Saccadic performance and cortical excitability as trait-markers and state-markers in rapid cycling bipolar disorder: a two-case follow-up study

Jennifer Malsert, Nathalie Guyader, Alan Chauvin, Mircea Polosan, David Szekely, Thierry Bougerol, Christian Marendaz, Jennifer Malsert, Nathalie Guyader, Alan Chauvin, Mircea Polosan, David Szekely, Thierry Bougerol, Christian Marendaz

Abstract

Background: The understanding of physiopathology and cognitive impairments in mood disorders requires finding objective markers. Mood disorders have often been linked to hypometabolism in the prefrontal dorsolateral cortex, and to GABAergic and glutamatergic neurotransmission dysfunction. The present study aimed to discover whether saccadic tasks (involving DPLFC activity), and cortical excitability (involving GABA/Glutamate neurotransmission) could provide neuropsychophysical markers for mood disorders, and/or of its phases, in patients with rapid cycling bipolar disorders (rcBD).

Methods: Two rcBD patients were followed for a cycle, and were compared to nine healthy controls. A saccade task, mixing prosaccades, antisaccades, and nosaccades, and an evaluation of cortical excitability using transcranial magnetic stimulation were performed.

Results: We observed a deficit in antisaccade in patients independently of thymic phase, and in nosaccade in the manic phase only. Cortical excitability data revealed global intracortical deficits in all phases, switching according to cerebral hemisphere and thymic phase.

Conclusion: Specific patterns of performance in saccade tasks and cortical excitability could characterize mood disorders (trait-markers) and its phases (state-markers). Moreover, a functional relationship between oculometric performance and cortical excitability is discussed.

Keywords: GABA/glutamate; TMS; cortical excitability; inhibition/facilitation; paired-pulse; saccade.

Figures

Figure 1
Figure 1
Examples of trial sequences for the three saccadic conditions (red: AS, Blue: NS, and green: PS).
Figure 2
Figure 2
Saccadic performance for each patient as a function of the two opposing illness phases (Depressive and Manic) and for controls (±CI). (A) Mean percentages of saccadic inhibition errors in antisaccades (AS) and nosaccades (NS). (B) Mean SRT (in milliseconds) in prosaccades (PS).
Figure 3
Figure 3
Cortical excitability. (A) Baseline modifications (%) in controls and patients (depressive/manic) according to Inter Stimulus Intervals (ISI short/long). (B) Baseline modifications (%) in controls and patients (depressive/manic) according to stimulated hemisphere.

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