FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain.
Addictive Behaviours Unit, Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Psychol Med. 2023 Feb;53(3):1021-1029. doi: 10.1017/S0033291721002452. Epub 2021 Aug 5.
Although executive impairment has been reported in mania, its brain functional correlates have been relatively little studied. This study examined goal management, believed to be more closely related to executive impairment in daily life than other executive tasks, using a novel functional magnetic resonance imaging (fMRI) paradigm in patients in this illness phase.
Twenty-one currently manic patients with bipolar disorder and 30 matched healthy controls were scanned while performing the Computerized Multiple Elements Test (CMET). This requires participants to sequentially play four simple games, with transition between games being made either voluntarily (executive condition) or automatically (control condition).
CMET performance was impaired in the manic patients compared to the healthy controls. Manic patients failed to increase activation in the lateral frontal, cingulate and inferior parietal cortex when the executive demands of the task increased, while this increase was observed in the healthy controls. Activity in these regions was associated with task performance.
Manic patients show evidence of impaired goal management, which is associated with a pattern of reduced medial and lateral frontal and parietal activity.
尽管已有研究报道躁狂症患者存在执行功能障碍，但对其大脑功能相关性的研究相对较少。本研究采用一种新颖的功能性磁共振成像（fMRI）范式，对处于疾病发作期的患者进行研究，以检验目标管理能力，该能力被认为与日常生活中的执行功能障碍关系更为密切，而非其他执行任务。
对 21 名目前处于躁狂状态的双相情感障碍患者和 30 名匹配的健康对照者进行了扫描，要求他们在执行计算机化多项元素测试（CMET）时完成四个简单游戏，游戏之间的转换可以是自愿的（执行条件）或自动的（控制条件）。
与健康对照组相比，CMET 测试在躁狂患者中表现出受损。当任务的执行要求增加时，躁狂患者未能增加外侧额叶、扣带回和下顶叶皮质的激活，而健康对照组则观察到了这种增加。这些区域的活动与任务表现相关。
躁狂症患者表现出目标管理受损的证据，这与内侧和外侧额叶及顶叶活动减少的模式有关。
