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Bair JL, Patrick SD, Noyes ET, Hale AC, Campbell EB, Wilson AM, Ransom MT, Spencer RJ. Semantic clustering on common list-learning tasks: a systematic review of the state of the literature and recommendations for future directions. J Clin Exp Neuropsychol 2023; 45:652-692. [PMID: 37865967 DOI: 10.1080/13803395.2023.2270204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION On some list-learning tasks, such as the California Verbal Learning Test (CVLT) or Hopkins Verbal Learning Test (HVLT), examinees have the opportunity to group words based on semantically related categories (i.e., semantic clustering). Semantic clustering (SC) is often considered the most efficient organizational strategy and adopting SC is presumed to improve learning and memory. In addition, SC is conceptualized as reflecting higher-order executive functioning skills. Although SC measures have intuitive appeal, to date, there are no comprehensive reviews of the SC literature base that summarize its psychometric utility. In this systematic review, we synthesize the literature to judge the validity of SC scores. METHOD We conducted a systematic literature search for empirical articles reporting SC from the CVLT and HVLT. We qualitatively described the relationship of SC with other list-learning and cognitive test scores and clinical diagnoses, contrasting SC with serial clustering and total learning scores when possible. RESULTS SC was inversely correlated with serial clustering. Higher SC was strongly associated with better learning and memory performances. When compared with cognitive tests, SC tended to have the strongest relationships with other memory measures and modest relationships with tests of executive functioning. SC had negligible to small relationships with most other cognitive domains. Traditional memory scores yielded stronger relationships to cognitive test performances than did SC. SC across clinical groups varied widely, but clinical groups tended to use SC less often than healthy comparison groups. CONCLUSION Our comprehensive review of the literature revealed that SC is strongly related to measures of learning and memory on the CVLT and HVLT and is correlated with a wide range of cognitive functions. SC has been understudied in relevant populations and additional research is needed to test the degree to which it adds incremental validity beyond traditional measures of learning and memory.
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Affiliation(s)
- Jessica L Bair
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Sarah D Patrick
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Emily T Noyes
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Andrew C Hale
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Elizabeth B Campbell
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
- Behavioral Health, St. Elizabeth Physicians, Crestview Hills, KY, USA
| | - Addie M Wilson
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Michael T Ransom
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
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Hasse-Sousa M, Martins DS, Petry-Perin C, Britto MJSD, Remus IB, Lapa CDO, Reckziegel RDFX, Sales SCD, Jesus LSD, Philippsen M, Massuda R, Van Rheenen TE, Gama CS, Czepielewski LS. The role of semantic clustering in the relationship between verbal memory and psychosocial functioning in schizophrenia and bipolar disorder: Possible distinct cognitive pathway compared to healthy controls. J Affect Disord 2023; 320:330-339. [PMID: 36162669 DOI: 10.1016/j.jad.2022.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Verbal memory (VM) is impaired in schizophrenia (SZ) and bipolar disorder (BD), and predicts psychosocial functioning. However, there is a lack of research exploring the role of VM component processes, including semantic clustering, in these disorders. Semantic clustering might impact this association, as effective semantic memory strategies may reflect unimpaired executive control, leading to an adequate functioning. We aimed to investigate VM components in SZ and BD, and the role of semantic clustering in the relationship between VM and functioning. METHODS We included 495 participants (156 SZ, 172 BD, and 167 healthy controls (HC)) that underwent an assessment using the Hopkins Verbal Learning Test - Revised for VM and the Functioning Assessment Short Test for psychosocial functioning. We compared groups through ANOVAs and investigated the effect of semantic clustering in the relationship between VM total immediate free recall and functioning through linear regression models. RESULTS SZ had worse overall VM performance compared to BD, which performed worse than HCs. HCs used more semantic clustering than SZ and BD, but there were no differences between the two clinical groups. In HCs, semantic clustering impacted the relationship between VM performance and functioning, while no interaction was observed in SZ or BD. LIMITATIONS Cross-sectional design; no medication effects or other cognitive functions were assessed. CONCLUSIONS SZ and BD may use an alternative cognitive pathway in which the relationship between VM and functioning is independent of complex cognitive processes such as semantic clustering, supporting the cognitive remediation targeting of VM in these disorders.
