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Little B, Anwyll M, Norsworthy L, Corbett L, Schultz-Froggatt M, Gallagher P. Processing speed and sustained attention in bipolar disorder and major depressive disorder: A systematic review and meta-analysis. Bipolar Disord 2024; 26:109-128. [PMID: 37973384 DOI: 10.1111/bdi.13396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Cognitive impairment is a core feature of bipolar disorder (BD) and major depressive disorder (MDD). Deficits in processing speed (PS) and sustained attention (SA) may be particularly impaired and may underpin a broader profile of deficits, however current knowledge of the nature of these impairments is limited by heterogeneous results in the literature. Few reviews to date have attempted to disentangle sources of heterogeneity to assess the presence and magnitude of impairments in PS and SA in BD and MDD. METHODS One hundred and three studies were reviewed to examine performance in tests of PS and SA in BD (n = 3452) and MDD (n = 5461) compared to healthy controls (n = 8016). Neuropsychological methodology used in the literature was summarised. Data were meta-analysed to assess impairments in PS and SA for each neuropsychological test separately. Subgroup analysis was performed across mood states to investigate sources of heterogeneity. RESULTS Impairments were found across most neuropsychological tests, with small to large effect sizes for BD (range: d = 0.19-0.96) and MDD (range: d = 0.29-0.86). Impairments were present in symptomatic states and euthymia in most cases. Some outcome measures were not impaired in euthymia. Heterogeneity was observed for most neuropsychological tests and remained after separating by mood state. There inadequate data to meta-analyse some outcome measures, particularly for symptomatic groups. CONCLUSION Impairments in PS and SA in BD and MDD can be observed across most neuropsychological tests. Future research should further investigate the nature of these impairments across mood states, controlling for clinical confounds.
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Affiliation(s)
- Bethany Little
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- CNNP Lab, Interdisciplinary Computing and Complex BioSystems Group, School of Computing, Newcastle University, Newcastle upon Tyne, UK
| | - Megan Anwyll
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Norsworthy
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Corbett
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mia Schultz-Froggatt
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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2
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Zurlo MC, Ruggiero M. Assessing Pragmatic Language Skills in Adults with Major Depressive Disorder: An Exploratory Study. Psychopathology 2021; 54:78-91. [PMID: 33690229 DOI: 10.1159/000513270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 11/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There is increasing evidence that major depressive disorder (MDD) is associated with significant pragmatic language impairments. However, there is a lack of studies that use standardized tools and simultaneously investigate all pragmatic language skills among MDD patients. The aim of this study was to propose a more thorough investigation of all pragmatic language skills in patients with MDD. METHODS Twenty adults (aged 22-65) with a DSM-5 diagnosis of MDD were assessed using BLED Santa Lucia (Batteria sul Linguaggio dell'Emisfero Destro Santa Lucia), a battery designed to evaluate pragmatic language skills (comprehension of inferences, of picture and written metaphors, of indirect requests, of humoristic expressions, and of prosody). The performance of the MDD participants on all BLED Santa Lucia subscales was compared to 20 healthy control subjects (aged 20-60) matched for gender, age, years of education, and employment status. RESULTS MDD patients performed poorer than controls in comprehension of inferences (p < 0.01), picture metaphors (p < 0.001), written metaphors (p < 0.001), indirect requests (p < 0.01), humoristic expression (p < 0.05), and prosody (p < 0.05). CONCLUSIONS All pragmatic language skills can be significantly impaired in MDD patients. A valid assessment of all pragmatic language skills can allow, for each patient, the definition of a specific profile of risk and protective factors before and during psychotherapy.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy,
| | - Maura Ruggiero
- Department of Humanities, University of Naples Federico II, Naples, Italy
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3
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Kauschke C, Mueller N, Kircher T, Nagels A. Do Patients With Depression Prefer Literal or Metaphorical Expressions for Internal States? Evidence From Sentence Completion and Elicited Production. Front Psychol 2018; 9:1326. [PMID: 30158885 PMCID: PMC6103481 DOI: 10.3389/fpsyg.2018.01326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022] Open
