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Neurocognitive intra-individual variability in mood disorders: effects on attentional response time distributions

  • P. Gallagher (a1), J. Nilsson (a1) (a2), A. Finkelmeyer (a1), M. Goshawk (a1), K. A. Macritchie (a3), A. J. Lloyd (a1) (a4), J. M. Thompson (a1), R. J. Porter (a5), A. H. Young (a6), I. N. Ferrier (a1), R. H. McAllister-Williams (a1) (a4) and S. Watson (a1) (a4)...
Abstract
Background.

Attentional impairment is a core cognitive feature of major depressive disorder (MDD) and bipolar disorder (BD). However, little is known of the characteristics of response time (RT) distributions from attentional tasks. This is crucial to furthering our understanding of the profile and extent of cognitive intra-individual variability (IIV) in mood disorders.

Method.

A computerized sustained attention task was administered to 138 healthy controls and 158 patients with a mood disorder: 86 euthymic BD, 33 depressed BD and 39 medication-free MDD patients. Measures of IIV, including individual standard deviation (iSD) and coefficient of variation (CoV), were derived for each participant. Ex-Gaussian (and Vincentile) analyses were used to characterize the RT distributions into three components: mu and sigma (mean and standard deviation of the Gaussian portion of the distribution) and tau (the ‘slow tail’ of the distribution).

Results.

Compared with healthy controls, iSD was increased significantly in all patient samples. Due to minimal changes in average RT, CoV was only increased significantly in BD depressed patients. Ex-Gaussian modelling indicated a significant increase in tau in euthymic BD [Cohen's d = 0.39, 95% confidence interval (CI) 0.09–0.69, p = 0.011], and both sigma (d = 0.57, 95% CI 0.07–1.05, p = 0.025) and tau (d = 1.14, 95% CI 0.60–1.64, p < 0.0001) in depressed BD. The mu parameter did not differ from controls.

Conclusions.

Increased cognitive variability may be a core feature of mood disorders. This is the first demonstration of differences in attentional RT distribution parameters between MDD and BD, and BD depression and euthymia. These data highlight the utility of applying measures of IIV to characterize neurocognitive variability and the great potential for future application.

Copyright
Corresponding author
* Address for correspondence: P. Gallagher, Institute of Neuroscience, Newcastle University, The Henry Wellcome Building, Framlington Place, Newcastle upon Tyne NE2 4HH, UK. (Email: peter.gallagher@newcastle.ac.uk)
References
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Ancín, I, Santos, JL, Teijeira, C, Sánchez-Morla, EM, Bescós, MJ, Argudo, I, Torrijos, S, Vázquez-Álvarez, B, De La Vega, I, López-Ibor, JJ, Barabash, A, Cabranes-Díaz, JA (2010). Sustained attention as a potential endophenotype for bipolar disorder. Acta Psychiatrica Scandinavica 122, 235245.
Antila, M, Kieseppä, T, Partonen, T, Lönnqvist, J, Tuulio-Henriksson, A (2011). The effect of processing speed on cognitive functioning in patients with familial bipolar I disorder and their unaffected relatives. Psychopathology 44, 4045.
Arts, B, Jabben, N, Krabbendam, L, van Os, J (2008). Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychological Medicine 38, 771785.
Assareh, A, Mather, KA, Schofield, PR, Kwok, JBJ, Sachdev, PS (2011). The genetics of white matter lesions. CNS Neuroscience and Therapeutics 17, 525540.
Astrup, C, Fossum, A, Holmboe, R (1959). A follow-up of 270 patients with acute affective psychoses. Acta Psychiatrica Scandinavica 34, 165.
Balanzá-Martínez, V, Rubio, C, Selva-Vera, G, Martinez-Aran, A, Sánchez-Moreno, J, Salazar-Fraile, J, Vieta, E, Tabarés-Seisdedos, R (2008). Neurocognitive endophenotypes (endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review. Neuroscience and Biobehavioral Reviews 32, 14261438.
