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Narula S, Pal A, Reddy MS, Mahajan SL. Research on clinical aspects of bipolar disorder: A review of Indian studies. Indian J Psychiatry 2024; 66:421-432. [PMID: 38919568 PMCID: PMC11195747 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_698_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 04/29/2024] [Accepted: 05/01/2024] [Indexed: 06/27/2024] Open
Abstract
Background Bipolar disorder is one of the severe mental disorders that are associated with significant morbidity of the patients. Despite advancements in our understanding about the disorder, it remains a challenging proposition to treat bipolar disorder, largely since the prophylactic treatment of the disorder requires assessment of complex clinical algorithms. The revisions of the classificatory systems have also changed the conceptualization of the disorder. In this background, we conducted a review of the Indian studies conducted on the clinical aspects of bipolar disorder. Methods A narrative review was conducted with focus on the literature published from India. The databases searched included PubMed, Scopus, and Google Scholar, and articles published over the last 15 years by Indian authors were included for this review. Results In our review, we could access a substantial volume of research published from India. We could identify studies that catered to most of the relevant themes in bipolar disorder including epidemiology, etiology, comorbidities, stigma, disability, clinical course, cognitive profile, pathways to care, and recovery. Conclusion The research trajectory was in line with the research conducted elsewhere in the world. However, certain dissimilarities in terms of focus could also be observed. The possible reason behind this deviation could be the difference in clinical need and unique challenges faced in the management and rehabilitation of patients in bipolar disorder in Indian scenario.
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Affiliation(s)
- Sharon Narula
- Department of Psychiatry, Postgraduate Institute of Medical Educations and Research, Chandigarh, India
| | - Arghya Pal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - MS Reddy
- Consultant Psychiatrist, ASHA Hospital, Hyderabad, Telangana, India
| | - Sudhir L. Mahajan
- Department of Psychiatry, Government Medical College and Hospital, Nagpur, Maharashtra, India
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Wang Z, Cao H, Cao Y, Song H, Jiang X, Wei C, Yang Z, Li J. Clinical characteristics and cognitive function in bipolar disorder patients with different onset symptom. Front Psychiatry 2023; 14:1253088. [PMID: 37840798 PMCID: PMC10569422 DOI: 10.3389/fpsyt.2023.1253088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Background In recent years, studies on the clinical features and cognitive impairment of patients with different first-episode types of bipolar disorder have received increasing attention. The patients with bipolar disorder may present with different symptoms at first onset. The aim of this study is to assess the cognitive functions of a patient's index episode of bipolar disorder, depression or mania, on risk factors of effecting on cognitive functions. Method One hundred sixty eight patients with bipolar disorder diagnosed for the first time were enrolled in the study. All patients were divided into two groups according to their index episode of bipolar disorder, either depression or mania. Seventy three patients of the cohort had an index episode mania and 95 patients had initial symptoms of depression. Demographic and clinical disease characteristic data of all enrolled patients were collected. Meanwhile, 75 healthy controls were included. Demographic data of controls were collected. The cognitive functions of all patients and controls were detected by continuous performance test (CPT), digital span test (DST) and Wisconsin card sorting test (WCST). The main cognitive functions data were compared among the mania group, depression group and control group. The relevant risk factors affecting cognitive function were analyzed. Results (1) Most patients with bipolar disorder had an index episode depression (56.55% vs. 43.45%). Compared with the depression group, the mania group had later age of onset [(24.01 ± 4.254) vs. (22.25 ± 6.472), t = 2. 122, p = 0.035]. The education level of patient groups was lower than control group (p < 0.001). (2) The healthy control group's DST, WCST and CPT scores were better than the patient groups (All p < 0.05). The mania group's DST (forward, reverse, sum), WCST (total responses, completed classifications, correct responses, incorrect responses, percentage of correct responses, completed the number of responses required for classification, the percentage of conceptualization level, the number of persistent responses, non-persistent errors), CPT (2 digit score, 3 digit score, 4 digit score) was better than the depression group (p < 0.05). (3) In mania group, correlation analysis showed that all CPT parameter, inverse digit span, and the sum of DST was negatively correlated with the education level (All p < 0.05). The CPT-4 digit score was negatively correlated with onset age (p < 0.05). In the WCST, the number of correct responses, the percentage of correct responses and the percentage of conceptualization level were positively correlated with the BRMS score (All p < 0.05). The number of false responses and persistent responses were negatively correlated with the BRMS score (All p < 0.05). The number of persistent errors and percentage of persistent errors was positively correlated with education years (All p < 0.05). In depression group, there was a positive correlation between inverse digit span and the education level (p < 0.05). Conclusion In our study, there were cognitive impairments in attention, memory, and executive function of patients with different onset syndromes of bipolar disorder. Compared with the mania group, the degree of cognitive impairments in bipolar patients with the depressive episode was more severe. The risk factors affecting cognitive impairments included the age of onset, education level, number of hospitalizations and severity of illness.