Abstract
In everyday communication metaphoric expressions are frequently used to refer to abstract concepts, such as feelings or mental states. Patients with depression are said to prefer literal over figurative language, i.e. they may show a concreteness bias. Given that both emotional functioning and the processing of figurative language may be altered in this clinical population, our study aims at investigating whether and how these dysfunctions are reflected in the understanding and production of metaphorical expressions for internal states. We used two behavioral approaches: a sentence completion task and elicited speech production. In the first experiment, patients with ICD 10 depression (n = 26) and healthy controls (n = 32) were asked to complete sentences by selecting an appropriate word out of four alternatives (metaphorical expression, literal expression, concrete distractor, abstract distractor). All participants–irrespective of the presence of depression–chose more literal (60%) than metaphorical (40%) expressions. In the second experiment, patients with depression (n = 44) and healthy controls (n = 36) described pictures showing emotive events. The descriptions were transcribed and coded for type of expression (non-figurative words for internal states vs. metaphorical expressions, valence, type of metaphor, source and target domain of metaphor). In addition, the Thought and Language Index was applied to assess formal thought disorder. When talking about internal states, both groups used more literal than metaphorical expressions. The groups did not differ with respect to the composition of internal state language, but patients with depression tended to verbalize positive content to a lesser extent. Correlation analyses within the patients' group revealed that signs of disorganization in their speech were related to a higher use of internal state expressions, whereas a negative correlation was found with dysregulation phenomena. Taken together, results indicate that people with and without depression prefer literal means in order to verbalize internal states, but they additionally make use of figurative language. Since patients with depression were able to understand and produce metaphors for internal states similar to controls, the concreteness bias cannot be confirmed by the present study. The results contribute to existing research by demonstrating associations between symptoms of formal thought disorder and internal state language.
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Affiliation(s)
- Christina Kauschke
- Clinical Linguistics, Department of German Linguistics, University of Marburg, Marburg, Germany
| | - Nadine Mueller
- Clinical Linguistics, Department of German Linguistics, University of Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Arne Nagels
- General Linguistics, Department of English and Linguistics, Johannes Gutenberg University Mainz, Mainz, Germany
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4
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Nostro AD, Müller VI, Reid AT, Eickhoff SB. Correlations Between Personality and Brain Structure: A Crucial Role of Gender. Cereb Cortex 2018; 27:3698-3712. [PMID: 27390020 DOI: 10.1093/cercor/bhw191] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 05/27/2016] [Indexed: 11/14/2022] Open
Abstract
Previous studies have shown that males and females differ in personality and gender differences have also been reported in brain structure. However, effects of gender on this "personality-brain" relationship are yet unknown. We therefore investigated if the neural correlates of personality differ between males and females. Whole brain voxel-based morphometry was used to investigate the influence of gender on associations between NEO FFI personality traits and gray matter volume (GMV) in a matched sample of 182 males and 182 females. In order to assess associations independent of and dependent on gender, personality-GMV relationships were tested across the entire sample and separately for males and females. There were no significant correlations between any personality scale and GMV in the analyses across the entire sample. In contrast, significant associations with GMV were detected for neuroticism, extraversion, and conscientiousness only in males. Interestingly, GMV in left precuneus/parieto-occipital sulcus correlated with all 3 traits. Thus, our results indicate that brain structure-personality relationships are highly dependent on gender, which might be attributable to hormonal interplays or differences in brain organization between males and females. Our results thus provide possible neural substrates of personality-behavior relationships and underline the important role of gender in these associations.
