Hostname: page-component-745bb68f8f-hvd4g Total loading time: 0 Render date: 2025-01-29T00:13:01.485Z Has data issue: false hasContentIssue false
  • English
  • Français

Working memory and inhibitory control among manic and euthymic patients with bipolar disorder

Published online by Cambridge University Press:  11 April 2005

ERIC R. LARSON ,
PAULA K. SHEAR ,
ROBERT KRIKORIAN ,
JEFFREY WELGE  and
STEPHEN M. STRAKOWSKI
ERIC R. LARSON
Affiliation:
Department of Psychiatry, University of Chicago, Chicago, Illinois
PAULA K. SHEAR
Affiliation:
Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio Department of Psychology, University of Cincinnati, Cincinnati, Ohio
ROBERT KRIKORIAN
Affiliation:
Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio
JEFFREY WELGE
Affiliation:
Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio
STEPHEN M. STRAKOWSKI
Affiliation:
Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio Department of Psychology, University of Cincinnati, Cincinnati, Ohio
Get access Rights & Permissions [Opens in a new window]

Abstract

Bipolar disorder (BPD) is a severe psychiatric illness that is characterized by episodes of extreme mood states. The affective components of bipolar disorder have been studied extensively, but only recently have investigators begun to systematically examine its cognitive concomitants. Although executive dysfunction has been reported in this population, especially while patients are manic, the tasks administered in many previous studies have made it difficult to determine the specific executive abilities that were compromised. The present study examined 15 patients with bipolar disorder who were manic, 18 who were euthymic, and 18 healthy participants. Tests were selected to evaluate two specific aspects of executive functioning in these participants. The Object Alternation Task was given as a measure of inhibitory control, and the Delayed Response Task was included as a measure of spatial delayed working memory. All groups performed similarly on the Delayed Response Task. On the Object Alternation Task, however, the manic and euthymic patients committed significantly more perseverative errors than healthy participants. These results indicated that patients in the present sample had relatively normal working memory abilities, but had a deficit in behavioral self-regulation, which was evident across mood states. (JINS, 2005, 11, 163–172.)Location of work: Center for Bipolar Disorders Research, Department of Psychiatry, University of Cincinnati School of Medicine, Cincinnati, Ohio.

