Fronto-temporal dysregulation in remitted bipolar patients: an fMRI delayed-non-match-to-sample (DNMS) study

Objectives:  Bipolar disorder is associated with working memory (WM) impairments that persist during periods of symptomatic remission. However, the neural underpinnings of these deficits are not well understood. Methods:  Fifteen clinically remitted bipolar patients and 15 demographically matched he...

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Bibliographic Details
Published in:Bipolar disorders 2009-06, Vol.11 (4), p.351-360
Main Authors: Robinson, Jennifer L, Bearden, Carrie E, Monkul, E Serap, Tordesillas-Gutiérrez, Diana, Velligan, Dawn I, Frangou, Sophia, Glahn, David C
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
bipolar disorder
Bipolar Disorder - pathology
Brain Mapping
cognition
Discrimination Learning
euthymia
Female
Frontal Lobe - blood supply
Frontal Lobe - physiopathology
Humans
Image Processing, Computer-Assisted - methods
Magnetic Resonance Imaging - methods
Male
medial temporal lobe
Memory - physiology
Middle Aged
Neuropsychological Tests
Oxygen - blood
prefrontal cortex
Reaction Time - physiology
Temporal Lobe - blood supply
Temporal Lobe - physiopathology
working memory
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Summary:Objectives:  Bipolar disorder is associated with working memory (WM) impairments that persist during periods of symptomatic remission. However, the neural underpinnings of these deficits are not well understood. Methods:  Fifteen clinically remitted bipolar patients and 15 demographically matched healthy controls underwent functional magnetic resonance imaging while performing a novel delayed‐non‐match‐to‐sample (DNMS) task. This nonverbal DNMS task involves two conditions, one requiring the organization of existing memory traces (‘familiarity’), and one involving the formation of new memory traces (‘novelty’). These processes are thought to differentially engage the prefrontal cortex and medial temporal lobe, respectively. Results:  Although behavioral performance did not differ between groups, bipolar patients and controls exhibited significantly different patterns of neural activity during task performance. Patients showed relative hyperactivation in the right prefrontal gyrus and relative hypoactivation in visual processing regions compared to healthy subjects across both task conditions. During the novelty condition, patients showed a pattern of hypoactivation relative to controls in medial temporal regions, with relative hyperactivation in the anterior cingulate. Conclusions:  These findings suggest that disruption in fronto‐temporal neural circuitry may underlie memory difficulties frequently observed in patients with bipolar disorder.
ISSN:1398-5647
1399-5618
DOI:10.1111/j.1399-5618.2009.00703.x