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Affiliation(s)
- Alessandra D Nostro
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Düsseldorf, Universitätstraße 1, 40225 Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany
| | - Veronika I Müller
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Düsseldorf, Universitätstraße 1, 40225 Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany
| | - Andrew T Reid
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany
| | - Simon B Eickhoff
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University Düsseldorf, Universitätstraße 1, 40225 Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany
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Cottle JE, Hall EE, Patel K, Barnes KP, Ketcham CJ. Concussion Baseline Testing: Preexisting Factors, Symptoms, and Neurocognitive Performance. J Athl Train 2017; 52:77-81. [PMID: 28071936 DOI: 10.4085/1062-6050-51.12.21] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Neurocognitive test scores are often considered an important aspect of concussion management. To best use these data, clinicians must understand potential factors that may influence baseline performance on these tests. OBJECTIVE To determine preexisting factors that may influence performance on the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 486 National Collegiate Athletic Association Division I collegiate student-athletes. MAIN OUTCOME MEASURE(S) To determine neurocognitive functioning and total symptom score at baseline, ImPACT was administered. Outcomes were verbal memory, visual memory, visual motor speed, reaction time, and total symptom score. A self-report demographic section at the beginning of ImPACT was used to gather information concerning previous treatment for headaches, migraines, and psychiatric conditions; diagnosis of attention-deficit/hyperactivity disorder; and exposure to previous strenuous exercise. We conducted multivariate analyses of variance to determine if the ImPACT composite and total symptom scores differed according to preexisting factors (P < .0083). RESULTS Sex showed an effect on verbal memory (P = .001), visual motor speed (P < .001), and reaction time (P = .006), with women performing better than men. A previous diagnosis of attention-deficit/hyperactivity disorder affected visual motor speed (P = .008). Previous treatment for headaches (P < .001), migraines (P = .001), a psychiatric condition (P < .001), or a diagnosis of attention-deficit/hyperactivity disorder (P < .001) all showed effects on the total symptom score. Strenuous exercise did not affect neurocogntive performance or total symptom score. CONCLUSIONS Based on our findings and the previous literature, we suggest that many preexisting factors influence baseline neurocognitive data. Baseline testing is an important aspect of concussion management. Sports medicine professionals should be cognizant of these factors when developing concussion-management protocols.
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Affiliation(s)
| | - Eric E Hall
- Department of Exercise Science, Elon University, NC
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Müller VI, Cieslik EC, Serbanescu I, Laird AR, Fox PT, Eickhoff SB. Altered Brain Activity in Unipolar Depression Revisited: Meta-analyses of Neuroimaging Studies. JAMA Psychiatry 2017; 74:47-55. [PMID: 27829086 PMCID: PMC5293141 DOI: 10.1001/jamapsychiatry.2016.2783] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE During the past 20 years, numerous neuroimaging experiments have investigated aberrant brain activation during cognitive and emotional processing in patients with unipolar depression (UD). The results of those investigations, however, vary considerably; moreover, previous meta-analyses also yielded inconsistent findings. OBJECTIVE To readdress aberrant brain activation in UD as evidenced by neuroimaging experiments on cognitive and/or emotional processing. DATA SOURCES Neuroimaging experiments published from January 1, 1997, to October 1, 2015, were identified by a literature search of PubMed, Web of Science, and Google Scholar using different combinations of the terms fMRI (functional magnetic resonance imaging), PET (positron emission tomography), neural, major depression, depression, major depressive disorder, unipolar depression, dysthymia, emotion, emotional, affective, cognitive, task, memory, working memory, inhibition, control, n-back, and Stroop. STUDY SELECTION Neuroimaging experiments (using fMRI or PET) reporting whole-brain results of group comparisons between adults with UD and healthy control individuals as coordinates in a standard anatomic reference space and using an emotional or/and cognitive challenging task were selected. DATA EXTRACTION AND SYNTHESIS Coordinates reported to show significant activation differences between UD and healthy controls during emotional or cognitive processing were extracted. By using the revised activation likelihood estimation algorithm, different meta-analyses were calculated. MAIN OUTCOMES AND MEASURES Meta-analyses tested for brain regions consistently found to show aberrant brain activation in UD compared with controls. Analyses were calculated across all emotional processing experiments, all cognitive processing experiments, positive emotion processing, negative emotion processing, experiments using emotional face stimuli, experiments with a sex discrimination task, and memory processing. All meta-analyses were calculated across experiments independent of reporting an increase or decrease of activity in major depressive disorder. For meta-analyses with a minimum of 17 experiments available, separate analyses were performed for increases and decreases. RESULTS In total, 57 studies with 99 individual neuroimaging experiments comprising in total 1058 patients were included; 34 of them tested cognitive and 65 emotional processing. Overall analyses across cognitive processing experiments (P > .29) and across emotional processing experiments (P > .47) revealed no significant results. Similarly, no convergence was found in analyses investigating positive (all P > .15), negative (all P > .76), or memory (all P > .48) processes. Analyses that restricted inclusion of confounds (eg, medication, comorbidity, age) did not change the results. CONCLUSIONS AND RELEVANCE Inconsistencies exist across individual experiments investigating aberrant brain activity in UD and replication problems across previous neuroimaging meta-analyses. For individual experiments, these inconsistencies may relate to use of uncorrected inference procedures, differences in experimental design and contrasts, or heterogeneous clinical populations; meta-analytically, differences may be attributable to varying inclusion and exclusion criteria or rather liberal statistical inference approaches.
