Neural correlates of reversal learning in severe mood dysregulation and pediatric bipolar disorder
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Objective Outcome and family history data differentiate children with severe mood dysregulation (SMD), a syndrome characterized by chronic irritability, from children with "classic" episodic bipolar disorder (BD). Nevertheless, the presence of cognitive inflexibility in SMD and BD highlights the need to delineate neurophysiologic similarities and differences between the two patient groups. Functional magnetic resonance imaging was used to examine neural correlates of cognitive flexibility deficits in patients with SMD and BD versus healthy volunteers (HV).Method During functional magnetic resonance imaging, subjects completed a response reversal task that assessed cognitive flexibility (n = 22 with SMD, 26 with BD, 34 HV). Task effects were examined in four regions of interest: caudate, cingulate gyrus, inferior frontal gyrus (IFG), and ventromedial prefrontal cortex.Results Diagnosis-by-accuracy interactions emerged in the caudate and IFG. In these regions, the difference in activation was calculated between incorrect and correct trials. In the caudate, this value was smaller in subjects with SMD and with BD than in HV. In the IFG, however, this value was smaller in subjects with SMD than in those with BD and in HV. Post hoc analyses indicated that comorbid attention-deficit/hyperactivity disorder in patients may influence the caudate findings. Exploratory whole-brain analysis confirmed the caudate and IFG findings. In addition, other regions differentiating SMD from BD were identified (e.g., superior parietal lobule/precuneus and inferior temporal gyrus).Conclusions In response to errors, similar perturbations occur in the caudate for youth with SMD and BD compared with HV youth. IFG deficits, in contrast, manifest in youth with SMD, but not with BD.
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Probabilistic reversal learning tasks have often been used to test cognitive flexibility.
“To test cognitive flexibility, probabilistic reversal learning tasks have often been used (e.g., Adleman et al., 2011; Britton et al., 2010; Clarke et al., 2004; Klanker et al., 2013; van der Plasse and Feenstra, 2008; Xue et al., 2013).”
From Cognitive flexibility in adolescence: Neural and behavioral mechanisms of reward prediction error processing in adaptive decision making during development (2015) · cites this paper as Adleman et al., 2011
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- Authors
- Adleman, N. E., Kayser, R., Dickstein, D., Blair, R. J. R., Pine, D., & Leibenluft, E.
- Affiliations
- National Institutes of Health (US)
- Brown University (US)
- Corresponding author
- Adleman, Nancy E.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-11
- Volume
- 50
- Issue
- 11
- Pages
- 1173-1185.e2
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC3206630
- OpenAlex
- W2058052047
- Cited by
- 106
- References
- 78
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 11 · 2021: 11 · 2020: 9 · 2019: 6 · 2018: 9 · 2017: 10 · 2016: 10 · 2015: 7 · 2014: 3 · 2013: 6 · 2012: 8
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 MH999999)
- National Institute of Mental Health (Z01MH002778, ZIAMH002778, ZIAMH002786)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- severe mood dysregulation, pediatric bipolar disorder, reversal learning, cognitive flexibility, caudate nucleus, inferior frontal gyrus, ventromedial prefrontal cortex, cingulate gyrus, ADHD comorbidity, chronic irritability, functional MRI
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Bipolar Disorder, Caudate Nucleus, Chronic Disease, Female, Gyrus Cinguli, Humans, Magnetic Resonance Imaging, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Reversal Learning, Severity of Illness Index, Comorbidity, Prefrontal Cortex, Mood Disorders
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