Skip to main content Accessibility help
×
Home

Disorder-specific and shared neurophysiological impairments of attention and inhibition in women with attention-deficit/hyperactivity disorder and women with bipolar disorder

  • G. Michelini (a1), G. L. Kitsune (a1) (a2), G. M. Hosang (a3), P. Asherson (a1), G. McLoughlin (a1) and J. Kuntsi (a1)...

Abstract

Background

In adults, attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) have certain overlapping symptoms, which can lead to uncertainty regarding the boundaries of the two disorders. Despite evidence of cognitive impairments in both disorders separately, such as in attentional and inhibitory processes, data on direct comparisons across ADHD and BD on cognitive–neurophysiological measures are as yet limited.

Method

We directly compared cognitive performance and event-related potential measures from a cued continuous performance test in 20 women with ADHD, 20 women with BD (currently euthymic) and 20 control women.

Results

The NoGo-N2 was attenuated in women with BD, reflecting reduced conflict monitoring, compared with women with ADHD and controls (both p < 0.05). Both ADHD and BD groups showed a reduced NoGo-P3, reflecting inhibitory control, compared with controls (both p < 0.05). In addition, the contingent negative variation was significantly reduced in the ADHD group (p = 0.05), with a trend in the BD group (p = 0.07), compared with controls.

Conclusions

These findings indicate potential disorder-specific (conflict monitoring) and overlapping (inhibitory control, and potentially response preparation) neurophysiological impairments in women with ADHD and women with BD. The identified neurophysiological parameters further our understanding of neurophysiological impairments in women with ADHD and BD, and are candidate biomarkers that may aid in the identification of the diagnostic boundaries of the two disorders.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Disorder-specific and shared neurophysiological impairments of attention and inhibition in women with attention-deficit/hyperactivity disorder and women with bipolar disorder
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Disorder-specific and shared neurophysiological impairments of attention and inhibition in women with attention-deficit/hyperactivity disorder and women with bipolar disorder
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Disorder-specific and shared neurophysiological impairments of attention and inhibition in women with attention-deficit/hyperactivity disorder and women with bipolar disorder
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Address for correspondence: J. Kuntsi, Ph.D., MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. (Email: jonna.kuntsi@kcl.ac.uk)

