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Prepulse inhibition in patients with bipolar disorder: a systematic review and meta-analysis

Authors
  • Mao, Zhen1, 2
  • Bo, Qijing1, 2
  • Li, Weidi1, 2
  • Wang, Zhimin1, 2
  • Ma, Xin1, 2
  • Wang, Chuanyue1, 2
  • 1 Capital Medical University, The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Institute for Brain Disorders Center of Schizophrenia, Beijing Anding Hospital, No.5 Ankang Lane, Dewai Avenue, Xicheng District, Beijing, 100088, China , Beijing (China)
  • 2 Capital Medical University, Advanced Innovation Center for Human Brain Protection, Beijing, 100069, China , Beijing (China)
Type
Published Article
Journal
BMC Psychiatry
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Sep 11, 2019
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12888-019-2271-8
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundPrepulse inhibition (PPI) is a measurement method for the sensory gating process, which helps the brain adapt to complex environments. PPI may be reduced in patients with bipolar disorder (BD). This study investigated PPI deficits in BD and pooled the effect size of PPI in patients with BD.MethodsWe conducted a literature search on PPI in patients with BD from inception to July 27, 2019 in PubMed, Embase, Cochrane Library databases, and Chinese databases. No age, sex, and language restriction were set. The calculation formula was PPI = 100 - [100*((prepulse - pulse amplitude) / pulse amplitude)]. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of studies.ResultsTen eligible papers were identified, of which five studies including a total of 141 euthymic patients and 132 healthy controls (HC) were included in the meta-analysis. Compared with HC, euthymic patients with BD had significantly lower PPI at the 60 ms interstimulus interval (ISI) between pulse and prepulse (P = 0.476, I2 = 0.0%, SMD = − 0.32, 95% CI = − 0.54 - -0.10). Sensitivity analysis shows no significant change in the combined effect value after removing any single study. There was no publication bias using the Egger’s test at 60 ms (P = 0.606). The meta-analysis of PPI at the 60 ms ISI could have significant clinical heterogeneity in mood episode state, as well as lack of data on BD I or II subtypes.ConclusionsEuthymic patients with BD show PPI deficits at the 60 ms, suggesting a deficit in the early sensory gate underlying PPI. The PPI inhibition rate at a 60 ms interval is a stable index. More research is needed in the future to confirm this outcome, and to delve deeper into the mechanisms behind deficits.

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