Neurocognitive impairments among youth with pediatric bipolar disorder: A systematic review of neuropsychological research

Frías, Álvaro; Palma, C.; Farriols, Núria

doi:10.1016/j.jad.2014.05.025

Cited by 40 publications

(23 citation statements)

References 115 publications

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“…Our study also showed that the presence of ADHD comorbidity was associated with poorer overall cognitive functioning over time. This result is in contrast with findings from other longitudinal and cross‐sectional studies in BP youth, which reported no effects of ADHD comorbidity on those cognitive domains included in our general cognitive index (e.g., sustained attention, working memory, and executive functions). Differences compared with prior studies may be accounted for by the fact that we used a large sample size of youth fully covering the bipolar spectrum disorders.…”

Section: Discussioncontrasting

confidence: 99%

“…These results are in contrast to cross‐sectional and longitudinal studies in BP youth. These studies showed cognitive impairments in verbal/visual‐spatial memory, processing speed, working memory, or social cognition, even as ascertained by the CANTAB . Specifically, one longitudinal study in BP youth, which also used similar average cognitive scores to those used in this study, found stable impairments in all cognitive domains over time .…”

Section: Discussionsupporting

confidence: 51%

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Longitudinal cognitive trajectories and associated clinical variables in youth with bipolar disorder

et al. 2017

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Objective There is substantial interest in delineating the course of cognitive functioning in bipolar (BP) youth. However, there are no longitudinal studies aimed at defining subgroups of BP youth based on their distinctive cognitive trajectories and their associated clinical variables. Method Cognitive functioning was measured in 135 participants from the Course and Outcome of BP Youth (COBY) study using several subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Youth were prospectively evaluated three times on average every 13.75 months over 2.5 years. Clinical and functional outcomes were assessed using the Longitudinal Interval Follow-Up Evaluation (LIFE). Results Latent class growth analysis identified three longitudinal patterns of cognitive functioning based on a general cognitive index: class 1, “persistently high” (N=21; 15.6%); class 2, “persistently moderate” (N=82; 60.74%); and class 3, “persistently low” (N=32; 23.7%). All classes showed normal cognitive functioning when compared with the CANTAB normative data. After adjustment for confounders, youth from class 3 had a significantly greater percentage of time with overall, manic, and depressive syndromal symptoms than youth in the other two classes. Also, after adjustment for confounders, youth from class 3 had significantly poorer global, academic, and social functioning than youth from class 1. Conclusions BP youth showed normal overall cognitive functioning that remained stable during the follow-up within each class. However, 24% of BP youth showed relatively poorer cognitive functioning than the other BP youth. This subgroup had poorer mood course and functioning, and may benefit from cognitive remediation and early management with evidence-based pharmacological treatments.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 51%

Longitudinal cognitive trajectories and associated clinical variables in youth with bipolar disorder

et al. 2017

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“…46–48 In the present study, youth with BD, compared with healthy controls, showed decreased connectivity between the laterobasal subdivision and both the hippocampus and the precentral gyrus, suggesting a vulnerability for functional impairments in learning and memory subserved by these regions. Indeed, youth with BD have well-documented impairments in multiple domains of memory function, 49,50 reduced hippocampal volumes, 51 and dysfunction in brain networks that support memory function. 52,53 Task-based functional abnormalities in the precentral gyrus have also been reported in adults with BD during autobiographical recall.…”

