MDD diagnosis (p = 0.015). This study supported the hypothesis that MMN amplitude differed according to MDD, BIID, and BID, and there was a relationship between MMN amplitude and LDAEP. These findings also suggested that BID patients had a reduced automatic and pre-attentive processing associated with serotonergic activity or N-methyl-D-aspartate receptor.
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Markers for the central serotonin system correlate to verbal ability and paralinguistic social voice processing in autism spectrum disorder. Sci Rep 2020; 10:14558. [PMID: 32883965 PMCID: PMC7471326 DOI: 10.1038/s41598-020-71254-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 08/12/2020] [Indexed: 01/06/2023] Open
Abstract
Impairment in verbal communication abilities has been reported in autism spectrum disorder (ASD). Dysfunction of the serotonergic system has also been reported in ASD. However, it is still unknown how the brain serotonergic system relates to impairment in verbal communication abilities in individuals with ASD. In the present study, we investigated the correlation between brain serotonergic condition and brain sensitivity to paralinguistic stimuli (i.e., amplitude in the human voice prosodic change-evoked mismatch field) measured by magnetoencephalography (MEG) or verbal ability in 10 adults with ASD. To estimate the brain serotonergic condition, we measured the serotonin transporter nondisplaceable binding potential cerebrum-wide using positron emission tomography with [11C]N,N-dimethyl-2-(2-amino-4-cyanophenylthio)benzylamine ([11C] DASB). The results demonstrated a significant positive correlation between brain activity to paralinguistic stimuli and brain serotonin transporter binding potential in the left lingual gyrus, left fusiform gyrus and left calcarine cortex. In addition, there were significant positive correlations between verbal ability and serotonergic condition in the right anterior insula, right putamen and right central operculum. These results suggested that the occipital cortex is implicated in recognition of the prosodic change in ASD, whereas the right insula-involved serotonergic system is important in nurturing verbal function in ASD.Trial registration: UMIN000011077.
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Fong CY, Law WHC, Uka T, Koike S. Auditory Mismatch Negativity Under Predictive Coding Framework and Its Role in Psychotic Disorders. Front Psychiatry 2020; 11:557932. [PMID: 33132932 PMCID: PMC7511529 DOI: 10.3389/fpsyt.2020.557932] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022] Open
Abstract
Traditional neuroscience sees sensory perception as a simple feedforward process. This view is challenged by the predictive coding model in recent years due to the robust evidence researchers had found on how our prediction could influence perception. In the first half of this article, we reviewed the concept of predictive brain and some empirical evidence of sensory prediction in visual and auditory processing. The predictive function along the auditory pathway was mainly studied by mismatch negativity (MMN)-a brain response to an unexpected disruption of regularity. We summarized a range of MMN paradigms and discussed how they could contribute to the theoretical development of the predictive coding neural network by the mechanism of adaptation and deviance detection. Such methodological and conceptual evolution sharpen MMN as a tool to better understand the structural and functional brain abnormality for neuropsychiatric disorder such as schizophrenia.
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Affiliation(s)
- Chun Yuen Fong
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan
| | - Wai Him Crystal Law
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan
| | - Takanori Uka
- Department of Integrative Physiology, Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shinsuke Koike
- Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Meguro-ku, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Meguro-ku, Japan.,University of Tokyo Center for Integrative Science of Human Behavior (CiSHuB), 3-8-1 Komaba, Meguro-ku, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), Institutes for Advanced Study (UTIAS), University of Tokyo, Bunkyo-ku, Japan
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8
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Lavoie S, Polari AR, Goldstone S, Nelson B, McGorry PD. Staging model in psychiatry: Review of the evolution of electroencephalography abnormalities in major psychiatric disorders. Early Interv Psychiatry 2019; 13:1319-1328. [PMID: 30688016 DOI: 10.1111/eip.12792] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/03/2018] [Accepted: 12/29/2018] [Indexed: 12/29/2022]
Abstract
AIM Clinical staging in psychiatry aims to classify patients according to the severity of their symptoms, from stage 0 (increased risk, asymptomatic) to stage 4 (severe illness), enabling adapted treatment at each stage of the illness. The staging model would gain specificity if one or more quantifiable biological markers could be identified. Several biomarkers reflecting possible causal mechanisms and/or consequences of the pathophysiology are candidates for integration into the clinical staging model of psychiatric illnesses. METHODS This review covers the evolution (from stage 0 to stage 4) of the most important brain functioning impairments as measured with electroencephalography (EEG), in psychosis spectrum and in severe mood disorders. RESULTS The present review of the literature demonstrates that it is currently not possible to draw any conclusion with regard to the state or trait character of any of the EEG impairments in both major depressive disorder and bipolar disorder. As for schizophrenia, the most promising markers of the stage of the illness are the pitch mismatch negativity as well as the p300 event-related potentials, as these components seem to deteriorate with increasing severity of the illness. CONCLUSIONS Given the complexity of major psychiatric disorders, and that not a single impairment can be observed in all patients, future research should most likely consider combinations of markers in the quest for a better identification of the stages of the psychiatric illnesses.
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Affiliation(s)
- Suzie Lavoie
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrea R Polari
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Orygen Youth Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Sherilyn Goldstone
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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Zhang B, Jia Y, Wang C, Shao X, Wang W. Visual event-related potentials in external emotional conditions in bipolar disorders I and II. Neurophysiol Clin 2019; 49:359-369. [PMID: 31718912 DOI: 10.1016/j.neucli.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Mutual influences of cognitive and emotional functions occur in bipolar disorder, but specific alterations in relation to external emotional stimuli in bipolar I (BD I) and II (BD II) subtypes remain unknown. This study aimed to explore the effects of external emotional stimuli on cerebral attentional function in BD I and BD II. METHODS We tested visual oddball event-related potentials (ERPs) during various external emotional stimuli (Disgust, Fear, Erotica, Happiness, Neutral and Sadness) in 31 patients with BD I, 19 BD II and 47 healthy volunteers. Participants' concurrent affective states were also evaluated. RESULTS The ERP N2 latencies during Fear and Happiness were prolonged, P3 amplitudes during Disgust and Erotica were decreased in BD I; P3 amplitudes during Disgust, Erotica, Happiness and Neutral conditions were decreased in BD II. Increased frontal and parietal and decreased temporal and occipital activations were found in BD I, while increased occipital and parietal and decreased frontal and limbic activations in BD II in relation to different external emotions. ERP components were not correlated with concurrent affective states in patients. CONCLUSIONS Automatic attention during Happiness and Fear, and voluntary attention during Disgust and Erotica conditions were impaired in BD I; and voluntary attention during Disgust, Happiness, Erotica and Neutral conditions was impaired in BD II. Our study illustrates different patterns of visual attentional deficits associated with different external emotional stimuli in BD I and BD II.
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Affiliation(s)
- Bingren Zhang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Yanli Jia
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Chu Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Xu Shao
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
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Auditory mismatch detection, distraction, and attentional reorientation (MMN-P3a-RON) in neurological and psychiatric disorders: A review. Int J Psychophysiol 2019; 146:85-100. [PMID: 31654696 DOI: 10.1016/j.ijpsycho.2019.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/14/2022]
Abstract
Involuntary attention allows for the detection and processing of novel and potentially relevant stimuli that lie outside of cognitive focus. These processes comprise change detection in sensory contexts, automatic orientation toward this change, and the selection of adaptive responses, including reorientation to the original goal in cases when the detected change is not relevant for task demands. These processes have been studied using the Event-Related Potential (ERP) technique and have been associated to the Mismatch Negativity (MMN), the P3a, and the Reorienting Negativity (RON) electrophysiological components, respectively. This has allowed for the objective evaluation of the impact of different neuropsychiatric pathologies on involuntary attention. Additionally, these ERP have been proposed as alternative measures for the early detection of disease and the tracking of its progression. The objective of this review was to integrate the results reported to date about MMN, P3a, and RON in different neurological and psychiatric disorders. We included experimental studies with clinical populations that reported at least two of these three components in the same experimental paradigm. Overall, involuntary attention seems to reflect the state of cognitive integrity in different pathologies in adults. However, if the main goal for these ERP is to consider them as biomarkers, more research about their pathophysiological specificity in each disorder is needed, as well as improvement in the general experimental conditions under which these components are elicited. Nevertheless, these ERP represent a valuable neurophysiological tool for early detection and follow-up of diverse clinical populations.
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Wada M, Kurose S, Miyazaki T, Nakajima S, Masuda F, Mimura Y, Nishida H, Ogyu K, Tsugawa S, Mashima Y, Plitman E, Chakravarty MM, Mimura M, Noda Y. The P300 event-related potential in bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2019; 256:234-249. [PMID: 31200163 DOI: 10.1016/j.jad.2019.06.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/21/2019] [Accepted: 06/03/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Neurophysiology including P300, that is a typical index of event-related potential, may be potential biomarkers for bipolar disorder (BD) and it can be useful towards elucidating the pathophysiology of BD. However, previous findings from P300 studies were inconsistent due to the heterogeneity of research methods, which make it difficult to understand the neurobiological significance of them. The aim of this study is to conduct a meta-analysis on P300 in patients with BD. METHOD A literature search was conducted using PubMed to identify studies that compared P300 event-related potential between patients with BD and healthy controls (HCs). We analyzed P300 indices such as amplitude and latency of P3a and P3b in auditory or visual paradigms. Further, moderator analyses were conducted to investigate the influence of patient characteristics (i.e. history of psychosis, diagnostic subcategories [BD-I/BD-II], and phase of illness [euthymic, manic, or depressive]) on P300 indices. RESULT Out of 124 initial records, we included 30 articles (BD: N = 1331; HCs: N = 1818). Patients with BD showed reduced P3a and P3b amplitude in both paradigms and delayed P3b latency in auditory paradigms compared to HCs. There was no influence on the history of psychosis, diagnostic subcategories, or phase of illness on P300 indices. LIMITATION The difference in medication use was difficult to control and it may affect the results. CONCLUSION This meta-analysis provides evidence for P300 abnormalities in patients with BD compared to HCs. Our results suggest that P300 may be trait markers rather than state markers in this illness.
