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双相情感障碍患者及对照组的特质冲动性和对强烈刺激的注意前敏感性增加。

Trait impulsivity and increased pre-attentional sensitivity to intense stimuli in bipolar disorder and controls.

作者信息

Lijffijt Marijn, Lane Scott D, Moeller F Gerard, Steinberg Joel L, Swann Alan C

机构信息

Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, BCM350, Houston, TX 77030, USA.

Department of Psychiatry and Behavioral Sciences, The University of Texas Health Sciences Center, Houston, TX 77054, USA.

出版信息

J Psychiatr Res. 2015 Jan;60:73-80. doi: 10.1016/j.jpsychires.2014.10.004. Epub 2014 Oct 12.

Abstract

Impulsivity and sensation seeking are stimulus-oriented traits. Because they differ in degree of intention and planning, they may have distinct neurophysiological mechanisms. Impulsivity is prominent in bipolar disorder, and may be related to pre-attentional information filtering and stimulus-orientation. We investigated specificity of relationships between impulsivity and sensitivity to stimulus intensity in bipolar disorder and controls, using intensity-sensitivity of auditory evoked potentials. Seventy-six subjects (37 healthy controls, 39 with bipolar disorder) were administered an intensity-sensitivity paradigm. Additional measures included Barratt Impulsiveness Scale (BIS-11) and Eysenck Impulsivity and Venturesomeness scores. State-dependent rapid-response impulsivity was measured using the Immediate Memory Task. Intensity-sensitivities of the auditory evoked P1N1, N1P2, P1, N1, and P2 potentials were assessed as the slope of amplitude relative to loudness. Analyses used general linear models (GLM) with impulsivity-related measures as dependent variables and age, gender, education, and diagnosis as dependent variables. BIS-11 total, motor, and attentional impulsivity scores correlated positively with pre-attentional N1 and P1N1 intensity-sensitivity slopes in bipolar disorder, but not in controls. BIS-11 nonplanning and Eysenck Venturesomeness scores did not correlate with intensity-sensitivity. Intensity-sensitivity slopes did not correlate with rapid-response impulsivity. Correlations between N1 or P1N1 slopes and BIS-11 scores in bipolar disorder were not affected by age, education, WAIS, treatment, symptoms, or gender. Trait impulsivity in bipolar disorder may be related to poorly modulated stimulus-driven late pre-attentional responses to stimuli, potentially resulting in exaggerated responses to intense stimuli even before conscious awareness. Components of trait impulsivity are physiologically heterogenous relative to intensity-sensitivity.

摘要

冲动性和感觉寻求是受刺激驱动的特质。由于它们在意图和计划程度上存在差异,可能具有不同的神经生理机制。冲动性在双相情感障碍中较为突出,可能与注意前信息过滤和刺激导向有关。我们使用听觉诱发电位的强度敏感性,研究了双相情感障碍患者和对照组中冲动性与刺激强度敏感性之间关系的特异性。76名受试者(37名健康对照者,39名双相情感障碍患者)接受了强度敏感性范式测试。其他测量指标包括巴拉特冲动性量表(BIS-11)以及艾森克冲动性和冒险性得分。使用即时记忆任务测量状态依赖的快速反应冲动性。听觉诱发的P1N1、N1P2、P1、N1和P2电位的强度敏感性通过振幅相对于响度的斜率来评估。分析采用一般线性模型(GLM),将与冲动性相关的测量指标作为因变量,年龄、性别、教育程度和诊断作为自变量。在双相情感障碍患者中,BIS-11总分、运动性和注意性冲动性得分与注意前N1和P1N1强度敏感性斜率呈正相关,但在对照组中并非如此。BIS-11非计划性得分和艾森克冒险性得分与强度敏感性无关。强度敏感性斜率与快速反应冲动性无关。双相情感障碍患者中N1或P1N1斜率与BIS-11得分之间的相关性不受年龄、教育程度、韦氏成人智力量表、治疗、症状或性别的影响。双相情感障碍中的特质冲动性可能与对刺激的注意前后期反应调节不良有关,这可能导致在有意识觉察之前对强烈刺激产生过度反应。相对于强度敏感性,特质冲动性的各个成分在生理上具有异质性。

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引用本文的文献

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