Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Westgate Road, Newcastle Upon Tyne, NE4 5LP, UK.
Eli Lilly and Company Limited, Lilly House, Priestly Road, Basingstoke RG24 9NL, UK.
Psychol Med. 2020 Jan;50(1):125-132. doi: 10.1017/S0033291718004038. Epub 2019 Jan 16.
Bipolar disorder (BD) is associated with attentional and processing abnormalities. Such abnormalities are also seen in healthy subjects with sleep disruption. We hypothesised cognitive abnormalities in BD patients would be worse in those with objectively verified sleep abnormalities.
Forty-six BD patients and 42 controls had comprehensive sleep/circadian rhythm assessment over 21 days alongside mood questionnaires. Cognitive function was assessed with a range of tasks including Psychomotor Vigilance Test (PVT), Attention Network Task (ANT) and Digit Symbol Substitution Test (DSST). BD participants with normal and abnormal sleep were compared with age- and sex-matched controls.
BD patients had longer response times and made more lapses (responses >500 ms) than controls on the PVT (both p < 0.001). However, patients with normal sleep patterns did not differ from controls while those with sleep abnormalities did (p < 0.001). An identical pattern of effects were seen with the ANT response times, with the abnormality in bipolar abnormal sleepers related to the executive attentional network. Similarly, patients made fewer correct responses on the DSST compared with the controls (p < 0.001). Bipolar normal sleepers did not differ while those with abnormal sleep did (p < 0.001). All these differences were seen in bipolar abnormal sleepers who were euthymic (p < 0.01) and across the main abnormal sleep phenotypes.
We confirm impairment in attention and processing speed in BD. Rather than sleep abnormalities exacerbating such dysfunction, the impairments were confined to bipolar abnormal sleepers, consistent with sleep disturbance being the main driver of cognitive dysfunction.
双相情感障碍（BD）与注意力和加工异常有关。睡眠紊乱的健康受试者也存在这种异常。我们假设 BD 患者的认知异常在客观证实的睡眠异常患者中会更严重。
46 名 BD 患者和 42 名对照者在 21 天内完成了全面的睡眠/昼夜节律评估，同时还进行了情绪问卷评估。认知功能通过一系列任务进行评估，包括精神运动警觉测试（PVT）、注意网络测试（ANT）和数字符号替代测试（DSST）。将具有正常和异常睡眠的 BD 参与者与年龄和性别匹配的对照组进行比较。
BD 患者的 PVT 反应时间比对照组更长，漏答（反应 >500 毫秒）更多（均 p<0.001）。然而，睡眠模式正常的患者与对照组没有差异，而睡眠异常的患者则有差异（p<0.001）。ANT 反应时间也出现了类似的影响模式，双相异常睡眠者的异常与执行注意网络有关。同样，患者在 DSST 上的正确反应比对照组少（p<0.001）。睡眠正常的双相患者没有差异，而睡眠异常的患者则有差异（p<0.001）。这些差异在双相异常睡眠者中均可见，且这些患者处于轻躁狂状态（p<0.01），并跨越主要的异常睡眠表型。
我们证实了 BD 存在注意力和加工速度受损。而不是睡眠异常加重了这种功能障碍，这些损伤仅限于双相异常睡眠者，这与睡眠紊乱是认知功能障碍的主要驱动因素一致。