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Affiliation(s)
- Masataka Wada
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Shin Kurose
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Takahiro Miyazaki
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Fumi Masuda
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Hana Nishida
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Kamiyu Ogyu
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Sakiko Tsugawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yuuki Mashima
- Center Hospital of the National Center for Global Health and Medicine, Japan
| | - Eric Plitman
- Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - M Mallar Chakravarty
- Cerebral Imaging Centre, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Department of Psychiatry, McGill University Biological and Biomedical Engineering, McGill University, Canada
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan
| | - Yoshihiro Noda
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan.
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Elucidating the glutamatergic processes underlying mismatch negativity deficits in early stage bipolar disorder and schizophrenia: A combined 1H-MRS and EEG study. J Psychiatr Res 2019; 113:83-89. [PMID: 30921632 DOI: 10.1016/j.jpsychires.2019.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 02/01/2019] [Accepted: 03/20/2019] [Indexed: 01/31/2023]
Abstract
Impairments in mismatch negativity (MMN) in schizophrenia are well-established; these findings have been extended to show impairments at early illness stages and in bipolar disorder. A substantial literature supports MMN as an index of NMDA receptor output, however, few studies have conducted in vivo assessments to elucidate the neurochemical underpinnings of MMN. Sixty young (16-33 years) participants with bipolar disorder (n = 47) or schizophrenia (n = 13) underwent 1H-MRS and MMN assessment. Glutamate over creatine (Glu/Cr) levels in the anterior cingulate cortex (ACC) and hippocampus were determined and MMN was measured frontally and temporally. Correlational analyses assessed the relationship between MMN amplitudes and Glu/Cr. Any significant relationships were assessed for specificity with a follow up correlation analysis of MMN and n-acetyleaspartate (NAA/Cr). No associations between frontal or temporal MMN and ACC or hippocampal Glu/Cr were noted in the bipolar group. In the schizophrenia group, frontal and right temporal MMN amplitudes corresponded with increased ACC Glu/Cr at the trend-level. Right temporal MMN was similarly significantly associated with NAA/Cr. MMN was not associated with hippocampal Glu/Cr. This work provides in vivo evidence that glutamatergic processes may underlie MMN generation in early stage schizophrenia but not in early stage bipolar disorder suggesting differences in the MMN mechanism in these groups. The negative association between ACC Glu/Cr and MMN is consistent with findings of reduced MMN and increased in vivo glutamatergic neurometabolite levels in early stage schizophrenia. Furthermore, these results indicate that examining in vivo NAA/Cr may have provide additional insights into the MMN mechanism in schizophrenia.
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Kim S, Jeon H, Jang KI, Kim YW, Im CH, Lee SH. Mismatch Negativity and Cortical Thickness in Patients With Schizophrenia and Bipolar Disorder. Schizophr Bull 2019; 45:425-435. [PMID: 29684224 PMCID: PMC6403065 DOI: 10.1093/schbul/sby041] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Mismatch negativity (MMN) is a measure of automatic neurophysiological brain processes for detecting unexpected sensory stimuli. This study investigated MMN reduction in patients with schizophrenia and bipolar disorder and examined whether cortical thickness is associated with MMN, for exploratory purposes. METHODS Electroencephalograms were recorded in 38 patients with schizophrenia, 37 patients with bipolar disorder, and 32 healthy controls (HCs) performing a passive auditory oddball paradigm. All participants underwent T1 structural magnetic resonance imaging scanning to investigate the cortical thickness of MMN-generating regions. Average MMN amplitudes from the frontocentral electrodes were analyzed. RESULTS Patients with schizophrenia and bipolar disorder exhibited significantly reduced MMN amplitude compared with HCs. In bipolar disorder, we found intermediate MMN amplitude among the groups. Average MMN and cortical thickness of the right superior temporal gyrus (STG) were significantly negatively correlated in patients with schizophrenia. In patients with bipolar disorder, average MMN was significantly correlated with cortical thickness of the left anterior cingulate cortex and the right STG. MMN showed negative correlations with social and occupational functioning in schizophrenia, and with the Korean auditory verbal learning test for delayed recall in bipolar disorder. CONCLUSIONS MMN reduction was associated with cortical thinning in frontal and temporal areas in patients, particularly with an auditory verbal hallucination-related region in schizophrenia and emotion-related regions in bipolar disorder. MMN was associated with functional outcomes in schizophrenia, whereas it was associated with neurocognition in bipolar disorder.
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Affiliation(s)
- Sungkean Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Hyeonjin Jeon
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Kuk-In Jang
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedicine & Health Sciences, The Catholic University of Korea, College of Medicine, Seoul, Republic of Korea
| | - Yong-Wook Kim
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea,Department of Psychiatry, Inje University, Ilsan-Paik Hospital, Goyang, Republic of Korea,To whom correspondence should be addressed; Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-Gu, Goyang 411-706, Republic of Korea; tel: +82-31-910-7260, fax: +82-31-910-7268, e-mail:
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A systematic review on neuropsychological function in bipolar disorders type I and II and subthreshold bipolar disorders-something to think about. CNS Spectr 2019; 24:127-143. [PMID: 30859934 DOI: 10.1017/s1092852918001463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Neuropsychological dysfunction is a well-established finding in individuals with bipolar disorder type I (BP-I), even during euthymic periods; however, it is less clear whether this also pertains to bipolar disorder type II (BP-II) or those with subthreshold states (SBP; subthreshold bipolar disorder), such as bipolar not otherwise specified (BP-NOS). Herein, we compare the literature regarding neuropsychological performance in BP-II vs BP-I to determine the extent of relative impairment, and we present and review all related studies on cognition in SBP. After systematically searching PubMed, Medline, PsycINFO, and The Cochrane Library, we found 17 papers that comprise all the published studies relevant for this review. The areas that are consistently found to be impaired in BP are executive function, verbal memory, visual spatial working memory, and attention. More studies than not show no significant difference between BP-I and BP-II, particularly in euthymic samples. Preliminary evidence suggests that patients experiencing major depressive episodes who also meet criteria for SBP show similar profiles to BP-II; however, these results pertain only to a depressed sample. SBP were found to perform significantly better than both MDD and healthy controls in a euthymic sample. A consensus on mood state, patient selection, and neuropsychological testing needs to be agreed on for future research. Furthermore, no studies have used the most recent DSM-5 criteria for SBP; future studies should address this. Finally, the underlying bases of cognitive dysfunction in these diagnostic groups need to be further investigated. We suggest recommendations on all of the above current research challenges.
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Kazemi R, Rostami R, Khomami S, Baghdadi G, Rezaei M, Hata M, Aoki Y, Ishii R, Iwase M, Fitzgerald PB. Bilateral Transcranial Magnetic Stimulation on DLPFC Changes Resting State Networks and Cognitive Function in Patients With Bipolar Depression. Front Hum Neurosci 2018; 12:356. [PMID: 30233346 PMCID: PMC6135217 DOI: 10.3389/fnhum.2018.00356] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/20/2018] [Indexed: 01/13/2023] Open
Abstract
Introduction: Bipolar patients have abnormalities in cognitive functions and emotional processing. Two resting state networks (RSNs), the default mode network (DMN) and the sensorimotor network (SMN), play a decisive role in these two functions. Dorsolateral prefrontal cortex (DLPFC) is one of the main areas in the central executive network (CEN), which is linked to the activities of each of the two networks. Studies have found DLPFC abnormalities in both hemispheres of patients with bipolar depression. We hypothesized that the bilateral repetitive transcranial magnetic stimulation (rTMS) of DLPFC would produce changes in the activity of both the SMN and DMN as well as relevant cognitive function in patients with bipolar depression that responded to treatment. Methods: 20 patients with bipolar depression underwent 10 sessions of 1 Hz rTMS on right DLPFC with subsequent 10 Hz rTMS on left DLPFC. Changes in electroencephalography resting networks between pre and post rTMS were evaluated utilizing low-resolution electromagnetic tomography (eLORETA). Depression symptom was assessed using the Beck Depression Inventory (BDI-II) and cognitive function was assessed by Verbal Fluency Test (VFT), Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, and Wisconsin Card Sorting Test (WCST). Results: Responders to rTMS showed significantly lower DMN activity at baseline and a significant decrease in SMN connectivity after treatment. Non-responders did not significantly differ from the control group at the baseline and they showed higher activity in the SMN, visual network, and visual perception network compared to control group following treatment. Bilateral rTMS resulted in significant changes in the executive functions, verbal memory, and depression symptoms. No significant changes were observed in selective attention and verbal fluency. Conclusion: Bilateral stimulation of DLPFC, as the main node of CEN, results in changes in the activity of the SMN and consequently improves verbal memory and executive functions in patients with bipolar depression.
