Journal List > J Korean Neuropsychiatr Assoc > v.52(5) > 1017645

Kim, Kim, Joe, and Won: Neurocognitive Deficits in Patients with Remitted Bipolar I Disorder and Unaffected First-Degree Relatives

Abstract

Objectives

Neurocognitive dysfunction may provide a marker of underlying neuropathology and disease vulnerability in bipolar disorder. The aim of this study was to identify the differences and the profiles of cognitive deficits in euthymic bipolar patients and first-degree relatives of bipolar probands.

Methods

Twenty four unaffected first-degree relatives of probands with bipolar I disorder (BD) were included in the study as an equal number of remitted BD patients and healthy controls who were matched on age, sex, years of education, and general intelligence. Cognitive assessments were performed using the Digit Span Test, Continuous Performance Test, Rey Auditory & verbal Learning Test, Complex Figure Test, Verbal Fluency Test, Wisconsin Card Sorting Test, and Finger Tapping Test. The effect of subsyndromal symptomatology was controlled.

Results

Patients showed significantly worse performance than healthy control subjects in several measures of attention, working memory, verbal learning and memory, visual memory (delayed recall), and verbal fluency (category). Relatives showed significant impairment in working memory. No differences were observed in sustained attention, cognitive flexibility, and psychomotor performance.

Conclusion

Findings of our study suggest that the deficit in working memory could be a potential endophenotypic marker of genetic vulnerability to BD. Verbal learning and memory impair ment appears to be more related to the fully developed BD.

Figures and Tables

Table 1
Demographic data and clinical characteristics of bipolar I disorder patients (BD), unaffected first-degree relatives (FR) and healthy controls without family history (HC)
jkna-52-318-i001

ANOVA was used. Data are mean±SD. *: By Tukey test, : By chi square test, : By atypical antipsychotics, §: Dosage equivalents of chlorpromazine. YMRS-K : Young Mania Rating Scale-Korean version, K-MADRS : Korean version of the Montgomery-Asberg Depression Rating Scale

Table 2
Group differences in neuropsychological tests of bipolar I disorder patients (BD), unaffected first-degree relatives (FR) and healthy controls without family history (HC)
jkna-52-318-i002

ANCOVA (Young Mania Rating Scale-Korean Version as covariates) was used. Data are mean±SD. *: By Tukey test. K-AVLT : Korean-Auditory Verbal Learning Test, K-CFT : Korean-Complex Figure Test, CPT : Continuous Performance Test, WCST : Wisconsin Card Sorting Test

Notes

The authors have no financial conflicts of interest.

