Tröger Anna, Carmellini Pietro, Tsapekos Dimosthenis, Gross Joachim, Young Allan H, Strawbridge Rebecca, Ritter Philipp
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Department of Molecular and Developmental Medicine, Division of Psychiatry, University of Siena School of Medicine, Siena, Italy.
Neurosci Biobehav Rev. 2025 Jun;173:106157. doi: 10.1016/j.neubiorev.2025.106157. Epub 2025 Apr 14.
People with bipolar disorder (BD) may experience impairing cognitive deficits, even in remission. Electroencephalographic (EEG) measures can depict neurophysiological activity with high temporal resolution. They could therefore be an adequate method to pinpoint the cognitive impairments in BD, facilitating understanding of when exactly the cognitive processing is disrupted and what neurophysiological systems are involved. In the absence of a previous literature examination, this systematic review aimed to synthesize the evidence of associations between EEG and cognitive measures to identify electrophysiological markers of cognitive performance in BD.
A systematic search across PubMed, EMBASE, APA PsycInfo and Cochrane Library until November 2023 was undertaken to identify studies in which a direct correlation between any continuous EEG measure and any continuous cognitive measure in participants with BD was reported. A narrative synthesis approach was used to present the identified correlations, across five cognitive (attention and processing speed, working memory, episodic memory, executive function, and intellectual capacity) and four EEG domains (event-related potentials (ERP), spectral, connectivity and other measures).
A total of 16 articles describing 15 studies were included in the review. Six studies identified significant correlations. Most significant correlations were reported between ERP measures and attention and processing speed performance, several between ERP measures and executive functioning and one within the working memory and the intellectual capacity domain respectively. However, most of the identified significant correlations were conflicting within (different measures or mood states) and across studies with no consistent significant correlation across studies. The majority of identified correlations were non-significant.
As yet no robust EEG markers of cognitive performance in people with BD are known. This review highlights the heterogeneity in measures and participant characteristics between studies and the need for standardization. Further studies with homogeneous methods and participant groups may help to establish consistent associations.
双相情感障碍（BD）患者即使在缓解期也可能经历损害性的认知缺陷。脑电图（EEG）测量可以以高时间分辨率描绘神经生理活动。因此，它们可能是确定BD认知障碍的一种适当方法，有助于理解认知加工究竟在何时被破坏以及涉及哪些神经生理系统。在没有先前文献审查的情况下，本系统评价旨在综合EEG与认知测量之间关联的证据，以确定BD认知表现的电生理标志物。
对PubMed、EMBASE、APA PsycInfo和Cochrane图书馆进行系统检索，直至2023年11月，以识别报告BD患者中任何连续EEG测量与任何连续认知测量之间直接相关性的研究。采用叙述性综合方法，在五个认知领域（注意力和处理速度、工作记忆、情景记忆、执行功能和智力）和四个EEG领域（事件相关电位（ERP）、频谱、连接性和其他测量）中呈现已识别的相关性。
本评价共纳入16篇描述15项研究的文章。六项研究确定了显著相关性。大多数显著相关性报告于ERP测量与注意力和处理速度表现之间，若干报告于ERP测量与执行功能之间，以及分别在工作记忆和智力领域内各有一项。然而，大多数已识别的显著相关性在（不同测量或情绪状态）内部以及跨研究之间存在冲突，没有跨研究一致的显著相关性。大多数已识别的相关性不显著。
目前尚不知道BD患者认知表现的可靠EEG标志物。本评价强调了研究之间测量方法和参与者特征的异质性以及标准化的必要性。采用同质方法和参与者群体的进一步研究可能有助于建立一致的关联。