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Affiliation(s)
- Reza Kazemi
- Cognitive Lab, Department of Psychology, University of Tehran, Tehran, Iran.,Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Reza Rostami
- Department of Psychology, University of Tehran, Tehran, Iran
| | - Sanaz Khomami
- Cognitive Lab, Department of Psychology, University of Tehran, Tehran, Iran
| | - Golnaz Baghdadi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Mehdi Rezaei
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Masahiro Hata
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yasunori Aoki
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ryouhei Ishii
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masao Iwase
- Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Paul B Fitzgerald
- Epworth Healthcare, Epworth Clinic Camberwell, Victoria Australia and Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University, Melbourne, VIC, Australia
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16
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Paris M, Mahajan Y, Kim J, Meade T. Emotional speech processing deficits in bipolar disorder: The role of mismatch negativity and P3a. J Affect Disord 2018; 234:261-269. [PMID: 29550743 DOI: 10.1016/j.jad.2018.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/20/2018] [Accepted: 02/15/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Deficits in emotional prosody processing have been observed in bipolar disorder (BD). While recent neural studies have explored impaired processing of facial expressions, little is known about deficits in emotional speech processing, or the specific stages of processing at which they occur. This study examined if pre-attentive detection and attention to emotional speech is impaired in BD, relative to healthy individuals. METHODS The EEG data was collected from 14 individuals with BD and 14 healthy control (HC) participants while the auditory stimuli was presented via a passive three-stimulus oddball sequence which included emotionally (neutral, happy, sad) spoken syllables and acoustically matched nonvocal tones. Event-related potentials (ERPs) were evaluated in terms of Mismatch Negativity (MMN) and P3a (event-related potentials signals). RESULTS Individuals with BD showed normal MMN amplitude, but significantly delayed MMN latency and reduced P3a amplitude in response to the emotional syllables compared to HC. LIMITATIONS Small sample size, lack of control of psychopharmacological intervention and no inclusion of an affective prosody-labelling task. CONCLUSIONS The finding that changes in emotional speech prosody in the pre-attentive stages of processing (MMN) were unimpaired in individuals with BD; while automatic orientation towards emotionally salient speech (P3a) was reduced compared to HC, suggests that vocal emotional cues may not be recognised as salient by individuals with BD, resulting in fewer attentional resources allocation to further processing. This may lead to poorer integration of auditory emotional cues and other sensory information and negatively impact interpersonal and psychosocial functions.
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Affiliation(s)
- Morgwn Paris
- School of Social Sciences and Psychology, Western Sydney University, Australia
| | - Yatin Mahajan
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Jeesun Kim
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Australia
| | - Tanya Meade
- School of Social Sciences and Psychology, Western Sydney University, Australia.
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17
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Cognitive Impairment In Treatment-Naïve Bipolar II and Unipolar Depression. Sci Rep 2018; 8:1905. [PMID: 29382902 PMCID: PMC5789863 DOI: 10.1038/s41598-018-20295-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/16/2018] [Indexed: 12/26/2022] Open
Abstract
Cognition dysfunction may reflect trait characteristics of bipolarity but cognitive effects of medications have confounded previous comparisons of cognitive function between bipolar II and unipolar depression, which are distinct clinical disorders with some overlaps. Therefore, we examined the executive function (WCST), attention, cognitive speed (TMT-A) and memory (CAVLT, WMS-Visual reproduction) of 20 treatment-naïve bipolar II patients (BPII), 35 treatment-naïve unipolar depressed (UD) patients, and 35 age/sex/education matched healthy controls. The subjects were young (aged 18–35), and had no history of psychosis or substance use, currently depressed and meeting either RDC criteria for Bipolar II Disorder or DSM-IV-TR criteria for Major Depressive Disorder. The patients were moderately depressed (MADRS) and anxious(HAM-A), on average within 3.44 years of illness onset. Sociodemographic data and IQ were similar between the groups. UD patients had significantly slower cognitive speed and cognitive flexibility (WCST perseverative error). BPII depressed patients showed relatively intact cognitive function. Verbal memory (CAVLT List A total) correlated with illness chronicity only in BPII depression, but not UD. In conclusion, young and treatment-naïve BPII depressed patients differed from unipolar depression by a relatively intact cognitive profile and a chronicity-cognitive correlation that suggested a stronger resemblance to Bipolar I Disorder than Unipolar Depression.
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Hermens DF, Chitty KM, Kaur M. Mismatch negativity in bipolar disorder: A neurophysiological biomarker of intermediate effect? Schizophr Res 2018; 191:132-139. [PMID: 28450056 DOI: 10.1016/j.schres.2017.04.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 04/11/2017] [Accepted: 04/13/2017] [Indexed: 02/04/2023]
Abstract
The event-related potential, mismatch negativity (MMN), has been touted as a robust and specific neurophysiological biomarker of schizophrenia. Earlier studies often included bipolar disorder (BD) as a clinical comparator and reported that MMN was significantly impaired only in schizophrenia. However, with the increasing number of MMN studies of BD (with larger sample sizes), the literature is now providing somewhat consistent evidence of this biomarker also being perturbed in BD, albeit to a lesser degree than that observed in schizophrenia. Indeed, two meta-analyses have now shown that the effect sizes in BD samples suggest a moderate impairment in MMN, compared to the large effect sizes shown in schizophrenia. Pharmacologically, MMN is an extremely useful non-invasive probe of glutamatergic (more specifically, N-methyl-d-aspartate [NMDA] receptor) disturbances and this system has been implicated in the pathophysiology of both schizophrenia and BD. Therefore, it may be best to conceptualize/utilize MMN as an index of a psychopathology that is shared across psychotic and related disorders, rather than being a diagnosis-specific biomarker. More research is needed, particularly longitudinal designs including studies that assess MMN over an individual's life course and then examine NMDA receptor expression/binding post-mortem. At this point and despite a disproportionate amount of research, the current evidence suggests that with respect to BD, MMN is a neurophysiological biomarker of intermediate effect. With replication and validation of this effect, MMN may prove to be an important indicator of a common psychopathology shared by a significant proportion of individuals with schizophrenia and bipolar spectrum illnesses.
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Affiliation(s)
- Daniel F Hermens
- Youth Mental Health Team, Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.
| | - Kate M Chitty
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Pharmacology, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Manreena Kaur
- Monash Alfred Psychiatry Research Centre, The Alfred and Monash University Central Clinical School, VIC, Australia
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19
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Meyers JL, Zhang J, Manz N, Rangaswamy M, Kamarajan C, Wetherill L, Chorlian DB, Kang SJ, Bauer L, Hesselbrock V, Kramer J, Kuperman S, Nurnberger JI, Tischfield J, Wang JC, Edenberg HJ, Goate A, Foroud T, Porjesz B. A genome wide association study of fast beta EEG in families of European ancestry. Int J Psychophysiol 2017; 115:74-85. [PMID: 28040410 PMCID: PMC5426060 DOI: 10.1016/j.ijpsycho.2016.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Differences in fast beta (20-28Hz) electroencephalogram (EEG) oscillatory activity distinguish some individuals with psychiatric and substance use disorders, suggesting that it may be a useful endophenotype for studying the genetics of disorders characterized by neural hyper-excitability. Despite the high heritability estimates provided by twin and family studies, there have been relatively few genetic studies of beta EEG, and to date only one genetic association finding has replicated (i.e., GABRA2). METHOD In a sample of 1564 individuals from 117 families of European Ancestry (EA) drawn from the Collaborative Study on the Genetics of Alcoholism (COGA), we performed a Genome-Wide Association Study (GWAS) on resting-state fronto-central fast beta EEG power, adjusting regression models for family relatedness, age, sex, and ancestry. To further characterize genetic findings, we examined the functional and behavioral significance of GWAS findings. RESULTS Three intronic variants located within DSE (dermatan sulfate epimerase) on 6q22 were associated with fast beta EEG at a genome wide significant level (p<5×10-8). The most significant SNP was rs2252790 (p<2.6×10-8; MAF=0.36; β=0.135). rs2252790 is an eQTL for ROS1 expressed most robustly in the temporal cortex (p=1.2×10-6) and for DSE/TSPYL4 expressed most robustly in the hippocampus (p=7.3×10-4; β=0.29). Previous studies have indicated that DSE is involved in a network of genes integral to membrane organization; gene-based tests indicated that several variants within this network (i.e., DSE, ZEB2, RND3, MCTP1, and CTBP2) were also associated with beta EEG (empirical p<0.05), and of these genes, ZEB2 and CTBP2 were associated with DSM-V Alcohol Use Disorder (AUD; empirical p<0.05).' DISCUSSION In this sample of EA families enriched for AUDs, fast beta EEG is associated with variants within DSE on 6q22; the most significant SNP influences the mRNA expression of DSE and ROS1 in hippocampus and temporal cortex, brain regions important for beta EEG activity. Gene-based tests suggest evidence of association with related genes, ZEB2, RND3, MCTP1, CTBP2, and beta EEG. Converging data from GWAS, gene expression, and gene-networks presented in this study provide support for the role of genetic variants within DSE and related genes in neural hyperexcitability, and has highlighted two potential candidate genes for AUD and/or related neurological conditions: ZEB2 and CTBP2. However, results must be replicated in large, independent samples.
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Affiliation(s)
- Jacquelyn L Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Jian Zhang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Niklas Manz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA; Department of Physics, College of Wooster, Wooster, OH, USA
| | | | - Chella Kamarajan
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David B Chorlian
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Sun J Kang
- Albany Stratton VA Medical Center, Albany, NY, USA
| | - Lance Bauer
- University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - John Kramer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - John I Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alison Goate
- Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Bersani FS, Minichino A, Bernabei L, Spagnoli F, Corrado A, Vergnani L, Mannarelli D, Pauletti C, Fattapposta F, Biondi M, Delle Chiaie R. Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation. J Affect Disord 2017; 209:262-269. [PMID: 27951511 DOI: 10.1016/j.jad.2016.11.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 11/07/2016] [Accepted: 11/25/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The present double blind placebo-controlled study aimed at investigating the efficacy of 3-weeks prefronto-cerebellar transcranial direct current stimulation (tDCS) on neurocognitive functioning in euthymic BD patients. METHODS Forty-two outpatients with BD were randomly assigned to receive either active (n=21) or sham (n=21) prefronto-cerebellar tDCS for 3 consecutive weeks. Neurocognitive abilities were assessed with both neuropsychological testing and psychophysiological evaluation with a P300 novelty task. RESULTS Our results showed that (i) Trail Making Test-B, a measure of executive functioning, decreased significantly in the active but not in the sham group, (ii) Rey Complex Figure Test Delay Recall, a measure of visuospatial memory, increased significantly in both groups with a greater increase in the active compared to the sham group, and (iii) P3b latency, a measure of brain information processing stream, decreased significantly in the active but not in the sham group. No significant changes were observed in the other explored neuropsychological and psychophysiological measures. CONCLUSIONS The study suggests that concomitant prefrontal-excitatory and cerebellar-inhibitory tDCS in euthymic BD patients may lead to better neurocognitive performance, quantified through neuropsychological and psychophysiological measures.