References

1. Won S, Kang BJ. Cognitive deficits in bipolar disorder. In : Bahk WM, Jun DI, editors. Bipolar disorder. Seoul: Sigma Press;2009.
2. Papadimitriou GN, Dikeos DG, Soldatos CR. Concept of bipolar disorder: a historical perspective. In : Kasper S, Hirschfeld RM, editors. Handbook of bipolar disorder. London & New York: Taylor & Francis;2005.
3. Tham A, Engelbrektson K, Mathé AA, Johnson L, Olsson E, Åberg-Wistedt A. Impaired neuropsychological performance in euthymic patients with recurring mood disorders. J Clin Psychiatry. 1997; 58:26–29.
crossref
4. Martínez-Arán A, Vieta E, Reinares M, Colom F, Torrent C, Sánchez-Moreno J, et al. Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. Am J Psychiatry. 2004; 161:262–270.
crossref
5. Robinson LJ, Thompson JM, Gallagher P, Goswami U, Young AH, Ferrier IN, et al. A meta-analysis of cognitive deficits in euthymic patients with bipolar disorder. J Affect Disord. 2006; 93:105–115.
crossref
6. Arts B, Jabben N, Krabbendam L, Van Os J. Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives. Psychol Med. 2008; 38:771–785.
crossref
7. Bora E, Yucel M, Pantelis C. Cognitive endophenotypes of bipolar disorder: a meta-analysis of neuropsychological deficits in euthymic patients and their first-degree relatives. J Affect Disord. 2009; 113:1–20.
crossref
8. Martínez-Arán A, Vieta E, Colom F, Torrent C, Sánchez-Moreno J, Reinares M, et al. Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disord. 2004; 6:224–232.
crossref
9. Balanzá-Martínez V, Rubio C, Selva-Vera G, Martinez-Aran A, Sánchez-Moreno J, Salazar-Fraile J, et al. Neurocognitive endophenotypes (endophenocognitypes) from studies of relatives of bipolar disorder subjects: a systematic review. Neurosci Biobehav Rev. 2008; 32:1426–1438.
crossref
10. Glahn DC, Laura A, Marcela B, Elizabeth H, Juan MP, Jack WKJ, et al. Neurocognitive Endophenotypes for Bipolar Disorder Identified in Multiplex Multigenerational Families. Arch Gen Psychiatry. 2010; 67:168–177.
crossref
11. Cho HS, Lee SM, Soh HS, Song JW, Kim JH, Jung HJ, et al. Neurocognitive Function in the Euthymic Bipolar I disorder. J Korean Neuropsychiatr Assoc. 2002; 41:638–648.
12. Hur JW, Kim YG. Changes of cognitive function and the relationship with manic symptoms between acute manic and euthymic states in patients with bipolar disorder. J Korean Neuropsychiatr Assoc. 2008; 47:325–333.
13. Woo JM, Cheong SS, Chung IW, Kim E, Lee D, Hong KS. Contrasts between remitted schizophrenic patients and euthymic bipolar patients on verbal memory and learning. J Korean Neuropsychiatr Assoc. 2001; 40:679–692.
14. Goh J, Kim B, Kim CY, Joo YH. Neurocognitive Functioning in Bipolar Disorder. J Korean Neuropsychiatr Assoc. 2008; 47:134–141.
15. Kim MK, Lee EJ, Kim HC. Cognitive impairments in patients with depressive disorder and bipolar disorder. J Korean Neuropsychiatr Assoc. 2012; 51:70–76.
crossref
16. Jung HY, Cho HS, Joo YH, Shin HK, Yi JS, Hwang S, et al. A validation study of the Korean-version of the Young Mania Rating Scale. J Korean Neuropsychiatr Assoc. 2003; 42:263–269.
17. Ahn YM, Lee KY, Yi JS, Kang MH, Kim DH, Kim JL, et al. A validation study of the Korean-version of the Montgomery-Asberg depression rating scale. J Korean Neuropsychiatr Assoc. 2005; 44:466–476.
18. Hahn OS, Ahn JH, Song SH, Cho MJ, Kim JK, Bae JN, et al. Development of Korean version of structured clinical interview schedule for DSM-IV axis I disorder: interrater reliability. J Korean Neuropsychiatr Assoc. 2000; 39:362–372.
19. Yeom TH PY, Oh KJ, Lee YH. Korean version wechsler adult intelligence scale. Seoul: Korean Guidance;1992.
20. Nuechterlein K, Asarnow R. Degraded Stimulus Continuous Performance Test (DS-CPT) Program for IBM-Compatible Microcomputers, Version 8.12. Los Angeles, CA: Nuechterlein KH and Asarnow RF;1999.
21. Kim HG. Kims Frontal-Executive Neuropsychological Test: Commentary. Daegu: neuropsy;2001.
22. Heaton R, Chelune G, Talley JL, Kay G, Curtiss G. Wisconsin card sorting test manual: revised and expanded. Odessa: Psychological Assessment Resources. Inc;1993.
23. Benton AL. Contributions to neuropsychological assessment: A clinical manual. USA: Oxford University Press;1994.
24. Morrison MW, Gregory RJ, Paul JJ. Reliability of the Finger Tapping Test and a note on sex differences. Percept Mot Skills. 1979; 48:139–142.
crossref
25. Gabrieli JD. Cognitive Neuroscience of human memory. Annu Rev Psychol. 1998; 49:87–115.
crossref
26. Henry JD, Crawford JR. A meta-analytic review of verbal fluency performance following focal cortical lesions. Neuropsychology. 2004; 18:284–295.
crossref
27. Albus M, Hubmann W, Ehrenberg C, Forcht U, Mohr F, Sobizack N, et al. Neuropsychological impairment in first-episode and chronic schizophrenic patients. Eur Arch Psychiatry Clin Neurosci. 1996; 246:249–255.
crossref
28. Pavuluri MN, Schenkel LS, Aryal S, Harral EM, Hill SK, Herbener ES, et al. Neurocognitive function in unmedicated manic and medicated euthymic pediatric bipolar patients. Am J Psychiatry. 2006; 163:286–293.
crossref
29. Torrent C, Martínez-Arán A, Daban C, Amann B, Balanzá-Martínez V, Bonnin C, et al. Effects of atypical antipsychotics on neurocognition in euthymic bipolar patients. Compr Psychiatry. 2011; 52:613–622.
crossref
30. MacQueen G, Young T. Cognitive effects of atypical antipsychotics: focus on bipolar spectrum disorders. Bipolar Disord. 2003; 5:suppl.2. 53–61.
crossref
TOOLS
Similar articles