Section: Discussionmentioning

confidence: 99%

Intrinsic Amygdala Functional Connectivity in Youth With Bipolar I Disorder

Singh

Kelley

Chang

et al. 2015

Journal of the American Academy of Child & Adolescent Psych

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Objective Bipolar disorder (BD) commonly begins during adolescence and may continue into adulthood. Studies in adults with BD suggest that disruptions in amygdalar neural circuitry explain the pathophysiology underlying the disorder. Importantly, however, amygdala subregion networks have not yet been examined in youth close to mania onset. The goal of this study was to compare resting state functional connectivity patterns in amygdala subregions in youth with bipolar-I (BP-1) disorder with patterns in healthy controls. Method Centromedial, laterobasal, and superficial amygdala subdivisions were assessed during rest and examined in relation to clinical measures of mania in youth (14 to 20 years old) with BP-I who experienced only a single episode of mania (n=20, “BD”) and age-matched healthy comparison youth without any personal or family history of DSM-IV Axis I disorders (n=23, “HC”). Results Relative to HC youth, youth with BD exhibited decreased connectivity between the laterobasal subdivision of the amygdala and the hippocampus and precentral gyrus, and increased connectivity between the laterobasal subdivision and the precuneus. Connectivity between the right laterobasal amygdala and right hippocampus was positively correlated with levels of anxiety in BD but not in HC youth, and connectivity between the right laterobasal amygdala and right precuneus was negatively correlated with insight about bipolar illness. Conclusion Youth with BD have abnormal amygdala resting state network connections to regions that are critical for emotional processing and self-awareness. Longitudinal studies are needed to determine whether these aberrant patterns in youth with BD can be altered with intervention and influence the course of disorder.

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“…These include verbal and visuospatial memory, processing speed, working memory, overall cognitive fl exibility and social cognition and theory of mind and are more pronounced in BD-I patients and in those with comorbid ADHD (Frias et al 2014 ;Schenkel et al 2014 ;Dickstein et al 2007 ;McClure et al 2005a , b ).…”

Section: Clinical Features Of Paediatric Bdmentioning

confidence: 99%

Special Issues

Fountoulakis¹

2014

Bipolar Disorder

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It is well known that concerning the prevalence of unipolar depression, females have almost double rates in comparison to males (Lloyd and Miller 1997 ;Blazer et al. 1994 ). However, this does not hold true concerning BD, for which similar rates between males and females are reported. There are some data suggesting that males might be over-represented in those diagnosed with a BD-I and females overrepresented in those diagnosed with a BD-II disorder (Parker et al. 2014 ).Some authors suggest that females with less social support and experiencing social stressors might be at the greatest risk to develop depression, but this concerns unipolar and not bipolar cases. It has been documented that women are more likely to experience stressful and even threatening life events and are at a higher risk of early sexual abuse and current spousal abuse (Roesler and McKenzie 1994 ;Finkelhor et al. 1990 ). Women also might use oral contraceptive and often experience mood disorders temporally related to their gender identity (e.g. premenstrualor postpartum-onset mood disorders) which might have an impact on the course of BD (Meinhard et al. 2014 ). A number of adverse experiences related to sexual life and determined by gender seem to happen in the lives of bipolar women. In comparison to healthy women, bipolar women might be more likely to have been forced by their partners to have sex, raped or suffering from sexually transmitted diseases. The use of contraceptives is usually sporadic and their rates of pregnancy and abortion are high (Ozcan et al. 2014 ).Also, in almost all societies, unequal roles for women are in place, and additionally there is a gender difference in copying styles; men might react to emotional distress by trying not to think about it, while women are more likely to ruminate over their problems (Nolen-Hoeksema and Girgus 1994 ;Nolen-Hoeksema et al. 1999, 2007. In this frame, women are more likely to report depressive symptoms due to marital problems than men (Joiner et al. 1992 ;Hammen and Peters 1978 ) and are more likely to be diagnosed with depression because they seek professional help more often for their depressive symptoms and maybe because they are more 660 sensitive to negative relationships (Phillips and Segal 1969 ). Concerning the neurocognitive function, the data are inconsistent (Bucker et al. 2014 ;Suwalska and Lojko 2014 ).Overall there does not seem to be any signifi cant gender difference concerning the risk of recurrence, thus suggesting that gender is among the risk factors for initiating depressive symptoms in unipolar depression but not among those determining the course and outcome either in unipolar or in bipolar cases (Nazroo et al. 1997 ;Philibert et al. 1997 ).There are a number of comorbid conditions which seem to be more frequent in bipolar women, including abdominal obesity. This happens possibly because of a higher frequency of predominant depressive polarity in women and more seasonal variations in mood disturbance and reproductive life events and related treatments (Baskara...

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Neurocognitive impairments among youth with pediatric bipolar disorder: A systematic review of neuropsychological research

Cited by 40 publications

References 115 publications

Longitudinal cognitive trajectories and associated clinical variables in youth with bipolar disorder

Longitudinal cognitive trajectories and associated clinical variables in youth with bipolar disorder

Intrinsic Amygdala Functional Connectivity in Youth With Bipolar I Disorder

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