Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder

Bora, Emre; Hıdıroğlu, Ceren; Özerdem, Ayşegül; Kaçar, Ömer; Sarısoy, Gökhan; Arslan, Filiz Civil; Aydemi̇r, Ömer; Tas, Zeynep Cubukcuoglu; Vahip, Simavi; Atalay, Adnan; Atasoy, Nuray; Ateşçi, Figen Çulha; Tümkaya, Selim

doi:10.1016/j.euroneuro.2016.04.002

Cited by 97 publications

(72 citation statements)

References 53 publications

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“…Our data is also in concordance with the suggestion that some of the heterogeneity of cognitive deficits in this population could be related to differential fluid intelligence deficits in BD patients (Bora et al, 2016). …”

Section: Discussionsupporting

confidence: 92%

“…Also, multitasking and theory of mind deficits have been described in this population (Bora et al, 2005; Ibáñez et al, 2012; Laloyaux et al, 2013). On this point, it has recently been suggested that the global cognitive impairment observed in some BD patients might be due to deficits in fluid intelligence (Bora et al, 2016) and the disregard of such variable could be a source of error in cluster analytic studies in this population. Even more, since ventral rather than dorsal frontal impairment has been proposed as a marker of BD (Frangou et al, 2005, Bora et al, 2009), the analysis of g might allow to differentiate executive deficits and exceeding anterior deficits, becoming fundamental to the understanding of the neuropsychology of BD.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between executive functions and fluid intelligence in euthymic Bipolar Disorder patients

Goitia

Manes

Torralva

et al. 2017

Psychiatry Research

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Distinct cognitive deficits have been described in Bipolar disorder (BD), including executive impairments, commonly attributed to frontal dysfunction. However, recent attention has been paid to the heterogeneity of cognitive functioning in this population, suggesting that the executive deficits observed in BD might be due to a loss in fluid intelligence (g). Following our previous line of investigation in multiple neurological and psychiatric conditions we aimed at determining the role of g in frontal deficits in BD. Euthymic BD patients (n = 51) and healthy controls (n = 37) were assessed with Wisconsin Card Sorting Test (WCST), Verbal Fluency, Trail Making Test B (TMTB), a multitasking test, and a theory of mind test. A general cognitive battery was used to derive a measure of g. As in other neuropsychiatric conditions, significant patient-control differences in WCST, Verbal Fluency and TMTB were removed when g was introduced as a covariate. Deficits remained significant in the multitasking test. We suggest that neuropsychological assessment in BD should include tests of general intelligence, together with one or more specific tasks that allow for the assessment of residual frontal deficits, putatively associated with anterior frontal functioning.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The relationship between executive functions and fluid intelligence in euthymic Bipolar Disorder patients

Goitia

Manes

Torralva

et al. 2017

Psychiatry Research

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“…Similar findings are evident in several independent studies using the same or very similar approaches . Nearly all of the studies that have identified and characterized cognitive subgroups in BD have converged to suggest that there may be important differences between cognitive subgroups with regard to premorbid functioning, clinical course and cognitive change over time . Indeed, impaired subgroups have been shown to have reduced premorbid IQ relative to controls, and a greater discrepancy between their premorbid IQ and current cognitive performance than patients with normal cognitive performance …”

Section: Trajectory Of Cognitive Functioning In Bdsupporting

confidence: 68%

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

et al. 2019

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Objectives Cognitive dysfunction affects a significant proportion of people with bipolar disorder (BD), but the cause, trajectory and correlates of such dysfunction remains unclear. Increased understanding of these factors is required to progress treatment development for this symptom dimension. Methods This paper provides a critical overview of the literature concerning the trajectories and emerging correlates of cognitive functioning in BD. It is a narrative review in which we provide a qualitative synthesis of current evidence concerning clinical, molecular, neural and lifestyle correlates of cognitive impairment in BD across the lifespan (in premorbid, prodromal, early onset, post‐onset, elderly cohorts). Results There is emerging evidence of empirical links between cognitive impairment and an increased inflammatory state, brain structural abnormalities and reduced neuroprotection in BD. However, evidence regarding the progressive nature of cognitive impairment is mixed, since consensus between different cross‐sectional data is lacking and does not align to the outcomes of the limited longitudinal studies available. Increased recognition of cognitive heterogeneity in BD may help to explain some inconsistencies in the extant literature. Conclusions Large, longitudinally focussed studies of cognition and its covariation alongside biological and lifestyle factors are required to better define cognitive trajectories in BD, and eventually pave the way for the application of a precision medicine approach for individual patients in clinical practice.

