1
|
Bergamasco MI, Vanyai HK, Garnham AL, Geoghegan ND, Vogel AP, Eccles S, Rogers KL, Smyth GK, Blewitt ME, Hannan AJ, Thomas T, Voss AK. Increasing histone acetylation improves sociability and restores learning and memory in KAT6B-haploinsufficient mice. J Clin Invest 2024; 134:e167672. [PMID: 38557491 PMCID: PMC10977983 DOI: 10.1172/jci167672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/26/2024] [Indexed: 04/04/2024] Open
Abstract
Mutations in genes encoding chromatin modifiers are enriched among mutations causing intellectual disability. The continuing development of the brain postnatally, coupled with the inherent reversibility of chromatin modifications, may afford an opportunity for therapeutic intervention following a genetic diagnosis. Development of treatments requires an understanding of protein function and models of the disease. Here, we provide a mouse model of Say-Barber-Biesecker-Young-Simpson syndrome (SBBYSS) (OMIM 603736) and demonstrate proof-of-principle efficacy of postnatal treatment. SBBYSS results from heterozygous mutations in the KAT6B (MYST4/MORF/QFK) gene and is characterized by intellectual disability and autism-like behaviors. Using human cells carrying SBBYSS-specific KAT6B mutations and Kat6b heterozygous mice (Kat6b+/-), we showed that KAT6B deficiency caused a reduction in histone H3 lysine 9 acetylation. Kat6b+/- mice displayed learning, memory, and social deficits, mirroring SBBYSS individuals. Treatment with a histone deacetylase inhibitor, valproic acid, or an acetyl donor, acetyl-carnitine (ALCAR), elevated histone acetylation levels in the human cells with SBBYSS mutations and in brain and blood cells of Kat6b+/- mice and partially reversed gene expression changes in Kat6b+/- cortical neurons. Both compounds improved sociability in Kat6b+/- mice, and ALCAR treatment restored learning and memory. These data suggest that a subset of SBBYSS individuals may benefit from postnatal therapeutic interventions.
Collapse
Affiliation(s)
- Maria I. Bergamasco
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Hannah K. Vanyai
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Alexandra L. Garnham
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Niall D. Geoghegan
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Adam P. Vogel
- Centre for Neurosciences of Speech, University of Melbourne, Parkville, Victoria, Australia
- Redenlab Inc., Melbourne, Australia
| | - Samantha Eccles
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Kelly L. Rogers
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Gordon K. Smyth
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- School of Mathematics and Statistics, University of Melbourne, Parkville, Victoria, Australia
| | - Marnie E. Blewitt
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Anthony J. Hannan
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- Department of Anatomy and Physiology, University of Melbourne, Parkville, Victoria, Australia
| | - Tim Thomas
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| | - Anne K. Voss
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology and
| |
Collapse
|
2
|
Leopold S, Quante A. [Effects of lithium, valproic acid, carbamazepine and antipsychotic agents on cognition in bipolar disorders-A systematic review]. DER NERVENARZT 2023; 94:417-424. [PMID: 36922444 PMCID: PMC10160133 DOI: 10.1007/s00115-023-01454-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Until now the long-term consequences of the medical treatment for bipolar disorder have barely been examined, especially the consequences with respect to cognitive impairment and dementia. Some studies show signs that some treatment options have a better effect on the brain than others. This review summarizes the current state of research. OBJECTIVE The effects of long-term consequences of lithium, valproic acid, carbamazepine and antipsychotic agents on the development of dementia or cognitive impairments in patients with bipolar disorder were investigated. METHODS A systematic literature search was carried out in the PubMed data base from May to July 2022. RESULTS The majority of studies showed that lithium has a neuroprotective effect and can lower the risk of developing dementia, whereas an increased risk was found in patients taking valproic acid. There are only very few studies that deal with antipsychotic medication and the long-term consequences concerning dementia. CONCLUSION Lithium should be recommended for the long-term treatment of bipolar disorder. Valproic acid should not or carefully be used as it can affect the risk of developing dementia. With respect to antipsychotics there is no recommendation as more studies are needed to evaluate the long-term consequences.