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Affiliation(s)
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
| | - Laura Bernabei
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Francesco Spagnoli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Alessandra Corrado
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Lucilla Vergnani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Daniela Mannarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | - Caterina Pauletti
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
| | | | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Italy
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Kremláček J, Kreegipuu K, Tales A, Astikainen P, Põldver N, Näätänen R, Stefanics G. Visual mismatch negativity (vMMN): A review and meta-analysis of studies in psychiatric and neurological disorders. Cortex 2016; 80:76-112. [DOI: 10.1016/j.cortex.2016.03.017] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 01/31/2016] [Accepted: 03/17/2016] [Indexed: 12/18/2022]
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Malhi GS, McAulay C, Gershon S, Gessler D, Fritz K, Das P, Outhred T. The Lithium Battery: assessing the neurocognitive profile of lithium in bipolar disorder. Bipolar Disord 2016; 18:102-15. [PMID: 27004564 DOI: 10.1111/bdi.12375] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The aim of the present study was to characterize the neurocognitive effects of lithium in bipolar disorder to inform clinical and research approaches for further investigation. METHODS Key words pertaining to neurocognition in bipolar disorder and lithium treatment were used to search recognized databases to identify relevant literature. The authors also retrieved gray literature (e.g., book chapters) known to them and examined pertinent articles from bibliographies. RESULTS A limited number of studies have examined the effects of lithium on neurocognition in bipolar disorder and, although in some domains a consistent picture emerges, in many domains the findings are mixed. Lithium administration appears to reshape key components of neurocognition - in particular, psychomotor speed, verbal memory, and verbal fluency. Notably, it has a sophisticated neurocognitive profile, such that while lithium impairs neurocognition across some domains, it seemingly preserves others - possibly those vulnerable to the effects of bipolar disorder. Furthermore, its effects are likely to be direct and indirect (via mood, for example) and cumulative with duration of treatment. Disentangling the components of neurocognition modulated by lithium in the context of a fluctuating and complex illness such as bipolar disorder is a significant challenge but one that therefore demands a stratified and systematic approach, such as that provided by the Lithium Battery. CONCLUSIONS In order to delineate the effects of lithium therapy on neurocognition in bipolar disorder within both research and clinical practice, a greater understanding and measurement of the relatively stable neurocognitive components is needed to examine those that indeed change with lithium treatment. In order to achieve this, we propose a Lithium Battery-Clinical and a Lithium Battery-Research that can be applied to these respective settings.
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Affiliation(s)
- Gin S Malhi
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Claire McAulay
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Samuel Gershon
- Emeritus Professor of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Mind and Brain Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Danielle Gessler
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Kristina Fritz
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Pritha Das
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Tim Outhred
- Academic Department of Psychiatry, Kolling Institute, Northern Sydney Local Health District, St. Leonards, Sydney, NSW, Australia.,Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.,CADE Clinic, Royal North Shore Hospital, Sydney, NSW, Australia
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Are there differences in pattern and magnitude of cognitive deficits between euthymic patients with bipolar I and bipolar II disorder? MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000475311.46243.2f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Electrical mapping in bipolar disorder patients during the oddball paradigm. J Psychiatr Res 2016; 72:64-71. [PMID: 26551764 DOI: 10.1016/j.jpsychires.2015.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 11/21/2022]
Abstract
Bipolar disorder (BD) is characterized by an alternated occurrence between acute mania episodes and depression or remission moments. The objective of this study is to analyze the information processing changes in BP (Bipolar Patients) (euthymia, depression and mania) during the oddball paradigm, focusing on the P300 component, an electric potential of the cerebral cortex generated in response to external sensorial stimuli, which involves more complex neurophysiological processes related to stimulus interpretation. Twenty-eight bipolar disorder patients (BP) (17 women and 11 men with average age of 32.5, SD: 9.5) and eleven healthy controls (HC) (7 women and 4 men with average age of 29.78, SD: 6.89) were enrolled in this study. The bipolar patients were divided into 3 major groups (i.e., euthymic, depressive and maniac) according to the score on the Clinical Global Impression--Bipolar Version (CGI-BP). The subjects performed the oddball paradigm simultaneously to the EEG record. EEG data were also recorded before and after the execution of the task. A one-way ANOVA was applied to compare the P300 component among the groups. After observing P300 and the subcomponents P3a and P3b, a similarity of amplitude and latency between euthymic and depressive patients was observed, as well as small amplitude in the pre-frontal cortex and reduced P3a response. This can be evidence of impaired information processing, cognitive flexibility, working memory, executive functions and ability to shift the attention and processing to the target and away from distracting stimuli in BD. Such neuropsychological impairments are related to different BD symptoms, which should be known and considered, in order to develop effective clinical treatment strategies.
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Chitty KM, Lagopoulos J, Hickie IB, Hermens DF. Alcohol use in bipolar disorder: A neurobiological model to help predict susceptibility, select treatments and attenuate cortical insult. Neurosci Biobehav Rev 2015; 56:193-206. [PMID: 26192106 DOI: 10.1016/j.neubiorev.2015.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 06/12/2015] [Accepted: 07/09/2015] [Indexed: 02/06/2023]
Abstract
In a series of neurophysiological and neuroimaging studies we investigated the neurobiology related to alcohol use in young people with bipolar disorder. Impairments were identified across frontal and temporal representations of event-related potential and proton magnetic resonance spectroscopy markers; mismatch negativity and in vivo glutathione, respectively. We propose these findings reflect impairments in the N-methyl-D-aspartate receptor and antioxidant capacity. This review seeks to place these findings within the broader literature in the context of two propositions: 1. Pathophysiological impairments in N-methyl-D-aspartate receptor functioning in bipolar disorder contribute to susceptibility toward developing alcohol problems. 2. Alcohol aggravates bipolar disorder neuroprogression via oxidative stress. A neurobiological model that incorporates these propositions is presented, with a focus on the potential for N-methyl-D-aspartate receptor antagonism and glutathione augmentation as potential adjunctive pharmacotherapies to treat the comorbidity. While this review highlights the importance of alcohol monitoring and reduction strategies in the treatment of bipolar disorder, the clinical impact of the proposed model remains limited by the lack of controlled trials of novel pharmacological interventions.
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Affiliation(s)
- Kate M Chitty
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
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Chitty KM, Lagopoulos J, Kaur M, Hickie IB, Hermens DF. The N-methyl-D-aspartate receptor as a neurobiological intersection between bipolar disorder and alcohol use: a longitudinal mismatch negativity study. Int J Neuropsychopharmacol 2015; 18:pyu113. [PMID: 25603860 PMCID: PMC4438551 DOI: 10.1093/ijnp/pyu113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 12/15/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Comorbid risky alcohol use in bipolar disorder (BD) is recognized for its high prevalence and clinical relevance, though understanding of its neurobiological underpinning is limited. The N-methyl-D-aspartate (NMDA) receptor has recognized alterations in BD and is a major site of ethanol's effects in the brain. The present study aimed to examine the NMDA receptor system in adolescents and young adults with BD by evaluating the longitudinal changes in a robust marker of NMDA function, mismatch negativity (MMN), in relation to changes in alcohol use patterns. METHODS Forty-six BD patients (aged 16-30) were recruited at baseline and 59% (n = 27) returned for follow-up 17.9 +/- 7.3 months later. At both time-points a two-tone, passive, duration-deviant MMN paradigm was conducted and alcohol measures were collected. Pearson's correlations were performed between changes in MMN amplitudes and changes in alcohol use. Multiple regression was used to assess whether MMN amplitudes at baseline could predict alcohol use at follow-up. RESULTS Reduction in risky drinking patterns was associated with increased temporal MMN and decreased fronto-central MMN. Larger temporal MMN at baseline was a significant predictor of greater alcohol use at follow-up. CONCLUSIONS Results suggest risky alcohol use in BD may further compound pre-existing NMDA receptor abnormalities and, importantly, reducing alcohol use early in stages of illness is associated with changes in MMN. This highlights the importance of monitoring alcohol use from first presentation. In addition, preliminary results present an exciting potential for utility of MMN as a neurobiological marker used to determine risk for alcohol misuse in BD.
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Affiliation(s)
- Kate M Chitty
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia (Drs Chitty, Lagopoulos, Kaur, Hickie, and Hermens)
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD. METHODS Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis. CONCLUSION The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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Lövdahl H, Bøen E, Malt EA, Malt UF. Somatic and cognitive symptoms as indicators of potential endophenotypes in bipolar spectrum disorders: an exploratory and proof-of-concept study comparing bipolar II disorder with recurrent brief depression and healthy controls. J Affect Disord 2014; 166:59-70. [PMID: 25012411 DOI: 10.1016/j.jad.2014.04.056] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/21/2014] [Accepted: 04/24/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND We examined whether somatic symptoms reported by patients with bipolar spectrum disorder (BSD), in this study defined as bipolar II (BD-2) or recurrent brief depression with (RBD-H) or without (RBD-O) a history of hypomanic symptoms might point to the possible underlying disease markers (endophenotypes). We hypothesized that somatic symptoms that are possible indirect indicators of endophenotypes should be more prevalent among patients than among healthy controls; should not correlate with neuroticism; should not correlate with the severity of current mental status (e.g., anxiety, depression); and should not correlate with the use of psychotropic drugs including antiepileptics or be explained by co-morbid medical diseases. METHODS Sixty-one patients (BD-2: n=21; RBD-H: n=19; RBD-O: n=21) were compared with 21 healthy controls. Assessments included a 123-item somatic symptom checklist; assessments for neuroticism, anxiety and depression. Candidate somatic symptoms were selected using a 4-step inclusion/exclusion procedure. RESULTS Seven symptoms survived in all three groups: general (fatigue, feeling exhausted); sensory (leaden sensation in legs, pain in the body, impaired sense of smell); cognitive (loss of memory) and autonomic (excessive perspiration). In addition 15 symptoms survived in one or two groups (examples: impaired hearing, hypersensitivity to sound, inability to find words). LIMITATIONS Possible selection bias and small sample size precludes firm conclusions with regards to specific symptoms. CONCLUSION Our approach identified symptoms for which an association with BSDs has been suggested previously, as well as symptoms not commonly associated with BSDs. The findings support the feasibility and validity of using assessment of somatic symptoms as an approach to identify potential endophenotypes in BSDs.
