The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes

Chen, Wen-Yin; Huang, Ming‐Chyi; Lee, Ya-Chin; Chang, Chiao-Erh; Lin, Shih-Ku; Chiu, Chih Chiang; Liu, Hsing‐Cheng; Kuo, Cheng‐Deng; Weng, Shih-Han; Chen, Po‐Yu; Kuo, Po-Hsiu

doi:10.3389/fpsyt.2021.684813

Cited by 9 publications

(7 citation statements)

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“…17 Some long-term follow-up studies have, however, found indications of decline. One study with a mean follow-up of 6.5 years found indices of deterioration for a subgroup with marked IQ deficits at baseline, 18 and a 9-year follow-up study of attention and executive functioning found signs of deterioration in executive functioning. 19 Studies of cognitive trajectories in representative first-treatment bipolar samples are rare.…”

Section: Introductionmentioning

confidence: 99%

Long‐term course of cognitive functioning in bipolar disorder: A ten‐year follow‐up study

et al. 2023

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IntroductionCognitive impairments are common in bipolar disorder (BD), but the long‐term course remains understudied. Longitudinal data on cognitive functioning from the start of the first treatment could help clarify pathophysiological processes that shape the illness outcome. We here aim to investigate the 10‐year cognitive course in BD compared to healthy controls (HC) and the effects of clinical symptoms on cognitive trajectories.MethodsFifty‐six BD participants recruited within their first year of treatment and 108 HC completed clinical and cognitive assessments at baseline and 10‐year follow‐up. We derived eight cognitive domain scores and a cognitive composite score, which were further investigated using linear mixed model analyses. Correlation analyses were used to assess associations between the composite score and depressive, manic and psychotic symptoms.ResultsBD participants performed poorer than HCs in all domains except mental speed and verbal fluency. Verbal learning and memory, verbal fluency and the composite score improved over time in both BD participants and HC, while short‐term memory, mental speed, psychomotor speed and working memory were stable. We found no significant correlations between cognition and symptom level at either time point in BD participants.ConclusionsWe found evidence of long‐term cognitive stability or improvement in BD participants from first treatment to 10‐year follow‐up. Though the BD group was impaired in all domains except mental speed and verbal fluency, the change in cognitive functioning was parallel to that of HCs. These findings are not consistent with the notion of neuroprogression in BD.

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Section: Introductionmentioning

confidence: 99%

Long‐term course of cognitive functioning in bipolar disorder: A ten‐year follow‐up study

et al. 2023

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“…More than half of the papers assessed patients in an (relatively) euthymic state (Martinez-Aran et al 2007;Mur et al 2008Mur et al , 2009Bello 2009;Bonnin et al 2014;Deckersbach et al 2010;Luo et al 2020;Solé et al 2012Solé et al , 2018Torrent et al 2007Torrent et al , 2013Wilder-Willis 2001;Fulford 2011;Jiménez et al 2012;Martinez-Camarillo et al 2019;Miguélez-Pan et al 2014;Varo et al 2017;Boland et al 2015;Jensen et al 2015;Samalin et al 2016;Kaya et al 2007;Rosa et al 2014;Liu et al 2021;Sachs et al 2020;Anaya et al 2016;Bearden et al 2011;Bonnín et al 2010;Dickerson et al 2010;Forcada et al 2015;Mora et al 2013;Zubieta et al 2001;Ryan et al 2013;O'Shea et al 2010;Zyto et al 2016;Esan et al 2020;Chen et al 2021;Latalova et al 2010;Leany 2011;Olley et al 2005;Rheenen and Rossell 2014). In around 1/5 the mood state was not reported, and the influence of mood was not establ...…”

Section: Neurocognitive Functions Clinical Variables and Occupational...mentioning

confidence: 99%

“…As to the predictive value of EF, 19 longitudinal studies were included in which predictors of occupational functioning were examined (Burdick et al 2010a;Levy et al 2013;Mur et al 2008;Strassnig et al 2017;Tabarés-Seisdedos et al 2008;Robertson 2006;Lee et al 2013Lee et al , 2015O'Donnell 2016;Bearden et al 2011;Bonnín et al 2010;Dickerson et al 2010;Mora et al 2013;O'Donnell et al 2017;Chen et al 2021;Crouse et al 2020;Leany 2011).…”

