Send to

Choose Destination
Schizophr Bull. 2018 Jan 13;44(1):54-64. doi: 10.1093/schbul/sbx050.

Too Fast or Too Slow? Time and Neuronal Variability in Bipolar Disorder-A Combined Theoretical and Empirical Investigation.

Northoff G1,2,3,4,5,6, Magioncalda P2,3,7, Martino M2,3,7, Lee HC8, Tseng YC9, Lane T5,6.

Author information

Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China.
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.
Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.
TMU Research Centre for Brain and Consciousness, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.
Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Radiology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.


Time is an essential feature in bipolar disorder (BP). Manic and depressed BP patients perceive the speed of time as either too fast or too slow. The present article combines theoretical and empirical approaches to integrate phenomenological, psychological, and neuroscientific accounts of abnormal time perception in BP. Phenomenology distinguishes between perception of inner time, ie, self-time, and outer time, ie, world-time, that desynchronize or dissociate from each other in BP: inner time speed is abnormally slow (as in depression) or fast (as in mania) and, by taking on the role as default-mode function, impacts and modulates the perception of outer time speed in an opposite way, ie, as too fast in depression and too slow in mania. Complementing, psychological investigation show opposite results in time perception, ie, time estimation and reproduction, in manic and depressed BP. Neuronally, time speed can be indexed by neuronal variability, ie, SD. Our own empirical data show opposite changes in manic and depressed BP (and major depressive disorder [MDD]) with abnormal SD balance, ie, SD ratio, between somatomotor and sensory networks that can be associated with inner and outer time. Taken together, our combined theoretical-empirical approach demonstrates that desynchronization or dissociation between inner and outer time in BP can be traced to opposite neuronal variability patterns in somatomotor and sensory networks. This opens the door for individualized therapeutic "normalization" of neuronal variability pattern in somatomotor and sensory networks by stimulation with TMS and/or tDCS.


bipolar disorder; neuronal variability; somatomotor network; time; visual network

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center