A Preliminary fMRI Study of Sustained Attention in Euthymic, Unmedicated Bipolar Disorder
Abstract
The symptoms of bipolar disorder suggest dysfunction of anterior limbic networks that modulate emotional behavior and that reciprocally interact with dorsal attentional systems. Bipolar patients maintain a constant vulnerability to mood episodes even during euthymia, when symptoms are minimal. Consequently, we predicted that, compared with healthy subjects, bipolar patients would exhibit abnormal activation of regions of the anterior limbic network with corresponding abnormal activation of other cortical areas involved in attentional processing. In all, 10 unmedicated euthymic bipolar patients and 10 group-matched healthy subjects were studied with fMRI while performing the Continuous Performance Task-Identical Pairs version (CPT-IP). fMRI scans were obtained on a 3.0 T Bruker system using an echo planar imaging (EPI) pulse sequence, while subjects performed the CPT-IP and a control condition to contrast group differences in regional brain activation. The euthymic bipolar and healthy subjects performed similarly on the CPT-IP, yet showed significantly different patterns of brain activation. Specifically, bipolar patients exhibited increased activation of limbic, paralimbic, and ventrolateral prefrontal areas, as well as visual associational cortices. Healthy subjects exhibited relatively increased activation in fusiform gyrus and medial prefrontal cortex. In conclusion, these differences suggest that bipolar patients exhibit overactivation of anterior limbic areas with corresponding abnormal activation in visual associational cortical areas, permitting successful performance of an attentional task. Since the differences occurred in euthymia, they may represent trait, rather than state, abnormalities of brain function in bipolar disorder.
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Over-activation of limbic regions including the hypothalamus and amygdala and underactivation of medial prefrontal cortex have been observed during performance of a sustained attention task in patients with bipolar disorder studied when euthymic.
“Over-activation of limbic regions including the hypothalamus and amygdala and underactivation of medial prefrontal cortex have been observed during performance of a sustained attention task in patients with bipolar disorder studied when euthymic (Strakowski et al. 2004).”
From Anatomical connectivity of the subgenual cingulate region targeted with deep brain stimulation for treatment-resistant depression (2008) · cites this paper as Strakowski et al. 2004
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- Authors
- Strakowski, S. M., Adler, C. M., Holland, S. K., Mills, N., & DelBello, M. P.
- Affiliations
- University of Cincinnati (US)
- Corresponding author
- Strakowski, Stephen M
- Venue
- Neuropsychopharmacology
- Published
- 2004-06-02
- Volume
- 29
- Issue
- 9
- Pages
- 1734-1740
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- OpenAlex
- W2062908676
- Cited by
- 242
- References
- 30
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 6 · 2018: 8 · 2017: 5 · 2016: 8 · 2015: 7 · 2014: 11 · 2013: 15 · 2012: 19
- FWCI
- 12.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stanley Medical Research Institute
- National Institutes of Health
- National Institute of Mental Health (MH 58170, R01MH058170)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, euthymia, sustained attention, dorsal attention network, unmedicated patients, fusiform gyrus, medial prefrontal cortex, ventrolateral prefrontal cortex
- MeSH terms
- Adult, Attention, Bipolar Disorder, Cerebral Cortex, Cognition, Female, Humans, Image Processing, Computer-Assisted, Limbic System, Magnetic Resonance Imaging, Male, Nerve Net, Psychiatric Status Rating Scales, Psychomotor Performance
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