Morsel Anne M, Morrens Manuel, Temmerman Anke, Sabbe Bernard, de Bruijn Ellen R A
Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp.
Bipolar Disord. 2014 Dec;16(8):820-9. doi: 10.1111/bdi.12256. Epub 2014 Sep 15.
Apart from mood episodes, many cognitive deficits are present in bipolar disorder (BD). Performance monitoring is an important aspect of executive functioning and involves continuous monitoring of behavior and making subsequent changes when an error is made. On a neurophysiological level, the error-related negativity (ERN), an event-related brain potential (ERP) generated in the anterior cingulate cortex (ACC), reflects this process of performance monitoring. Abnormal ERN amplitudes have been observed in many major psychiatric disorders. However, despite conflicting evidence regarding the role of the ACC in BD, no studies to date have investigated performance monitoring as reflected in the ERN in BD.
Sixteen patients with BD in a euthymic state and 14 matched healthy controls performed a speeded two-choice reaction-time paradigm (Flankers Task) while electroencephalogram (EEG) measures were obtained. Behavioral and ERP measurements were analyzed for the two groups.
The patients with BD, although euthymic, scored higher on depressive symptoms than healthy controls. While no behavioral group differences were found, patients with BD displayed lower ERN amplitudes than healthy controls when controlling for effects of residual mood.
The lower ERN amplitudes in the BD group reflect reduced performance monitoring and extend current knowledge of executive functioning in BD. Importantly, these findings go a long way to resolving the contradictory results regarding ACC involvement in BD by showing that taking into account residual mood may greatly influence error-related ACC activations and is critically important in understanding cognitive deficits in BD.
除情绪发作外，双相情感障碍（BD）还存在许多认知缺陷。执行功能监测是执行功能的一个重要方面，涉及对行为的持续监测，并在出现错误时做出后续改变。在神经生理层面，错误相关负波（ERN）是在前扣带回皮质（ACC）产生的一种事件相关脑电位（ERP），反映了这种执行功能监测过程。在许多主要精神疾病中都观察到ERN波幅异常。然而，尽管关于ACC在BD中的作用存在相互矛盾的证据，但迄今为止尚无研究调查BD中ERN所反映的执行功能监测情况。
16名处于心境正常状态的BD患者和14名匹配的健康对照者进行了快速二选一反应时范式（侧翼任务），同时记录脑电图（EEG）测量数据。对两组的行为和ERP测量数据进行分析。
尽管处于心境正常状态，但BD患者的抑郁症状得分高于健康对照者。虽然未发现行为上的组间差异，但在控制残余情绪影响后，BD患者的ERN波幅低于健康对照者。
BD组较低的ERN波幅反映了执行功能监测的降低，并扩展了目前对BD执行功能的认识。重要的是，这些发现对于解决关于ACC参与BD的矛盾结果有很大帮助，表明考虑残余情绪可能会极大地影响与错误相关的ACC激活，并且对于理解BD中的认知缺陷至关重要。