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Affiliation(s)
- Zhonggang Wang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Haiyan Cao
- Institute of Mental Health, Tianjin Anding Hospital, Tianjin, China
| | - Yuying Cao
- Department of Medical Imaging, Affiliated Hospital of Jining Medical University, Jining, China
| | - Haining Song
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Xianfei Jiang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Chen Wei
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Zhenzhen Yang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, China
| | - Jie Li
- Institute of Mental Health, Tianjin Anding Hospital, Tianjin, China
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Prajapati N, Kumar M, Sharma V. Cognitive dysfunction in euthymic bipolar patients on prophylaxis of lithium monotherapy. Indian J Psychiatry 2022; 64:426-427. [PMID: 36060723 PMCID: PMC9435615 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_151_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 01/17/2022] [Accepted: 06/05/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Manoj Kumar
- Department of Psychiatry, IHBAS, East Delhi, India E-mail:
| | - Vibha Sharma
- Department of Clinical Psychology, IHBAS, East Delhi, India
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Baena-Oquendo S, García Valencia J, Vargas C, López-Jaramillo C. Neuropsychological aspects of bipolar disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:218-226. [PMID: 36075855 DOI: 10.1016/j.rcpeng.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/10/2020] [Indexed: 06/15/2023]
Abstract
Bipolar disorder (BD) is a chronic condition with serious consequences on the health and functionality of patients who suffer from it, with a high heritability and segregation, and aprevalence of between 1% and 2%. Neuropsychological deficits have been implicated as a very important issue related to BD prognosis, so a review was conducted of these deficits, the related factors and their functional consequences. It has been determined that the presence of neuropsychological deficits can vary in patients with BD according to their mood state, with a great influence of depressive symptoms on the cognitive variability of patients with respect to the general population and differences with respect to patients in the manic phase. In euthymic patients, the most affected cognitive domains are those of memory, attention, and executive function, associated with a more severe disease, sociodemographic vulnerability factors, and stable over time. A relationship has been found between poor cognitive performance, especially executive dysfunction, and objective functional deficit. Furthermore, cognitive differences have been outlined between BD and other serious mental illnesses that are described in this review.
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Affiliation(s)
- Stephen Baena-Oquendo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Baena-Oquendo S, Valencia JG, Vargas C, López-Jaramillo C. Neuropsychological Aspects of Bipolar Disorder. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30092-5. [PMID: 33735035 DOI: 10.1016/j.rcp.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022]
Abstract
Bipolar disorder (BD) is a chronic condition with serious consequences on the health and functionality of patients who suffer from it, with a high heritability and segregation, and a prevalence of between 1% and 2%. Neuropsychological deficits have been implicated as a very important issue related to BD prognosis, so a review was conducted of these deficits, the related factors and their functional consequences. It has been determined that the presence of neuropsychological deficits can vary in patients with BD according to their mood state, with a great influence of depressive symptoms on the cognitive variability of patients with respect to the general population and differences with respect to patients in the manic phase. In euthymic patients, the most affected cognitive domains are those of memory, attention, and executive function, associated with a more severe disease, sociodemographic vulnerability factors, and stable over time. A relationship has been found between poor cognitive performance, especially executive dysfunction, and objective functional deficit. Furthermore, cognitive differences have been outlined between BD and other serious mental illnesses that are described in the review.
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Affiliation(s)
- Stephen Baena-Oquendo
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jenny García Valencia
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Cristian Vargas
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Carlos López-Jaramillo
- Grupo de Investigación en Psiquiatría GIPSI, Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Abstract
Bipolar disorder (BD) is a severe, recurrent mood disorder, associated with a significant morbidity and mortality, with high rates of suicides and medical comorbidities. There is a high risk of mood disorders among the first-degree relatives of patients with BD. In the current clinical practice, the diagnosis of BD is made by history taking, interview and behavioural observations, thereby lacking an objective, biological validation. This approach may result in underdiagnosis, misdiagnosis and eventually poorer outcomes. Due to the heterogeneity of BD, the possibility of developing a single, specific biomarker is still remote; however, there is a set of promising biomarkers which may serve as predictive, prognostic or treatment markers in the future. The review presents a critical appraisal and update on some of the most promising candidates for biomarkers, namely, neuroimaging markers, peripheral biomarkers and genetic markers, including a brief discussion on cognitive endophenotypes as indicative of genetic risk. The lessons learnt from other fields and specialties in medicine need to be applied to psychiatry to translate the knowledge from ‘bench to bedside’ by means of clinically useful biomarkers. Overall, the biomarkers may help in pushing the shift towards personalized medicine for psychiatric patients.
