Hot and cold inhibitory control in bipolar disorder: An antisaccade study of emotion processing and attentional modulation

Background: Bipolar disorder (BD) is associated with inhibitory control impairments, but traditional inhibitory control tasks may be confounded by reading ability, which is impaired in some BD patients. Eye-movement tasks assessing antisaccade performance avoid these limitations, but few studies have examined inhibitory control in BD using such tasks, particularly those modulating valence and attention. Method: We used eye-tracking in a sample of 44 euthymic BD patients and 30 controls to measure antisaccade performance on tasks employing emotional "hot" and nonemotional "cold" stimuli. Attentional modulation was examined by comparing performance across step and gap trials. Results: No significant between-group differences were found in antisaccade error rates or latencies for neutral or emotional stimuli. Both groups performed worse during neutral compared to emotional stimuli. BD patients showed a slight negativity bias, trending toward slower responses to negative compared to positive stimuli. Both groups performed more quickly and accurately during gap compared to step condition. Conclusions: These findings suggest that inhibitory control in BD, as measured by antisaccade performance, is influenced by valence and attentional modulation in a similar way to controls. The lack of significant group differences contrasts with previous research, necessitating further investigation into the mechanisms of antisaccade performance in BD.