Is aberrant affective cognition an endophenotype for affective disorders? – A monozygotic twin study

Meluken, Iselin; Ottesen, Ninja Meinhard; Harmer, Catherine J.; Scheike, Thomas; Kessing, Lars Vedel; Vinberg, Maj; Miskowiak, Kamilla Woznica

doi:10.1017/s0033291718001642

Cited by 16 publications

(21 citation statements)

References 56 publications

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“…This is relevant as executive function in particular is often compromised in recovered individuals with affective disorders (75, 76). However, affective disorders are largely heterogeneous with regards to cognition (77, 78); for instance, affected twins in our sample did not show any cognitive deficits compared to low-risk twins (54). Answering the above question may be relevant with a view to personalizing therapeutic interventions.…”

Section: Discussionmentioning

confidence: 55%

Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins

et al. 2019

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Background: Mental imagery abnormalities feature across affective disorders including bipolar disorder (BD) and unipolar depression (UD). Maladaptive emotional imagery has been proposed as a maintenance factor for affective symptomatology and a target for mechanism-driven psychological treatment developments. Where imagery abnormalities feature beyond acute affective episodes, further opportunities for innovation arise beyond treatments, such as for tertiary/relapse prevention (e.g., in remitted individuals) or primary prevention (e.g., in non-affected but at-risk individuals). The aim of our study was to investigate for the first time the presence of possible mental imagery abnormalities in affected individuals in remission and at-risk individuals for affective disorders using a familial risk design. Methods: A population-based cohort of monozygotic twins was recruited through linkage between the Danish national registries (N=204). Participants were grouped as: affected (remitted BD/UD; n = 115); high-risk (co-twin with history of BD/UD; n = 49), or low-risk (no co-twin history of BD/UD; n = 40). Twins completed mental imagery measures spanning key subjective domains (spontaneous imagery use and emotional imagery) and cognitive domains (imagery inspection and imagery manipulation). Results: Affected twins in remission reported enhanced emotional mental imagery compared to both low- and high-risk twins. This was characterized by greater impact of i) intrusive prospective imagery (Impact of Future Events Scale) and ii) deliberately-generated prospective imagery of negative scenarios (Prospective Imagery Task). There were no significant differences in these key measures between affected BD and UD twins in remission. Additionally, low- and high-risk twins did not significantly differ on these emotional imagery measures. There were also no significant differences between the three groups on non-emotional measures including spontaneous imagery use and cognitive stages of imagery. Conclusions: Abnormalities in emotional prospective imagery are present in monozygotic twins with affective disorders in remission—despite preserved cognitive stages of imagery—but absent in unaffected high-risk twins, and thus do not appear to index familial risk (i.e., unlikely to qualify as “endophenotypes”). Elevated emotional prospective imagery represents a promising treatment/prevention target in affective disorders.

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Section: Discussionmentioning

confidence: 55%

Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins

et al. 2019

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“…16,17 The present fMRI study is part of a larger cross-sectional monozygotic twin study that includes the behavioural assessment of affective cognition in 183 twins. 18 In the full sample, we observed no risk endophenotypes across affected and high-risk versus low-risk twins. However, we did observe unexpected behavioural displays of compensation or resilience in high-risk versus affected twins, including attentional avoidance of emotional faces.…”

Section: Introductionmentioning

confidence: 63%

“…We calculated avoidance of emotional faces as a mean vigilance score of unmasked fearful and masked happy conditions from the faces dot-probe task, based on observations from the full monozygotic sample. 18 Additionally for the discordant twin pairs, we investigated correlation of the extracted percent signal change in high-risk twins with age at illness onset for affected twins and discordant time. We calculated discordant time as the time passed between illness onset for the affected twin and the assessment of the high-risk twin.…”

Section: Group (Second-level) Analysismentioning

confidence: 99%

“…However, we did observe unexpected behavioural displays of compensation or resilience in high-risk versus affected twins, including attentional avoidance of emotional faces. 18 Attentional avoidance was measured as response latency when identifying probes were preceded by an emotional face in a faces dot-probe task. Accordingly, the aims of the present fMRI study were 2-fold: to investigate the neural correlates of the observed attentional avoidance of emotional faces in high-risk versus affected monozygotic twins, and to investigate whether aberrant neur al response to emotional faces represents a risk endophe-notype that is present in high-risk twins and affected twins relative to low-risk twins, consistent with the idea that aberrant neural activity may be a more sensitive assay of abnormal brain functioning than behavioural measures.…”

Section: Introductionmentioning

confidence: 99%

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Neural response to emotional faces in monozygotic twins: association with familial risk of affective disorders