Balota, DA, Yap, MJ (2011). Moving beyond the mean in studies of mental chronometry: the power of response time distributional analyses. Current Directions in Psychological Science 20, 160166.
Bielak, AA, Hultsch, DF, Strauss, E, MacDonald, SW, Hunter, MA (2010). Intraindividual variability is related to cognitive change in older adults: evidence for within-person coupling. Psychology and Aging 25, 575586.
Bora, E, Harrison, BJ, Yücel, M, Pantelis, C (2013). Cognitive impairment in euthymic major depressive disorder: a meta-analysis. Psychological Medicine 43, 20172026.
Bora, E, Vahip, S, Akdeniz, F (2006). Sustained attention deficits in manic and euthymic patients with bipolar disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry 30, 10971102.
Bora, E, Yucel, M, Pantelis, C (2009). Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. Journal of Affective Disorders 113, 120.
Bourne, C, Aydemir, O, Balanzá-Martínez, V, Bora, E, Brissos, S, Cavanagh, JTO, Clark, L, Cubukcuoglu, Z, Dias, VV, Dittmann, S, Ferrier, IN, Fleck, DE, Frangou, S, Gallagher, P, Jones, L, Kieseppä, T, Martínez-Aran, A, Melle, I, Moore, PB, Mur, M, Pfennig, A, Raust, A, Senturk, V, Simonsen, C, Smith, DJ, Soares, D, Soeiro-de-Souza, MG, Stoddart, SDR, Sundet, K, Szöke, A, Thompson, JM, Torrent, C, Zalla, T, Craddock, N, Andreassen, OA, Leboyer, M, Vieta, E, Bauer, M, Worhunsky, P, Tzagarakis, C, Rogers, RD, Geddes, JR, Goodwin, GM (2013). Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatrica Scandinavica 128, 149162.
Bratfos, O, Haug, JO (1968). The course of manic-depressive psychosis. A follow up investigation of 215 patients. Acta Psychiatrica Scandinavica 44, 89112.
Brotman, MA, Rooney, MH, Skup, M, Pine, DS, Leibenluft, E (2009). Increased intrasubject variability in response time in youths with bipolar disorder and at-risk family members. Journal of the American Academy of Child and Adolescent Psychiatry 48, 628635.
Cegalis, J, Bowlin, J (1991). Vigil: Software for the Assessment of Attention. Forthought: Nashua, NH.
Cepeda, NJ, Blackwell, KA, Munakata, Y (2013). Speed isn't everything: complex processing speed measures mask individual differences and developmental changes in executive control. Developmental Science 16, 269286.
Christensen, MV, Kyvik, KO, Kessing, LV (2006). Cognitive function in unaffected twins discordant for affective disorder. Psychological Medicine 36, 11191129.
Clark, L, Kempton, MJ, Scarna, A, Grasby, PM, Goodwin, GM (2005a). Sustained attention-deficit confirmed in euthymic bipolar disorder but not in first-degree relatives of bipolar patients or euthymic unipolar depression. Biological Psychiatry 57, 183187.
Clark, L, Sarna, A, Goodwin, GM (2005b). Impairment of executive function but not memory in first-degree relatives of patients with bipolar I disorder and in euthymic patients with unipolar depression. American Journal of Psychiatry 162, 19801982.
Cohen, R, Lohr, I, Paul, R, Boland, R (2001). Impairments of attention and effort among patients with major affective disorders. Journal of Neuropsychiatry and Clinical Neurosciences 13, 385395.
Daban, C, Mathieu, F, Raust, A, Cochet, B, Scott, J, Etain, B, Leboyer, M, Bellivier, F (2012). Is processing speed a valid cognitive endophenotype for bipolar disorder? Journal of Affective Disorders 139, 98101.