References

Hide All
Albrecht, B, Brandeis, D, Uebel, H, Valko, L, Heinrich, H, Drechsler, R, Heise, A, Müller, UC, Steinhausen, HC, Rothenberger, A, Banaschewski, T (2013). Familiality of neural preparation and response control in childhood attention deficit-hyperactivity disorder. Psychological Medicine 43, 19972011.
Albrecht, B, Brandeis, D, Uebel-von Sandersleben, H, Valko, L, Heinrich, H, Xu, X, Drechsler, R, Heise, A, Kuntsi, J, Müller, UC, Asherson, P, Steinhausen, HC, Rothenberger, A, Banaschewski, T (2014). Genetics of preparation and response control in ADHD: the role of DRD4 and DAT1. Journal of Child Psychology and Psychiatry 55, 914923.
Altman, EG, Hedeker, D, Peterson, JL, Davis, JM (1997). The Altman Self-Rating Mania Scale. Biological Psychiatry 42, 948955.
Anderer, P, Saletu, B, Semlitsch, HV, Pascual-Marqui, RD (2002). Perceptual and cognitive event-related potentials in neuropsychopharmacology: methodological aspects and clinical applications (pharmaco-ERP topography and tomography). Methods and Findings in Experimental and Clinical Pharmacology 24, 121137.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.
Asherson, P, Young, AH, Eich-Höchli, D, Moran, P, Porsdal, V, Deberdt, W (2014). Differential diagnosis, comorbidity, and treatment of attention-deficit/hyperactivity disorder in relation to bipolar disorder or borderline personality disorder in adults. Current Medical Research and Opinion 30, 16571672.
Banaschewski, T, Brandeis, D (2007). Annotation: what electrical brain activity tells us about brain function that other techniques cannot tell us – a child psychiatric perspective. Journal of Child Psychology and Psychiatry 48, 415435.
Banaschewski, T, Brandeis, D, Heinrich, H, Albrecht, B, Brunner, E, Rothenberger, A (2004). Questioning inhibitory control as the specific deficit of ADHD – evidence from brain electrical activity. Journal of Neural Transmission 111, 841864.
Barry, RJ, Clarke, AR, McCarthy, R, Selikowitz, M, Brown, CR, Heaven, PC (2009). Event-related potentials in adults with attention-deficit/hyperactivity disorder: an investigation using an inter-modal auditory/visual oddball task. International Journal of Psychophysiology 71, 124131.
Beck, AT, Steer, RA, Ball, R, Ranieri, WF (1996). Comparison of Beck Depression Inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment 67, 588597.
Bestelmeyer, PE (2012). The visual P3a in schizophrenia and bipolar disorder: effects of target and distractor stimuli on the P300. Psychiatry Research 197, 140144.
Bokura, H, Yamaguchi, S, Kobayashi, S (2001). Electrophysiological correlates for response inhibition in a Go/NoGo task. Clinical Neurophysiology 112, 22242232.
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.
Cabranes, JA, Ancín, I, Santos, JL, Sánchez-Morla, E, García-Jiménez, MA, Rodríguez-Moya, L, Fernández, C, Barabash, A (2013). P50 sensory gating is a trait marker of the bipolar spectrum. European Neuropsychopharmacology 23, 721727.
Cheung, CHM, Rijsdijk, F, McLoughlin, G, Brandeis, D, Banaschewski, T, Asherson, P, Kuntsi, J (2015). Cognitive and neurophysiological markers of ADHD persistence and remission. British Journal of Psychiatry. Published online 6 August 2015. doi:10.1192/bjp.bp.114.145185.
Chun, J, Karam, ZN, Marzinzik, F, Kamali, M, O'Donnell, L, Tso, IF, Manschreck, TC, McInnis, M, Deldin, PJ (2013). Can P300 distinguish among schizophrenia, schizoaffective and bipolar I disorders? An ERP study of response inhibition. Schizophrenia Research 151, 175184.
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Lawrence Erlbaum Associates: Hillsdale, NJ.
Das, D, Cherbuin, N, Butterworth, P, Anstey, KJ, Easteal, S (2012). A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults. PLOS One 7, e31500.
Dhar, M, Been, PH, Minderaa, RB, Althaus, M (2010). Information processing differences and similarities in adults with dyslexia and adults with attention deficit hyperactivity disorder during a continuous performance test: a study of cortical potentials. Neuropsychologia 48, 30453056.
Doehnert, M, Brandeis, D, Imhof, K, Drechsler, R, Steinhausen, HC (2010). Mapping attention-deficit/hyperactivity disorder from childhood to adolescence – no neurophysiologic evidence for a developmental lag of attention but some for inhibition. Biological Psychiatry 67, 608616.
Doehnert, M, Brandeis, D, Schneider, G, Drechsler, R, Steinhausen, HC (2013). A neurophysiological marker of impaired preparation in an 11-year follow-up study of attention-deficit/hyperactivity disorder (ADHD). Journal of Child Psychology and Psychiatry 54, 260270.
Doehnert, M, Brandeis, D, Straub, M, Steinhausen, HC, Drechsler, R (2008). Slow cortical potential neurofeedback in attention deficit hyperactivity disorder: is there neurophysiological evidence for specific effects? Journal of Neural Transmission 115, 14451456.
