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Overlapping prefrontal systems involved in cognitive and emotional processing in euthymic bipolar disorder and following sleep deprivation: a review of functional neuroimaging studies - PubMed

Review

Overlapping prefrontal systems involved in cognitive and emotional processing in euthymic bipolar disorder and following sleep deprivation: a review of functional neuroimaging studies

Benjamin S McKenna et al. Clin Psychol Rev. 2012 Nov.

Abstract

Prefrontal cortex (PFC) mediated cognitive and emotional processing deficits in bipolar disorder lead to functional limitations even during periods of mood stability. Alterations of sleep and circadian functioning are well-documented in bipolar disorder, but there is little research directly examining the mechanistic role of sleep and/or circadian rhythms in the observed cognitive and emotional processing deficits. We systematically review the cognitive and emotional processing deficits reliant upon PFC functioning of euthymic patients with bipolar disorder and in healthy individuals deprived of sleep. The evidence from two parallel lines of investigation suggests that sleep and circadian rhythms may be involved in the cognitive and emotional processing deficits seen in bipolar disorder through overlapping neurobiological systems. We discuss current models of bipolar highlighting the PFC-limbic connections and discuss inclusion of sleep-related mechanisms. Sleep and circadian dysfunction is a core feature of bipolar disorder and models of neurobiological abnormalities should incorporate chronobiological measures. Further research into the role of sleep and circadian rhythms in cognition and emotional processing in bipolar disorder is warranted.

Published by Elsevier Ltd.

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Figures

Figure 1
Figure 1

Lateral (left) and medial (right) views of the human brain with subdivisions of the prefrontal cortex discussed in this review colorized.

Figure 2
Figure 2

Additive model of bipolar disorder and sleep / circadian disruption. The interaction between dorsal and ventral systems is presented for: Left: healthy comparison individuals without bipolar or sleep / circadian disruption; Middle: bipolar patients; and right: bipolar patients who also have sleep and circadian disruption. Thicker black borders and arrows relative to healthy comparison represent increases in brain activation and functional connectivity, respectively. Thinner/dashed borders and smaller arrows relative to healthy comparison represent decreases in brain activation and functional connectivity, respectively

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