Neurocognitive Deficits in Patients with Remitted Bipolar I Disorder and Unaffected First-Degree Relatives

Do Hoon Kim; Jiwoo Kim; Soohyun Joe; Seunghee Won

doi:10.4306/jknpa.2013.52.5.318

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

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

Original Article

Journal of Korean Neuropsychiatric Association 2013; 52(5): 318-326.

Published online: 30 September 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.5.318

Neurocognitive Deficits in Patients with Remitted Bipolar I Disorder and Unaffected First-Degree Relatives

Do Hoon Kim, MD¹, Jiwoo Kim, MD¹, Soohyun Joe, MD, PhD², Seunghee Won, MD, PhD¹

¹Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea.

²Department of Psychiatry, Ulsan University Hospital, Ulsan, Korea.

Address for correspondence: Seunghee Won, MD, PhD. Department of Psychiatry, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 700-721, Korea. Tel: +82-53-200-5747, Fax: +82-53-426-5361, wonsh864@knu.ac.kr

Received 8 July 2013 Revised 6 August 2013 Accepted 20 August 2013

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.

Keywords: Bipolar disorder, Neurocognitive function, Remission, First-degree relatives, Endophenotype

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)

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)

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.

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