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Affiliation(s)
- Rajesh Sagar
- Department of Psychiatry, All Institute of Medical Sciences, New Delhi, India
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Dickinson T, Becerra R, Coombes J. Executive functioning deficits among adults with Bipolar Disorder (types I and II): A systematic review and meta-analysis. J Affect Disord 2017; 218:407-427. [PMID: 28501741 DOI: 10.1016/j.jad.2017.04.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/04/2017] [Accepted: 04/07/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Executive functioning (EF) deficits contribute to a significant proportion of the burden of disease associated with bipolar disorder (BD). Yet, there is still debate in the literature regarding the exact profile of executive functioning in BD. The purpose of the present project was to assess whether EF deficits exist among adults suffering BD, and whether these deficits (if apparent) differ by BD subtype. METHODS A systematic search identified relevant literature. Randomised controlled trials that used neuropsychological assessment to investigate EF among adults 16-65 years) with a remitted DSM diagnosis of BD (type I or II) were included. Studies were published between 1994 and 2015. A systematic review and meta-analysis were undertaken. For individual studies, standardised mean differences (Cohen's d) and 95% confidence intervals were calculated and represented in forest plots to illustrate differences in executive performance between groups. Summary effects were produced and tests of heterogeneity employed to assess the dispersion and generalisability of results. RESULTS Thirty-six studies met criteria for inclusion. Six domains of EF were identified: Set-shifting (SS), inhibition (INH), planning (PLA), verbal fluency (VF), working memory (WM), and attention (ATT). BD1s performed worse than HCs in all domains. BD2s demonstrated impairment in VF, WM, SS, and ATT. The results were mixed for comparisons between BD1s and BD2s, but revealed that BD2s can experience similar (or sometimes greater) EF impairment. LIMITATIONS Only a limited number of studies that included BD2 samples were available for inclusion in the current study. Subgroup analysis to elucidate potential moderators of within-study variance was not undertaken. CONCLUSION This is the first systematic review and meta-analysis to have compared the EF of remitted BD1s, BD2s, and HCs. The results provided useful insight into the EF profile of patients with BD, and offered commentary as to some of the contradictory results reported in the literature. A standardised methodological protocol for assessment of EF in BD was proposed. The information in this review could enhance our understanding of EF impairment inherent in BD, and the methods and efficacy with which clinicians assess and treat this population.
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Affiliation(s)
- Tania Dickinson
- Clear Health Psychology, Edith Cowan University, 99 Central Avenue, Mount Lawley, Western Australia 6050, Australia.
| | - Rodrigo Becerra
- School of Psychology and Social Science, Edith Cowan Univeristy, Room 30.129, Building 30, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
| | - Jacqui Coombes
- Centre for Learning and Teaching, Edith Cowan University, Room 5.119, Building 5, 270 Joondalup Drive, Joondalup, Western Australia 6027, Australia.
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Bostock ECS, Kirkby KC, Garry MI, Taylor BVM. Systematic Review of Cognitive Function in Euthymic Bipolar Disorder and Pre-Surgical Temporal Lobe Epilepsy. Front Psychiatry 2017; 8:133. [PMID: 28848456 PMCID: PMC5552675 DOI: 10.3389/fpsyt.2017.00133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 07/10/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) and temporal lobe epilepsy (TLE) overlap in domains including epidemiology, treatment response, shared neurotransmitter involvement and temporal lobe pathology. Comparison of cognitive function in both disorders may indicate temporal lobe mediated processes relevant to BD. This systematic review examines neuropsychological test profiles in euthymic bipolar disorder type I (BD-I) and pre-surgical TLE and compares experimental designs used. METHODS A search of PubMed, PsychINFO, and Scopus using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Inclusion criteria were comparison group or pre- to post-surgical patients; reported neuropsychological tests; participants aged 18-60 years. Fifty six studies met criteria: 27 BD-I; 29 TLE. RESULTS Deficits in BD-I compared to healthy controls (HC) were in executive function, attention span and verbal memory. Deficits in TLE compared to HC were in executive function and memory. In the pre- to post-surgical comparisons, verbal memory in left temporal lobe (LTL) and, less consistently, visuospatial memory in right temporal lobe (RTL) epilepsy declined following surgery. BD-I studies used comprehensive test batteries in well-defined euthymic patients compared to matched HC groups. TLE studies used convenience samples pre- to post-surgery, comparing LTL and RTL subgroups, few included comparisons to HC (5 studies). TLE studies typically examined a narrow range of known temporal lobe-mediated neuropsychological functions, particularly verbal and visuospatial memory. CONCLUSION Both disorders exhibit deficits in executive function and verbal memory suggestive of both frontal and temporal lobe involvement. However, deficits in TLE are measured pre- to post-surgery and not controlled at baseline pre-surgery. Further research involving a head-to-head comparison of the two disorders on a broad range of neuropsychological tests is needed to clarify the nature and extent of cognitive deficits and potential overlaps.