Keywords

Bipolar disorderCognitiveExecutive functioning
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 2 , March 2005 , pp. 163 - 172
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Albert, M.S., Wolfe, J., & Lafleche, G. (1990). Differences in abstraction ability with age. Psychology and Aging, 5, 94–100.Google Scholar
Andreasen, N.C. (1982). Scale for the assessment of positive symptoms (SAPS). Iowa City, IA: The University of Iowa.
Bardenhagen, F.J. & Bowden, S.C. (1998). Cognitive components in perseverative and nonperseverative errors on the object alternation task. Brain and Cognition, 37, 224–236.Google Scholar
Benton, A.L., Hamsher, K., & Sivan, A.B. (1994). Multilingual Aphasia Examination (3rd ed.). Iowa City, IA: AJA Associates.
Benton, A.L. & Van Allen, M.W. (1968). Impairment in facial recognition in patients with cerebral disease. Cortex, 4, 344–358.Google Scholar
Blumberg, H.P., Leung, H.C., Skudlarski, P., Lacadie, C.M., Fredericks, C.A., Harris, B.C., Charney, D.S., Gore, J.C., & Krystal, J.H. (2003). A functional magnetic resonance imaging study of bipolar disorder. Archives of General Psychiatry, 60, 601–609.Google Scholar
Brewer, W.J., Edwards, J., Anderson, V., Robinson, T., & Pantelis, C. (1996). Neuropsychological, olfactory, and hygiene deficits in men with negative symptom schizophrenia. Biological Psychiatry, 40, 1021–1031.Google Scholar
Cavanagh, J.T.O., Van Beck, M., Muir, W., & Blackwood, D.H.R. (2002). Case-control study of neurocognitive function in euthymic patients with bipolar disorder: An association with mania. Journal of Psychiatry, 180, 320–326.Google Scholar
Chowdhury, R., Ferrier, N., & Thompson, J.M. (2003). Cognitive dysfunction in bipolar disorder. Current Opinions in Psychiatry, 16, 7–12.Google Scholar
Clark, L., Iversen, S.D., & Goodwin, G.M. (2002). Sustained attention deficit in bipolar disorder. British Journal of Psychiatry, 180, 313–319.Google Scholar
Denicoff, K.D., Ali, S.O., Mirsky, A.F., Smith-Jackson, E.E., Leverich, G.S., Duncan, C.C., Connell, E.G., & Post, R.M. (1999). Relationship between prior course of illness and neuropsychological functioning in patients with bipolar disorder. Journal of Affective Disorders, 56, 67–73.CrossRefGoogle Scholar
DeRenzi, E. & Vignolo, L. (1962). The token test: A sensitive test to detect receptive disturbances in aphasics. Brain, 85, 665–678.Google Scholar
Ferrier, I.N., Stanton, B.R., Kelly, T.P., & Scott, J. (1999). Neuropsychological function in euthymic patients with bipolar disorder. British Journal of Psychiatry, 175, 246–251.Google Scholar
Freedman, M. (1990). Object alternation and orbitofrontal system dysfunction in Alzheimer's and Parkinson's disease. Brain and Cognition, 14, 134–143.CrossRefGoogle Scholar
Gansler, D.A., Covall, S., McGrath, N., & Oscar-Berman, M. (1996). Measures of prefrontal dysfunction after closed head injury. Brain and Cognition, 30, 194–204.Google Scholar
Gellerman, L.W. (1933). Chance order of alternating stimuli in visual discrimination experiments. Journal of Genetic Psychology, 42, 207–208.Google Scholar
Goldman-Rakic, P.S. (1987). Circuitry of primate prefrontal cortex and regulation of behavior by representational memory. In F. Plum & V. Mountcastle (Eds.), Handbook of physiology—the nervous system, Vol. 5 (pp. 373–417). Washington, DC: American Physiological Society.
Goldman, P.S. & Rosvold, H.E. (1970). Localization of function within the dorsolateral prefrontal cortex of the rhesus monkey. Experimental Neurology, 27, 291–304.Google Scholar
Grober, E. & Sliwinski, M. (1991). Development and validation of a model for estimating premorbid verbal intelligence in the elderly. Journal of Clinical and Experimental Neuropsychology, 13, 933–949.Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.CrossRefGoogle Scholar
Harmer, C.J., Clark, L., Grayson, L., & Goodwin, G.M. (2002). Sustained attention deficit in bipolar disorder is not a working memory impairment in disguise. Neuropsychologia, 40, 1586–1590.Google Scholar
Henry, G.M., Weingartner, H., & Murphy, D.L. (1971). Idiosyncratic patterns of learning and word association during mania. American Journal of Psychiatry, 128, 564–573.Google Scholar
Henry, G.M., Weingartner, H., & Murphy, D.L. (1973). Influence of affective states and psychoactive drugs on verbal learning and memory. American Journal of Psychiatry, 130, 966–971.Google Scholar
Hoff, A.L., Shukla, S., Cook, B.L., Aronson, T.A., Ollo, C.L., & Pass, H.L. (1988). Cognitive function in manics with associated neurologic factors. Journal of Affective Disorders, 14, 251–255.Google Scholar
Larson, E.R., Krikorian, R., & Strakowski, S. (1998). Neuropsychological functioning in first-episode mania. Archives of Clinical Neuropsychology, 13, 59–60.Google Scholar
