Article

Preliminary evidence for increased frontosubcortical activation on a motor impulsivity task in mixed episode bipolar disorder

Division of Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH 45267–0583, USA.
Journal of Affective Disorders (Impact Factor: 3.71). 05/2011; 133(1-2):333-9. DOI: 10.1016/j.jad.2011.03.053
Source: PubMed

ABSTRACT Of all mood states, patients in mixed episodes of bipolar disorder are at the greatest risk for impulsive behaviors including attempted suicide. The aim of this study was to examine whether the neural correlates of motor impulsivity are distinct in patients with mixed mania.
Ten patients with bipolar disorder in a mixed episode (BP-M), 10 bipolar comparison participants in a depressed episode (BP-D), and 10 healthy comparison (HC) participants underwent functional MRI while performing a Go/No-Go task of motor impulsivity.
Both patient groups had elevated, self-rated motor impulsiveness scores. The BP-M group also had a trend-level increase in commission errors relative to the HC group on the Go/No-Go task. While the full sample strongly activated a ventrolateral prefrontal-subcortical brain network, the BP-M group activated the amygdala and frontal cortex more strongly than the HC group, and the thalamus, cerebellum, and frontal cortex more strongly than the BP-D group.
This study is primarily limited by a relatively small sample size.
Higher commission error rates on the Go/No-Go task suggest increased vulnerability to impulsive responding during mixed episodes of bipolar disorder. Moreover, the distinct pattern of increased brain activation during mixed mania may indicate a connection between behavioral impulsivity and a failure of neurophysiological "inhibition", especially in the amygdala.

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Available from: Michelle Durling, May 23, 2014
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    • "BDII Mixture of mood states Yes Not an exclusion, but details not provided Not provided Yes, current AAO 19.6 (4.0) 8 [4e99] GNG Comparable Welander-Vatn et al., 2013 24 (14) 24 (11) 35.6 (11.3) 34.5 (9.4) BDI Mixture of mood states Yes Yes Not provided Yes, current AAO 23.8 (9.5) Median 6.5 GNG Slower response times and more errors in BD Wessa et al., 2007 17 (7) 17 (6) 44.9 (12.7) 44.9 (11.4) BDI, II Euthymic Yes Yes Not provided No current 21.9 (12.7) Not provided GNG Comparable T. Hajek et al. / Journal of Psychiatric Research 47 (2013) 1955e1966 2003b; Cerullo et al., 2009; Deveney et al., 2012a; Diler et al., 2013; Elliott et al., 2004; Fleck et al., 2011; Frangou, 2012; Hummer et al., 2013; Kaladjian et al., 2009b; Kronhaus et al., 2006; Lagopoulos and Malhi, 2007; Malhi et al., 2005; Mazzola- Pomietto et al., 2009; McIntosh et al., 2008b; Nelson et al., 2007; Passarotti et al., 2010a, 2010b; Pavuluri et al., 2010; Roberts et al., 2013; Roth et al., 2006; Singh et al., 2010; Strakowski et al., 2005, 2008; Townsend et al., 2012; Weathers et al., 2012; Welander-Vatn et al., 2009, 2013; Wessa et al., 2007 "
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