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Affiliation(s)
| | - Kenneth C Kirkby
- Psychiatry, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Michael I Garry
- Psychology, School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Bruce V M Taylor
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Are there differences in pattern and magnitude of cognitive deficits between euthymic patients with bipolar I and bipolar II disorder? MIDDLE EAST CURRENT PSYCHIATRY 2016. [DOI: 10.1097/01.xme.0000475311.46243.2f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Zhao L, Lin Y, Lao G, Wang Y, Guan L, Wei J, Yang Z, Ni P, Li X, Jiang Z, Li T, Hao X, Lin D, Cao L, Ma X. Association study of dopamine receptor genes polymorphism with cognitive functions in bipolar I disorder patients. J Affect Disord 2015; 170:85-90. [PMID: 25233244 DOI: 10.1016/j.jad.2014.08.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 07/21/2014] [Accepted: 08/13/2014] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To determine the correlation among the polymorphisms of dopamine receptor genes, cognitive function of Bipolar disorder (BD) patients, and BD. METHODS Twenty-three Single Nucleotide Polymorphisms (SNPs) of dopamine receptor genes were genotyped using Illumina GoldenGate genotyping assay in 375 patients with bipolar I disorder (BD-I) (patients group) and 475 healthy controls (control group). Cognitive function tests were performed in 158 patients who were clinically stable and 307 healthy controls who were matched with the patients in age, sex, and education. RESULTS The allele frequencies of rs3758653 in the promoter region of the DRD4 gene were significantly different between patients group and control group (χ(2)=9.386, Corrected P=0.046). This significant difference was also observed between BD-I patients with psychotic symptoms and healthy controls (χ(2)=9.27, Corrected P=0.049). Patients with BD-I performed significantly worse than healthy controls in all cognitive domains (p<0.01) except TMTA errors and illegal time. Significant interactions between polymorphisms of rs5326 in DRD1 gene and phenotype (affected or unaffected with BD-I) were found in non-perseverative errors (β=3.20 and Corrected P=0.0034) on the Wisconsin Card Sorting Test (WCST). The allele of this SNP denoted the positive effect on the WCST non-perseverative errors in BD-I patients group (β=2.80 and Corrected P=0.017). The genotypic association analyses also supported the findings (F=4.24 and P=0.007), but this effect was not found in controls. LIMITATIONS The sample size was relatively small and the SNP coverage was limited, making it very important to be cautious when drawing a conclusion. CONCLUSIONS DRD4 gene may play an important role in psychotic symptomatology rather than in unique diagnosis, BD, for example. A genetic association exists between DRD1 gene and impaired cognition in BD.
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Affiliation(s)
- Liansheng Zhao
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Yin Lin
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Guohui Lao
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Yingcheng Wang
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Lijie Guan
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Jinxue Wei
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Zhenxing Yang
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Peiyan Ni
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Xuan Li
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Zeyu Jiang
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Tao Li
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China
| | - Xiaoyu Hao
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China
| | - Dongtao Lin
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; College of Foreign Languages and Cultures, Sichuan University, Chengdu 610064, PR China
| | - Liping Cao
- Guangzhou Brain Hospital, Affilated Brain Hospital of Guangzhou Medical University, No. 36 Minxin Road, Liwan District, Guangzhou 510370, PR China.
| | - Xiaohong Ma
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, No. 1 Keyuan 4 Road, High Tech Parkm, Chengdu 610041, PR China; National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, PR China.
