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Pain‐processing abnormalities in bipolar I disorder, bipolar II disorder, and schizophrenia: A novel trait marker for psychosis proneness and functional outcome?
Author(s) -
Minichino Amedeo,
Delle Chiaie Roberto,
Cruccu Giorgio,
Piroso Serena,
Di Stefano Giulia,
Francesconi Marta,
Bersani Francesco Saverio,
Biondi Massimo,
Truini Andrea
Publication year - 2016
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/bdi.12439
Subject(s) - bipolar disorder , psychosis , psychology , schizophrenia (object oriented programming) , anterior cingulate cortex , cognition , psychiatry , audiology , medicine
Objectives Overlapping neural system dysfunctions, mainly involving the secondary somatosensory cortex (S2), the anterior cingulate cortex ( ACC ) and the anterior insular cortex ( AIC ), seem to be related to both pain‐perception abnormalities and psychotic symptoms in schizophrenia ( SCZ ) and bipolar disorder ( BD ). Laser‐evoked potentials ( LEP s) were used to investigate pain‐perception and central pain‐processing abnormalities in SCZ , bipolar I disorder ( BD ‐I), and bipolar II disorder ( BD ‐ II ), and to evaluate their relationship with history of psychosis, and social‐cognitive and functional impairments. Methods Twenty patients with SCZ , 17 patients with BD ‐I, and 21 patients with BD ‐ II who were all under similar pharmacological treatment underwent clinical, functional, and neuro‐psychological assessment. LEP s were analyzed in patients and 19 healthy subjects ( HS ). LEP s elicit responses reflecting the activity of the S2 (N1 wave) and the ACC / AIC cortices (N2/P2 complex). A four‐group ANOVA was conducted between patients and HS to compare pain‐perceptive thresholds ( PT hs), N1, and N2/P2‐ LEP components. Results Compared to HS : (i) patients with SCZ showed pain‐processing and pain‐perception abnormalities, as revealed by significantly higher PT h ( P <.01), and lower N1 ( P <.01) and N2/P2 ( P <.01) amplitudes, (ii) patients with BD ‐I showed only pain‐processing abnormalities, as revealed by significantly lower N1 ( P <.05) and N2 ( P <.01) amplitudes; and patients with BD ‐ II did not differ for any of the LEP variables investigated. N1 and N2 amplitudes negatively correlated to history of psychosis ( P <.01), social‐cognition ( P <.05), and real‐world functioning ( P <.01) measures in the whole group of patients. Conclusions To the best of our knowledge, this is the first study comparing central pain processing in patients with SCZ , BD ‐I, and BD ‐ II . Our results suggest that pain‐processing abnormalities may represent a novel locus of interest for research investigating trait markers of the psychosis spectrum.