Comparison of neurocognitive deficit among euthymic bipolar I disorder patients, their first-degree relatives and healthy controls

Abstract

Background: Bipolar patients often suffer from debilitating cognitive impairment in different stages of the disease (manic, depressive or euthymic states). We assessed and compared the frequency of neurocognitive deficit among individual with bipolar I disorder but currently in euthymic state, their first-degree blood relatives and healthy controls. In addition, we also probed further into the type of neurocognitive deficit that can be seen among them and observed the influence of sociodemographic characteristics with the occurrence of neurocognitive deficit in individual with bipolar I disorder patient.Methods: Patients (N=30) who fulfilled the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV TR) criteria for bipolar I disorder but currently in remission were assessed for any neurological deficits using the standard instruments. In this study, 30 first-degree blood relatives of bipolar I disorder patients and selected 30 hospital staff as healthy controls were also assessed for neurological deficits.Results: We did not find any significant frontal dysfunction among first-degree blood relatives of bipolar I disorder patient when compared with euthymic bipolar I disorder patients. Factor that significantly affected neurocognitive performance in the bipolar patients who were in euthymic state included age, total duration of illness and number of manic episode.Conclusions: As neurocognitive impairment is associated with number of manic episode and total duration of illness; the objective of treatment should be to prolong remission and impart psychoeducation regarding nature of illness. On the contrary, anticipating definite cognitive impairment in first-degree blood relatives of bipolar I disorder patient when compared to healthy control warrants periodic neurocognitive testing and psychoeducation about deficit and medical intervention, if required.

Social Cognition and Neuro-cognition in Patients with Bipolar Disorder, Their First-Degree Relatives and Healthy Controls

“…These findings are in concordance with literature that states that there is persistent cognitive impairment in the domains of attention, memory, and executive functions in BPAD patients in the euthymic state. 20 Executive functions, memory, and tasks involving mental flexibility and psychomotor speed are specifically affected in patients with BPAD, 11 which is in concurrence with our finding that speed of processing and problem-solving are two domains that have yielded medium effect size in performance amongst patients and FDR.…”

“…According to National Mental Health Sur-sessing the neurocognitive functioning in stable patients with BPAD reported that compared to controls, the patients performed poorly overall in frontal functions, with lower scores in Mini Mental State Examination and Trail Making A and B, indicative of deficits in general cognitive abilities. 20 Currently, deficits with clinical significance have been identified only in symptomatic patients, but these impairments persist even in the remission phase, leading to poor prognosis. [9][10][11] It has been observed that cognitive abilities such as executive functioning and attention are compromised in first-degree relatives (FDR) of patients with BPAD when compared to healthy controls.…”

“…An Indian study assessing the neurocognitive functioning in stable patients with BPAD reported that compared to controls, the patients performed poorly overall in frontal functions, with lower scores in Mini Mental State Examination and Trail Making A and B, indicative of deficits in general cognitive abilities. 20…”

Assessment of the Impairment in Domain functionalities and Executive Functions in Euthymic Patients, with Bipolar Disorder I/II - Utilizing the FAST and FAB tests

“…Although FAB [64].Regarding psychiatric illnesses, only EXIT-25 and FAB test can evaluate the cognitive tasks and be associated with specific areas of the frontal lobes (that is, able to measure, i.e., conceptualization with the dorsolateral areas, word generation with the medial areas, and inhibitory control with the orbital or medial areas, just as the FAB test was able to exhibit a degree of sensitivity to focal lesions near the anterior insula in the middle right lower frontal gyrus, and in the lower right frontal gyrus), [65]; [66], but, it will be discussed forward.…”

Assessment of different domain impairments in Cognitive Functions and Functionalities found in Euthymic Patients with Bipolar Disorder I / II - during the early and late phases of the disease, using the FAB and FAST tests.

“…Although FAB [64]. Regarding psychiatric illnesses, the FAB test can evaluate the cognitive tasks and be associated with specific areas of the frontal lobes (that is, able to measure, i.e., conceptualization with the dorsolateral areas, word generation with the medial areas, and inhibitory control with the orbital or medial areas.…”