Beneficial Cognitive Effects of Transcranial Infrared Laser Stimulation (TILS) in Bipolar Disorder
Highlights from the International Society for Bipolar Disorders Conference Posters and Presentations, Chicago, June 22-25, 2023
Michael Gentry of The University of Texas At Austin reported on 30 individuals with remitted bipolar disorder (type I or type II). TILS was administered weekly to each participant over six consecutive weeks (1064 nm wavelength; bilaterally to the frontal poles; 10 minutes per weekly session)….. after six weeks of TILS administration, participants demonstrated decreased impulsivity on the Stop Signal Task and improved abilities to select correct responses on the Multitasking Test.
Children Who Are Bullied Have Poorer Mental Health
A 2017 study of twins between the ages of 11 and 16 found that being bullied around age 11 caused anxiety, depression, hyperactivity and impulsivity, inattention, and conduct problems, some of which lasted for years. Participants recorded their experiences with physical or verbal bullying, social manipulation, and property attacks (trying to break one’s belongings, for example).
The effects of bullying decreased over time. The bullied children were still significantly more anxious than their non-bullied twins two years later, but this difference faded by the five-year mark. However, paranoid thoughts and cognitive disorganization did persist for 5 years.
The twin study design helped researchers zone in on the causal effect bullying might have on the children’s mental health, rather than other factors the twins shared, such as genetics or family environment. The study included 11,108 twins born in England and Wales.
The research by Timothy Singham and colleagues was published in the journal JAMA Psychiatry. Interestingly, the researchers found that prior mental health difficulties increased children’s likelihood of being bullied, such that being bullied could be considered a symptom of preexisting vulnerabilities. Singham and colleagues suggest that in addition to interventions to reduce bullying and address familial factors that might make children susceptible to bullying, children should also be taught resilience skills.
TDCS May Improve ADHD Symptoms
Transcranial direct current stimulation (tDCS) is a therapy in which electrodes placed on the skull deliver a steady, low level current to the brain, changing its threshold for electrical activity. Anodal tDCS to the prefrontal cortex can improve working memory. In a small 2017 study in the Journal of Neural Transmission, Cornelia Soff and colleagues found for the first time that tDCS may improve symptoms of attention-deficit hyperactivity disorder (ADHD).
People with ADHD tend to have underactivation of the prefrontal cortex and deficits in working memory. The study randomized 15 young people aged 12–16 (three girls and twelve boys) to receive either real tDCS or a sham stimulation. The anodal tDCS was delivered at 1 mA targeting the left dorsolateral prefrontal cortex for 5 days. Those participants who received tDCS showed a reduction in inattention, impulsivity, and hyperactivity compared to those who received the sham stimulation. The effects were more pronounced 7 days after the stimulation, suggesting that tDCS’ effects may be long-term. Larger, more definitive trials are needed to clarify the effects of tDCS on ADHD, but these preliminary findings are promising.
Children at Risk for Bipolar Disorder May Have Adverse Reactions to Antidepressants
At the 2015 meeting of the American Academy of Child and Adolescent Psychiatry, researcher Jeffrey R. Strawn reported that among children at high risk for bipolar disorder (because of a family history of the disorder) who are prescribed antidepressants for depression and anxiety, adverse reactions are common. These reactions include irritability, aggression, impulsivity, and hyperactivity, and often lead to discontinuation of the antidepressant treatment.
Younger patients at risk for bipolar disorder were more likely to have an adverse reaction to antidepressants. Risk of an adverse reaction decreased 27% with each year of age.
High Impulsivity and Low Resilience Characterize Euthymic Patients with Bipolar Disorder
Resilience is the ability to cope with adversity. While its role in anxiety disorder, post-traumatic stress disorder (PTSD), and unipolar depression has been investigated, there have been few studies of resilience in bipolar disorder.
A recent study presented by B. Cha et al. at the 2014 meeting of the International Society for Bipolar Disorders found that even euthymic patients with bipolar disorder show low levels of resilience (as rated on the Connor-Davidson Resilience Scale). Patients with a history of prior bipolar episodes had greater impulsivity (measured on the Barratt Impulsion Scale) and lower resilience than participants in a control group. Impulsivity in bipolar disorder was associated with lower resilience. Higher Clinical Global Impressions (CGI) scores, greater number of prior depressive episodes, and more impulsiveness were associated with lower resilience scores.
Both high impulsiveness and low resilience may be trait-related phenomena even in patients who have recovered from bipolar disorder. Number of prior depressive episodes is also associated with more cognitive impairment on multiple tests of executive functioning, attention, learning, and memory. Therapy aimed at problem solving and coping skills might help build resilience.
