Mania and attention-deficit/hyperactivity disorder: common symptomatology, common pathophysiology and common treatment?

Hegerl, Ulrich; Himmerich, Hubertus; Engmann, Birk; Hensch, Tilman

doi:10.1097/yco.0b013e328331f694

Cited by 88 publications

(42 citation statements)

References 64 publications

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“…The fact that a stable vigilance regulation pattern is frequently found in patients with MD is in line with the recently presented vigilance regulation model of affective disorders [1,3,30]. This framework is underpinned by other signs of increased central nervous arousal such as the problems these patients have falling asleep, signs of increased activity of the hypothalamic-pituitary-adrenal axis [31] or decreased activity of the parasympathetic branch of the autonomous nervous system as revealed by decreased heart rate variability in patients with MD [32].…”

Section: Discussionmentioning

confidence: 57%

“…It is remarkable that without any a priori assumption about the number of clusters, the gap analysis found the 3-cluster solution to be superior to other numbers of clusters. The vigilance regulation model of affective disorders [1,6] suggests the existence of at least three different types of vigilance regulation, one with stable EEG vigilance over time, one with slowly declining vigilance and one with a rapid decline of vigilance. When looking at the time series of the 3 clusters, exactly those patterns described have been delineated.…”

Section: Discussionmentioning

confidence: 99%

“…The regulation and the precise adaptation of the level of vigilance to the environment are of fundamental importance for all higher organisms. Recently, a framework has been proposed that links different types of vigilance regulation to psychopathological syndromes [1]. In EEG recordings under quiet resting conditions, in both patients with mania and attention deficit/hyperactivity disorder, unstable vigilance regulation is found with rapid drops to lower vigilance stages or even sleep stages within the first minutes [2,3,4,5], while hyperstable vigilance regulation is found in unmedicated depressed patients [6].…”

Section: Introductionmentioning

confidence: 99%

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EEG Vigilance Regulation Patterns and Their Discriminative Power to Separate Patients with Major Depression from Healthy Controls

Olbrich¹,

Sander

Minkwitz

et al. 2012

Neuropsychobiology

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Background/Aim: Recently, a framework has been presented that links vigilance regulation, i.e. tonic brain arousal, with clinical symptoms of affective disorders. Against this background, the aim of this study was to deepen the knowledge of vigilance regulation by (1) identifying different patterns of vigilance regulation at rest in healthy subjects (n = 141) and (2) comparing the frequency distribution of these patterns between unmedicated patients with major depression (MD; n = 30) and healthy controls (HCs; n = 30). Method: Each 1-second segment of 15-min resting EEGs from 141 healthy subjects was classified as 1 of 7 different vigilance stages using the Vigilance Algorithm Leipzig. K-means clustering was used to distinguish different patterns of EEG vigilance regulation. The frequency distribution of these patterns was analyzed in independent data of 30 unmedicated MD patients and 30 matched HCs using a χ² test. Results: The 3-cluster solution with a stable, a slowly declining and an unstable vigilance regulation pattern yielded the highest mathematical quality and performed best for separation of MD patients and HCs (χ² = 13.34; p < 0.001). Patterns with stable vigilance regulation were found significantly more often in patients with MD than in HCs. Conclusion: A stable vigilance regulation pattern, derived from a large sample of HCs, characterizes most patients with MD and separates them from matched HCs with a sensitivity between 67 and 73% and a specificity between 67 and 80%. The pattern of vigilance regulation might be a useful biomarker for delineating MD subgroups, e.g. for treatment prediction.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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EEG Vigilance Regulation Patterns and Their Discriminative Power to Separate Patients with Major Depression from Healthy Controls

Olbrich¹,

Sander

Minkwitz

et al. 2012

Neuropsychobiology

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“…Specific patterns of vigilance regulation occur in several mental disorders, e.g. hyperstable vigilance regulation in patients with major depression and unstable vigilance regulation in manic patients or patients with ADHD (Bschor et al 2001;Hegerl et al 2008aHegerl et al , b, 2010Small et al 1999;Ulrich and Furstenberg 1999).…”

Section: Vigilance Regulationmentioning

confidence: 97%

Cholinergic receptor subtypes and their role in cognition, emotion, and vigilance control: An overview of preclinical and clinical findings

et al. 2011

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“…In contrast, mania was characterized by rapid EEG vigilance decline under resting conditions in former EEG case reports [58,62,63] , which was replicated in a more recent case report applying VIGALL [64] . In attention-deficit/hy- peractivity disorder (ADHD), which shows overlap with mania not only on the symptom level [65] , an unstable arousal regulation has long been suggested as a pathogenetic factor [66] . Using VIGALL, further evidence for unstable arousal in ADHD has been given [67] .…”

Section: Application Of Vigallmentioning

confidence: 99%

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

Sander¹,

Hensch²,

Wittekind³

et al. 2015

Neuropsychobiology

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tion of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and nonpharmacological interventions for these conditions. AbstractDuring the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adap-

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Mania and attention-deficit/hyperactivity disorder: common symptomatology, common pathophysiology and common treatment?

Cited by 88 publications

References 64 publications

EEG Vigilance Regulation Patterns and Their Discriminative Power to Separate Patients with Major Depression from Healthy Controls

EEG Vigilance Regulation Patterns and Their Discriminative Power to Separate Patients with Major Depression from Healthy Controls

Cholinergic receptor subtypes and their role in cognition, emotion, and vigilance control: An overview of preclinical and clinical findings

Assessment of Wakefulness and Brain Arousal Regulation in Psychiatric Research

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