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Affiliation(s)
- H Lövdahl
- Department of Psychosomatic Medicine, Division of Surgery & Neuroscience, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Clinical Psychiatry, Sørlandet Hospital, Arendal, Norway.
| | - E Bøen
- Department of Psychosomatic Medicine, Division of Surgery & Neuroscience, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Normood (Norwegian Research Network on Mood Disorders), Norway
| | - E A Malt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Adult Habilitation, Akershus University Hospital and Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Norway
| | - U F Malt
- Department of Psychosomatic Medicine, Division of Surgery & Neuroscience, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Normood (Norwegian Research Network on Mood Disorders), Norway
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Shimano S, Onitsuka T, Oribe N, Maekawa T, Tsuchimoto R, Hirano S, Ueno T, Hirano Y, Miura T, Kanba S. Preattentive dysfunction in patients with bipolar disorder as revealed by the pitch-mismatch negativity: a magnetoencephalography (MEG) study. Bipolar Disord 2014; 16:592-9. [PMID: 24807680 DOI: 10.1111/bdi.12208] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 11/12/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Mismatch negativity (MMN) and its magnetic counterpart (MMNm) are thought to reflect an automatic process that detects a difference between an incoming stimulus and the sensory memory trace of preceding stimuli. In patients with schizophrenia, an attenuation of the MMN/MMNm amplitude has been repeatedly reported. Heschl's gyrus (HG) is one of the major generators of MMN and the functional alteration of HG has been reported in patients with bipolar disorder. The present study investigated the pitch-MMNm in patients with bipolar disorder using whole-head 306-ch magnetoencephalography (MEG). METHODS Twenty-two patients and 22 healthy controls participated in this study. Subjects were presented with two types of auditory stimulus sequences. One consisted of 1,000 Hz standards (probability = 90%) and 1,200 Hz deviants (probability = 10%), and the other consisted of 1,000 Hz standards (90%) and 1,200 Hz deviants (10%). These two tasks were each performed twice. Event-related brain responses to standard tones were subtracted from responses to deviant tones. RESULTS Patients with bipolar disorder showed a significant bilateral reduction in magnetic global field power (mGFP) amplitudes (p = 0.02) and dipole moments of the MMNm (p = 0.04) compared with healthy controls. Patients with admission experience showed significantly reduced mGFP amplitudes of MMNm compared with patients without admission experience (p = 0.004). Additionally, patients with more severe manic symptoms had smaller mGFP amplitudes of MMNm (ρ = -0.50, p = 0.05). CONCLUSIONS The results of this study suggest that patients with bipolar disorder may exhibit preattentive auditory dysfunction indexed by reduced pitch-MMNm responses. Pitch-MMNm could be a potential trait marker reflecting the global severity of bipolar disorder.
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Affiliation(s)
- Satomi Shimano
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Näätänen R, Sussman ES, Salisbury D, Shafer VL. Mismatch negativity (MMN) as an index of cognitive dysfunction. Brain Topogr 2014; 27:451-66. [PMID: 24838819 DOI: 10.1007/s10548-014-0374-6] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 04/29/2014] [Indexed: 01/08/2023]
Abstract
Cognition is often affected in a variety of neuropsychiatric, neurological, and neurodevelopmental disorders. The neural discriminative response, reflected in mismatch negativity (MMN) and its magnetoencephalographic equivalent (MMNm), has been used as a tool to study a variety of disorders involving auditory cognition. MMN/MMNm is an involuntary brain response to auditory change or, more generally, to pattern regularity violation. For a number of disorders, MMN/MMNm amplitude to sound deviance has been shown to be attenuated or the peak-latency of the component prolonged compared to controls. This general finding suggests that while not serving as a specific marker to any particular disorder, MMN may be useful for understanding factors of cognition in various disorders, and has potential to serve as an indicator of risk. This review presents a brief history of the MMN, followed by a description of how MMN has been used to index auditory processing capability in a range of neuropsychiatric, neurological, and neurodevelopmental disorders. Finally, we suggest future directions for research to further enhance our understanding of the neural substrate of deviance detection that could lead to improvements in the use of MMN as a clinical tool.
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Affiliation(s)
- Risto Näätänen
- Department of Psychology, University of Tartu, Tartu, Estonia
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31
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Baldeweg T, Hirsch SR. Mismatch negativity indexes illness-specific impairments of cortical plasticity in schizophrenia: a comparison with bipolar disorder and Alzheimer's disease. Int J Psychophysiol 2014; 95:145-55. [PMID: 24681247 DOI: 10.1016/j.ijpsycho.2014.03.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 03/14/2014] [Accepted: 03/18/2014] [Indexed: 01/15/2023]
Abstract
Cognitive impairment is an important predictor of functional outcome in patients with schizophrenia, yet its neurobiology is still incompletely understood. Neuropathological evidence of impaired synaptic connectivity and NMDA receptor-dependent transmission in superior temporal cortex motivated us to explore the correlation of in vivo mismatch negativity (MMN) with cognitive status in patients with schizophrenia. MMN elicited in a roving stimulus paradigm displayed a response proportional to the number of stimulus repetitions (memory trace effect). Preliminary evidence in patients with chronic schizophrenia suggests that attenuation of this MMN memory trace effect was correlated with the degree of neuropsychological memory dysfunction. Here we present data from a larger confirmatory study in patients with schizophrenia, bipolar disorder, probable Alzheimer's disease and healthy controls. We observed that the diminution of the MMN memory trace effect and its correlation with memory impairment was only found in the schizophrenia group. Recent pharmacological studies using the roving paradigm suggest that attenuation of the MMN trace effect can be understood as abnormal modulation of NMDA receptor-dependent plasticity. We suggest that the convergence of the previously identified synaptic pathology in supragranular cortical layers with the intracortical locus of MMN generation accounts for the remarkable robustness of MMN impairments in schizophrenia. We further speculate that this layer-specific synaptic pathology identified in supragranular neurons plays a pivotal computational role, by weakening the encoding and propagation of prediction errors to higher cortical modules. According to predictive coding theory such breakdown will have grave implications not only for perception, but also for higher-order cognition and may thus account for the MMN-cognition correlations observed here. Finally, MMN is a sensitive and specific biomarker for detecting the early prodromal phase of schizophrenia and is well suited for the exploration of novel cognition-enhancing agents in humans.
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Affiliation(s)
- Torsten Baldeweg
- University College London, Institute of Child Health, London, United Kingdom; Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, United Kingdom.
| | - Steven R Hirsch
- Division of Neuroscience & Psychological Medicine, Imperial College School of Science, Technology and Medicine, Charing Cross Hospital, London W6 8RP, United Kingdom
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Chitty KM, Kaur M, Lagopoulos J, Hickie IB, Hermens DF. Risky alcohol use predicts temporal mismatch negativity impairments in young people with bipolar disorder. Biol Psychol 2014; 99:60-8. [PMID: 24594113 DOI: 10.1016/j.biopsycho.2014.02.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 01/22/2014] [Accepted: 02/23/2014] [Indexed: 01/08/2023]
Abstract
Alcohol misuse in bipolar disorder (BD) has a negative impact on illness progression. The NMDA/glutamatergic system is implicated in BD pathophysiology and is critically involved in the effects of alcohol on the brain. Mismatch negativity (MMN) is purported to reflect NMDA receptor output, providing a measure for investigating this association. Forty-two patients and 34 controls (16-30 years) were split into low and high-risk drinkers (based on the Alcohol Use Disorders Identification Test) and underwent a two-tone passive auditory oddball, duration deviant MMN paradigm. Multiple regression models revealed risky drinking and BD diagnosis were predictors of impaired temporal MMN. Potentially reflecting an additive effect of alcohol on a perturbed NMDA/glutamatergic system in BD, these findings highlight alcohol as both a modifiable risk factor of neurobiological impairments and as a potential confounder in MMN studies. Given the increasing use of glutamatergic agents for BD treatment, this finding is important clinically.
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Affiliation(s)
- Kate M Chitty
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia.
| | - Manreena Kaur
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Research Institute, The University of Sydney, Sydney, Australia
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Hoover S, Zottoli TM, Grose-Fifer J. ERP correlates of malingered executive dysfunction. Int J Psychophysiol 2014; 91:139-46. [PMID: 24394183 DOI: 10.1016/j.ijpsycho.2013.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Revised: 12/20/2013] [Accepted: 12/27/2013] [Indexed: 11/26/2022]
Abstract
Assessment of malingering has become an integral part of many neuropsychological evaluations, particularly in forensic settings. However, traditional malingering measures are known to be vulnerable to both manipulation and coaching. Consequently, recent research has attempted to identify physiological indices of cognitive functioning that are less susceptible to overt manipulation. While prior studies have explored the validity of physiological assessment of memory deficits, this study evaluates the effectiveness of a physiological measure of executive functioning. This study used EEG recording in conjunction with a three-stimulus oddball design to compare neural responses in simulated malingerers feigning cognitive deficits associated with traumatic brain injury (TBI) and controls. Specifically, the study explored the efficacy of an event-related potential (ERP) known as P3a, which is believed to be an index of frontal lobe executive processes, specifically the attentional orienting response. The results of this study demonstrated that simulated malingerers did not produce a P3a response that was significantly different from control participants. Furthermore, the P3a in simulated malingerers did not demonstrate any of the properties reported in prior studies with TBI patients. Not only were malingerers unable to produce a significant change in their basic orienting response, but the very process of attempting to employ additional strategies to appear impaired produced other physiological markers of deception. Therefore, the P3a component appeared to be unaffected by an individual's motivation or overt performance, which suggests that it may have potential for development as a physiological measure for differentiating between malingerers and those with genuine TBI.