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Affiliation(s)
- Veronika I. Müller
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany2Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Edna C. Cieslik
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany2Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Ilinca Serbanescu
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Angela R. Laird
- Department of Physics, Florida International University, Miami
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio5Research Service, South Texas Veterans Administration Medical Center, San Antonio6State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Simon B. Eickhoff
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany2Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
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7
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Poeppl TB, Müller VI, Hoffstaedter F, Bzdok D, Laird AR, Fox PT, Langguth B, Rupprecht R, Sorg C, Riedl V, Goya-Maldonado R, Gruber O, Eickhoff SB. Imbalance in subregional connectivity of the right temporoparietal junction in major depression. Hum Brain Mapp 2016; 37:2931-42. [PMID: 27090056 DOI: 10.1002/hbm.23217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 03/09/2016] [Accepted: 04/05/2016] [Indexed: 11/11/2022] Open
Abstract
Major depressive disorder (MDD) involves impairment in cognitive and interpersonal functioning. The right temporoparietal junction (RTPJ) is a key brain region subserving cognitive-attentional and social processes. Yet, findings on the involvement of the RTPJ in the pathophysiology of MDD have so far been controversial. Recent connectivity-based parcellation data revealed a topofunctional dualism within the RTPJ, linking its anterior and posterior part (aRTPJ/pRTPJ) to antagonistic brain networks for attentional and social processing, respectively. Comparing functional resting-state connectivity of the aRTPJ and pRTPJ in 72 MDD patients and 76 well-matched healthy controls, we found a seed (aRTPJ/pRTPJ) × diagnosis (MDD/controls) interaction in functional connectivity for eight regions. Employing meta-data from a large-scale neuroimaging database, functional characterization of these regions exhibiting differentially altered connectivity with the aRTPJ/pRTPJ revealed associations with cognitive (dorsolateral prefrontal cortex, parahippocampus) and behavioral (posterior medial frontal cortex) control, visuospatial processing (dorsal visual cortex), reward (subgenual anterior cingulate cortex, medial orbitofrontal cortex, posterior cingulate cortex), as well as memory retrieval and social cognition (precuneus). These findings suggest that an imbalance in connectivity of subregions, rather than disturbed connectivity of the RTPJ as a whole, characterizes the connectional disruption of the RTPJ in MDD. This imbalance may account for key symptoms of MDD in cognitive, emotional, and social domains. Hum Brain Mapp 37:2931-2942, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Veronika I Müller
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Felix Hoffstaedter
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Danilo Bzdok
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Parietal team, INRIA, Neurospin, Gif-sur-Yvette, France.,Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany.,JARA-BRAIN, RWTH Aachen and Research Centre Jülich, Aachen and Jülich, Germany
| | - Angela R Laird
- Department of Physics, Florida International University, Miami, Florida
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center, San Antonio, Texas
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Christian Sorg
- Department of Neuroradiology, Technische Universität München, Munich, Germany.,Department of Psychiatry and Psychotherapy, Technische Universität München, Munich, Germany.,Department of Nuclear Medicine, Technische Universität München, Munich, Germany
| | - Valentin Riedl
- Department of Neuroradiology, Technische Universität München, Munich, Germany.,Department of Nuclear Medicine, Technische Universität München, Munich, Germany.,Neuroimaging Center, Technische Universität München, Munich, Germany.,Department of Neurology, Technische Universität München, Munich, Germany
| | - Roberto Goya-Maldonado
- Center for Translational Research in Systems Neuroscience and Psychiatry, Georg August University, Göttingen, Germany
| | - Oliver Gruber
- Center for Translational Research in Systems Neuroscience and Psychiatry, Georg August University, Göttingen, Germany
| | - Simon B Eickhoff
- Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Düsseldorf, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
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