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Affiliation(s)
- Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina Petry-Perin
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Julia Silva de Britto
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isadora Bosini Remus
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Clara de Oliveira Lapa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Ramiro de Freitas Xavier Reckziegel
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sarah Corrêa de Sales
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Letícia Stephane de Jesus
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Marielli Philippsen
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Raffael Massuda
- Psychosis Treatment and Research Program, Department of Forensic Medicine and Psychiatry, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia; Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, VIC, Australia
| | - Clarissa Severino Gama
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Letícia Sanguinetti Czepielewski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre; Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Characterisation of Deficits and Sex Differences in Verbal and Visual Memory/Learning in Bipolar Disorder. J Int Neuropsychol Soc 2023; 29:12-23. [PMID: 35067269 DOI: 10.1017/s1355617721001442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Cognitive impairment is consistently reported in bipolar disorder (BD), but few studies have characterised which memory component processes are affected. Further, it is unknown whether the component processes underlying memory impairment are moderated by sex. The present study examined diagnosis and sex differences in both verbal and visual memory/learning domains in patients with BD and psychiatrically healthy controls. METHOD Verbal and visual memory/learning were measured using the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). 114 patients with BD (n = 50 males, n = 64 females), were compared to 105 psychiatrically healthy controls (n = 42 males, n = 63 females). RESULTS Patients with BD had worse performance in verbal and visual immediate and total recall, verbal and visual delayed free recall, and verbal recognition discrimination scores, but there were no group differences in learning slopes and cumulative learning index scores. There were trends for BD females to outperform BD males in visual memory/learning free recall and cumulative learning, but these results did not survive multiple testing correction. These findings did not change in a secondary sensitivity analysis comparing only strictly euthymic BD patients to controls (n = 64). CONCLUSION The present study found trait-like verbal and visual memory/learning impairment in BD that was attributable to deficient encoding and/or consolidation processes rather than deficits in learning. We did not find marked sex differences in either visual or verbal memory/learning measures, although some trend level effects were apparent and deserve exploration in future studies.
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Bauer IE, Suchting R, Van Rheenen TE, Wu MJ, Mwangi B, Spiker D, Zunta-Soares GB, Soares JC. The use of component-wise gradient boosting to assess the possible role of cognitive measures as markers of vulnerability to pediatric bipolar disorder. Cogn Neuropsychiatry 2019; 24:93-107. [PMID: 30774035 PMCID: PMC6675623 DOI: 10.1080/13546805.2019.1580190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 01/27/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS Cognitive impairments are primary hallmarks symptoms of bipolar disorder (BD). Whether these deficits are markers of vulnerability or symptoms of the disease is still unclear. This study used a component-wise gradient (CGB) machine learning algorithm to identify cognitive measures that could accurately differentiate pediatric BD, unaffected offspring of BD parents, and healthy controls. METHODS 59 healthy controls (HC; 11.19 ± 3.15 yo; 30 girls), 119 children and adolescents with BD (13.31 ± 3.02 yo, 52 girls) and 49 unaffected offspring of BD parents (UO; 9.36 ± 3.18 yo; 22 girls) completed the CANTAB cognitive battery. RESULTS CGB achieved accuracy of 73.2% and an AUROC of 0.785 in classifying individuals as either BD or non-BD on a dataset held out for validation for testing. The strongest cognitive predictors of BD were measures of processing speed and affective processing. Measures of cognition did not differentiate between UO and HC. CONCLUSIONS Alterations in processing speed and affective processing are markers of BD in pediatric populations. Longitudinal studies should determine whether UO with a cognitive profile similar to that of HC are at less or equal risk for mood disorders. Future studies should include relevant measures for BD such as verbal memory and genetic risk scores.