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Affiliation(s)
- Steven Hoover
- The Graduate Center, The City University of New York, 365 Fifth Ave, New York, NY 10016, United States.
| | - Tina M Zottoli
- Department of Psychology, St. Joseph's College of New York, 245 Clinton Ave, Brooklyn, NY 11205, United States
| | - Jillian Grose-Fifer
- The Graduate Center, The City University of New York, 365 Fifth Ave, New York, NY 10016, United States; Department of Psychology, John Jay College of Criminal Justice, The City University of New York, 524 West 59th Street, New York, NY 10019, United States
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Van Rheenen TE, Rossell SL. Auditory-prosodic processing in bipolar disorder; from sensory perception to emotion. J Affect Disord 2013; 151:1102-7. [PMID: 24074483 DOI: 10.1016/j.jad.2013.08.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 08/30/2013] [Accepted: 08/30/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Accurate emotion processing is critical to understanding the social world. Despite growing evidence of facial emotion processing impairments in patients with bipolar disorder (BD), comprehensive investigations of emotional prosodic processing is limited. The existing (albeit sparse) literature is inconsistent at best, and confounded by failures to control for the effects of gender or low level sensory-perceptual impairments. The present study sought to address this paucity of research by utilizing a novel behavioural battery to comprehensively investigate the auditory-prosodic profile of BD. METHODS Fifty BD patients and 52 healthy controls completed tasks assessing emotional and linguistic prosody, and sensitivity for discriminating tones that deviate in amplitude, duration and pitch. RESULTS BD patients were less sensitive than their control counterparts in discriminating amplitude and durational cues but not pitch cues or linguistic prosody. They also demonstrated impaired ability to recognize happy intonations; although this was specific to male's with the disorder. The recognition of happy in the patient group was correlated with pitch and amplitude sensitivity in female patients only. LIMITATIONS The small sample size of patients after stratification by current mood state prevented us from conducting subgroup comparisons between symptomatic, euthymic and control participants to explicitly examine the effects of mood. CONCLUSIONS Our findings indicate the existence of a female advantage for the processing of emotional prosody in BD, specifically for the processing of happy. Although male BD patients were impaired in their ability to recognize happy prosody, this was unrelated to reduced tone discrimination sensitivity. This study indicates the importance of examining both gender and low order sensory perceptual capacity when examining emotional prosody.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Brain and Psychological Sciences Research Centre, Swinburne University, Melbourne, VIC 3122, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, VIC 3004, Australia.
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Chitty KM, Lagopoulos J, Lee RSC, Hickie IB, Hermens DF. A systematic review and meta-analysis of proton magnetic resonance spectroscopy and mismatch negativity in bipolar disorder. Eur Neuropsychopharmacol 2013; 23:1348-63. [PMID: 23968965 DOI: 10.1016/j.euroneuro.2013.07.007] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/16/2013] [Accepted: 07/26/2013] [Indexed: 12/15/2022]
Abstract
Aberrant glutamate neurotransmission has been implicated in the pathophysiology of bipolar disorder with accumulating evidence from imaging, post-mortem and pathology studies. Studies investigating in vivo changes to the glutamatergic system have not been as consistent and warrant clarification. Studies utilizing proton-magnetic resonance spectroscopy ((1)H-MRS) have reported increased levels of combined glutamate and glutamine ("Glx"), which have been linked to impairments in N-methyl-d-aspartate (NMDA) receptor function. Similarly, neurophysiological studies utilising mismatch negativity (MMN) as an index of NMDA receptor function, have reported impairments in bipolar disorder. Here, we provide a systematic review of the literature in regards to the concentration of Glx and the magnitude of MMN in bipolar disorder. Separate meta-analyses revealed that bipolar disorder was associated with increased Glx concentration and decreased MMN-both measured frontally. The current findings corroborate previous evidence indicating that bipolar disorder is characterized by a perturbed frontal glutamate system. These observed changes in bipolar disorder might manifest as impairments in neuronal-glial interactions that lead to disrupted neuronal output and ultimately result in the characteristic neurocognitive sequelae associated with this disorder.
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Affiliation(s)
- Kate M Chitty
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
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Maekawa T, Katsuki S, Kishimoto J, Onitsuka T, Ogata K, Yamasaki T, Ueno T, Tobimatsu S, Kanba S. Altered visual information processing systems in bipolar disorder: evidence from visual MMN and P3. Front Hum Neurosci 2013; 7:403. [PMID: 23898256 PMCID: PMC3724050 DOI: 10.3389/fnhum.2013.00403] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/09/2013] [Indexed: 12/13/2022] Open
Abstract
Objective: Mismatch negativity (MMN) and P3 are unique ERP components that provide objective indices of human cognitive functions such as short-term memory and prediction. Bipolar disorder (BD) is an endogenous psychiatric disorder characterized by extreme shifts in mood, energy, and ability to function socially. BD patients usually show cognitive dysfunction, and the goal of this study was to access their altered visual information processing via visual MMN (vMMN) and P3 using windmill pattern stimuli. Methods: Twenty patients with BD and 20 healthy controls matched for age, gender, and handedness participated in this study. Subjects were seated in front of a monitor and listened to a story via earphones. Two types of windmill patterns (standard and deviant) and white circle (target) stimuli were randomly presented on the monitor. All stimuli were presented in random order at 200-ms durations with an 800-ms inter-stimulus interval. Stimuli were presented at 80% (standard), 10% (deviant), and 10% (target) probabilities. The participants were instructed to attend to the story and press a button as soon as possible when the target stimuli were presented. Event-related potentials (ERPs) were recorded throughout the experiment using 128-channel EEG equipment. vMMN was obtained by subtracting standard from deviant stimuli responses, and P3 was evoked from the target stimulus. Results: Mean reaction times for target stimuli in the BD group were significantly higher than those in the control group. Additionally, mean vMMN-amplitudes and peak P3-amplitudes were significantly lower in the BD group than in controls. Conclusions: Abnormal vMMN and P3 in patients indicate a deficit of visual information processing in BD, which is consistent with their increased reaction time to visual target stimuli. Significance: Both bottom-up and top-down visual information processing are likely altered in BD.
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Affiliation(s)
- Toshihiko Maekawa
- Department of Neuropsychiatry, Faculty of Medical Sciences, Kyushu University Fukuoka, Japan ; Departments of Clinical Neurophysiology, Faculty of Medical Sciences, Kyushu University Fukuoka, Japan
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Korsnes MS, Lövdahl H, Andersson S, Björnerud A, Due-Tönnesen P, Endestad T, Malt UF. Working memory in recurrent brief depression: an fMRI pilot study. J Affect Disord 2013; 149:383-92. [PMID: 23510545 DOI: 10.1016/j.jad.2013.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 02/12/2013] [Accepted: 02/12/2013] [Indexed: 01/17/2023]
Abstract
BACKGROUND We examined women with recurrent brief depression (RBD) with and without episodes of hypomania with an n-back working memory paradigm to assess how working memory load affects the neurological network corresponding to working memory for these groups. METHOD Participants (n=33) were medication-free and mostly euthymic while performing a 1-back and a 2-back task in the fMRI scanner. Differential activation results between the tasks were assessed globally and within seven predefined regions of interest associated with working memory activation. The patient groups were compared with healthy women and matched for age, handedness, and length of education. RESULTS Poor task modulation was observed in both RBD groups in the prefrontal cortex (BA9) in the 1-back task and activation during the 2-back task, particularly in a subgroup with a history of brief hypomanic episodes (RBD-H) compared with the subgroup without such episodes (RBD-O). Task modulation in the right parahippocampal gyrus (BA27) distinguished the RBD-O group, and task modulation in the right insula clearly distinguished the RBD-H group. LIMITATIONS Small sample size and recruitment of most patients through media that may induce a selection bias towards better-functioning subjects. CONCLUSION The observed lack of deactivation within the right insula has also been reported in patients with bipolar I disorders. Activation differences in BA9 and the parahippocampal region between RBD patients with and without a history of hypomania suggest different functional hypersensitivity of early limbic regions and ability to sustain attention and working memory, respectively, possibly identifying functional differences between the two subgroups.
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Udal AH, Øygarden B, Egeland J, Malt UF, Løvdahl H, Pripp AH, Grøholt B. Executive deficits in early onset bipolar disorder versus ADHD: impact of processing speed and lifetime psychosis. Clin Child Psychol Psychiatry 2013; 18:284-99. [PMID: 22977268 DOI: 10.1177/1359104512455181] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Executive deficits are reported in both early onset bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD), and controversies regarding comorbidity and symptom overlap have complicated the research on executive function in BD. Reports of the negative impact of executive difficulties on academic functioning indicate a need for a greater focus on executive difficulties in early onset psychiatric disorders. Executive function and processing speed in youths with BD (n = 4), ADHD (n = 26) and BD + ADHD (n = 13) were compared with controls (n = 69). All clinical groups demonstrated executive impairment. The combined group was most impaired. There were no significant differences between the groups. Executive deficit in the BD group was associated with a history of psychotic symptoms. The BD-nonpsychotic group was impaired only with regard to processing speed. Processing speed adjustment improved working memory and normalized interference control in both BD and ADHD. CONCLUSION executive deficits in BD may be determined by a history of psychotic symptoms rather than by comorbid ADHD. Some aspects of executive problems appear speed-related.