Larson, E.R., Shear, P.K., Krikorian, R., & Strakowski, S.M. (2001). Spatial working memory in manic and euthymic patients with bipolar disorder. Journal of the International Neuropsychological Society, 7, 223.Google Scholar
Levin, H.S., Eisenberg, H.M., & Benton, A.L. (1991). Frontal lobe function and dysfunction. New York: Oxford University Press.
Levine, B., Freedman, M., Dawson, D., Black, S., & Stuss, D.T. (1999). Ventral frontal contribution to self-regulation: Convergence of episodic memory and inhibition. Neurocase, 5, 263–275.Google Scholar
Martinez-Aran, A., Penades, R., Vieta, E., Colom, F., Reinares, M., Benabarre, A., Salamero, M., & Gasto, C. (2001). Executive function in patients with remitted bipolar disorder and schizophrenia and its relationship with functional outcome. Psychotherapy and Psychosomatics, 71, 39–46.Google Scholar
Martinez-Aran, A., Vieta, E., Colom, F., Reinares, M., Benabarre, A., Gasto, C., & Salamero, M. (2000). Cognitive dysfunctions in bipolar disorder: Evidence of neuropsychological disturbances. Psychotherapy and Psychosomatics, 69, 2–18.Google Scholar
McClellan, A.T., Luborsky, L., Woody, G.E., & O'Brien, C.P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disorders, 168, 26–33.Google Scholar
McGrath, J., Scheldt, S., & Clair, A. (1997). Performance on tests sensitive to impaired executive ability in schizophrenia, mania, and well controls: Acute and subacute phases. Schizophrenia Research, 26, 127–137.Google Scholar
Meeks, S. (1999). Bipolar disorder in the latter half of life: Symptom presentation, global functioning and age of onset. Journal of Affective Disorders, 52, 161–167.Google Scholar
Mishkin, M., Vest, B., Waxler, M., & Rosvold, E. (1969). A re-examination of the effects of frontal lesions on object alternation. Neuropsychologia, 7, 357–363.Google Scholar
Morice, R. (1990). Cognitive inflexibility and pre-frontal dysfunction in schizophrenia and mania. British Journal of Psychiatry, 157, 50–54.Google Scholar
Murphy, F.C., Sahakian, B.J., Rubinsztein, J.S., Michael, A., Rogers, R.D., Robbins, T.W., & Paykel, E.S. (1999). Emotional bias and inhibitory control processes in mania and depression. Psychological Medicine, 29, 1307–1321.Google Scholar
Oscar-Berman, M. (1975). The effects of dorsolateral-frontal and ventrolateral-orbitofrontal lesions on spatial discrimination learning and delayed response in two modalities. Neuropsychologia, 13, 237–246.Google Scholar
Oscar-Berman, M. (1991). Clinical and experimental approaches to varieties of memory. International Journal of Neuroscience, 58, 135–150.Google Scholar
Park, S. & Holzman, P.S. (1992). Schizophrenics show spatial working memory deficits. Archives of General Psychiatry, 49, 975–982.Google Scholar
Sax, K.W., Strakowski, S.M., McElroy, S.L., Keck, P.E., & West, S. (1995). Attention and formal thought disorder in mixed and pure mania. Biological Psychiatry, 37, 420–423.Google Scholar
Shapiro, R.W. & Keller, M.B. (1981). Initial 6-month follow-up of patients with major depressive disorder. Journal of Affective Disorders, 3, 205–220.Google Scholar
Spitzer, R.L., Willimas, J.B., Gibbon, M., & First, M.G. (1995). Structured clinical interview for DSM-IV patient edition (SCID-P). New York: New York State Psychiatric Institutes.
Spreen, O. & Strauss, E. (1998). A compendium of neuropsychological tests: Administration, norms, and commentary. New York, NY: Oxford University Press.
Strakowski, S.M., Keck, P.E., McElroy, S.L., West, S.A., Sax, K.W., Hawkins, J.M., Kmetz, G.F., Upadhyaya, V.H., Tugrul, K.C., & Bourne, M.L. (1998). MRI brain structural abnormalities in pathways that modulate mood in bipolar disorder. Archives of General Psychiatry, 55, 49–55.Google Scholar
Strakowski, S.M., DelBello, M.P., Sax, K.W., Zimmerman, M.E., Hawkins, J.M., Shear, P.K., & Larson, E.R. (1999). Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. Archives of General Psychiatry, 56, 254–260.Google Scholar
Swann, A.C., Anderson, J.C., Dougherty, D.M., & Moeller, F.G. (2001). Measurement of inter-episode impulsivity in bipolar disorder. Psychiatry Research, 101, 195–197.Google Scholar
Sweeney, J.A., Kmiec, J.A., & Kupfer, D.J. (2000). Neuropsychologic impairments in bipolar and unipolar mood disorders on the CANTAB neurocognitive battery. Biological Psychiatry, 48, 674–685.Google Scholar
van Gorp, W.G., Altshuler, L., Theberge, D.C., Wilkins, J., & Dixon, W. (1998). Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. Archives of General Psychiatry, 55, 41–46.Google Scholar
Young, R.C., Biggs, J.T., Zeigler, V.E., & Meyer, D.A. (1978). A rating scale for mania: Reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429–435.Google Scholar