Doyle, AE, Wilens, TE, Kwon, A, Seidman, LJ, Faraone, SV, Fried, R, Swezey, A, Snyder, L, Biederman, J (2005). Neuropsychological functioning in youth with bipolar disorder. Biological Psychiatry 58, 540548.
First, MB, Spitzer, RL, Williams, JBW, Gibbon, M (1995). Structured Clinical Interview for DSM-IV (SCID-I), Research Version. Biometrics Research Department, New York State Psychiatric Institute: New York.
Fjell, AM, Westlye, LT, Amlien, IK, Walhovd, KB (2011). Reduced white matter integrity is related to cognitive instability. Journal of Neuroscience 31, 1806018072.
Fleck, DE, Eliassen, JC, Durling, M, Lamy, M, Adler, CM, DelBello, MP, Shear, PK, Cerullo, MA, Lee, J-H, Strakowski, SM (2012). Functional MRI of sustained attention in bipolar mania. Molecular Psychiatry 17, 325336.
Gallagher, P, Gray, JM, Kessels, RPC (2015). Fractionation of visuo-spatial memory processes in bipolar depression: a cognitive scaffolding account. Psychological Medicine 45, 545558.
Gallagher, P, Gray, JM, Watson, S, Young, AH, Ferrier, IN (2014). Neurocognitive functioning in bipolar depression: a component structure analysis. Psychological Medicine 44, 961974.
Gallagher, P, Watson, S, Smith, MS, Young, AH, Ferrier, IN (2007). Plasma cortisol-dehydroepiandrosterone (DHEA) ratios in schizophrenia and bipolar disorder. Schizophrenia Research 90, 258265.
Glahn, DC, Bearden, CE, Niendam, TA, Escamilla, MA (2004). The feasibility of neuropsychological endophenotypes in the search for genes associated with bipolar affective disorder. Bipolar Disorders 6, 171182.
Goswami, U, Sharma, A, Varma, A, Gulrajani, C, Ferrier, IN, Young, AH, Gallagher, P, Thompson, JM, Moore, PB (2009). The neurocognitive performance of drug-free and medicated euthymic bipolar patients does not differ. Acta Psychiatrica Scandinavica 120, 456463.
Gottesman, II, Gould, TD (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 160, 636645.
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.
Hasler, G, Drevets, WC, Gould, TD, Gottesman, II, Manji, HK (2006). Toward constructing an endophenotype strategy for bipolar disorders. Biological Psychiatry 60, 93105.
Heathcote, A, Popiel, SJ, Mewhort, DJK (1991). Analysis of response time distributions: an example using the Stroop Task. Psychological Bulletin 109, 340347.
Henderson, SE, Johnson, AR, Vallejo, AI, Katz, L, Wong, E, Gabbay, V (2013). A preliminary study of white matter in adolescent depression: relationships with illness severity, anhedonia, and irritability. Frontiers in Psychiatry 4, 152.
Heng, S, Song, A, Sim, K (2010). White matter abnormalities in bipolar disorder: insights from diffusion tensor imaging studies. Journal of Neural Transmission 117, 639654.
Hervey, AS, Epstein, JN, Tonev, S, Arnold, LE, Conners, CK, Hinshaw, SP, Swanson, JM, Hechtman, L (2006). Reaction time distribution analysis of neuropsychological performance in an ADHD sample. Child Neuropsychology 12, 125140.
Hultsch, DF, MacDonald, SWS, Dixon, RA (2002). Variability in reaction time performance of younger and older adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences 57, P101P115.
Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, Sanislow, C, Wang, P (2010). Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry 167, 748751.
Jabben, N, Arts, B, Krabbendam, L, Van Os, J (2009). Investigating the association between neurocognition and psychosis in bipolar disorder: further evidence for the overlap with schizophrenia. Bipolar Disorders 11, 166177.
Jackson, JD, Balota, DA, Duchek, JM, Head, D (2012). White matter integrity and reaction time: intraindividual variability in healthy aging and early-stage Alzheimer disease. Neuropsychologia 50, 357366.
