Functional Magnetic Resonance Imaging Study of Inhibitory Control in Bipolar Disorder and Major Depressive Disorder

Condition(s) studied

Investigational drug(s) / intervention(s)

Analysis of inhibitory control: Investigation of neurofunctional characterization of inhibitory control using a comprehensive clinical, cognitive assessment and task-based MRI exams

Study summary

Bipolar disorder and unipolar depressive disorder are two chronic mood disorders associated with a significant social impact, even during euthymic phases. Their differential diagnosis remains complex, particularly when bipolar disorder begins with a depressive episode. Identifying distinctive markers between these pathologies therefore represents a major clinical and economic challenge, as appropriate mood-stabilizing treatment can reduce healthcare costs and improve patients' functional outcomes.

Among potential biomarkers, executive functions-and more specifically inhibition-have received particular attention. Inhibitory deficits are observed in both disorders, including during euthymic states, and also among first-degree relatives, suggesting their potential as cognitive and cerebral endophenotypes. These deficits may help explain the difficulties in emotion regulation and impulsivity frequently observed in mood disorders.

Two components of inhibition are distinguished:

1. Behavioral inhibition, which refers to the ability to stop an ongoing response.
2. Interference control, which refers to the ability to resist distraction. These processes rely on partially distinct neural networks and operate at different stages of information processing. The few studies comparing these two components in bipolar disorder have shown contradictory results, and neuroimaging investigations have only partially explored these mechanisms, particularly their emotional dimension. It is, however, well established that patients with bipolar or depressive disorders show greater difficulties in executive tasks involving emotional stimuli than in purely cognitive tasks.

The study is expected to reveal:

* Differences in brain activation between euthymic bipolar and unipolar depressive patients in regions involved in inhibitory control, modulated by the emotional content of the task.
* Distinct cognitive performance profiles according to pathology, reflecting specific alterations in inhibitory and interference processes.

These findings should provide a better understanding of the differential neurocognitive bases of mood disorders. Identifying specific cognitive and neural profiles could contribute to more accurate differential diagnosis and to the personalization of therapeutic interventions, particularly through cognitive remediation strategies targeting executive and emotional deficits.

Eligibility

Primary outcome measure(s)

• fMRI activations during an behavioral inhibition task (emotional stop signal task) — Day 0
  Participants will perform a gender discrimination task on emotional and non-emotional faces. Under Go conditions, the participant must respond. Under non-Go conditions, the frame of the image changes color and the participant must not respond. The faces express neutrality (50%) or anger (50%).
• fMRI activations during an emotional interference control (emotional Flanker task) — Day 0
  Participants were instructed to discriminate the gender of a target stimulus during an emotional Flanker task. The stimuli consist of faces expressing a neutral or angry emotion. The central face (the target) may display the same emotion (congruent condition) or a different emotion (incongruent condition) from the faces on the right and left (two flankers). Participants must say, as quickly and accurately as possible, what the gender of the central face is

Trial sites (1)

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