Stability of estimated IQ across mood state in patients with bipolar disorder

Lebowitz, Brian K.; Shear, Paula K.; Steed, Marc; Strakowski, Stephen M.

doi:10.1111/j.1399-5618.2006.00245.x

Cited by 6 publications

(6 citation statements)

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“…Additionally, general measures of premorbid intellectual function (IQ) were obtained using the American Modification of the National Adult Reading Test (ANART) (18) or the Wechsler Abbreviated Scale of Intelligence (WASI) (19). The ANART provides an estimate of premorbid IQ that is strongly correlated with the Verbal (VIQ) WASI score and is resilient to the influence of affective symptoms in bipolar disorder (20).…”

Section: Methodsmentioning

confidence: 99%

A longitudinal functional connectivity analysis of the amygdala in bipolar I disorder across mood states

et al. 2012

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Objective Bipolar I disorder is characterized by affective symptoms varying between depression and mania. The specific neurophysiology responsible for depression in bipolar I disorder is unknown, but prior neuroimaging studies suggest impairments in corticolimbic regions that are responsible for regulating emotion. The amygdala seems to play a central role in this network and is responsible for appraisal of emotional stimuli. To further understand the role of the amygdala in the generation of mood symptoms, we used functional magnetic resonance imaging (fMRI) to examine a group of patients with bipolar I disorder longitudinally. Methods fMRI was used to study regional brain activation in 15 bipolar I disorder patients followed for up to one year. Patients received an fMRI scan during an initial manic episode and a subsequent depressive episode. During the scans, patients performed an attentional task that incorporated emotional pictures. Fifteen healthy comparison subjects were also scanned at baseline and then at four months. Wholebrain functional connectivity analysis was performed using the left and right amygdala as seed regions. Results Significant changes in amygdala functional connectivity were found between the manic and depressed phases of illness. The right amygdala was significantly more positively correlated with the left inferior frontal gyrus during mania and with the right insula during depression. There were no significant differences in left amygdala correlations across mood states in the bipolar I disorder group. Conclusions In the transition from a manic/mixed episode to a depressive episode, subjects with bipolar I disorder showed unique changes in cortical–amygdala functional connectivity. Increased connectivity between the insula and right amygdala may generate excessive positive feedback, in that both of these regions are involved in the appraisal of emotional stimuli. Increased correlation between the right amygdala and the inferior frontal gyrus in mania is consistent with prior findings of decreased prefrontal modulation of limbic regions in mania. These differences in connectivity may represent neurofunctional markers of mood state, as they occurred in the same individuals across manic and depressive episodes.

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Section: Methodsmentioning

confidence: 99%

A longitudinal functional connectivity analysis of the amygdala in bipolar I disorder across mood states

et al. 2012

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“…Additionally, general measures of premorbid intellectual function (IQ) were obtained using the American Modification of the National Adult Reading Test (ANART) (30) or the Wechsler Abbreviated Scale of Intelligence (WASI) (31). The ANART provides an estimate of premorbid IQ that is strongly correlated with the Verbal (VIQ) WASI score and is resilient to the influence of affective symptoms in bipolar disorder (32). …”

Section: Methodsmentioning

confidence: 99%

Functional Magnetic Resonance Imaging Brain Activation in Bipolar Mania: Evidence for Disruption of the Ventrolateral Prefrontal-Amygdala Emotional Pathway

Strakowski¹,

Eliassen²,

Lamy³

et al. 2011

Biological Psychiatry

134

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Background Bipolar I disorder is defined by the occurrence of mania. The presence of mania, coupled with a course of illness characterized by waxing and waning of affective symptoms, suggests that bipolar disorder arises from dysfunction of neural systems that maintain emotional arousal and homeostasis. We used functional magnetic resonance imaging (fMRI) to study manic bipolar subjects as they performed a cognitive task designed to examine the ventrolateral prefrontal emotional arousal network. Methods We used fMRI to study regional brain activation in 40 DSM-IV manic bipolar I patients and 36 healthy subjects while they performed a continuous performance task with emotional and neutral distracters. Event-related region-of-interest analyses were performed to test the primary hypothesis. Voxelwise analyses were also completed. Results Compared with healthy subjects, the manic subjects exhibited blunted activation to emotional and neutral images, but not targets, across most of the predefined regions of interest. Several additional brain regions identified in the voxelwise analysis also exhibited similar differences between groups, including right parahippocampus, right lingual gyrus, and medial thalamus. In addition to these primary findings, the manic subjects also exhibited increased activation in response to targets in number of brain regions that were primarily associated with managing affective stimuli. Group differences did not appear to be secondary to medication exposure or other confounds. Conclusions Bipolar manic subjects exhibit blunted brain fMRI response to emotional cues throughout the ventrolateral prefrontal emotional arousal network. Disruption of this emotional network may contribute to the mood dysregulation of bipolar disorder.