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Affiliation(s)
- Isabelle E. Bauer
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Robert Suchting
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Tamsyn E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Level 3, Alan Gilbert Building, 161 Barry St, Carlton, VIC 3053, Australia
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Victoria, Australia
| | - Mon-Ju Wu
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Benson Mwangi
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Danielle Spiker
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Giovana B. Zunta-Soares
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
| | - Jair C. Soares
- The University of Texas Health Science Center at Houston, Department of Psychiatry and Behavioral Sciences, Houston (Texas), USA
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Dean OM, Gliddon E, Van Rheenen TE, Giorlando F, Davidson SK, Kaur M, Ngo TT, Williams LJ. An update on adjunctive treatment options for bipolar disorder. Bipolar Disord 2018; 20:87-96. [PMID: 29369487 DOI: 10.1111/bdi.12601] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 11/19/2017] [Accepted: 12/15/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Bipolar disorder is a complex illness often requiring combinations of therapies to successfully treat symptoms. In recent years, there have been significant advancements in a number of therapies for bipolar disorder. It is therefore timely to provide an overview of current adjunctive therapeutic options to help treating clinicians to inform their patients and work towards optimal outcomes. METHODS Publications were identified from PubMed searches on bipolar disorder and pharmacotherapy, nutraceuticals, hormone therapy, psychoeducation, interpersonal and social rhythm therapy, cognitive remediation, mindfulness, e-Health and brain stimulation techniques. Relevant articles in these areas were selected for further review. This paper provides a narrative review of adjunctive treatment options and is not a systematic review of the literature. RESULTS A number of pharmacotherapeutic, psychological and neuromodulation treatment options are available. These have varying efficacy but all have shown benefit to people with bipolar disorder. Due to the complex nature of treating the disorder, combination treatments are often required. Adjunctive treatments to traditional pharmacological and psychological therapies are proving useful in closing the gap between initial symptom remission and full functional recovery. CONCLUSIONS Given that response to monotherapy is often inadequate, combination regimens for bipolar disorder are typical. Correspondingly, psychiatric research is working towards a better understanding of the disorder's underlying biology. Therefore, treatment options are changing and adjunctive therapies are being increasingly recognized as providing significant tools to improve patient outcomes. Towards this end, this paper provides an overview of novel treatments that may improve clinical outcomes for people with bipolar disorder.
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Affiliation(s)
- Olivia M Dean
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic., Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia
| | - Emma Gliddon
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia.,Centre for Mental Health, Swinburne University, Melbourne, Vic., Australia.,Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Vic., Australia
| | - Francesco Giorlando
- Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia
| | - Sandra K Davidson
- Department of General Practice, Melbourne Medical School, University of Melbourne, Carlton, Vic., Australia
| | - Manreena Kaur
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Vic., Australia
| | - Trung T Ngo
- Mater Research Institute-UQ, Faculty of Medicine, The University of Queensland and Translational Research Institute, Brisbane, Qld, Australia.,Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia
| | - Lana J Williams
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic., Australia
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Calafiore D, Rossell SL, Van Rheenen TE. Cognitive abilities in first-degree relatives of individuals with bipolar disorder. J Affect Disord 2018; 225:147-152. [PMID: 28829959 DOI: 10.1016/j.jad.2017.08.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 03/16/2017] [Accepted: 08/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although the study of cognition in first degree relatives (FDRs) is not new, findings in this group are still somewhat inconsistent and much of the research examining FDR populations include individuals under the age of 25, who are arguably still at significant risk to go on to develop BD. The present study aimed to establish the value of cognitive performance as a genuine endophenotypic marker of familial risk for bipolar disorder (BD), by examining cognition in FDRs aged 25 years or older. METHODS The current study compared the cognitive performance of 27 unaffected FDRs to 47 healthy controls (HCs) and 28 BD patients using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS Results indicated that FDRs had impaired verbal learning performance, as well as selective impairments on a measure of speed of processing; and a measure of spatial working memory compared to HC. LIMITATIONS Limitations relate to the potential insensitivity of some of the tests in the MCCB for detecting cognitive deficits that have been previously noted in BD and FDR samples using other batteries. CONCLUSIONS Findings from this study implicate verbal learning, processing speed and working memory performance as promising candidate endophenotypes of familial risk for BD.