Kaiser, S, Roth, A, Rentrop, M, Friederich, H-C, Bender, S, Weisbrod, M (2008). Intra-individual reaction time variability in schizophrenia, depression and borderline personality disorder. Brain and Cognition 66, 7382.
Klimes-Dougan, B, Ronsaville, D, Wiggs, EA, Martinez, PE (2006). Neuropsychological functioning in adolescent children of mothers with a history of bipolar or major depressive disorders. Biological Psychiatry 60, 957965.
Koetsier, GC, Volkers, AC, Tulen, JHM, Passchier, J, van den Broek, WW, Bruijn, JA (2002). CPT performance in major depressive disorder before and after treatment with imipramine or fluvoxamine. Journal of Psychiatric Research 36, 391397.
Kolur, US, Reddy, YCJ, John, JP, Kandavel, T, Jain, S (2006). Sustained attention and executive functions in euthymic young people with bipolar disorder. British Journal of Psychiatry 189, 453458.
Kosanke, J, Bergstralh, E (1995). SAS Match algorithm. Mayo Clinic, Division of Biostatistics (http://www.mayo.edu/research/documents/matchsas/doc-10027556). Accessed May 2015.
Kurtz, MM, Gerraty, RT (2009). A meta-analytic investigation of neurocognitive deficits in bipolar illness: profile and effects of clinical state. Neuropsychology Review 23, 551562.
Lacouture, Y, Cousineau, D (2008). How to use MATLAB to fit the ex-Gaussian and other probability functions to a distribution of response times. Tutorials in Quantitative Methods for Psychology 4, 3545.
Lee, RSC, Hermens, DF, Porter, MA, Redoblado-Hodge, MA (2012). A meta-analysis of cognitive deficits in first-episode major depressive disorder. Journal of Affective Disorders 140, 113124.
Leow, A, Ajilore, O, Zhan, L, Arienzo, D, GadElkarim, J, Zhang, A, Moody, T, Van Horn, J, Feusner, J, Kumar, A, Thompson, P, Altshuler, L (2013). Impaired inter-hemispheric integration in bipolar disorder revealed with brain network analyses. Biological Psychiatry 73, 183193.
Leth-Steensen, C, King Elbaz, Z, Douglas, VI (2000). Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach. Acta Psychologica 104, 167190.
Liu, SK, Chiu, CH, Chang, CJ, Hwang, TJ, Hwu, HG, Chen, WJ (2002). Deficits in sustained attention in schizophrenia and affective disorders: stable versus state-dependent markers. American Journal of Psychiatry 159, 975982.
Lupien, SJ, McEwen, BS (1997). The acute effects of corticosteroids on cognition: integration of animal and human model studies. Brain Research Reviews 24, 127.
Macritchie, KA, Lloyd, AJ, Bastin, ME, Vasudev, K, Gallagher, P, Eyre, R, Marshall, I, Wardlaw, JM, Ferrier, IN, Moore, PB, Young, AH (2010). White matter microstructural abnormalities in euthymic bipolar disorder. British Journal of Psychiatry 196, 5258.
Meyer, TD, Blechert, J (2005). Are there attentional deficits in people putatively at risk for affective disorders? Journal of Affective Disorders 84, 6372.
Mullin, BC, Perlman, SB, Versace, A, de Almeida, JRC, LaBarbara, EJ, Klein, C, Ladouceur, CD, Phillips, ML (2012). An fMRI study of attentional control in the context of emotional distracters in euthymic adults with bipolar disorder. Psychiatry Research: Neuroimaging 201, 196205.
Nelson, HE (1982). National Adult Reading Test, NART. Nelson Publishing Company: Windsor.
Nilsson, J, Thomas, AJ, O'Brien, JT, Gallagher, P (2014). White matter and cognitive decline in ageing: a focus on processing speed and variability. Journal of the International Neuropsychological Society 20, 262267.