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“…General measures of premorbid intellectual function (IQ) were obtained using the American Modification of the National Adult Reading Test (ANART) (20,21,41). Healthy subjects and bipolar patients achieving euthymia also received a more comprehensive assessment using the four-subtest version of the Wechsler Abbreviated Scale of Intelligence (WASI) (22).…”

Section: Methodsmentioning

confidence: 99%

Impulsivity across the course of bipolar disorder

Strakowski

Fleck

DelBello³

et al. 2010

Bipolar Disorders

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Objective-To determine whether abnormalities of impulse control persist across the course of bipolar disorder, thereby representing potential state markers and endophenotypes.Methods-Impulse control of 108 bipolar I manic or mixed patients was measured on three tasks designed to study response inhibition, ability to delay gratification, and attention; namely a stop signal task, a delayed reward task, and a continuous performance task, respectively. Barrett Impulsivity Scale (BIS-11) scores were also obtained. Patients were then followed for up to one year and re-assessed with the same measures if they developed depression or euthymia. Healthy comparison subjects were also assessed with the same instruments on two occasions to assess measurement stability.Results-At baseline, bipolar subjects demonstrated significant deficits on all three tasks as compared to healthy subjects, consistent with more impulsive responding in the bipolar manic/ mixed group. In general, performance on the three behavioral tasks normalized upon switching to depression or developing euthymia. In contrast, BIS-11 scores were elevated during mania and remained elevated as bipolar subjects developed depression or achieved euthymia.Conclusions-Bipolar I disorder patients demonstrate deficits on laboratory tests of various aspects of impulsivity when manic, as compared to healthy subjects, that largely normalize with recovery and switching into depression. However, elevated BIS scores persist across phases of illness. These findings suggest that impulsivity has both affective-state dependent and trait components in bipolar disorder. KeywordsBipolar disorder; BIS; impulsivity; delayed reward; inattention; response inhibition Impulsivity is a frequent component of the course and presentation of bipolar disorder; it has therefore been proposed to represent a core feature of the illness that persists across different affective states (1)(2)(3)(4)(5)(6)(7)(8). However, impulsivity is a multi-faceted construct that cannot be defined by a single behavior. For example, based on studies with the Barratt Impulsiveness Scale (BIS), Barratt and colleagues suggested that impulsivity consists of three independent Direct all correspondence to Stephen M. Strakowski, MD; Center for Imaging Research; University of Cincinnati College of Medicine; 231 Albert Sabin Way (ML0583), Cincinnati, Stephen.Strakowski@uc.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript behavioral factors (9,10). These factors include: 1) Non-planning Impulsiveness, which refers to a present orientation or failure to consider the future; 2) Motor Impulsiveness, i.e., acting without thinking; and 3) Attentional Impulsiveness, which is a tendency to shift attention quickly, causing inappropriately rapid decisions. This work and that of others (e.g., 11-13) suggests that impulsivity is comprised of three components: 1) an inability to delay gratification, i.e., an inability to delay response for an immediate reward in order to gain a la...

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Stability of estimated IQ across mood state in patients with bipolar disorder

Abstract: While the results are preliminary and based on a small sample, the highly consistent scores achieved across mood states in this study suggest that the ANART is a reliable indicator of premorbid IQ.

Cited by 6 publications

References 24 publications

A longitudinal functional connectivity analysis of the amygdala in bipolar I disorder across mood states

A longitudinal functional connectivity analysis of the amygdala in bipolar I disorder across mood states

Functional Magnetic Resonance Imaging Brain Activation in Bipolar Mania: Evidence for Disruption of the Ventrolateral Prefrontal-Amygdala Emotional Pathway

Impulsivity across the course of bipolar disorder

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