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Visuospatial planning in unmedicated major depressive disorder and bipolar disorder: distinct and common neural correlates

Published online by Cambridge University Press:  20 May 2016

M. M. Rive ,
M. W. J. Koeter ,
D. J. Veltman ,
A. H. Schene  and
H. G. Ruhé
M. M. Rive*
Affiliation:
Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
M. W. J. Koeter
Affiliation:
Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
D. J. Veltman
Affiliation:
Department of Psychiatry, VU University medical center, Amsterdam, The Netherlands
A. H. Schene
Affiliation:
Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
H. G. Ruhé
Affiliation:
Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands Department of Psychiatry, Mood and Anxiety Disorders, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
*
*Address for correspondence: M. M. Rive, Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, PA3-221, PO Box 22660, 1100 DD Amsterdam, The Netherlands. (Email: M.M.Rive@AMC.UvA.NL)
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Abstract

Background

Cognitive impairments are an important feature of both remitted and depressed major depressive disorder (MDD) and bipolar disorder (BD). In particular, deficits in executive functioning may hamper everyday functioning. Identifying the neural substrates of impaired executive functioning would improve our understanding of the pathophysiology underlying these disorders, and may eventually aid in discriminating between MDD and BD, which is often difficult during depression and remission. To date, mostly medicated MDD and BD subjects have been investigated, which may have influenced results. Therefore, we investigated executive functioning in medication-free depressed and remitted MDD and BD subjects.

Method

We used the Tower of London (ToL) visuospatial planning task to assess behavioural performance and blood oxygen-level dependent responses in 35 healthy controls, 21 remitted MDD, 23 remitted BD, 19 depressed MDD and nine depressed BD subjects.

Results

Visuospatial planning per se was associated with increased frontostriatal activity in depressed BD compared to depressed MDD. In addition, post-hoc analyses indicated that visuospatial planning load was associated with increased parietal activity in depressed compared to remitted subjects, and BD compared to MDD subjects. Task performance did not significantly differ between groups.

Conclusions

More severely affected, medication-free mood disorder patients require greater parietal activity to perform in visuospatial planning, which may be compensatory to maintain relatively normal performance. State-dependent frontostriatal hyperactivity during planning may be a specific BD characteristic, providing clues for further characterization of differential pathophysiology in MDD v. BD. This could potentially provide a biomarker to aid in the differentiation of these disorders.

Keywords

Bipolar disorderexecutive functioningfMRImajor depressive disordermood statevisuospatial planning
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 11 , August 2016 , pp. 2313 - 2328
Copyright
Copyright © Cambridge University Press 2016 

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