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“…2007, Mann Wrabel ve ark. 2011 ve BB ile bilişsel işlev bozukluğu ilişkisini inceleyen izlem çalışmalarına gereksinim duyulmaktadır (Bora ve ark. 2016).…”

Section: Introductionunclassified

Cognitive Functions of Bipolar Disorder Patients in Remission on Monotherapy: A Follow-Up Study

Cankorur¹,

Demirel²,

Yucel³

et al. 2017

Turkish Journal of Psychiatry

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ÖZETAmaç: Bipolar bozuklukta (BB) bilişsel kusurların varlığı ve süreçte arttığı birçok kesitsel çalışma tarafından desteklenmektedir. Ancak bulguların yorumlanmasındaki önemli güçlükler izlem çalışmalarının sınırlı sayıda olması ve çoklu ilaç tedavilerinin rolünün dışlanamamasıdır. Bu çalışmanın amacı tek ilaçla remisyonda olan BB hastalarının bilişsel iş-levlerinin kesitsel olarak sağlıklı kontrollerle karşılaştırılması ve BB'si olan hastaların bilişsel işlevlerinin uzunlamasına incelenmesidir.Yöntem: En az 1 ay boyunca tek ilaçla remisyonda olan 27 BB hastasının bilişsel işlevleri (premorbid IQ, dikkat, yürütücü işlevler, bellek, görsel-uzaysal beceriler ve psikomotor hız) 35 sağlıklı kontrolle karşılaştırılmış ve hasta grubu ortalama 18 ay (6-77 ay) sonra tekrar değerlendirilmiştir. Bulgular: BB grubu bilişsel işlevlerden dikkat, kavram oluşturma ve zihinsel esneklik, tepkiyi ketleyebilme, set değiştirme ve akıl yürütmeyi içeren yürütücü işlevler, sözel bellek ve psikomotor hız alanlarında kontrol grubuna göre daha kötü performans gösterirken ilk ve izlem değer-lendirmelerinde farklılık göstermemiştir. Sonuç:Tek ilaçla izlemde ve remisyondaki BB hastalarının bilişsel iş-levlerinin kesitsel olarak sağlıklı kontrollerle kıyaslandığında bozuk olduğu, izlemde ise bilişsel işlevlerin aynı düzeyde seyrettiği saptanmıştır. Bilişsel işlevlerin süreçte bozulma göstermemesi hastaların iyi gidişli bir grubu temsil etmeleriyle ilişkili olabileceği gibi tekli ilaçla tedavinin bilişsel işlevler üzerinde olumsuz bir etki oluşturmadığı biçiminde de yorumlanabilir. Ancak bilişsel işlevlerde bozulmanın daha uzun zaman dilimlerinde ortaya çıkabileceği de akılda bulundurulmalıdır.Anahtar Kelimeler: Bipolar Bozukluk, bilişsel işlev, ötimi, tek ilaç, uzunlamasına desen SUMMARY Cognitive Functions of Bipolar Disorder Patients in Remission onMonotherapy: A Follow-Up StudyObjective: Multiple sectional studies indicate that the cognitive functions of bipolar disorder (BD) patients in remission are damaged. These studies also suggest that cognitive functions get worse over time. Although the results are inconsistent, there are limited follow-up studies that reveal any contradictory results. Interestingly, there have been major difficulties in the interpretation related to this subject. In particular, scarcity of longitudinal studies and not eliminating the role of multidrug side effects on cognitive functions are just a few. Due to these aforementioned limitations, the longitudinal course of cognitive functions and their sectional differences were investigated in BD patients that underwent remission with monotherapy in this study. Methods:In this study, the cognitive functions (premorbid IQ, attention, executive functions, memory, visual-spatial skills, and psychomotor speed) of BD patients (n=27) in remission and on monotherapy for at least 1 month were assessed at baseline and at an 18 (6-77) month follow-up period and compared to healthy controls (n=35). Results:The BD group's performance was worse than those of the control group o...

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Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder

Cited by 97 publications

References 53 publications

The relationship between executive functions and fluid intelligence in euthymic Bipolar Disorder patients

The relationship between executive functions and fluid intelligence in euthymic Bipolar Disorder patients

Current understandings of the trajectory and emerging correlates of cognitive impairment in bipolar disorder: An overview of evidence

Cognitive Functions of Bipolar Disorder Patients in Remission on Monotherapy: A Follow-Up Study

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