Section: Predictive Value Of Ef On Occupational Functioningmentioning

confidence: 99%

“…One study (Drakopoulos et al 2020) used the whole of D-KEFS (Delis et al 2001) a test battery comprising executive functioning, consisting of many of the traditional executive measures described above. Five studies (Deckersbach et al 2010;Demant et al 2015a;Dickerson et al 2004;Esan et al 2020;Chen et al 2021) used screening tools and test batteries in which tests for EF are embedded to a limited extent such as the Screen for Cognitive Impairment in Psychiatry, SCIP (Purdon 2005), the BAC-A (Barker et al 1994) and the Repeatable Battery of the Assessment of Neuropsychological Status, RBANS (Randolph 1998).…”

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confidence: 99%

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The relations between executive functions and occupational functioning in individuals with bipolar disorder: a scoping review

Koene

Zyto

Stel

et al. 2022

Int J Bipolar Disord

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Background Patients with bipolar disorder experience impairments in their occupational functioning, despite remission of symptoms. Previous research has shown that neurocognitive deficits, especially deficits in executive functions, may persist during euthymia and are associated with diminished occupational functioning. Objectives The aim of this scoping review was to identify published studies that report on the relationships between executive functions and occupational functioning in BD to review current knowledge and identify knowledge gaps. In addition to traditional neuropsychological approaches, we aimed to describe executive functioning from a self-regulation perspective, including emotion regulation. Methods We applied the methodological framework as described by Arksey and O’Malley (Int J Soc Res Methodol Theory Pract 8:19–32, 2005) and Levac et al. (Implement Sci 5:1–9, 2010). We searched PubMed and psycINFO for literature up to November 2021, after which we screened papers based on inclusion criteria. Two reviewers independently performed the screening process, data charting process, and synthesis of results. Results The search yielded 1202 references after deduplication, of which 222 remained after initial screening. The screening and inclusion process yielded 82 eligible papers in which relationships between executive functions and occupational functioning are examined. Conclusion Neurocognitive deficits, including in executive functions and self-regulation, are associated with and predictive of diminished occupational functioning. Definitions and measurements for neurocognitive functions and occupational functioning differ greatly between studies, which complicates comparisons. Studies on functional remediation show promising results for improving occupational functioning in patients with BD. In research and clinical practice more attention is needed towards the quality of work functioning and the various contexts in which patients with BD experience deficits.

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“… 2 Studies have also suggested that patients with bipolar disorder can experience accelerated cognitive ageing, which presents as a steeper decline in function. 3 , 4 Cognitive impairment in patients with bipolar disorder may worsen as the disease progresses, which may negatively affect patient recovery. 5 In addition, age can dynamically, neurodevelopmentally and neuroprogressively interact with the neuropathology of bipolar disorder.…”

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confidence: 99%

The interactions between vitamin D and neurofilament light chain levels on cognitive domains in bipolar disorder

Chen

Huang²,

Chiu³

et al. 2022

BJPsych open

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Background Bipolar disorder is a chronic mental disorder related to cognitive deficits. Low serum vitamin D levels are significantly associated with compromised cognition in neuropsychiatric disorders. Although patients with bipolar disorder frequently exhibit hypovitaminosis D, the association between vitamin D and cognition in bipolar disorder, and their neuroaxonal integrity, is unclear. Aims To investigate the interaction effects between vitamin D and neurofilament light chain (NfL) levels on cognitive domains in bipolar disorder. Method Serum vitamin D and NfL levels were determined in 100 euthymic patients with bipolar disorder in a cross-sectional study. Cognitive function was measured with the Brief Assessment of Cognition in Affective Disorders. We stratified by age groups and used general linear models to identify associations between vitamin D and NfL levels and their interaction effects on cognitive domains. Results The mean vitamin D and NfL levels were 16.46 ng/nL and 11.10 pg/mL, respectively; 72% of patients were vitamin D deficient. In the older group, more frequent hospital admissions and lower physical activity were identified in the group with versus without vitamin D deficiency. The age-modified interaction effect of vitamin D and NfL was associated with composite neurocognitive scores and verbal fluency in both age groups, and with processing speed domain in the younger group. Conclusions We observed a high vitamin D deficiency prevalence in bipolar disorder. We identified the interaction of vitamin D and NfL on cognitive domains, and the effect was modified by age. Longitudinal or randomised controlled studies enrolling patients with various illness durations and mood statuses are required to validate our findings.

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The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes

Cited by 9 publications

References 64 publications

Long‐term course of cognitive functioning in bipolar disorder: A ten‐year follow‐up study

Long‐term course of cognitive functioning in bipolar disorder: A ten‐year follow‐up study

The relations between executive functions and occupational functioning in individuals with bipolar disorder: a scoping review

The interactions between vitamin D and neurofilament light chain levels on cognitive domains in bipolar disorder

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