Cognitive Impairment in Euthymic Bipolar Patients With and Without Prior Alcohol Dependence

Gorp, Wilfred G. van; Altshuler, Lori L.; Theberge, David C.; Wilkins, Jeffery N.; Dixon, W. J.

doi:10.1001/archpsyc.55.1.41

Cited by 397 publications

(367 citation statements)

References 33 publications

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“…The cognitive deficits in BD may be partially explained by abnormalities in functional brain structures and/or metabolism (Stoll et al, 2000;Manji et al, 2000;van Gorp et al, 1999;Coffman et al, 1990). As cognitive impairments are present in FH and persist during clinical remission in BD patients, they may be regarded as trait markers (Henry et al, 1973;van Gorp et al, 1998;Murphy et al, 1999;Coffman et al, 1990;Ferrier et al, 1999;Rubinsztein et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…Manic patients showed impairments on planning and reaction time (RT) (Murphy et al, 1999). During remission, cognitive deficits may persist (van Gorp et al, 1998;Ferrier et al, 1999;Rubinsztein et al, 2000;Scott et al, 2000); euthymic BD patients showed impairments on visuospatial recognition, verbal and nonverbal memory and learning, retrieval of information from semantic memory an increased RT on a planning task (Coffman et al, 1990;Ferrier et al, 1999;Rubinsztein et al, 2000). The fact that cognitive deficits persist during remission suggests that they constitute a trait marker in BD.…”

Section: Introductionmentioning

confidence: 99%

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Pronounced Cognitive Deficits Following an Intravenous L-Tryptophan Challenge in First-Degree Relatives of Bipolar Patients Compared to Healthy Controls

Sobczak

Honig

Schmitt

et al. 2002

Neuropsychopharmacol

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Cognitive impairment has repeatedly been described in bipolar disorders (BD). Serotonin (5-hydroxytryptophan; 5-HT) is possibly involved in these cognitive processes, more particularly in executive functions, learning, memory, and attention. The aim of this study was to investigate serotonergic vulnerability and its relation to cognitive functioning in healthy first-degree relatives of BD patients. We investigated the effects of an intravenous (i.v.) tryptophan (Trp) challenge and placebo on cognitive performance in 30 healthy firstdegree relatives of bipolar patients (FH) and 15 matched controls in a double-blind crossover design. A distinction was made between relatives of type I BD patients (FH I) and type II BD patients (FH II). Performances on planning, memory, attention, and psychomotor tasks were assessed 3 h after Trp infusion. After Trp, planning and attention were impaired in FH subjects but not in controls. Independent of Trp, FH subjects showed cognitive deficits on memory, focused and divided attention, and psychomotor performance. FH I subjects showed more pronounced cognitive impairments then FH II and controls. In all groups, Trp impaired memory and psychomotor performance significantly. In conclusions, cognitive deficits in FH following Trp may reflect a central 5-HT vulnerability in frontal brain areas. Independent of Trp, cognitive deficits in FH provide evidence for a trait marker for BD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pronounced Cognitive Deficits Following an Intravenous L-Tryptophan Challenge in First-Degree Relatives of Bipolar Patients Compared to Healthy Controls

Sobczak

Honig

Schmitt

et al. 2002

Neuropsychopharmacol

View full text Add to dashboard Cite

show abstract

“…Although patients with affective psychoses also have cognitive impairment, in these patients cognitive deficits are more strongly associated with clinical symptoms and state-related factors than they are in patients with schizophrenia (17,18). In a study of patients with schizophrenia or bipolar disorder who were assessed when psychotic at baseline and then 8 months later when remitted, only the bipolar patients improved in their cognitive performance (19); the patients with schizophrenia showed the same level of cognitive impairment at followup.…”

Section: Diagnostic Differences Regarding Relation Of Cognitive Impaimentioning

confidence: 99%

Should cognitive impairment be included in the diagnostic criteria for schizophrenia?

Keefe

2008

World Psychiatry

147

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“…In fact, there is evidence that performance on cognitive tests declines as a function of past illness burden, 154,162,163 and that a past history of alcohol abuse can impact on cognitive performance in certain domains. 164 Neither the short-nor long-term impact of medication on cognitive performance is known, 165 and evidence is just emerging supporting a recurrent or even chronic dysregulation of HPA axis function in BD. 166,167 It is important, therefore, that potential cognitive endophenotypes be studied in unaffected family members of BD probands.…”

Section: Cognitive Endophenotypesmentioning

confidence: 99%

The phenotypes of bipolar disorder: relevance for genetic investigations

2005

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The search for susceptibility genes for bipolar disorder (BD) depends on appropriate definitions of the phenotype. In this paper, we review data on diagnosis and clinical features of BD that could be used in genetic studies to better characterize patients or to define homogeneous subgroups. Clinical symptoms, long-term course, comorbid conditions, and response to prophylactic treatment may define groups associated with more or less specific loci. One such group is characterized by symptoms of psychosis and linkage to 13q and 22q. A second group includes mainly bipolar II patients with comorbid panic disorder, rapid mood switching, and evidence of chromosome 18 linkage. A third group comprises typical BD with an episodic course and favourable response to lithium prophylaxis. Reproducibility of cognitive deficits across studies raises the possibility of using cognitive profiles as endophenotypes of BD, with deficits in verbal explicit memory and executive function commonly reported. Brain imaging provides a more ambiguous data set consistent with heterogeneity of the illness. Keywords: bipolar disorder; genetics; endophenotype; neurocognitive function; brain imaging Bipolar disorder (BD) has a genetic basis with heritability of at least 80%. 1 A number of studies have attempted to map the susceptibility loci giving evidence of linkage in multiple genomic regions. In particular, findings in 4p, 4q, 8q, 10p, 12q24, 13q, 18p, 18q, 21q, and 22q have been supported by more than one study. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] However, these studies have not identified any specific genes, and a recent metaanalysis of available genome scans showed no regions with a conclusive evidence of linkage. 20 The relatively slow progress of gene-mapping efforts is often explained by the 'complex' nature of the illness and of the genotype-phenotype relation. The complexity most likely includes heterogeneity, interactions of multiple loci, incomplete penetrance, as well as phenotypes resulting from environmental effects-either alone or in interaction with the genetic predisposition. The goal of psychiatric genetic research is identification of (heritable) variations in DNA sequence or function that influence behaviour or give rise to mental illness. By definition, in complex (multifactorial) traits, this link is not unique and specific. That is, a particular change in gene sequence does not necessarily lead to a specific behaviour, and similar behaviours (symptoms) may be due to distinct (sets of) genes. Moreover, we must consider the possibility that the path between the genotype and behaviour is not unidirectional. Emerging examples point not only to general effects of environment, for instance stress, on behaviour, but also to specific behaviours influencing gene function that can be transmitted onto the next generation. 21 No single method is considered clearly superior in identifying susceptibility genes for complex traits such as BD. Most researchers agree that a combination of strategies is most lik...

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Cognitive Impairment in Euthymic Bipolar Patients With and Without Prior Alcohol Dependence

Cited by 397 publications

References 33 publications

Pronounced Cognitive Deficits Following an Intravenous L-Tryptophan Challenge in First-Degree Relatives of Bipolar Patients Compared to Healthy Controls

Pronounced Cognitive Deficits Following an Intravenous L-Tryptophan Challenge in First-Degree Relatives of Bipolar Patients Compared to Healthy Controls

Should cognitive impairment be included in the diagnostic criteria for schizophrenia?

The phenotypes of bipolar disorder: relevance for genetic investigations

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