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Affiliation(s)
- Daniela Calafiore
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia.
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Nikolakaros G, Kurki T, Paju J, Papageorgiou SG, Vataja R, Ilonen T. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients. Variable Cognitive Presentation and Impaired Frontotemporal Connectivity. Front Psychiatry 2018; 9:204. [PMID: 29910747 PMCID: PMC5992887 DOI: 10.3389/fpsyt.2018.00204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI) data are scarce. Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men) with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems. Results: All patients had abnormal neuropsychological test results, predominantly in memory. Thus, the neuropsychological findings were compatible with Korsakoff syndrome. However, the neuropsychological findings were not uniform. The impairment of delayed verbal memory of the first patient was evident only when the results of the memory tests were compared to her general cognitive level. In addition, the logical memory test and the verbal working memory test were abnormal, but the word list memory test was normal. The second patient had impaired attention and psychomotor speed in addition to impaired memory. In the third patient, the word list memory test was abnormal, but the logical memory test was normal. All patients had intrusions in the neuropsychological examination. Executive functions were preserved, except for planning and foresight, which were impaired in two patients. Conventional MRI examination was normal. DTI showed reduced fractional anisotropy values in the uncinate fasciculus in two patients, and in the corpus callosum and in the subgenual cingulum in one patient. Conclusions: Non-alcoholic Korsakoff syndrome can have diverse neuropsychological findings. This may partly explain its marked underdiagnosis. Therefore, a strong index of suspicion is needed. The presence of intrusions in the neuropsychological examination supports the diagnosis. Damage in frontotemporal white matter tracts, particularly in the uncinate fasciculus, may be a feature of non-alcoholic Korsakoff syndrome in psychiatric patients.
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Affiliation(s)
- Georgios Nikolakaros
- "Specialists in Psychiatry" Medical Center, Turku, Finland.,Satakunta Hospital District, Psychiatric Care Division, General Psychiatry Outpatient Clinic, Pori, Finland.,Turku University Central Hospital, Salo Psychiatry Outpatient Clinic, Salo, Finland
| | - Timo Kurki
- Terveystalo Pulssi Medical Center, Turku, Finland.,Department of Radiology, University of Turku, Turku, Finland
| | - Janina Paju
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Sokratis G Papageorgiou
- Cognitive Disorders/Dementia Unit, 2nd University Department of Neurology, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - Risto Vataja
- Division of Neuropsychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Tuula Ilonen
- Department of Psychiatry, University of Turku, Turku, Finland
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Abstract
BACKGROUND Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. METHODS The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. RESULTS Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. CONCLUSIONS VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or "chunking" techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358-366).
