Neurocognitive Impairment in Bipolar Disorder and Associated Factors: Using Population-based Norms and a Strict Criterion for Impairment Definition

Sarmento, Stella; Bittencourt, Lorna; Filho, Euclides José de Mendonça; Abreu, Neander; Lacerda, Acioly Luiz Tavares de; Miranda‐Scippa, Ângela

doi:10.1097/wnn.0000000000000231

Cited by 3 publications

(1 citation statement)

References 39 publications

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“…Bipolar Disorder (BD) is a severe mental illness with significant psychosocial consequences for affected individuals and their families. Patients with BD experience noticeable cognitive and social impairment, not only during episodes, but also within the period of euthymia (Sarmento et al 2020, Bortolato et al 2015, Bourne et al 2013, Torres et al 2007. A systematic review of neurocognitive functioning in patients with BD revealed neurocognitive deficits in almost all cognitive domains (Esan et al 2020, Tsitsipa & Fountoulakis 2015.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Cognitive Function, Social Disability and Basic Life Skills in Euthymic Patients With Bipolar Disorder

Batinić¹,

Djokic²,

Ivković³

2021

Preprint

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Background: Data from the literature suggests the presence of cognitive impairments which persist in the euthymic phase of bipolar disorder (BD) and have significant consequences in regards to psychosocial functioning. The aims of our study were: 1) to ascertain the cognitive function (CF), social disability (SD) and basic life skills (BLS) of euthymic patients diagnosed with BD, 2) their relationship and 3) to compare CF, SD and BLS in euthymic patients diagnosed with BD to euthymic patients with recurrent major depressive disorder (rMDD).Subjects and methods: Ninety eight euthymic patients diagnosed either with BD (N=48, mean age 48.79 years, SD = 8.587) or rMDD (N=50, mean age 50.02 years, SD = 9.826) underwent testing using the Brief Assessment of Cognition in Affective Disorders (BAC-A) test, the Sheehan Disability Scale (SDS) and the UCSD performance-based skills assessment (UPSA-brief). Results: Euthymic patients with BD demonstrated significantly lower scores as compared to normal population values in verbal, learning and working memory, verbal fluency, attention and processing speed, affective memory for negative and positive words (p?0.01 each) and motor speed (p<0.05), but not for reasoning/problem solving (p=0.05). Furthermore, their mean total SDS score of 17.60 (SD = 6.450, Sk = -0.833) and its subscale scores were higher, while their UPSA-B total scores were lower (M = 76.01, SD = 17.148, Sk = -0.412). There was a correlation between CF, SD and BLS scores (p<0.01), as well as between BLS and SD scores (p<0.05). The analysis of variance did not however show significant differences between subgroups of patients. Conclusion: Patients with euthymic BD had lower cognitive function, greater social disability and lower basic life skills. There were similar decreases in cognitive and psychosocial function between patients in the euthymic phase of either BD or MDD.

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Section: Introductionmentioning

confidence: 99%

Assessment of Cognitive Function, Social Disability and Basic Life Skills in Euthymic Patients With Bipolar Disorder

Batinić¹,

Djokic²,

Ivković³

2021

Preprint

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Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study

et al. 2021

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Brain pathological features during manic/hypomanic and depressive episodes in the same patients with bipolar disorder (BPD) have not been described precisely. The study aimed to investigate depressive and manic-phase-specific brain neural activity patterns of BPD in the same murine model to provide information guiding investigation of the mechanism of phase switching and tailored prevention and treatment for patients with BPD. In vivo two-photon imaging was used to observe brain activity alterations in the depressive and manic phases in the same murine model of BPD. Two-photon imaging showed significantly reduced Ca2+ activity in temporal cortex pyramidal neurons in the depression phase in mice exposed to chronic unpredictable mild stress (CUMS), but not in the manic phase in mice exposed to CUMS and ketamine. Total integrated calcium values correlated significantly with immobility times. Brain Ca2+ hypoactivity was observed in the depression and manic phases in the same mice exposed to CUMS and ketamine relative to naïve controls. The novel object recognition preference ratio correlated negatively with the immobility time in the depression phase and the total distance traveled in the manic phase. With recognition of its limitations, this study revealed brain neural activity impairment indicating that intrinsic emotional network disturbance is a mechanism of BPD and that brain neural activity is associated with cognitive impairment in the depressive and manic phases of this disorder. These findings are consistent with those from macro-imaging studies of patients with BPD. The observed correlation of brain neural activity with the severity of depressive, but not manic, symptoms need to be investigated further.

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Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review

Rajashekar

Blumberg

Villa

2022

J Psychiatry Brain Sci

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Bipolar disorder (BD) is a common mood disorder that can have severe consequences during later life, including suffering and impairment due to mood and cognitive symptoms, elevated risk for dementia and an especially high risk for suicide. Greater understanding of the brain circuitry differences involved in older adults with BD (OABD) in later life and their relationship to aging processes is required to improve outcomes of OABD. The current literature on gray and white matter findings, from high resolution structural and diffusion-weighted magnetic resonance imaging (MRI) studies, has shown that BD in younger age groups is associated with gray matter reductions within cortical and subcortical brain regions that subserve emotion processing and regulation, as well as reduced structural integrity of white matter tracts connecting these brain regions. While fewer neuroimaging studies have focused on OABD, it does appear that many of the structural brain differences found in younger samples are present in OABD. There is also initial suggestion that there are additional brain differences, for at least a subset of OABD, that may result from more pronounced gray and white matter declines with age that may contribute to adverse outcomes. Preclinical and clinical data supporting neuro-plastic and -protective effects of mood-stabilizing medications, suggest that treatments may reverse and/or prevent the progression of brain changes thereby reducing symptoms. Future neuroimaging research implementing longitudinal designs, and large-scale, multi-site initiatives with detailed clinical and treatment data, holds promise for reducing suffering, cognitive dysfunction and suicide in OABD.

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Neurocognitive Impairment in Bipolar Disorder and Associated Factors: Using Population-based Norms and a Strict Criterion for Impairment Definition

Cited by 3 publications

References 39 publications

Assessment of Cognitive Function, Social Disability and Basic Life Skills in Euthymic Patients With Bipolar Disorder

Assessment of Cognitive Function, Social Disability and Basic Life Skills in Euthymic Patients With Bipolar Disorder

Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study

Neuroimaging Studies of Brain Structure in Older Adults with Bipolar Disorder: A Review

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