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Changes in saccadic eye movement (SEM) and quantitative EEG parameter in bipolar patients. J Affect Disord 2013; 145:378-85. [PMID: 22832171 DOI: 10.1016/j.jad.2012.04.049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 04/25/2012] [Indexed: 12/22/2022]
Abstract
BACKGROUND There is increasing evidence that neurocognitive dysfunction is associated with the different states in Bipolar Disorder. Gamma coherence is strongly related to cognitive processes and cortico-cortical communication. This paper aims at shedding light on the relationship between cortical gamma coherence within bipolar patients and a control group during a prosaccadic attention task. We hypothesized that gamma coherence oscillations act as a main neural mechanism underlying information processing which changes in bipolar patients. METHOD Thirty-two (12 healthy controls and 20 bipolar patients) subjects were enrolled in this study. The subjects performed a prosaccadic attention task while their brain activity pattern was recorded using quantitative electroencephalography (20 channels). RESULTS We observed that the maniac group presented lower saccade latency when compared to depression and control groups. The main finding was a greater gamma coherence for control group in the right hemisphere of both frontal and motor cortices caused by the execution of a prosaccadic attention task. LIMITATIONS The findings need to be confirmed in larger samples and in bipolar patients before start the pharmacological treatment. CONCLUSIONS Our findings suggest a disrupted connection of the brain's entire functioning of maniac patients and represent a deregulation in cortical inhibitory mechanism. Thus, our results reinforce our hypothesis that greater gamma coherence in the right and left frontal cortices for the maniac group produces a "noise" during information processing and highlights that gamma coherence might be a biomarker for cognitive dysfunction during the manic state.
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Neurophysiological findings in patients with bipolar disorder. APPLICATION OF BRAIN OSCILLATIONS IN NEUROPSYCHIATRIC DISEASES - SELECTED PAPERS FROM “BRAIN OSCILLATIONS IN COGNITIVE IMPAIRMENT AND NEUROTRANSMITTERS” CONFERENCE, ISTANBUL, TURKEY, 29 APRIL–1 MAY 2011 2013; 62:197-206. [DOI: 10.1016/b978-0-7020-5307-8.00013-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Kaur M, Lagopoulos J, Ward PB, Watson TL, Naismith SL, Hickie IB, Hermens DF. Mismatch negativity/P3a complex in young people with psychiatric disorders: a cluster analysis. PLoS One 2012; 7:e51871. [PMID: 23251645 PMCID: PMC3522589 DOI: 10.1371/journal.pone.0051871] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 11/12/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We have recently shown that the event-related potential biomarkers, mismatch negativity (MMN) and P3a, are similarly impaired in young patients with schizophrenia- and affective-spectrum psychoses as well as those with bipolar disorder. A data driven approach may help to further elucidate novel patterns of MMN/P3a amplitudes that characterise distinct subgroups in patients with emerging psychiatric disorders. METHODS Eighty seven outpatients (16 to 30 years) were assessed: 19 diagnosed with a depressive disorder; 26 with a bipolar disorder; and 42 with a psychotic disorder. The MMN/P3a complex was elicited using a two-tone passive auditory oddball paradigm with duration deviant tones. Hierarchical cluster analysis utilising frontal, central and temporal neurophysiological variables was conducted. RESULTS Three clusters were determined: the 'globally impaired' cluster (n = 53) displayed reduced frontal and temporal MMN as well as reduced central P3a amplitudes; the 'largest frontal MMN' cluster (n = 17) were distinguished by increased frontal MMN amplitudes and the 'largest temporal MMN' cluster (n = 17) was characterised by increases in temporal MMN only. Notably, 55% of those in the globally impaired cluster were diagnosed with schizophrenia-spectrum disorder, whereas the three patient subgroups were equally represented in the remaining two clusters. The three cluster-groups did not differ in their current symptomatology; however, the globally impaired cluster was the most neuropsychologically impaired, compared with controls. CONCLUSIONS These findings suggest that in emerging psychiatric disorders there are distinct MMN/P3a profiles of patient subgroups independent of current symptomatology. Schizophrenia-spectrum patients tended to show the most global impairments in this neurophysiological complex. Two other subgroups of patients were found to have neurophysiological profiles suggestive of quite different neurobiological (and hence, treatment) implications.
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Affiliation(s)
- Manreena Kaur
- Clinical Research Unit, Brain and Mind Research Institute, University of Sydney, Sydney, Australia.
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Ha TH, Kim JS, Chang JS, Oh SH, Her JY, Cho HS, Park TS, Shin SY, Ha K. Verbal and Visual Memory Impairments in Bipolar I and II Disorder. Psychiatry Investig 2012; 9:339-46. [PMID: 23251197 PMCID: PMC3521109 DOI: 10.4306/pi.2012.9.4.339] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 10/07/2012] [Accepted: 10/07/2012] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To compare verbal and visual memory performances between patients with bipolar I disorder (BD I) and patients with bipolar II disorder (BD II) and to determine whether memory deficits were mediated by impaired organizational strategies. METHODS Performances on the Korean-California Verbal Learning Test (K-CVLT) and the Rey-Osterrieth Complex Figure Test (ROCF) in 37 patients with BD I, 46 patients with BD II and 42 healthy subjects were compared. Mediating effects of impaired organization strategies on poor delayed recall was tested by comparing direct and mediated models using multiple regression analysis. RESULTS Both patients groups recalled fewer words and figure components and showed lower Semantic Clustering compared to controls. Verbal memory impairment was partly mediated by difficulties in Semantic Clustering in both subtypes, whereas the mediating effect of Organization deficit on the visual memory impairment was present only in BD I. In all mediated models, group differences in delayed recall remained significant. CONCLUSION Our findings suggest that memory impairment may be one of the fundamental cognitive deficits in bipolar disorders and that executive dysfunctions can exert an additional influence on memory impairments.
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Affiliation(s)
- Tae Hyon Ha
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Sun Kim
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Seung Chang
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung Hee Oh
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ju Young Her
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun Sang Cho
- Department of Psychiatry, Severance Mental Health Hospital, Gwangju, Republic of Korea
| | - Tae Sung Park
- Department of Statistics, Seoul National University, Seoul, Republic of Korea
| | - Soon Young Shin
- Institute of Biomedical Science and Technology, Konkuk University Hospital, Seoul, Republic of Korea
| | - Kyooseob Ha
- Mood Disorders Clinic & Clinical Affective Neuroscience Laboratory, Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine and Institute for Human Behavioral Medicine, Seoul, Republic of Korea
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Kaur M, Battisti RA, Lagopoulos J, Ward PB, Hickie IB, Hermens DF. Neurophysiological biomarkers support bipolar-spectrum disorders within psychosis cluster. J Psychiatry Neurosci 2012; 37:313-21. [PMID: 22469054 PMCID: PMC3447130 DOI: 10.1503/jpn.110081] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Mismatch negativity (MMN) and P3a are event-related potentials that index deviance detection and the orienting response, respectively. We have previously shown that the MMN/P3a complex is impaired in patients with schizophrenia and affective spectrum psychoses, which suggests that it may index a common pathophysiology and argues against the purported specificity in schizophrenia. Further research is warranted to determine whether patients with bipolar-spectrum disorders show similar impairments in these biomarkers. METHODS We assessed patients aged 15-30 years with early schizophrenia-spectrum disorders (schizophrenia, schizoaffective disorder, schizophreniform disorder), early bipolar-spectrum disorders (bipolar I or II, with and without psychotic features) and healthy, matched controls. We acquired MMN/P3a amplitudes during a 2-tone, auditory paradigm with 8% duration deviants. Clinical, psychosocial and neuro psychological assessments were also undertaken. RESULTS We included 20 patients with schizophrenia-spectrum disorders, 20 with bipolar-spectrum disorders and 20 controls in our study. Both patient groups showed significantly reduced frontocentral MMN and central P3a amplitudes. The schizophrenia-spectrum group had additional impairments in left temporal MMN and frontal P3a. Both patient groups performed worse than controls across psychosocial and clinical measures; however, only the schizophrenia-spectrum group performed significantly worse than controls for cognitive measures. Correlational analyses between patient groups revealed associations between frontocentral or left temporal MMN and psychiatric symptomatology or quality of life measures. LIMITATIONS Limitations to our study include the modest sample size and the lack of control with regards to the effects of other (i.e., nonantipsychotic) psychotropic medications. CONCLUSION Compared with patients in early stages of schizophrenia-spectrum disorders, those in the early stages of bipolar-spectrum disorders are similarly impaired in established biomarkers for schizophrenia. These findings support a shared diathesis model for psychotic and bipolar disorders. Furthermore, MMN/P3a may be a biomarker for a broader pathophysiology that overlaps traditional diagnostic clusters.
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Affiliation(s)
- Manreena Kaur
- Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Sydney, Australia.
