Neurocognitive correlates of emotion-based urgency in DSM-5 bipolar disorder: the moderating role of diagnosis status and positive affect in a functional near-infrared spectroscopy (fNIRS) experimental study

Abstract

Background

A key goal of clinical neuroscience is to uncover reliable neurobiological targets for treatment. Urgency (negative or positive urgency subdomains, or N.urg/P.urg respectively), or affect-based impulsivity, is clinically relevant in bipolar disorder (BD). However, the neurocognitive correlates of positive and negative urgency have been mixed, with few considering the moderating effects of BD diagnosis and positive emotional context.

Methods

We conducted a 2 (group: BD vs. gender-matched healthy controls, or HC) by 2 (condition: positive vs. neutral affect) by 2 (task difficulty; within subjects) mixed, single-blind study. We examined neurocognitive correlates of urgency using EF performance and neuroimaging data from 74 participants (60 % females, M_age = 36).

Results

Between-group differences (HC > BD) in EF performance ranged from negligible to large (η_p²: 0 to 0.18). At the p < .05 threshold, positive urgency was correlated with lower cognitive control and working memory efficiency (r ranging from 0.25 to 0.34, p < .05). N.urg was correlated with reduced activity in the ventrolateral PFC (vlPFC) during cognitive control (r = −0.26 to −0.29, p < .05). Multivariate Analysis of Variance (MANOVA) and subsequent simple slopes analyses revealed significant moderation by emotional context and BD diagnosis. High N.urg predicted hypoactivity in the left orbitofrontal cortex in BD only, whereas high P.urg predicted hyperactivity in the right vlPFC in positive emotion context condition only. No correlations/MANOVA findings remained significant after p-value correction.

Conclusion

Notwithstanding the study's limitations, the nature of the relationship between urgency and neurocognitive factors may be person- and context dependent.