Evidence for cognitive subgroups in bipolar disorder and the influence of subclinical depression and sleep disturbances

Volkert, Julia; Kopf, Juliane; Kazmaier, J.; Glaser, F.; Zierhut, Kathrin C.; Schiele, Miriam A.; Kittel‐Schneider, Sarah; Reif, Andreas

doi:10.1016/j.euroneuro.2014.07.017

Cited by 67 publications

(64 citation statements)

References 64 publications

(95 reference statements)

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“…Using a depression scale, one study demonstrated that individuals with bipolar disorder who demonstrate poorer cognitive performance on a neuropsychological battery report higher rates of insomnia compared to individuals with bipolar disorder who demonstrate intact cognitive performance (Volkert et al, 2015). Using post-hoc exploratory correlational analyses, a second study demonstrated an association between the Pittsburgh Sleep Quality Index (PSQI; Buysse et al, 1989) rated daytime dysfunction and a working memory task (Boland et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder

Kanady

Soehner

Klein

et al. 2017

Journal of Psychiatric Research

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Sleep disturbance and cognitive dysfunction are two domains of impairment during inter-episode bipolar disorder. Despite evidence demonstrating the importance of sleep for cognition in healthy and sleep-disordered samples, this link has been minimally examined in bipolar disorder. The present study tested the association between insomnia-related sleep disruptions and cognitive dysfunction during inter-episode bipolar disorder. Forty-seven participants with bipolar disorder and a comorbid insomnia diagnosis (BD-Insomnia) and 19 participants with bipolar disorder without sleep disturbance in the last six months (BD-Control) participated in the study. Two domains of cognition were assessed: working memory and verbal learning. Insomnia-related sleep disruptions were assessed both categorically (i.e., insomnia diagnosis) and dimensionally (i.e., total wake time, total sleep time, total wake time variability, and total sleep time variability). Hierarchical linear regressions, adjusting for participant age, demonstrated that insomnia diagnosis did not have an independent or interactive effect on cognition. However, regardless of insomnia diagnosis, greater total sleep time variability predicted poorer working memory and verbal learning performance. Further, following sleep treatment, a reduction in total wake time predicted improved working memory performance and a reduction in total sleep time variability predicted improved verbal learning performance. These findings raise the possibility that sleep disturbance may contribute to cognitive dysfunction in bipolar disorder and highlight the importance of treating sleep disturbance in bipolar disorder.

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Section: Introductionmentioning

confidence: 99%

The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder

Kanady

Soehner

Klein

et al. 2017

Journal of Psychiatric Research

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“…Working memory impairments have been documented in subjects with bipolar I disorder during euthymic and depressed phases (Murphy et al 1999; Malhi et al 2007; Godard et al 2011; Yates et al 2011; Xu et al 2012; Volkert et al 2014). Impairment of working memory in this population has been associated with occupational deficits (Bearden et al 2011) and suicidal behavior (Keilp et al 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Recent evidence further suggests that a major part of the cognitive impairment observed in euthymic bipolar I and II disorder may be due to subthreshold depressive symptoms rather than disease severity (Volkert et al 2014), highlighting a need for bipolar studies during the depressed phase of the illness. Even so, the underlying neural correlates of working memory performance in bipolar II depression have yet to be identified.…”

Section: Introductionmentioning

confidence: 99%

Prefrontal hypoactivation during working memory in bipolar II depression

Brooks¹,

Vizueta²,

Penfold³

et al. 2015

Psychol. Med.

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Background Patterns of abnormal neural activation have been observed during working memory tasks in bipolar I depression, yet the neural changes associated with bipolar II depression have yet to be explored. Method An n-back working memory task was administered during a 3T functional magnetic resonance imaging scan in age- and gender-matched groups of 19 unmedicated, bipolar II depressed subjects and 19 healthy comparison subjects. Whole-brain and region-of-interest analyses were performed to determine regions of differential activation across memory-load conditions (0-, 1- and 2-back). Results Accuracy for all subjects decreased with higher memory load, but there was no significant group × memory load interaction. Random-effects analyses of memory load indicated that subjects with bipolar II depression exhibited significantly less activation than healthy subjects in left hemispheric regions of the middle frontal gyrus [Brodmann area (BA) 11], superior frontal gyrus (BA 10), inferior parietal lobule (BA 40), middle temporal gyrus (BA 39) and bilateral occipital regions. There was no evidence of differential activation related to increasing memory load in the dorsolateral prefrontal or anterior cingulate cortex. Conclusions Bipolar II depression is associated with hypoactivation of the left medio-frontal and parietal cortex during working memory performance. Our findings suggest that bipolar II depression is associated with disruption of the fronto-parietal circuit that is engaged in working memory tasks, which is a finding reported across bipolar subtypes and mood states.

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“…A possible explanation may be that patients in the current study were euthymic or, at most, mildly depressed. Diagnosis of depression has been observed as a moderator of AMT performance [20] and, accordingly, self-rated depression as a predictor of the effect size of OGM in individuals with affective disorders [60] . The lack of OGM in our BD sample may therefore be explained by their low level of depressive symptoms (mean Beck Depression Inventory = 10).…”

Section: Specificity Of Autobiographical Memoriesmentioning

confidence: 99%

Autobiographical Memory in Bipolar Disorder and Its Link to Neuropsychological Functioning

Quinlivan

Dallacker

Renneberg³

et al. 2017

Psychopathology

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Objective: The aim of this study was to examine the specificity of autobiographical memory (AM) in bipolar disorder (BD) and to investigate the association between AM and neuropsychological functions. Method: Twenty bipolar patients and 22 matched healthy controls (HCs) were included in this study. AM was assessed with an extended version of the Autobiographical Memory Test (AMT) including rejection cue words. A neuropsychological test battery was used to examine verbal memory, executive functions, and attention. Results: Across both groups, the number of specific memories in the AMT was significantly smaller in response to rejection cue words and positive cue words than in response to negative cue words. Participants with BD and HCs did not differ significantly in neuropsychological measures. Across both groups, scores of verbal memory, executive functions, and attention were significantly correlated with specificity of retrieved memories. Limitations: Although our clinical sample consisted of clinically stable outpatients, 6 out of 20 patients were not rated as euthymic but as mildly depressed. All BD patients were medicated. Conclusion: Contrary to previous results, patients with BD did not differ in the number of specific memories compared to an HC group. Our findings suggest that neuropsychological functioning is associated with AMT specificity. Further research is required to gain a better understanding of the underlying mechanisms which may influence the ease of memory retrieval.

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Evidence for cognitive subgroups in bipolar disorder and the influence of subclinical depression and sleep disturbances

Cited by 67 publications

References 64 publications

The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder

The association between insomnia-related sleep disruptions and cognitive dysfunction during the inter-episode phase of bipolar disorder

Prefrontal hypoactivation during working memory in bipolar II depression

Autobiographical Memory in Bipolar Disorder and Its Link to Neuropsychological Functioning

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