Ethridge, LE, Hamm, JP, Shapiro, JR, Summerfelt, AT, Keedy, SK, Stevens, MC, Pearlson, G, Tamminga, CA, Boutros, NN, Sweeney, JA, Keshavan, MS, Thaker, G, Clementz, BA (2012). Neural activations during auditory oddball processing discriminating schizophrenia and psychotic bipolar disorder. Biological Psychiatry 72, 766774.
Faraone, SV, Biederman, J (2005). What is the prevalence of adult ADHD? Results of a population screen of 966 adults. Journal of Attention Disorders 9, 384391.
Gajewski, PD, Falkenstein, M (2013). Effects of task complexity on ERP components in Go/Nogo tasks. International Journal of Psychophysiology 87, 273278.
Galletly, CA, Clark, CR, McFarlane, AC (2005). Clozapine improves working memory updating in schizophrenia. European Neuropsychopharmacology 15, 601608.
Groom, MJ, Scerif, G, Liddle, PF, Batty, MJ, Liddle, EB, Roberts, KL, Cahill, JD, Liotti, M, Hollis, C (2010). Effects of motivation and medication on electrophysiological markers of response inhibition in children with attention-deficit/hyperactivity disorder. Biological Psychiatry 67, 624631.
Hall, MH, Rijsdijk, F, Kalidindi, S, Schulze, K, Kravariti, E, Kane, F, Sham, P, Bramon, E, Murray, RM (2007). Genetic overlap between bipolar illness and event-related potentials. Psychological Medicine 37, 667678.
Henry, BL, Minassian, A, Perry, W (2013). Everyday functional ability across different phases of bipolar disorder. Psychiatry Research 210, 850856.
Holroyd, CB, Nieuwenhuis, S, Yeung, N, Cohen, JD (2003). Errors in reward prediction are reflected in the event-related brain potential. Neuroreport 14, 24812484.
Hosang, GM, Uher, R, Maughan, B, McGuffin, P, Farmer, AE (2012). The role of loss and danger events in symptom exacerbation in bipolar disorder. Journal of Psychiatric Research 46, 15841589.
Ibanez, A, Cetkovich, M, Petroni, A, Urquina, H, Baez, S, Gonzalez-Gadea, ML, Kamienkowski, JE, Torralva, T, Torrente, F, Strejilevich, S, Teitelbaum, J, Hurtado, E, Guex, R, Melloni, M, Lischinsky, A, Sigman, M, Manes, F (2012). The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD). PLOS ONE 7, e37306.
Jahshan, C, Wynn, JK, Mathis, KI, Altshuler, LL, Glahn, DC, Green, MF (2012). Cross-diagnostic comparison of duration mismatch negativity and P3a in bipolar disorder and schizophrenia. Bipolar Disorders 14, 239248.
Jung, TP, Makeig, S, Humphries, C, Lee, TW, McKeown, MJ, Iragui, V, Sejnowski, TJ (2000). Removing electroencephalographic artifacts by blind source separation. Psychophysiology 37, 163178.
Karaaslan, F, Gonul, AS, Oguz, A, Erdinc, E, Esel, E (2003). P300 changes in major depressive disorders with and without psychotic features. Journal of Affective Disorders 73, 283287.
Kooij, JJS, Francken, MH (2007). Diagnostic Interview for ADHD in Adults (DIVA) (http://www.psyq.nl/files/1263005/DIVA_2_EN.pdf). Accessed September 2015.
Kuntsi, J, Klein, C (2012). Intraindividual variability in ADHD and its implications for research of causal links. Current Topics in Behavioral Neurosciences 9, 6791.
Kuntsi, J, Wood, AC, Rijsdijk, F, Johnson, KA, Andreou, P, Albrecht, B, Arias-Vasquez, A, Buitelaar, JK, McLoughlin, G, Rommelse, NN, Sergeant, JA, Sonuga-Barke, EJ, Uebel, H, van der Meere, JJ, Banaschewski, T, Gill, M, Manor, I, Miranda, A, Mulas, F, Oades, RD, Roeyers, H, Rothenberger, A, Steinhausen, HC, Faraone, SV, Asherson, P (2010). Separation of cognitive impairments in attention-deficit/hyperactivity disorder into 2 familial factors. Archives of General Psychiatry 67, 11591167.
Luck, SJ (2005). An Introduction to the Event-Related Potential Technique. MIT Press: Cambridge, MA.
Maekawa, T, Katsuki, S, Kishimoto, J, Onitsuka, T, Ogata, K, Yamasaki, T, Ueno, T, Tobimatsu, S, Kanba, S (2013). Altered visual information processing systems in bipolar disorder: evidence from visual MMN and P3. Frontiers in Human Neuroscience 7, 403.
McLoughlin, G, Albrecht, B, Banaschewski, T, Rothenberger, A, Brandeis, D, Asherson, P, Kuntsi, J (2009). Performance monitoring is altered in adult ADHD: a familial event-related potential investigation. Neuropsychologia 47, 31343142.
McLoughlin, G, Albrecht, B, Banaschewski, T, Rothenberger, A, Brandeis, D, Asherson, P, Kuntsi, J (2010). Electrophysiological evidence for abnormal preparatory states and inhibitory processing in adult ADHD. Behavioral and Brain Functions 6, 66.
McLoughlin, G, Asherson, P, Albrecht, B, Banaschewski, T, Rothenberger, A, Brandeis, D, Kuntsi, J (2011). Cognitive–electrophysiological indices of attentional and inhibitory processing in adults with ADHD: familial effects. Behavioral and Brain Functions 7, 26.
McLoughlin, G, Makeig, S, Tsuang, MT (2014 a). In search of biomarkers in psychiatry: EEG-based measures of brain function. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 165B, 111121.
