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Bipolar Disorder (BD) is associated with impairment in a number of areas including poor work functioning, often despite the remission of mood symptoms. The present study aimed to examine the role of sleep disturbance and cognitive functioning in occupational impairment in BD. Twenty-four euthymic BD participants and 24 healthy control participants completed a week of prospective assessment of sleep disruption via self-report and actigraphy, a battery of neuropsychological tests of executive functioning, working memory, and verbal learning, and assessments of work functioning. BD participants experienced significantly poorer cognitive functioning as well as greater months of unemployment and greater incidence of being fired than controls. Moderation analyses revealed that both poor sleep and cognitive functioning were associated with poor work performance in BD participants, but not control participants. Sleep and cognitive functioning may be impaired in euthymic BD and are associated with poor work functioning in this population. More research should be conducted to better understand how sleep and cognitive functioning may interact in BD.

Abstract-A preliminary study by Sneddon et al. (2005) using visual working memory tasks coupled with quantified EEG (qEEG) analysis distinguished mild dementia subjects from normal aging ones with a high degree of accuracy. The present study hypothesizes that a simpler task such as having a subject count backwards mentally by ones can be coupled with qEEG to yield a similar degree of accuracy for classifying early dementia. The study focuses on participants with mild cognitive impairment (MCI) and includes both a delayed visual match-tosample (working memory) task and a counting backwards task (eyes closed) for comparison. The counting backwards protocol included 15 normal aging and 11 MCI participants, and the working memory task included 9 normal aging and 7 MCI individuals. The EEG data were quantified using Tsallis entropy, and the brain regions analyzed included the prefrontal cortex, occipital lobe, and the posterior parietal cortex. The

Summary Objective We aimed to predict language deficits after epilepsy surgery. In addition to evaluating surgical factors examined previously, we determined the impact of the extent of functional magnetic resonance imaging (fMRI) activation that was resected on naming ability. Method Thirty‐five adults (mean age 37.5 ± 10.9 years, 13 male) with temporal lobe epilepsy completed a preoperative fMRI auditory description decision task, which reliably activates frontal and temporal language networks. Patients underwent temporal lobe resections (20 left resection). The Boston Naming Test (BNT) was used to determine language functioning before and after surgery. Language dominance was determined for Broca and Wernicke area (WA) by calculating a laterality index following statistical parametric mapping processing. We used an innovative method to generate anatomic resection masks automatically from pre‐ and postoperative MRI tissue map comparison. This mask provided the following: (a) resection volume; (b) overlap between resection and preoperative activation; and (c) overlap between resection and WA. We examined postoperative language change predictors using stepwise linear regression. Predictors included parameters described above as well as age at seizure onset (ASO), preoperative BNT score, and resection side and its relationship to language dominance. Results Seven of 35 adults had significant naming decline (6 dominant‐side resections). The final regression model predicted 38% of the naming score change variance (adjusted r2 = 0.28, P = 0.012). The percentage of top 10% fMRI activation resected (P = 0.017) was the most significant contributor. Other factors in the model included WA LI, ASO, volume of WA resected, and WA LI absolute value (extent of laterality). Significance Resection of fMRI activation during a word‐definition decision task is an important factor for postoperative change in naming ability, along with other previously reported predictors. Currently, many centers establish language dominance using fMRI. Our results suggest that the amount of the top 10% of language fMRI activation in the intended resection area provides additional predictive power and should be considered when planning surgical resection.

Background Some evidence suggests that individuals with bipolar spectrum disorders (BSD) generate stressful life events, contributing to a more severe course of disorder. A recent update to the Behavioral Approach System (BAS) dysregulation theory of BSD highlights the need to investigate anger as approach motivation. Although research has shown that individuals with BSD generate stress, it is unclear whether personality traits characteristic of BSD, such as aggression and impulsivity, are related to this stress generation. Methods The current longitudinal study employed multilevel modeling to examine stress generation in a sample of 104 individuals with BSD and 96 healthy controls. We examined rates of BAS-deactivating, BAS-activating, and Anger-evoking life events over a period of up to 4.5 years as a function of levels of aggression and impulsivity. Results Individuals with BSD reported significantly higher numbers of dependent Anger-evoking events and BAS-deactivating events, but not dependent BAS-activating events, than controls. Trait levels of hostility and impulsivity predicted all types of events, although bipolar diagnosis remained a significant predictor of BAS-deactivating and Anger-evoking events. Limitations: The life events measures were not designed to assess Anger-evoking events; further research should replicate these findings and develop more finely tuned assessments of stressful anger events. In addition, the sample was not a clinical sample. Conclusions This study adds to the literature on stress generation in BSD; trait level personality differences predict stress generation, beyond bipolar diagnosis. This also further establishes the importance of including anger-evoking events in the BAS model of BSDs and stress generation.