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Yang Z, Lin Y, Guan L, Li X, Deng W, Jiang Z, Lao G, Wang Q, Hao X, Liu X, Wang Y, Zhao L, Ma X, Cao L, Li T. Association analysis of genes in serotonin pathway with attention and executive function in patients with bipolar affective disorder. Compr Psychiatry 2014; 55:1785-90. [PMID: 25200194 DOI: 10.1016/j.comppsych.2014.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 07/17/2014] [Accepted: 07/17/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The reason why it is difficult to identify susceptibility genes attributed to bipolar disorder (BPD) is the phenotypic heterogeneity. The use of endophenotypes has been advocated as one possible strategy to discovery cause variants of BPD. METHODS A total of 164 patients with BPD and 164 matched controls were employed in the present research. Fifty-two single nucleotide polymorphisms (SNPs) within the genes in serotonin pathway were selected for genotyping using the GoldenGate genotyping assay. All participants completed three neurocognitive tests including the tower of Hanoi (TOH), the Wisconsin card sorting test (WCST) and Trail making tests (TMTA and TMTB-M). RESULTS Patients with BPD demonstrated a wide range of deficits in mental activities of attention and speed of information processing, and executive function. Significant interactions between rs2760347 in 5HTR2A gene and diagnosis were found for the executive time of TOH, with β=11.82 and P=0.002 (adjusted P=0.03 after Bonferroni correction). CONCLUSIONS Cognitive impairments existing in BPD may be particularly notable in certain domains of attention and executive function, and 5HTR2A gene may be involved in modulating executive function of BP-I patients.
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Affiliation(s)
- Zhenxing Yang
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yin Lin
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; Guangzhou Brain Hospital, Guangzhou, PR China
| | - Lijie Guan
- Guangzhou Brain Hospital, Guangzhou, PR China
| | - Xuan Li
- Guangzhou Brain Hospital, Guangzhou, PR China
| | - Wei Deng
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Zeyu Jiang
- Guangzhou Brain Hospital, Guangzhou, PR China
| | - Guohui Lao
- Guangzhou Brain Hospital, Guangzhou, PR China
| | - Qiang Wang
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaoyu Hao
- Guangzhou Brain Hospital, Guangzhou, PR China
| | - Xiang Liu
- The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Yingcheng Wang
- The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Lianshen Zhao
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaohong Ma
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Liping Cao
- Guangzhou Brain Hospital, Guangzhou, PR China.
| | - Tao Li
- The State Key Laboratory of Biotherapy, Laboratory of Psychiatry Research, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China; The Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
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Wang YC, Wang EN, Wang CC, Huang CL, Huang ACW. Dissociating effects of spatial learning from locomotor activity for ouabain-induced bipolar disorder-like rats. Psychiatry Res 2014; 216:432-7. [PMID: 24656518 DOI: 10.1016/j.psychres.2014.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 02/26/2014] [Accepted: 03/01/2014] [Indexed: 12/11/2022]
Abstract
Whether ouabain, a Na+ - and K+-activated adenosine triphosphatase inhibitor, mimics cognitive impairments that can be dissociated from motor effects in the bipolar disorder-like animal model remains unclear. Ouabain and the vehicle aCSF were microinjected into the left lateral ventricle immediately, after 4h, and after 24h. The results showed that (a) locomotion responses of the Immediate group were significantly decreased compared to those of the aCSF group, particularly the first five minutes. (b) The ouabain-treated rats have longer latency and total distance traveled in the water maze task; however, the velocity was not affected for the ouabain group. (c) The analysis of covariance showed that the latency time (but not the total distance traveled and velocity) of the ouabain group was more impaired than that of the aCSF group, regardless of omitting total distance traveled and cross movement in the open field test. The latency might be more sensitive than the distance traveled and the velocity for assessing spatial learning. Dissociating the spatial learning from the movement may allow testing drug treatments of cognitive deficits independent of locomotor effects associated with bipolar disorder.
