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Low baseline startle and deficient affective startle modulation in remitted bipolar disorder patients and their unaffected siblings

Authors

  • Stella G. Giakoumaki,

    1. Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Greece
    2. Section of Neurobiology of Psychosis, NIHR Biomedical Research Centre for Mental Health and Institute of Psychiatry, King's College London, London, UK
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  • Panos Bitsios,

    1. Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Greece
    2. Section of Neurobiology of Psychosis, NIHR Biomedical Research Centre for Mental Health and Institute of Psychiatry, King's College London, London, UK
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  • Sofia Frangou,

    1. Section of Neurobiology of Psychosis, NIHR Biomedical Research Centre for Mental Health and Institute of Psychiatry, King's College London, London, UK
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  • Panos Roussos,

    1. Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Greece
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  • Ingrid Aasen,

    1. Department of Psychology, Institute of Psychiatry, King's College, London, London, UK
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  • Adrian Galea,

    1. Division of Psychological Medicine, Institute of Psychiatry, King's College, London, London, UK
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  • Veena Kumari

    1. Department of Psychology, Institute of Psychiatry, King's College, London, London, UK
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  • S.G.G. was supported by an honorary postdoctorate fellowship by the Greek State Scholarship Foundation and a “Propondis Foundation” scholarship. P.R. was supported by a Manasaki Foundation scholarship. V.K. is supported by the Wellcome Trust, UK (067427/z/02). These funding/support bodies had no role in the design and conduct of the study, in collection, management, analysis and interpretation of the data, and in preparation, review, or approval of the manuscript. The authors of this paper do not have any financial interests or conflicts to disclose in connection with this manuscript.

Address reprint requests to: Panos Bitsios, Department of Psychiatry & Behavioral Sciences, Faculty of Medicine PO BOX 2208, University of Crete, Heraklion 71003, Crete, Greece. E-mail: pbitsios@med.uoc.gr

Abstract

We examined whether startle abnormalities are present in bipolar disorder (BD) patients and their unaffected siblings. Twenty-one remitted patients with BD, 19 unaffected siblings, and 42 controls were presented with 18 pleasant, 18 unpleasant, and 18 neutral pictures. Acoustic probes (104 dB) were presented during 12 of 18 pictures in each affective category at 300, 3000, and 4500 ms after picture onset, so that there were 4 pictures per valence per probe onset type. Baseline startle was assessed during blank screens and was found reduced in patients and sibling groups. We found startle inhibition with the 300 probes and a linear increase in amplitude with valence with the late probes in controls; these effects were absent in patients and their siblings. Low startle and blunted startle reactivity may represent trait deficits in remitted BD patients and their relatives, possibly associated with attentional deficits and adaptive down-regulation of emotion.

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