Elsevier

Journal of Affective Disorders

Volume 158, April 2014, Pages 161-171
Journal of Affective Disorders

Research report
Natural speech comprehension in bipolar disorders: An event-related brain potential study among manic patients

https://doi.org/10.1016/j.jad.2013.11.013Get rights and content

Abstract

Background

Thought and language disturbances are crucial clinical features in Bipolar Disorders (BD), and constitute a fundamental basis for social cognition. In BD, clinical manifestations such as disorganization and formal thought disorders may play a role in communication disturbances. However, only few studies have explored language disturbances in BD at a neurophysiological level. Two main Event-Related brain Potentials (ERPs) have been used in language comprehension research: the N400 component, elicited by incongruous word with the preceding semantic context, and the Late Positive Component (LPC), associated with non-specifically semantic and more general cognitive processes. Previous studies provided contradictory results regarding N400 in mood disorders, showing either preserved N400 in depression or dysthymia, or altered N400 in BD during semantic priming paradigm. The aim of our study was to explore N400 and LPC among patients with BD in natural speech conditions.

Methods

ERPs from 19 bipolar type I patients with manic or hypomanic symptomatology and 19 healthy controls were recorded. Participants were asked to listen to congruous and incongruous complete sentences and to judge the match between the final word and the sentence context. Behavioral results and ERPs data were analyzed.

Results

At the behavioral level, patients with BD show worst performances than healthy participants. At the electrophysiological level, our results show preserved N400 component in BD. LPC elicited under natural speech conditions shows preserved amplitude but delayed latency in difference waves.

Limitations

Small size of samples, absence of schizophrenic group and medication status.

Conclusions

In contrast with the only previous N400 study in BD that uses written semantic priming, our results show a preserved N400 component in ecological and natural speech conditions among patients with BD. Possible implications in terms of clinical specificity are discussed.

Section snippets

Background

Language and speech skills are widely involved in daily-life situations for patients suffering from Bipolar Disorders (BD). They constitute a fundamental basis for social cognition and a crucial condition for accessibility to psychotherapy. In BD, clinical manifestations such as disorganization and Formal Thought Disorders (FTD) may play a role in communication disturbances. A growing body of evidence from clinical and cognitive studies tends to go against the classical distinction between

Participants

A total of 38 participants, including 19 bipolar type I patients and 19 healthy comparison subjects, were enrolled in this study. In the BD group, both inpatients (n=10) and outpatients (n=9) were recruited from the Marseille University Department of Psychiatry while presenting a mild to severe manic episode. Diagnoses of type I Bipolar Disorder (BD) were performed according to the DSM IV-TR criteria (American Psychiatric Association, 2000) using the Mini-International Neuropsychiatric

Demographic, clinical and medication characteristics

The BD patients (10 women) and HS participants (10 women) were 21–59 years old (mean age=41.3 years old, sd=11.7) and 21–61 years old (mean age=40.1 years old, sd=11.8), respectively. In both groups, 89.5% of the participants were right-handed (17 participants for each group). Socio-demographic characteristics of both bipolar and healthy participants are reported in Table 1, with no significant differences between groups regarding age (p=.69), sex (p=1), education level (p=.28) or handedness (p

Discussion

In spite of its central role in communication and social cognition, only a few studies explore language and speech comprehension in patients suffering from BD (Goodwin and Jamison, 2007). Most of the current research extensively focuses on clinical manifestations of bipolar FTD (Cuesta and Peralta, 2011) and neurocognitive impairments at a more general level (Bora et al., 2010; Aminoff et al., 2013). The aim of the present study was to explore ERPs in natural speech conditions among bipolar

Conclusion

N400 exploration under automatic conditions may exhibit limited specificity because N400 alterations during word-pairs and non-ecological paradigms have been found in both schizophrenia (Koyama et al., 1991, Bobes et al., 1996, Strandburg et al., 1997, Kostova et al., 2005, Kiang et al., 2008, Kreher et al., 2008) and bipolar mania (Ryu et al., 2012). On the contrary and in line with previous findings in other mood disorders (Deldin et al., 2006, Iakimova et al., 2009), the main result of our

Role of funding source

No funding source to declare.

Conflict of interest

The authors report no conflict of interest related to the topic of this publication.

Acknowledgment

The technical assistance of Adeline Surray and Estelle Pierard-Labadie is gratefully acknowledged. The authors of this study would also like to thank patients with bipolar disorders who agreed to participate in this study.

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