EEG markers of cognitive performance in bipolar disorder - A systematic review
- PMID: 40239908
- DOI: 10.1016/j.neubiorev.2025.106157
EEG markers of cognitive performance in bipolar disorder - A systematic review
Abstract
Background: People with bipolar disorder (BD) may experience impairing cognitive deficits, even in remission. Electroencephalographic (EEG) measures can depict neurophysiological activity with high temporal resolution. They could therefore be an adequate method to pinpoint the cognitive impairments in BD, facilitating understanding of when exactly the cognitive processing is disrupted and what neurophysiological systems are involved. In the absence of a previous literature examination, this systematic review aimed to synthesize the evidence of associations between EEG and cognitive measures to identify electrophysiological markers of cognitive performance in BD.
Methods: A systematic search across PubMed, EMBASE, APA PsycInfo and Cochrane Library until November 2023 was undertaken to identify studies in which a direct correlation between any continuous EEG measure and any continuous cognitive measure in participants with BD was reported. A narrative synthesis approach was used to present the identified correlations, across five cognitive (attention and processing speed, working memory, episodic memory, executive function, and intellectual capacity) and four EEG domains (event-related potentials (ERP), spectral, connectivity and other measures).
Results: A total of 16 articles describing 15 studies were included in the review. Six studies identified significant correlations. Most significant correlations were reported between ERP measures and attention and processing speed performance, several between ERP measures and executive functioning and one within the working memory and the intellectual capacity domain respectively. However, most of the identified significant correlations were conflicting within (different measures or mood states) and across studies with no consistent significant correlation across studies. The majority of identified correlations were non-significant.
Conclusions: As yet no robust EEG markers of cognitive performance in people with BD are known. This review highlights the heterogeneity in measures and participant characteristics between studies and the need for standardization. Further studies with homogeneous methods and participant groups may help to establish consistent associations.
Keywords: Bipolar disorder; Cognition; EEG; Systematic review.
Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rebecca Strawbridge reports a relationship with Janssen Pharmaceuticals Inc that includes: speaking and lecture fees. Allan H Young reports a relationship with Flow Neuroscience that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Novartis that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Roche that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Janssen Pharmaceuticals Inc that includes: consulting or advisory, funding grants, and speaking and lecture fees. Allan H Young reports a relationship with Takeda that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Noema pharma that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Compass that includes: consulting or advisory, funding grants, and speaking and lecture fees. Allan H Young reports a relationship with AstraZeneca that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Boehringer Ingelheim that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Eli Lilly that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with LivaNova that includes: consulting or advisory, funding grants, and speaking and lecture fees. Allan H Young reports a relationship with Lundbeck that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Sunovion that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Servier that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Allegan that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Bionomics that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Sumitomo Dainippon Pharma that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Sage that includes: consulting or advisory and speaking and lecture fees. Allan H Young reports a relationship with Neurocentrx that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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