Paelecke-Habermann, Y, Pohl, J, Leplow, B (2005). Attention and executive functions in remitted major depression patients. Journal of Affective Disorders 89, 125135.
Poletti, S, Bollettini, I, Mazza, E, Locatelli, C, Radaelli, D, Vai, B, Smeraldi, E, Colombo, C, Benedetti, F (2015). Cognitive performances associate with measures of white matter integrity in bipolar disorder. Journal of Affective Disorders 174, 342352.
Porter, RJ, Gallagher, P, Thompson, JM, Young, AH (2003). Neurocognitive impairment in drug-free patients with major depressive disorder. British Journal of Psychiatry 182, 214220.
Preiss, M, Kucerova, H, Lukavsky, J, Stepankova, H, Sos, P, Kawaciukova, R (2009). Cognitive deficits in the euthymic phase of unipolar depression. Psychiatry Research 169, 235239.
Ratcliff, R (1979). Group reaction time distributions and an analysis of distribution statistics. Psychological Bulletin 86, 446461.
Riccio, CA, Reynolds, CR, Lowe, P, Moore, JJ (2002). The continuous performance test: a window on the neural substrates for attention? Archives of Clinical Neuropsychology 17, 235272.
Robinson, LJ, Thompson, JM, Gallagher, P, Goswami, U, Young, AH, Ferrier, IN, Moore, PB (2006). A meta-analysis of cognitive deficits in euthymic bipolar subjects. Journal of Affective Disorders 93, 105115.
Robinson, LJ, Thompson, JM, Gray, JM, Young, AH, Ferrier, IN (2013). Performance monitoring and executive control in euthymic bipolar disorder: employing the CPT-AX paradigm. Psychiatry Research 210, 457464.
Rock, PL, Roiser, JP, Riedel, WJ, Blackwell, AD (2014). Cognitive impairment in depression: a systematic review and meta-analysis. Psychological Medicine 44, 20292040.
Rosvold, HE, Mirsky, AF, Sarason, I, Bransome, ED, Beck, LH (1956). A continuous performance test of brain damage. Journal of Consulting Psychology 20, 343350.
Rubinsztein, JS, Michael, A, Underwood, BR, Tempest, M, Sahakian, BJ (2006). Impaired cognition and decision-making in bipolar depression but no ‘affective bias’ evident. Psychological Medicine 36, 629639.
Rybakowski, JK, Twardowska, K (1999). The dexamethasone/corticotropin-releasing hormone test in depression in bipolar and unipolar affective illness. Journal of Psychiatric Research 33, 363370.
Sachdev, PS, Wen, W, Christensen, H, Jorm, AF (2005). White matter hyperintensities are related to physical disability and poor motor function. Journal of Neurology, Neurosurgery, and Psychiatry 76, 362367.
Sarrazin, S, Poupon, C, Linke, J, Wessa, M, Phillips, M, Delavest, M, Versace, A, Almeida, J, Guevara, P, Duclap, D, Duchesnay, E, Mangin, JF, Le Dudal, K, Daban, C, Hamdani, N, D'Albis, MA, Leboyer, M, Houenou, J (2014). A multicenter tractography study of deep white matter tracts in bipolar I disorder: psychotic features and interhemispheric disconnectivity. JAMA Psychiatry 71, 388396.
Schmiedek, F, Oberauer, K, Wilhelm, O, Su, H-M, Wittmann, WW (2007). Individual differences in components of reaction time distributions and their relations to working memory and intelligence. Journal of Experimental Psychology: General 136, 414429.
Sepede, G, De Berardis, D, Campanella, D, Perrucci, MG, Ferretti, A, Serroni, N, Moschetta, FS, Del Gratta, C, Salerno, RM, Ferro, FM, Di Giannantonio, M, Onofrj, M, Romani, GL, Gambi, F (2012). Impaired sustained attention in euthymic bipolar disorder patients and non-affected relatives: an fMRI study. Bipolar Disorders 14, 764779.