McLoughlin, G, Palmer, JA, Rijsdijk, F, Makeig, S (2014 b). Genetic overlap between evoked frontocentral theta-band phase variability, reaction time variability, and attention-deficit/hyperactivity disorder symptoms in a twin study. Biological Psychiatry 75, 238247.
Merikangas, KR, He, JP, Burstein, M, Swendsen, J, Avenevoli, S, Case, B, Georgiades, K, Heaton, L, Swanson, S, Olfson, M (2011). Service utilization for lifetime mental disorders in US adolescents: results of the National Comorbidity Survey–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 50, 3245.
Morsel, AM, Morrens, M, Temmerman, A, Sabbe, B, de Bruijn, ER (2014). Electrophysiological (EEG) evidence for reduced performance monitoring in euthymic bipolar disorder. Bipolar Disorders 16, 820829.
Pini, S, de Queiroz, V, Pagnin, D, Pezawas, L, Angst, J, Cassano, GB, Wittchen, HU (2005). Prevalence and burden of bipolar disorders in European countries. European Neuropsychopharmacology 15, 425434.
Robinson, LJ, Thompson, JM, Gallagher, P, Goswami, U, Young, AH, Ferrier, IN, Moore, PB (2006). A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. Journal of Affective Disorders 93, 105115.
Robinson, LJ, Thompson, JM, Gallagher, P, Gray, JM, Young, AH, Ferrier, IN (2013). Performance monitoring and executive control of attention in euthymic bipolar disorder: employing the CPT-AX paradigm. Psychiatry Research 210, 457464.
Schulze, KK, Hall, MH, McDonald, C, Marshall, N, Walshe, M, Murray, RM, Bramon, E (2008). Auditory P300 in patients with bipolar disorder and their unaffected relatives. Bipolar Disorders 10, 377386.
Skirrow, C (2012). Investigating Emotional Lability in Adults with Attention Deficit Hyperactivity Disorder: An Integrative Approach. Ph.D. Thesis, King's College London.
Skirrow, C, Ebner-Priemer, U, Reinhard, I, Malliaris, Y, Kuntsi, J, Asherson, P (2014). Everyday emotional experience of adults with attention deficit hyperactivity disorder: evidence for reactive and endogenous emotional lability. Psychological Medicine 44, 35713583.
Skirrow, C, Hosang, GM, Farmer, AE, Asherson, P (2012). An update on the debated association between ADHD and bipolar disorder across the lifespan. Journal of Affective Disorders 141, 143159.
Swann, AC, Lijffijt, M, Lane, SD, Steinberg, JL, Acas, MD, Cox, B, Moeller, FG (2013). Pre-attentive information processing and impulsivity in bipolar disorder. Journal of Psychiatric Research 47, 19171924.
Torralva, T, Gleichgerrcht, E, Torrente, F, Roca, M, Strejilevich, SA, Cetkovich, M, Lischinsky, A, Manes, F (2011). Neuropsychological functioning in adult bipolar disorder and ADHD patients: a comparative study. Psychiatry Research 186, 261266.
Torres, IJ, Boudreau, VG, Yatham, LN (2007). Neuropsychological functioning in euthymic bipolar disorder: a meta-analysis. Acta Psychiatrica Scandinavica 116, 1726.
Tye, C, Asherson, P, Ashwood, KL, Azadi, B, Bolton, P, McLoughlin, G (2014). Attention and inhibition in children with ASD, ADHD and co-morbid ASD + ADHD: an event-related potential study. Psychological Medicine 44, 11011116.
Valko, L, Doehnert, M, Müller, UC, Schneider, G, Albrecht, B, Drechsler, R, Maechler, M, Steinhausen, HC, Brandeis, D (2009). Differences in neurophysiological markers of inhibitory and temporal processing deficits in children and adults with ADHD. Journal of Psychophysiology 23, 235246.
van Leeuwen, TH, Steinhausen, HC, Overtoom, CC, Pascual-Marqui, RD, van't Klooster, B, Rothenberger, A, Sergeant, JA, Brandeis, D (1998). The continuous performance test revisited with neuroelectric mapping: impaired orienting in children with attention deficits. Behavioral and Brain Functions 94, 97110.
Wechsler, D (1999). Wechsler Abbreviated Scale of Intelligence (WASI). Harcourt Assessment: San Antonio, TX.
Willcutt, EG (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 9, 490499.
Yeung, N, Cohen, JD (2006). The impact of cognitive deficits on conflict monitoring. Predictable dissociations between the error-related negativity and N2. Psychological Science 17, 164171.
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA (1978). Rating-scale for mania – reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.

Keywords

Type Description Title
WORD
Supplementary materials

Michelini supplementary material
Michelini supplementary material 1

 Word (27 KB)
27 KB

Disorder-specific and shared neurophysiological impairments of attention and inhibition in women with attention-deficit/hyperactivity disorder and women with bipolar disorder

  • G. Michelini (a1), G. L. Kitsune (a1) (a2), G. M. Hosang (a3), P. Asherson (a1), G. McLoughlin (a1) and J. Kuntsi (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed