1887
Volume 2025, Issue 1
  • EISSN: 2220-2749

Abstract

Autonomic dysfunction, characterized by heightened sympathetic and diminished parasympathetic activity, is increasingly recognized as a significant factor in the pathophysiology and therapeutic management of bipolar disorder (BD). The aim of this study is to investigate the changes in sympathetic skin response (SSR) among BD type 1 patients during the manic phase compared to their state after clinical remission.

This retrospective cross-sectional study enrolled 17 patients who were newly diagnosed with BD type 1 in the manic phase, adhering to DSM V criteria, over 4 years from January 2018 to December 2022. All subjects received treatment with sodium valproate, and SSR testing was performed during both the manic phase and following a washout period. The latency and amplitude of bilateral palmar and plantar SSRs were examined using electrical stimulation of the median and tibial nerves. Statistical analyses were conducted using paired -tests and Mann–Whitney tests to assess the mean differences in SSR latency and amplitude pre- and post-treatment.

The treatment led to a statistically significant reduction in SSR latency for the right tibial nerve (from 2.380 ± 0.370 to 2.126 ± 0.241 seconds, = 0.014) and the left median nerve (from 1.829 ± 0.410 to 1.600 ± 0.217 seconds, = 0.033), indicating moderate effect sizes. In contrast, SSR amplitude demonstrated minimal variation across all examined nerves, with no statistically significant increase observed following treatment (all -values = 0.05).

The small number of participants in the study could affect the reliability of the results.

The results of the study indicate that SSR latency may serve as a promising biomarker for evaluating autonomic function in patients experiencing manic and euthymic phases of BD following mood stabilizer treatment. Nonetheless, further validation through larger cohort studies with long-term follow-up is essential to corroborate these preliminary findings and better understand the implications for clinical practice.

© 2025 The Author(s), licensee HBKU Press.
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2025-12-07

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Understanding autonomic changes in bipolar disorder: Sympathetic skin response from the manic phase to euthymia
Avicenna 2025, 5 (2025); https://doi.org/10.5339/avi.2025.5
/content/journals/10.5339/avi.2025.5
/content/journals/10.5339/avi.2025.5
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  • Article Type: Research Article
Keyword(s): Acute mania, autonomic nervous system dysfunction, bipolar disorder and sympathetic skin response

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