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Nikolakaros G, Ilonen T, Kurki T, Paju J, Papageorgiou SG, Vataja R. Non-alcoholic Korsakoff syndrome in psychiatric patients with a history of undiagnosed Wernicke's encephalopathy. J Neurol Sci 2016; 370:296-302. [PMID: 27772780 DOI: 10.1016/j.jns.2016.09.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/30/2016] [Accepted: 09/14/2016] [Indexed: 12/12/2022]
Abstract
Wernicke's encephalopathy is often undiagnosed, particularly in non-alcoholics. There are very few reports of non-alcoholic patients diagnosed with Korsakoff syndrome in the absence of a prior diagnosis of Wernicke's encephalopathy and no studies of diffusion tensor imaging in non-alcoholic Korsakoff syndrome. We report on three non-alcoholic psychiatric patients (all women) with long-term non-progressive memory impairment that developed after malnutrition accompanied by at least one of the three Wernicke's encephalopathy manifestations: ocular abnormalities, ataxia or unsteadiness, and an altered mental state or mild memory impairment. In neuropsychological examination, all patients had memory impairment, including intrusions. One patient had mild cerebellar vermis atrophy in MRI taken after the second episode of Wernicke's encephalopathy. The same patient had mild hypometabolism in the lateral cortex of the temporal lobes. Another patient had mild symmetrical atrophy and hypometabolism of the superior frontal lobes. Two patients were examined with diffusion tensor imaging. Reduced fractional anisotropy values were found in the corona radiata in two patients, and the uncinate fasciculus and the inferior longitudinal fasciculus in one patient. Our results suggest that non-alcoholic Korsakoff syndrome is underdiagnosed. Psychiatric patients with long-term memory impairment may have Korsakoff syndrome and, therefore, they should be evaluated for a history of previously undiagnosed Wernicke's encephalopathy.
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Affiliation(s)
- Georgios Nikolakaros
- "Specialists in Psychiatry" Medical Center, Yliopistonkatu 33C28, 20100 Turku, Finland; Satakunta Hospital District, Psychiatric Care Division, General Psychiatry Outpatient Clinic, Sairaalantie 3, 28500 Pori, Finland.
| | - Tuula Ilonen
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, rak. 9, 20700 Turku, Finland.
| | - Timo Kurki
- Terveystalo Pulssi Medical Center, Humalistonkatu 9-11, 20100 Turku, Finland; Department of Radiology, University of Turku, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
| | - Janina Paju
- Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, rak. 9, 20700 Turku, Finland.
| | - Sokratis G Papageorgiou
- Cognitive Disorders/Dementia Unit, 2nd University Department of Neurology, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Rimini street, 12462 Athens, Greece.
| | - Risto Vataja
- Division of Neuropsychiatry, Helsinki University Hospital, PL 100, 00029 HUS, Helsinki, Finland.
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Van Rheenen TE, Bryce S, Tan EJ, Neill E, Gurvich C, Louise S, Rossell SL. Does cognitive performance map to categorical diagnoses of schizophrenia, schizoaffective disorder and bipolar disorder? A discriminant functions analysis. J Affect Disord 2016; 192:109-15. [PMID: 26720009 DOI: 10.1016/j.jad.2015.12.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/13/2015] [Accepted: 12/14/2015] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Despite known overlaps in the pattern of cognitive impairments in individuals with bipolar disorder (BD), schizophrenia (SZ) and schizoaffective disorder (SZA), few studies have examined the extent to which cognitive performance validates traditional diagnostic boundaries in these groups. METHOD Individuals with SZ (n=49), schizoaffective disorder (n=33) and BD (n=35) completed a battery of cognitive tests measuring the domains of processing speed, immediate memory, semantic memory, learning, working memory, executive function and sustained attention. RESULTS A discriminant functions analysis revealed a significant function comprising semantic memory, immediate memory and processing speed that maximally separated patients with SZ from those with BD. Initial classification scores on the basis of this function showed modest diagnostic accuracy, owing in part to the misclassification of SZA patients as having SZ. When SZA patients were removed from the model, a second cross-validated classifier yielded slightly improved diagnostic accuracy and a single function solution, of which semantic memory loaded most heavily. CONCLUSIONS A cluster of non-executive cognitive processes appears to have some validity in mapping onto traditional nosological boundaries. However, since semantic memory performance was the primary driver of the discrimination between BD and SZ, it is possible that performance differences between the disorders in this cognitive domain in particular, index separate underlying aetiologies.
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Affiliation(s)
- Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia; Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia.
| | - Shayden Bryce
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Eric J Tan
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - Erica Neill
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - Caroline Gurvich
- Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - Stephanie Louise
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD. METHODS Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis. CONCLUSION The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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