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Affiliation(s)
- Ying-Chou Wang
- Department of Clinical Psychology, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - En-Nan Wang
- Department of Clinical Psychology, Fu Jen Catholic University, New Taipei City 24205, Taiwan; Department of Psychiatry, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Graduate Institute of Humanities in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Chuan Wang
- School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Chung-Lei Huang
- Department of Psychology, Fo Guang University, Yilan County 26247, Taiwan
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Li CT, Hsieh JC, Wang SJ, Yang BH, Bai YM, Lin WC, Lan CC, Su TP. Differential relations between fronto-limbic metabolism and executive function in patients with remitted bipolar I and bipolar II disorder. Bipolar Disord 2012; 14:831-42. [PMID: 23167933 DOI: 10.1111/bdi.12017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relationship between resting brain glucose metabolism and cognitive profiles in patients with remitted bipolar I disorder (BD-I) and bipolar II disorder (BD-II). We hypothesized that BD-I patients (compared to BD-II patients) would perform worse on tests of cognitive function because of abnormal metabolism in the prefrontal cortex and other mood-related brain areas. METHODS Thirty-four patients with remitted bipolar disorder (BD) (BD-I = 17, BD-II = 17) under treatment and 17 well-matched healthy controls received both fluorodeoxyglucose ((18) F-FDG) positron emission tomography (PET) and neuropsychological tests of attention, memory, and executive function. RESULTS Clinical features in patients with BD-I and BD-II were comparable. Executive function, as indicated by performance on the Wisconsin Card Sorting Test, was significantly worse (i.e., higher percentage of errors, lower percentage of conceptual level responses, and fewer categories completed) in BD-I patients than in BD-II patients and healthy subjects. No difference in attention and memory tests was found among these three groups. Brain PET analysis showed that BD-I patients (compared to BD-II patients) had significantly lower glucose uptake in the bilateral anterior cingulum, insula, striatum, and part of the prefrontal cortex, and higher glucose uptake in the left parahippocampus. Further analyses revealed significant correlations between poor executive function and abnormal glucose uptake in other brain areas in BD-I patients. CONCLUSIONS There are neurobiological differences between subtypes of BD. BD-I is associated with more impaired fronto-limbic circuitry, which might account for reduced executive function in BD-I patients during remission.
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Affiliation(s)
- Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
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15
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fMRI abnormalities in dorsolateral prefrontal cortex during a working memory task in manic, euthymic and depressed bipolar subjects. Psychiatry Res 2010; 182:22-9. [PMID: 20227857 PMCID: PMC2918407 DOI: 10.1016/j.pscychresns.2009.11.010] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 10/05/2009] [Accepted: 11/22/2009] [Indexed: 12/21/2022]
Abstract
Neuropsychological studies of subjects with bipolar disorder suggest impairment of working memory not only in acute mood states, but also while subjects are euthymic. Using fMRI to probe working memory regions in bipolar subjects in different mood states, we sought to determine the functional neural basis for these impairments. Typical working memory areas in normal populations include dorsolateral prefrontal cortex (BA9/46) and the posterior parietal cortex (BA40). We evaluated the activation in these regions using an n-back task in 42 bipolar subjects (13 manic, 15 euthymic and 14 depressed subjects) and 14 control subjects. While both control and bipolar subjects performed similarly on the task, bipolar subjects in all three mood states showed a significant reduction in activation in right BA9/46 and right BA40. Patients with bipolar disorder exhibit significantly attenuated neural activation in working memory circuits, independent of mood state. The reduction of neural activation may suggest a trait-related deficit. Subjects with bipolar disorder activated other additional frontal and temporal regions, perhaps as a compensatory mechanism, but this remains to be further explored.
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Kallivayalil RA, Chadda RK, Mezzich JE. Indian psychiatry: Research and international perspectives. Indian J Psychiatry 2010; 52:S38-42. [PMID: 21836710 PMCID: PMC3146192 DOI: 10.4103/0019-5545.69205] [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: 11/28/2022] Open
Abstract
Indian psychiatry has many contributions to the world psychiatry to its credit. These include active participation in the international scientific organizations, research, and also creation of the manpower resources in many other countries. India has been an active partner in the research initiatives of the World Health Organization and the World Psychiatric Association. Research by the Indian psychiatrists played an important role in recognition of the entity of acute and transient psychotic disorders, some culture bound syndromes like Dhat syndrome and understanding the role of families in care of schizophrenia and course and outcome of schizophrenia.
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Affiliation(s)
| | | | - Juan E. Mezzich
- International Center for Mental Health, Mount Sinai School of Medicine, New York University, New York, USA
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Abstract
Cognitive deficits have been shown to exist in various psychiatric disorders. Though most Indian studies pertaining to cognition have been replication studies, well designed original studies have also been conducted. This article traces the evolution of cognitive psychiatry in India. Cognitive research has huge potential in India and can help us unravel mysteries of the human mind, identify etiopathogenesis and facilitate treatment of psychiatric disorders.
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Affiliation(s)
- P K Dalal
- Department of Psychiatry, C.S.M. Medical University UP, (Erstwhile King George's medical College), Lucknow - 226 003, India
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