Differential executive functioning performance by phase of bipolar disorder

Abstract

Objective This study examined the influence of illness phase on executive functioning performance using factor-derived cognitive scores in a cross-sectional design. Methods Healthy control (HC) subjects (n = 57), and euthymic (E-BD) (n = 117), depressed (D-BD) (n = 73), and hypomanic/mixed (HM/M-BD) (n = 26) patients with bipolar disorder (BD) were evaluated using executive functioning measures (Wisconsin Card Sorting Test, Trail Making Test–Parts A and B, Verbal Fluency, Parametric Go/No-Go, Stroop, and Digit Symbol) comprising Conceptual Reasoning and Set-Shifting (CRSS), Processing Speed with Interference Resolution (PSIR), Verbal Fluency and Processing Speed (VFPS), and Inhibitory Control (IC) factor scores. Results Two of the four executive functioning factors were significantly different between groups based upon phase of illness. The HM/M group was significantly worse than both of the other BD groups and the HC group in IC. The VFPS factor was sensitive to the active phase of BD, with the HM/M-BD and D-BD groups worse than HC. Extending our prior work, the PSIR factor, and now the CRSS factor were significantly worse in BD relative to HC, irrespective of phase of illness. Conclusions Phase of illness had differential cognitive profiles in executive functioning factors, even after considering and excluding the impact of clinical features, illness characteristics, medications, and demographics. Consolidating executive functioning tasks into reliable factor scores provides unique information to measure and define cognitive deficiencies throughout phases of BD, and to measure intermediate phenotypes in BD, and may aid in tracking and clarifying treatment focus.

Attention orienting and inhibitory control across the different mood states in bipolar disorder: An emotional antisaccade task

“…Although the slow antisaccade latencies in BD patients could be due to anticipation for saccade execution given a fixed and predictable preparation interval (1600 ms), it is unlikely as other studies that employed a non-predictable preparation interval documented similar findings (e.g., Katsanis et al, 1997). Furthermore, this pattern of data is also consistent with response time experiments in BD that reported inhibitory control deficits across mood states, including euthymia (Ryan et al, 2012;). To obtain the whole picture, we should note that in the latencies of the prosaccade task, euthymic patients were not slower than controls.…”

Response inhibition in the parametric Go/No-Go task in psychopathic offenders

“…The apparent discrepancy between previous null effects when investigating the effect of psychopathy on response inhibition in the standard Go/No-go task (Kiehl et al, 2000;Verona et al, 2012) and the uncovered relationships when utilising the PGNG (Weidacker et al, 2017) supports the view that this task is more likely to capture aberrant response inhibition. There is evidence that it is the dynamic parametric approach of the PGNG and associated increased difficulty, which reveals response inhibition deficits previously unseen when using the standard Go/No-go task (Langenecker et al, 2010;Ryan et al, 2012). In terms of psychopathy for example, LaPierre et al (1995) reported a deficit in response inhibition performance in psychopathic offenders when utilizing a Go/No-go design, which incorporated a high demand on spatial attention by including a measure of uncertainty in the location of targets which appeared at pseudorandom locations.…”

“…The addition of these design features has led to the PGNG capturing response inhibition deficits in, for example, bipolar disorder, where impulsivity is by definition part of the disorder (American Psychiatric Association, 2013), although response inhibition deficits had been unseen when utilising the standard Go/No-go task in bipolar patients (e.g. Elliott et al, 2004;Altshuler et al, 2005;Langenecker et al, 2010;Ryan et al, 2012).…”

Aplicabilidade da bateria neurocognitiva computadorizada da Universidade da Pensilvânia em adultos com transtorno bipolar

“…Durante as fases agudas do transtorno, pode haver exacerbação transitória de alguns déficits cognitivos como controle inibitório e fluência/aprendizado verbal (Ryan et al, 2012 (Senju, 2012;Bora;. Alguns autores propuseram que a cognição social poderia ser relativamente preservada no TB em comparação com a esquizofrenia (Lee et al, 2013).…”

“…Assim, o padrão de comprometimento cognitivo observado aqui com a BNT em pacientes TB em relação ao CS é consistente com a literatura anterior, incluindo estudos que adotaram a (Van Rheenen e Rossell, 2014, Ishisaka et al, 2016, Bo et al, 2017 (Volkert et al, 2015). O impacto dos sintomas do humor na cognição foi avaliado principalmente por estudos e meta-análises comparando ou regredindo pacientes com TB de acordo com o estado de humor (ou seja, depressivo vs maníaco vs eutímico) (Kurtz e Gerraty, 2009;Ryan et al, 2012;Lee et al, 2014), mas, poucas investigações correlacionaram os sintomas de humor sub-sindrômicos em pacientes eutímicos com o com desempenho neurocognitivo.…”