Sprooten, E, Sussmann, JE, Clugston, A, Peel, A, McKirdy, J, Moorhead, TWJ, Anderson, S, Shand, AJ, Giles, S, Bastin, ME, Hall, J, Johnstone, EC, Lawrie, SM, McIntosh, AM (2011). White matter integrity in individuals at high genetic risk of bipolar disorder. Biological Psychiatry 70, 350356.
Strakowski, SM, Adler, CM, Holland, SK, Mills, N, DelBello, MP (2004). A preliminary fMRI study of sustained attention in euthymic, unmedicated bipolar disorder. Neuropsychopharmacology 29, 17341740.
Tamnes, CK, Fjell, AM, Westlye, LT, Østby, Y, Walhovd, KB (2012). Becoming consistent: developmental reductions in intraindividual variability in reaction time are related to white matter integrity. Journal of Neuroscience 32, 972982.
Taylor Tavares, JV, Clark, L, Cannon, DM, Erickson, K, Drevets, WC, Sahakian, BJ (2007). Distinct profiles of neurocognitive function in unmedicated unipolar depression and bipolar II depression. Biological Psychiatry 62, 917924.
The MathWorks Inc. (2010). MATLAB R2010b. The MathWorks Inc.: Natick, MA.
The Psychological Corporation (1998). Vigil™ Continuous Performance Test. Harcourt Brace & Company: San Antonio, TX.
Thompson, JM, Gallagher, P, Hughes, JH, Watson, S, Gray, JM, Ferrier, IN, Young, AH (2005). Neurocognitive impairment in euthymic bipolar disorder. British Journal of Psychiatry 186, 3240.
Torrent, C, Martinez-Aran, A, Daban, C, Sanchez-Moreno, J, Comes, M, Goikolea, JM, Salamero, M, Vieta, E (2006). Cognitive impairment in bipolar II disorder. British Journal of Psychiatry 189, 254259.
Torres, IJ, Boudreau, VG, Yatham, LN (2007). Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatrica Scandinavica 116, 1726.
Trivedi, JK, Goel, D, Dhyani, M, Sharma, S, Singh, AP, Sinha, PK, Tandon, R (2008). Neurocognition in first-degree healthy relatives (siblings) of bipolar affective disorder patients. Psychiatry and Clinical Neurosciences 62, 190196.
Tse, CS, Balota, DA, Yap, MJ, Duchek, JM, McCabe, DP (2010). Effects of healthy aging and early stage dementia of the Alzheimer's type on components of response time distributions in three attention tasks. Neuropsychology 24, 300315.
Walshe, M, Schulze, KK, Stahl, D, Hall, M-H, Chaddock, C, Morris, R, Marshall, N, McDonald, C, Murray, RM, Bramon, E, Kravariti, E (2012). Sustained attention in bipolar I disorder patients with familial psychosis and their first-degree relatives. Psychiatry Research 199, 7073.
Wang, L, Leonards, CO, Sterzer, P, Ebinger, M (2014). White matter lesions and depression: a systematic review and meta-analysis. Journal of Psychiatric Research 56, 5664.
Weiland-Fiedler, P, Erickson, K, Waldeck, T, Luckenbaugh, DA, Pike, D, Bonne, O, Charney, DS, Neumeister, A (2004). Evidence for continuing neuropsychological impairments in depression. Journal of Affective Disorders 82, 253258.
Wilder-Willis, KE, Sax, KW, Rosenberg, HL, Fleck, DE, Shear, PK, Strakowski, SM (2001). Persistent attentional dysfunction in remitted bipolar disorder. Bipolar Disorders 3, 5862.
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.
Zakzanis, KK, Leach, L, Kaplan, E (1998). On the nature and pattern of neurocognitive function in major depressive disorder. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 11, 111119.
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