Intermediate: Cognitive phenotypes in bipolar disorder

Abstract

Background Intermediate cognitive phenotypes (ICPs) are measurable and quantifiable states that may be objectively assessed in a standardized method, and can be integrated into association studies, including genetic, biochemical, clinical, and imaging based correlates. The present study used neuropsychological measures as ICPs, with factor scores in executive functioning, attention, memory, fine motor function, and emotion processing, similar to prior work in schizophrenia. Methods Healthy control subjects (HC, n=34) and euthymic (E, n=66), depressed (D, n=43), or hypomanic/mixed (HM, n=13) patients with bipolar disorder (BD) were assessed with neuropsychological tests. These were from eight domains consistent with previous literature; auditory memory, visual memory, processing speed with interference resolution, verbal fluency and processing speed, conceptual reasoning and set-shifting, inhibitory control, emotion processing, and fine motor dexterity. Results Of the eight factor scores, the HC group outperformed the E group in three (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity), the D group in seven (all except Inhibitory Control), and the HM group in four (Inhibitory Control, Processing Speed with Interference Resolution, Fine Motor Dexterity, and Auditory Memory). Limitations The HM group was relatively small, thus effects of this phase of illness may have been underestimated. Effects of medication could not be fully controlled without a randomized, double-blind, placebo-controlled study. Conclusions Use of the factor scores can assist in determining ICPs for BD and related disorders, and may provide more specific targets for development of new treatments. We highlight strong ICPs (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity) for further study, consistent with the existing literature.

Response inhibition in the parametric Go/No-Go task in psychopathic offenders

“…The apparent discrepancy between previous null effects when investigating the effect of psychopathy on response inhibition in the standard Go/No-go task (Kiehl et al, 2000;Verona et al, 2012) and the uncovered relationships when utilising the PGNG (Weidacker et al, 2017) supports the view that this task is more likely to capture aberrant response inhibition. There is evidence that it is the dynamic parametric approach of the PGNG and associated increased difficulty, which reveals response inhibition deficits previously unseen when using the standard Go/No-go task (Langenecker et al, 2010;Ryan et al, 2012). In terms of psychopathy for example, LaPierre et al (1995) reported a deficit in response inhibition performance in psychopathic offenders when utilizing a Go/No-go design, which incorporated a high demand on spatial attention by including a measure of uncertainty in the location of targets which appeared at pseudorandom locations.…”

“…The addition of these design features has led to the PGNG capturing response inhibition deficits in, for example, bipolar disorder, where impulsivity is by definition part of the disorder (American Psychiatric Association, 2013), although response inhibition deficits had been unseen when utilising the standard Go/No-go task in bipolar patients (e.g. Elliott et al, 2004;Altshuler et al, 2005;Langenecker et al, 2010;Ryan et al, 2012).…”

Intact interference and inhibitory functions in participants with bipolar disorder and their first-degree relatives

“…Secondly, the majority of the BD participants and some of the relatives were medicated, whereas the control participants were not. We were unable to control for medication, but similarly to the methods described by Langenecker, Saunders, Kade, Ransom, and McInnis (2010), we analyzed effects of medication classes. These medication class comparisons showed no significant differences.…”

Neurocognitive Functioning in Bipolar Disorder: A Comprehensive Review of Recent Data

“…The speed of mental processing was reported to be slower in BD patients irrespective of illness phase and symptom severity (Antila et al 2009 ;Chaves et al 2011 ;Dittmann et al 2008a ;Hsiao et al 2009 ;Langenecker et al 2010 ;Martino et al 2011a ;Mur et al 2007 ;Basso et al 2009 ;Olley et al 2005 ;Xu et al 2012 ;McIntosh et al 2005 ;McGrath et al 1997 ;El-Badri et al 2001 ;Stoddart et al 2007 ;Coffman et al 1990 ;Seidman et al 2002 ;Fitzgerald et al 2004 ;Szoke et al 2008 ;Martinez-Aran et al 2008 ;Hill et al 2009 ;Dittmann et al 2008b ). It is less affected in comparison to patients with schizophrenia (Goldberg et al 1993 ;Hawkins et al 1997 ;Gard et al 1999 ;Mojtabai et al 2000 ) in spite of some data suggesting the presence of a similar degree of impairment (Hobart et al 1999 ).…”

“…Other defi cits identifi ed concerned associative learning (Brambilla et al 2011 ), delayed memory (Dittmann et al 2008a ;Ha et al 2012 ;Zubieta et al 2001 ;Seidman et al 2002 ;Bora et al 2007 ;Martinez-Aran et al 2008 ;Basso et al 2009 ;Hill et al 2009 ;Dittmann et al 2008b ), nonverbal memory (Deckersbach et al 2004a ), visual memory (Langenecker et al 2010 ;Sanchez-Morla et al 2009 ;Xu et al 2012 ;Goldberg et al 1993 ;Coffman et al 1990 ;Zubieta et al 2001 ;Fitzgerald et al 2004 ;Ali et al 2000 ) and autobiographical (Scott et al 2000 ) and prospective memory (Chan et al 2012 ).…”