Meluken

Ottesen

Harmer

et al. 2019

jpn

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Background: Aberrant neural and cognitive response to emotional faces has been observed in people at familial risk of an affective disorder. In this functional MRI (fMRI) study of monozygotic twins, we explored neural correlates of the attentional avoidance of emotional faces that we had previously observed in high-risk versus affected twins, and whether an abnormal neural response to emotional faces represents a risk endophenotype. Methods: We recruited unaffected monozygotic twins with a co-twin history of mood episodes (highrisk), monozygotic twins with previous mood episodes (affected) and monozygotic twins with no personal or first-degree history of mood episodes (low-risk) between December 2014 and January 2017 based on a nationwide register linkage. Participants viewed fearful and happy faces while performing a gender discrimination task during fMRI and performed emotional faces dot-probe and facial expression recognition tasks outside the scanner. Results: A total of 129 monozygotic twins underwent whole-brain fMRI. High-risk twins (n = 38) displayed greater medial and superior prefrontal response to emotional faces than affected twins (n = 62). This greater activity correlated with stronger attentional avoidance of emotional faces in high-risk twins. In contrast, high-risk and affected twins showed no aberrant neural activity to emotional faces compared with low-risk twins (n = 29). Limitations: A limitation of this study was its cross-sectional design. Conclusion: Greater recruitment of the medial and superior prefrontal cortex during implicit emotion processing in high-risk versus affected twins may represent a compensatory or resilience mechanism. In contrast, aberrant neural response to emotional faces does not seem to be a risk endophenotype for affective disorders. Affiliations: From the Copenhagen Affective

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“…These abnormalities were, however, absent in patients' high-risk relatives. Behavioural studies on emotion regulation in remitted BD and URs have yielded inconsistent results, with some studies showing impaired regulation of positive emotions (Rive et al ., 2015; Kærsgaard et al ., 2018), negative emotions (Rive et al ., 2015; Kjærstad et al ., 2016), or no significant differences between patients and controls (Morris et al ., 2012; Heissler et al ., 2014; Hay et al ., 2015; Kanske et al ., 2015; Meluken et al ., 2018). Behavioural measures of emotion regulation likely do not provide sufficient sensitivity to identify deficits.…”

Section: Discussionmentioning

confidence: 99%

Aberrant cognition in newly diagnosed patients with bipolar disorder and their unaffected relatives

et al. 2019

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BackgroundPatients with bipolar disorder (BD) experience persistent impairments in both affective and non-affective cognitive function, which is associated with a worse course of illness and poor functional outcomes. Nevertheless, the temporal progression of cognitive dysfunction in BD remains unclear and the identification of objective endophenotypes can inform the aetiology of BD.MethodsThe present study is a cross-sectional investigation of cognitive baseline data from the longitudinal Bipolar Illness Onset-study. One hundred seventy-two remitted patients newly diagnosed with BD, 52 of their unaffected relatives (UR), and 110 healthy controls (HC) were compared on a large battery of behavioural cognitive tasks tapping into non-affective (i.e. neurocognitive) and affective (i.e. emotion processing and regulation) cognition.ResultsRelative to HCs, patients with BD exhibited global neurocognitive deficits (ps < 0.001), as well as aberrant emotion processing and regulation (ps ⩽ 0.011); including decreased emotional reactivity to positive social scenarios, impaired ability to down-regulate positive emotion, as well as a specific deficit in the ability to recognise surprised facial expressions. Their URs also showed a trend towards difficulties identifying surprised faces (p = 0.075). No other differences in cognitive function were found for URs compared to HCs.ConclusionsNeurocognitive deficits and impairments within emotion processing and regulation may be illness-related deficits of BD that present after illness-onset, whereas processing of emotional faces may represent an early risk marker of BD. However, longitudinal studies are needed to examine the association between cognitive impairments and illness progression in BD.

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Is aberrant affective cognition an endophenotype for affective disorders? – A monozygotic twin study

Abstract: Our findings provide no support of aberrant affective cognition as an endophenotype for affective disorders. High-risk twins' attentional avoidance of emotional faces and greater use of task-oriented coping strategies may reflect compensatory mechanisms.

Cited by 16 publications

References 56 publications

Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins

Emotional Mental Imagery Abnormalities in Monozygotic Twins With, at High-Risk of, and Without Affective Disorders: Present in Affected Twins in Remission but Absent in High-Risk Twins

Neural response to emotional faces in monozygotic twins: association with familial risk of affective disorders

Aberrant cognition in newly diagnosed patients with bipolar disorder and their unaffected relatives

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