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Domján N, Csifcsák G, Drótos G, Janka Z, Szendi I. Different patterns of auditory information processing deficits in chronic schizophrenia and bipolar disorder with psychotic features. Schizophr Res 2012; 139:253-9. [PMID: 22717275 DOI: 10.1016/j.schres.2012.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 03/28/2012] [Accepted: 06/01/2012] [Indexed: 12/20/2022]
Abstract
With the development of DSM-V and ICD-11 the definitions of psychiatric disorders are under re-evaluation. The emphasis is shifted from distinct disorders to clusters defined not only by symptomatology, but also by underlying neurobiology and cognitive deficits. Bipolar disorder I (BD-I) and schizophrenia (SZ) are of special interest since their differential diagnosis is often problematic and they partially overlap in measures ranging from genetics to neurophysiology. Event-related potentials (ERPs) are one of the most studied factors but the results are still controversial, primarily in BD-I, where ERPs reflecting different stages of auditory information processing have been much less investigated. In this study, we aimed at investigating the changes of five auditory event-related potentials (P50 and N100 suppression, duration and pitch deviant mismatch negativity (MMN) and P3b) in 20 SZ and 20 BD-I patients with a history of psychosis and 21 healthy control subjects. Our data revealed substantial differences between the two patient groups. Only patients with SZ demonstrated impaired N100 suppression, shorter duration deviant MMN latency and attenuated P3b amplitude, while prolonged pitch deviant MMN latency was found to be characteristic of the BD-I group. No shared ERP abnormalities were observed among the patient groups. Our results indicate that SZ and BD-I are characterized by highly different neurophysiological profiles when measured in the same laboratory setting.
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Affiliation(s)
- Nóra Domján
- Department of Psychiatry, Faculty of Medicine, Albert Szent-Györgyi Medical and Pharmaceutical Center, University of Szeged, Kálvária sgt. 57., 6725 Szeged, Hungary.
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Jahshan C, Wynn JK, Mathis KI, Altshuler L, Glahn DC, Green MF. Cross-diagnostic comparison of duration mismatch negativity and P3a in bipolar disorder and schizophrenia. Bipolar Disord 2012; 14:239-48. [PMID: 22548897 PMCID: PMC3342839 DOI: 10.1111/j.1399-5618.2012.01008.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Bipolar disorder and schizophrenia share common pathophysiological processes and may have similar perceptual abnormalities. Mismatch negativity (MMN) and P3a - event-related potentials associated with auditory preattentional processing - have been extensively studied in schizophrenia, but rarely in bipolar disorder. Furthermore, MMN and P3a have not been examined between diagnostic subgroups of patients with bipolar disorder. We evaluated MMN and P3a in patients with bipolar disorder compared to patients with schizophrenia and healthy controls. METHODS MMN and P3a were assessed in 52 bipolar disorder patients, 30 schizophrenia patients, and 27 healthy control subjects during a duration-deviant auditory oddball paradigm. RESULTS Significant MMN and P3a amplitude reductions were present in patients with bipolar disorder and schizophrenia relative to controls. The MMN reduction was more prominent in patients with schizophrenia than bipolar disorder, at a trend level. P3a did not differ significantly between patient groups. There were no MMN or P3a differences between patients with bipolar I (n = 34) and bipolar II (n = 18) disorder. Patients with bipolar I disorder failed to show lateralized MMN, in contrast to the other groups. No MMN or P3a differences were found between patients with bipolar disorder taking (n = 12) and not taking (n = 40) lithium, as well as between those taking (n = 30) and not taking (n = 22) antipsychotic medications. CONCLUSIONS Patients with bipolar disorder showed deficits in preattentive auditory processing, including MMN deficits that are less severe and P3a deficits that are slightly more pronounced, than those seen in schizophrenia.
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Affiliation(s)
- Carol Jahshan
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
| | - Jonathan K. Wynn
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA,Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA
| | - Kristopher I. Mathis
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Lori Altshuler
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA,Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA
| | - David C. Glahn
- Olin Neuropsychiatry Research Center, Institute of Living, Yale University School of Medicine, New Haven, CT, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Michael F. Green
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA,Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA
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Lin YT, Liu CM, Chiu MJ, Liu CC, Chien YL, Hwang TJ, Jaw FS, Shan JC, Hsieh MH, Hwu HG. Differentiation of schizophrenia patients from healthy subjects by mismatch negativity and neuropsychological tests. PLoS One 2012; 7:e34454. [PMID: 22496807 PMCID: PMC3320618 DOI: 10.1371/journal.pone.0034454] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 02/28/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Schizophrenia is a heterogeneous disorder with diverse presentations. The current and the proposed DSM-V diagnostic system remains phenomenologically based, despite the fact that several neurobiological and neuropsychological markers have been identified. A multivariate approach has better diagnostic utility than a single marker method. In this study, the mismatch negativity (MMN) deficit of schizophrenia was first replicated in a Han Chinese population, and then the MMN was combined with several neuropsychological measurements to differentiate schizophrenia patients from healthy subjects. METHODOLOGY/PRINCIPAL FINDINGS 120 schizophrenia patients and 76 healthy controls were recruited. Each subject received examinations for duration MMN, Continuous Performance Test, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale Third Edition (WAIS-III). The MMN was compared between cases and controls, and important covariates were investigated. Schizophrenia patients had significantly reduced MMN amplitudes, and MMN decreased with increasing age in both patient and control groups. None of the neuropsychological indices correlated with MMN. Predictive multivariate logistic regression models using the MMN and neuropsychological measurements as predictors were developed. Four predictors, including MMN at electrode FCz and three scores from the WAIS-III (Arithmetic, Block Design, and Performance IQ) were retained in the final predictive model. The model performed well in differentiating patients from healthy subjects (percentage of concordant pairs: 90.5%). CONCLUSIONS/SIGNIFICANCE MMN deficits were found in Han Chinese schizophrenia patients. The multivariate approach combining biomarkers from different modalities such as electrophysiology and neuropsychology had a better diagnostic utility.
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Affiliation(s)
- Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Ming-Jang Chiu
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Fu-Shan Jaw
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Jia-Chi Shan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Dou-Liou City, Yun-Lin, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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Solé B, Bonnin CM, Torrent C, Balanzá-Martínez V, Tabarés-Seisdedos R, Popovic D, Martínez-Arán A, Vieta E. Neurocognitive impairment and psychosocial functioning in bipolar II disorder. Acta Psychiatr Scand 2012; 125:309-17. [PMID: 21848702 DOI: 10.1111/j.1600-0447.2011.01759.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is a growing body of evidence on neurocognitive impairment in euthymic bipolar patients, but this issue has been studied mostly in bipolar I disorder, data on bipolar II (BD-II) are scant and discrepant. The two aims of this study were to ascertain whether strictly defined euthymic BD-II patients would present neurocognitive disturbances and to evaluate their impact on functional outcome. METHOD Forty-three BD-II patients and 42 demographically and educationally matched healthy subjects were assessed with a comprehensive neuropsychological test battery and with the Social and Occupational Functioning Assessment Scale (SOFAS). The euthymia criteria were reduced (Hamilton Rating Scale for Depression score ≤6 and a Young Mania Rating Scale score ≤6) to minimize the influence of subdepressive symptomatology on cognition and functioning. RESULTS BD-II patients showed a significantly lower performance on several measures of attention, learning and verbal memory, and executive function compared with healthy controls. The presence of subthreshold depressive symptomatology and one measure related to executive function (Trail Making Test, part B) was the variables that best predicted psychosocial functioning measured with the SOFAS. CONCLUSION This report provides further evidence that euthymic BD-II patients present cognitive impairment which may impact psychosocial functioning.
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Affiliation(s)
- B Solé
- Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Spain
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Bowirrat A, Chen TJH, Oscar-Berman M, Madigan M, Chen AL, Bailey JA, Braverman ER, Kerner M, Giordano J, Morse S, Downs BW, Waite RL, Fornari F, Armaly Z, Blum K. Neuropsychopharmacology and neurogenetic aspects of executive functioning: should reward gene polymorphisms constitute a diagnostic tool to identify individuals at risk for impaired judgment? Mol Neurobiol 2012; 45:298-313. [PMID: 22371275 DOI: 10.1007/s12035-012-8247-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 02/08/2012] [Indexed: 12/25/2022]
Abstract
Executive functions are processes that act in harmony to control behaviors necessary for maintaining focus and achieving outcomes. Executive dysfunction in neuropsychiatric disorders is attributed to structural or functional pathology of brain networks involving prefrontal cortex (PFC) and its connections with other brain regions. The PFC receives innervations from different neurons associated with a number of neurotransmitters, especially dopamine (DA). Here we review findings on the contribution of PFC DA to higher-order cognitive and emotional behaviors. We suggest that examination of multifactorial interactions of an individual's genetic history, along with environmental risk factors, can assist in the characterization of executive functioning for that individual. Based upon the results of genetic studies, we also propose genetic mapping as a probable diagnostic tool serving as a therapeutic adjunct for augmenting executive functioning capabilities. We conclude that preservation of the neurological underpinnings of executive functions requires the integrity of complex neural systems including the influence of specific genes and associated polymorphisms to provide adequate neurotransmission.
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Affiliation(s)
- Abdalla Bowirrat
- Clinical Neuroscience and Population Genetics, The Nazareth English Hospital (EMME), 16100 Nazareth, Israel.
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Torres I, Solé B, Vieta E, Martinez-Aran A. Neurocognitive impairment in the bipolar spectrum. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/npy.12.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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The mismatch negativity (MMN)--a unique window to disturbed central auditory processing in ageing and different clinical conditions. Clin Neurophysiol 2011; 123:424-58. [PMID: 22169062 DOI: 10.1016/j.clinph.2011.09.020] [Citation(s) in RCA: 268] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/16/2011] [Accepted: 09/20/2011] [Indexed: 12/14/2022]
Abstract
In this article, we review clinical research using the mismatch negativity (MMN), a change-detection response of the brain elicited even in the absence of attention or behavioural task. In these studies, the MMN was usually elicited by employing occasional frequency, duration or speech-sound changes in repetitive background stimulation while the patient was reading or watching videos. It was found that in a large number of different neuropsychiatric, neurological and neurodevelopmental disorders, as well as in normal ageing, the MMN amplitude was attenuated and peak latency prolonged. Besides indexing decreased discrimination accuracy, these effects may also reflect, depending on the specific stimulus paradigm used, decreased sensory-memory duration, abnormal perception or attention control or, most importantly, cognitive decline. In fact, MMN deficiency appears to index cognitive decline irrespective of the specific symptomatologies and aetiologies of the different disorders involved.
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