State- and trait-related deficits in sustained attention in bipolar disorder. Eur Arch Psychiatry Clin Neurosci 254: 61-68

University of Cambridge, Cambridge, England, United Kingdom
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.53). 05/2004; 254(2):61-8. DOI: 10.1007/s00406-004-0460-y
Source: PubMed


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.
    • "j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / j a d depressed nor manic) individuals with BD. Studies focusing on euthymic patients have demonstrated impairments in executive functioning, verbal memory, attention, and processing speed (Arts et al., 2008; Bearden et al., 2001; Clark and Goodwin, 2004; Hsiao et al., 2009; Kieseppä et al., 2005; Malhi et al., 2007; Martínez-Arán et al., 2004; Quraishi and Frangou, 2002; Thompson et al., 2005). Recent studies have also found that some first-degree relatives show deficits in the same brain areas and cognitive functions as bipolar patients. "
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    ABSTRACT: Bipolar disorder (BD) patients have cognitive deficits that may remain in the euthymic phase. Similar although milder cognitive deficits may be found in their first-degree relatives. We wanted to analyze whether the self-report of seasonality, the season when individuals were tested or the circadian preference influences the neuropsychological test performance measured in the familial BD, type I, patients and their healthy first-degree relatives. A structured diagnostic interview (SCID) and neuropsychological test battery were administered to 32 familial BD type I patients, 40 of their unaffected first-degree relatives and 50 controls, all from population-based samples. BD patients and their relatives filled in the Seasonal Pattern Assessment Questionnaire (SPAQ) and the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ). Individuals, who reported that seasonal variation was a problem, scored worse on the measures of visuoconstructional functions, visuospatial reasoning, auditory attention and working memory, and verbal memory than those with no seasonal variation. The season when tested had an influence on test performance. Individuals from the families that were tested in spring, summer and autumn scored better than those tested in winter on the measures of visual and verbal attention, working memory, verbal ability, verbal fluency, and executive functioning. Among the controls there was no difference in the test scores from season to season. The circadian preference had no effect on test performance. Only relatives, not BD patients were tested in winter. Seasonal variation in mood and behavior as a problem in patients and their first-degree relatives influences negatively the neuropsychological test performance. In addition, among the patients and first-degree relatives the neuropsychological test performance in winter may be worse than in other seasons.
    Journal of Affective Disorders 05/2010; 127(1-3):58-65. DOI:10.1016/j.jad.2010.04.021 · 3.38 Impact Factor
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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 · 2.93 Impact Factor
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