State- and trait-related deficits in sustained attention in bipolar disorder

University of Cambridge, Cambridge, England, United Kingdom
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.36). 05/2004; 254(2):61-8. DOI: 10.1007/s00406-004-0460-y
Source: PubMed

ABSTRACT Investigation of neuropsychological functioning in bipolar disorder provides a potential link from the prominent cognitive symptoms of the disorder to the underlying neural mechanisms. Continuous performance measures of sustained attention have yielded consistent findings in bipolar disorder patients. There are impairments that appear to be both state- and trait-related. Impaired target detection may represent one of the most sensitive markers of illness course in bipolardisorder. It is unrelated to residual mood symptomatology and medication status, and is present in patients with good functional recovery. The impairment in target detection is exacerbated in the manic state, and is accompanied by an increased rate of false responding. Sustained attention deficit is present early in the course of the disorder, but becomes more pronounced with repeated episodes. This cognitive profile, of an early-onset, state-modulated, trait marker, is distinct from the profile of attentional disruption seen in schizophrenia or unipolar depression. The state- and trait-related impairments may be differentially associated with the ascending dopamine and noradrenaline projections.

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    • "ind a major depresszió, mind pedig a bipoláris depresszió lényegesen befolyásolja a végrehajtó funkciókat, melynek mérésére egy általánosan elterjedt módszer a Stroop teszt (Stroop, 1935). Funkcionális képalkotókkal végzett kutatások a dorzális és laterális prefrontális kortex regulációs zavarát tárták fel végrehajtó funkciókat igénylő feladatok végzése közben major depressziós pácienseknél (Clark és Goodwin, 2004), mely jól összecseng azokkal az eredményekkel, melyek a prefrontális kortex fokozott működését mutatták ki a Stroop teszt során. A jelen összefoglalóban arra keresünk választ, hogy van-e örökölhető komponense a Stroop tesztben mutatott teljesítménynek, és ha igen, akkor ez mely génekre vezethető vissza. "
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    ABSTRACT: Impairment of executive control functions in depression is well documented, and performance on the Stroop Test is one of the most widely used markers to measure the decline. This tool provides reliable quantitative phenotype data that can be used efficiently in candidate gene studies investigating inherited components of executive control. Aim of the present review is to summarize research on genetic factors of Stroop performance. Interestingly, only a few such candidate gene studies have been carried out to date. Twin studies show a 30-60% heritability estimate for the Stroop test, suggesting a significant genetic component. A single genome-wide association study has been carried out on Stroop performance, and it did not show any significant association with any of the tested polymorphisms after correction for multiple testing. Candidate gene studies to date pointed to the polymorphisms of several neurotransmitter systems (dopamine, serotonin, acetylcholine) and to the role of the APOE ε4 allele. Surprisingly, little is known about the genetic role of neurothrophic factors and survival factors. In conclusion, further studies are needed for clarifying the genetic background of Stroop performance, characterizing attentional functions.
    Neuropsychopharmacologia Hungarica: a Magyar Pszichofarmakológiai Egyesület lapja = official journal of the Hungarian Association of Psychopharmacology 12/2012; 14(4):252-8.
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    • "Taken together , these results are consistent with the view that excessive recruitment of the right prefrontal cortex by the BD group during NoGo blocks may represent a mechanism for improving behavioral performance during response inhibition . Furthermore , our results support previous behavioral studies , suggesting that problems in sustained attention may represent a trait deficit of BD ( Clark and Goodwin 2004 ; Doyle et al . 2005 ; Fleck et al . "
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    ABSTRACT: Pediatric bipolar disorder is characterized by core deficits in mood and executive function and commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD). We aimed to examine response inhibition in this population, as an element of executive function, which, if aberrant, may interfere with learning and information processing. Children (9-18 years) with bipolar I or II disorder (BD, n = 26) and age, gender, and intelligence quotient (IQ) comparable healthy children (HC, n = 22) without any psychopathology were given a standardized Go/NoGo computerized task measuring response inhibition. A whole-brain functional magnetic resonance imaging (MRI) group analysis was performed using statistical parametric mapping software (SPM2) for comparing NoGo to Go epochs. There were no statistically significant group differences between groups in age, gender, or ethnicity. The BD group had high rates of co-morbid disorders, including 81% with ADHD, 62% with oppositional defiant disorder (ODD), and 46% with anxiety disorders. This BD group had fewer correct responses on Go (84% vs. 96%, T[46] = 3.35, p = 0.002) and overall (85% vs. 94%, T[46] = 4.12, p = 0.0002) trials as compared to the HC group. However, there were no statistically significant group differences in response inhibition on NoGo trials (p = 0.11). In the NoGo-Go contrast, the BD group showed increased neural activation in the right dorsolateral prefrontal cortex (DLPFC) compared to HC (T[46] = 4.21, p < 0.001). During accurate NoGo but impaired Go trial performance, children with BD showed increased right DLPFC activation versus controls, suggesting increased recruitment of executive control regions for accurate response inhibition. Studies relating these results to mood regulation in pediatric BD are warranted.
    Journal of child and adolescent psychopharmacology 02/2010; 20(1):15-24. DOI:10.1089/cap.2009.0004 · 3.07 Impact Factor
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    • "Many studies have demonstrated that patients with bipolar disorder (BD) present a neuropsychological deficit that affects different cognitive domains, such as executive functioning, attention, verbal and visual memory, or speed of information processing in acute phases of illness and euthymic periods (Gruzelier et al., 1988; Murphy et al., 1999; Sweeney et al., 2000; Clark et al., 2002; Quraishi and Frangou 2002; Seidman et al., 2002; Martínez-Arán et al., 2004a, b; Savitz et al., 2005; Pavuluri et al., 2006; Schretlen et al., 2007). However, not all studies support the existence of a generalized cognitive deficit in BD. "
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    ABSTRACT: Few studies have compared neurocognitive performance in euthymic patients with bipolar disorder (BD), stabilized patients with schizophrenia (SC) and normal controls (NC) using a comprehensive neuropsychological battery, and those that have been conducted have yielded discrepant results. We evaluated the neurocognitive profile shown by 73 euthymic patients with BD, 89 stabilized patients with SC and 67 NC. All participants completed a cognitive battery in which the domains evaluated were executive functioning, sustained attention, and verbal and visual memory. Individuals with BD were administered the Quality of Life Scale (QLS). Patients with BD manifested dysfunction in executive functioning (moderate-to-large effect size), sustained attention (moderate effect size) and verbal/visual memory (large effect size) compared with NC. Verbal memory deficit in patients with BD was related to poor functional outcome on the QLS and Global Assessment of Functioning (GAF). Patients with BD performed significantly better than patients with SC on the Trail Making Test (TMT) part B, backward digit span, and California Verbal Learning Test (CVLT) learning trials. Other neuropsychological measures showed no significant differences between the two patient groups. These findings support the notion that euthymic BD patients suffer from an extensive neurocognitive deficit that affects all cognitive domains and is qualitatively similar to that in SC patients. Persistent verbal memory impairment in BD has clinical relevance because it is associated with poor psychosocial function.
    Psychiatry Research 10/2009; 169(3):220-8. DOI:10.1016/j.psychres.2008.06.032 · 2.68 Impact Factor
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