Slower and Less Variable Binocular Rivalry Rates in Patients With Bipolar Disorder, OCD, Major Depression, and Schizophrenia

Abstract

When two different images are presented to the two eyes dichoptically, observers usually experience a perceptual alternation between the two images. This phenomenon, known as binocular rivalry, has been used as a powerful tool to investigate mechanisms of visual awareness. It was also found that the rates of perceptual alternation are slower in patients with bipolar disorder than in healthy controls ( Pettigrew and Miller, 1998 ; Miller et al., 2003 ). To investigate the broader clinical relevance of binocular rivalry in psychiatric disorders, we measured the perceptual alternation rates during rivalry in healthy controls ( n = 39) and in patients with different types of psychiatric disorders, including bipolar disorder type I (BD, n = 28), obsessive–compulsive disorder (OCD, n = 22), major depression (MD, n = 50), schizophrenia (SCZ, n = 44), and first-degree relatives (FDRs) of SCZ patients ( n = 32). Participants viewed competing red–green images on a computer monitor through red–green anaglyph glasses and pressed buttons to record their perceptual alternations. The distributions of the rivalry rates were well described by a lognormal function in all groups. Critically, the median rate of perceptual alternation was 0.27 Hz for BD patients, 0.26 Hz for the OCD patients, 0.25 Hz for the MD patients, and 0.23 Hz and 0.27 Hz for the SCZ patients and their FDRs, respectively. All of which were significantly slower than the rate of 0.41 Hz obtained for the healthy controls, suggesting there may be shared genotypes between these different disorders. While rivalry alternations were generally slower in different types of psychiatric disorders compared to healthy controls, adding variance of rivalry rates in the analysis helped to partially separate among the different patient groups. Our results suggest that the slowing of binocular rivalry is likely due to certain common factors among the patient groups, but more subtle differences between different patient groups could be revealed when additional properties of rivalry dynamics are considered.

Fluctuations of consciousness, mood, and science: The interhemispheric switch and sticky switch models two decades on

“…An important issue for the clinical BR literature concerns the specificity of slow BR to BD. While our study in 2003 was suggestive that BR is not slow in schizophrenia or major depression, other data since then have challenged this notion, and pointed toward a general slowing of BR rate across psychiatric disorders (Jia et al, 2015;Xiao et al, 2019;Ye, Zhu, Zhou, He, & Wang, 2019). While the finding of slow BR in BD is consistent across our and independent studies, the inconsistencies in specificity findings raise issues concerning the use of differing BR test protocols (discussed below).…”

“…In such cases, accurate diagnosis of an underlying BD would direct specific treatment choices and improve patient outcomes. However, recent data have questioned the specificity of slow BR to BD as mentioned in Section 5.2 (Jia et al, 2015; Xiao et al, 2019; Ye et al, 2019) and though the specificity issue awaits clarification with larger samples and standardized protocols, it may well turn out that this potential clinical translation will not come to pass. If so, however, there remains the possibility that the presence of the slow BR trait, irrespective of underlying diagnosis, will predict a particular disorder sub‐type or response to particular medications.…”

Missing the forest because of the trees: slower alternations during binocular rivalry are associated with lower levels of visual detail during ongoing thought

“…Mean dominance duration shows robust and stable individual differences ( Pettigrew and Miller 1998 ), which have previously been shown to be associated with connectivity between regions of parietal cortex ( Baker et al 2015 ), as well as the concentration of inhibitory neurotransmitters (gamma-aminobutyric acid, GABA) in visual regions of the brain ( van Loon et al 2013 ). Dominance durations are also affected by various personality types ( Antinori et al 2017a , b ) and clinical conditions including autism ( Robertson et al 2013 ), bipolar disorder ( Pettigrew and Miller 1998 ; Miller et al 2003 ) and schizophrenia ( Xiao et al 2018 ; Ye et al 2019 ). The second metric was the time when neither percept dominated experience, and so corresponds to the amount of time that participants reported seeing both percepts (mixed).…”

Missing the forest because of the trees: Slower alternations during binocular rivalry are associated with lower levels of visual detail during ongoing thought

“…Mean dominance duration shows robust and stable individual differences (Pettigrew and Miller, 1998), which have previously been shown to be associated with connectivity between regions of parietal cortex (Baker et al, 2015), as well as the concentration of inhibitory neurotransmitters (GABA) in visual regions of the brain (van Loon et al, 2013). Dominance durations are also affected by various personality types (Antinori et al, 2017a;Antinori et al, 2017b) and clinical conditions including autism (Robertson et al, 2013), bipolar disorder (Miller et al, 2003;Pettigrew and Miller, 1998) and schizophrenia (Xiao et al, 2018;Ye et al, 2019). The second metric was the time when neither percept dominated experience ('Mixed').…”