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According to this model, sensation avoidance and withdrawal in depression and sensation seeking and hyperactivity in mania can be explained as auto\u2010regulatory attempts to counteract a tonically high (depression) or unstable (mania) arousal. The aim of this study was to compare brain arousal regulation between manic and depressive bipolar patients and healthy controls. We hypothesized that currently depressed patients with bipolar disorder show hyperstable arousal regulation, while currently manic patients show unstable arousal regulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010eight patients with bipolar disorder received a 15\u2010min resting electroencephalogram (<jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>) during a depressive episode and 19 patients received the same during a manic\/hypomanic episode. Twenty\u2010eight healthy control subjects were matched for age and sex. The Vigilance Algorithm Leipzig (<jats:styled-content style=\"fixed-case\">VIGALL<\/jats:styled-content>), which classifies 1\u2010s <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content> segments as one of seven <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\u2010vigilance substages, was used to measure brain arousal regulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Manic patients showed more unstable <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\u2010vigilance regulation as compared to the control sample (<jats:italic>P\u00a0<\/jats:italic>=\u00a0.004) and to patients with a depressive episode (<jats:italic>P\u00a0<\/jats:italic>\u2264\u00a0.001). Depressive patients had significantly higher mean vigilance levels (<jats:italic>P\u00a0<\/jats:italic>=\u00a0.045) than controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A clear difference was found in the regulation of brain arousal of manic patients vs depressive patients and controls. These data suggest that brain arousal might depend on the current mood state, which would support the arousal regulation model of affective disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12440","type":"journal-article","created":{"date-parts":[[2016,10,19]],"date-time":"2016-10-19T11:15:19Z","timestamp":1476875719000},"page":"502-510","source":"Crossref","is-referenced-by-count":27,"title":["Early report on brain arousal regulation in manic vs depressive episodes in bipolar disorder"],"prefix":"10.1111","volume":"18","author":[{"given":"Dirk Alexander","family":"Wittekind","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Universit\u00e4t Leipzig  Leipzig Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janek","family":"Spada","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy Universit\u00e4t Leipzig  Leipzig Germany"},{"name":"Research Centre of the German Depression Foundation 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