Prefrontal and paralimbic metabolic dysregulation related to sustained attention in euthymic older adults with bipolar disorder

Authors


  • This paper was presented at the 2007 Society of Biological Psychiatry 62nd Annual Convention, May 17–19, 2007, San Diego, CA, USA.

  • JOB is on the speakers bureau of Merck and Pfizer. TAK receives/has received grant/research support from Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Eisai, Elan Pharmaceuticals, Eli Lilly & Co., GlaxoSmithKline, Janssen Pharmaceutica, Novartis, Pfizer, Repligen, Shire Pharmaceuticals, Solvay, and Wyeth; has served as a consultant for Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Cephalon, Corcept Therapeutics, Elan Pharmaceuticals, Eli Lilly & Co., Forest Laboratories, GlaxoSmithKline, Janssen Pharmaceutica, Jazz Pharmaceuticals, Merck & Co., Novartis, Pfizer, Repligen, Shire Pharmaceuticals, Solvay, UCB Pharmaceuticals, and Wyeth; has received lecture honoraria from Abbott Laboratories, AstraZeneca, Bristol-Myers Squibb, Eli Lilly & Co., GlaxoSmithKline, Janssen Pharmaceutica, Novartis, Pfizer, Shire Pharmaceuticals; and his wife has been an employee/stockholder of Johnson & Johnson. CEB, JCH, and SAW have no financial disclosures to report.

Corresponding author:
John O. Brooks, III, Ph.D., M.D.
Semel Institute for Neuroscience and Human Behavior
760 Westwood Plaza, B8-233b
Los Angeles, CA 90024, USA
Fax: (310) 206-2072
E-mail: john.brooks@ucla.edu

Abstract

Brooks JO III, Bearden CE, Hoblyn JC, Woodard SA, Ketter TA. Prefrontal and paralimbic metabolic dysregulation related to sustained attention in euthymic older adults with bipolar disorder.
Bipolar Disord 2010: 12: 866–874. © 2010 The Authors.
Journal compilation © 2010 John Wiley & Sons A/S.

Objective:  Reports of sustained attention deficits in the euthymic phase of bipolar disorder have been variable, and have yet to be related to cerebral metabolism. In the present study, we evaluated relationships between cognitive performance deficits and resting cerebral metabolism in euthymic older adults with bipolar disorder.

Methods:  Sixteen older (mean age 58.7 years) euthymic outpatients with bipolar disorder (10 type I, 6 type II; 44% female) and 11 age-matched healthy controls received resting positron emission tomography with 18fluorodeoxyglucose and, within 10 days, the Conners’ Continuous Performance Test-II, a commonly used measure of sustained attention and inhibitory control.

Results:  Bipolar disorder patients had significantly more omission errors (z = 2.53, p = 0.01) and a trend toward more commission errors (z = 1.83, p < 0.07) than healthy controls. Relative to healthy controls, among bipolar disorder subjects commission errors were more strongly related to inferior frontal gyrus [Brodmann area (BA) 45/47] hypometabolism and paralimbic hypermetabolism. In bipolar disorder subjects, relative to controls, omission errors were more strongly related to dorsolateral prefrontal (BA 9/10) hypometabolism and greater paralimbic, insula, and cingulate hypermetabolism.

Conclusions:  In older adults with bipolar disorder, even during euthymia, resting-state corticolimbic dysregulation was related to sustained attention deficits and inhibitory control, which could reflect the cumulative impact of repeated affective episodes upon cerebral metabolism and neurocognitive performance. The relative contributions of aging and recurrent affective episodes to these differences in bipolar disorder patients remain to be established.

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