State- and trait-related deficits in sustained attention in bipolar disorder
State- and trait-related deficits in sustained attention in bipolar disorder
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DOI：
10.1007/s00406-004-0460-y
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发表时间：
2004-04-01
影响因子：
4.7
通讯作者：
Goodwin, GM
中科院分区：
文献类型：
--
作者：
Clark, L;Goodwin, GM
对双相情感障碍神经心理功能的研究提供了从该障碍的突出认知症状到潜在神经机制的潜在联系。在双相情感障碍患者中，持续注意力的持续表现测量得到了一致的结果。有些缺陷似乎既与状态有关，也与特质有关。受损的目标检测可能是双相情感障碍病程中最敏感的标志之一。它与残余情绪代谢和药物状态无关，存在于功能恢复良好的患者中。在躁狂状态下，目标检测的障碍会加剧，并伴随着错误反应率的增加。持续的注意力缺陷在疾病的早期就存在，但随着反复发作而变得更加明显。这种认知特征是一种早发性、状态调节的特质标记，与精神分裂症或单相抑郁症中的注意力中断特征不同。状态和特质相关的损伤可能与多巴胺和去甲肾上腺素投射的上升有差异。
Investigation of neuropsychological functioning in bipolar disorder provides a potential link from the prominent cognitive symptoms of the disorder to the underlying neural mechanisms. Continuous performance measures of sustained attention have yielded consistent findings in bipolar disorder patients. There are impairments that appear to be both state- and trait-related. Impaired target detection may represent one of the most sensitive markers of illness course in bipolar disorder. It is unrelated to residual mood symptomatology and medication status, and is present in patients with good functional recovery. The impairment in target detection is exacerbated in the manic state, and is accompanied by an increased rate of false responding. Sustained attention deficit is present early in the course of the disorder, but becomes more pronounced with repeated episodes. This cognitive profile, of an early-onset, state- modulated, trait marker, is distinct from the profile of attentional disruption seen in schizophrenia or unipolar depression. The state- and trait-related impairments may be differentially associated with the ascending dopamine and noradrenaline projections.