Collapse
Affiliation(s)
- Sophie Leopold
- Abteilung für Psychotherapie und Psychiatrie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland.
| | - Arnim Quante
- Abteilung für Psychotherapie und Psychiatrie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland. .,Abteilung für Psychotherapie und Psychiatrie, Friedrich von Bodelschwingh-Klinik, Landhausstraße 33-35, 10717, Berlin, Deutschland.
| |
Collapse
|
3
|
Protective effects of L-carnitine against valproic acid-induced memory impairment and anxiety-like behavior in adult rat. Physiol Behav 2022; 253:113853. [PMID: 35609723 DOI: 10.1016/j.physbeh.2022.113853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/08/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022]
Abstract
This study was designed to explore the effects of valproic acid (VPA) on spatial and passive avoidance learning and memory as well as to assess the protective effects of L-Carnitine (LC) against VPA-induced memory deficit in the rat. Male Wistar rats received VPA (300 mg/kg/daily by i.p. injection), or LC (50 mg/kg/ daily by i.p. injection), or co-treatment with VPA and LC for 28 days. Following 28 days, Elevated Plus-Maze (EPM), Morris Water Maze (MWM), and Passive Avoidance Learning (PAL) tasks were used to evaluate the anxiety-like behavior and spatial and passive learning and memory, respectively. Our results showed that VPA has no effect on memory acquisition (in both MWM and PAL) but induced reference memory impairment. We demonstrated that treatment with LC partially ameliorated the impairment in the retrieval of reference memory and passive avoidance learning. Moreover, VPA increased anxiety-like behavior, which was partially reversed by the administration of LC. In conclusion, these results show that LC is effective in counteracting the anxiety-like behavior and reference memory impairment caused by VPA. Therefore, LC may serve as a possible therapeutic agent for VPA-induced memory change.
Collapse
|
4
|
Díaz Ortiz AC, Vargas Upeguí C, Zapata Ospina JP, Aguirre Acevedo DC, Pineda Zapata JA, López Jaramillo CA. Correlation between cognitive performance and structural neuroanatomy in patients with type I bipolar affective disorder treated with and without lithium. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:133-145. [PMID: 35717384 DOI: 10.1016/j.rcpeng.2020.10.003] [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: 07/13/2020] [Accepted: 10/05/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD = .67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ = -0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.
Collapse
Affiliation(s)
- Andrés Camilo Díaz Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Cristian Vargas Upeguí
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Carlos Alberto López Jaramillo
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
5
|
Abbasalipour H, Hajizadeh Moghaddam A, Ranjbar M. Sumac and gallic acid-loaded nanophytosomes ameliorate hippocampal oxidative stress via regulation of Nrf2/Keap1 pathway in autistic rats. J Biochem Mol Toxicol 2022; 36:e23035. [PMID: 35307911 DOI: 10.1002/jbt.23035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 01/05/2022] [Accepted: 03/02/2022] [Indexed: 11/07/2022]
Abstract
Autism spectrum disorders cover a range of neurodevelopmental disorders characterized by impairments in social interaction and cognitive deficits. Phenolic compound applications have been restricted due to their poor solubility, bioavailability, and low stability. This paper aimed to explore the neuroprotective effects of sumac and gallic acid-loaded nanophytosomes (GNP) on oxidative stress-induced cognitive impairment and Nrf2/Keap1 gene expression in the autism model. Valproic acid (VPA) was administered intraperitoneally at doses of 500 mg/kg to female rats during gestational 12.5 days (E12.5). The prenatal VPA-exposed rats were divided into five groups, including VPA, VPA treated with sumac, gallic acid (GA), sumac-loaded nanophytosome (SNP), and GNP at doses of 20 mg/kg for 4 weeks (n = 6). A novel object test was conducted and antioxidant parameters and Nrf2/Keap1gene expression were evaluated in the hippocampus. According to the obtained results, the rat model of autism exhibited recognition memory impairment. We observed an increase in glutathione peroxidase (GPx), glutathione reductase (GRx), superoxide dismutase (SOD), catalase (CAT) enzyme activity, total antioxidant capacity (TAC), and glutathione (GSH) levels. Furthermore, sumac and GNP improved recognition memory deficits and increased GPx, GRx, SOD, and CAT activities, GSH and TAC levels, and Nrf2/Keap1gene expression in the hippocampal area. Our results also suggested that SNP and GNP ameliorate VPA-induced learning and memory deficits more efficiently than sumac extract and pure GA by reducing oxidative stress, enhancing antioxidant enzyme activity, and Keap1/Nrf2 gene expression. The present study demonstrated that the utilization of SNP and GNP significantly improved recognition memory deficits.
Collapse
Affiliation(s)
- Haniyeh Abbasalipour
- Department of Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | | | - Mojtaba Ranjbar
- Department of Microbial Biotechnology, Faculty of Biotechnology, Amol University of Special Modern Technologies, Amol, Iran
| |
Collapse
|
6
|
BIPOLAR DISORDER, MOOD STABILIZERS AND COGNITIVE FLEXIBILITY: TRANSLATIONALLY DISSECTING ILLNESS FROM DRUG EFFECTS. Behav Brain Res 2022; 424:113799. [PMID: 35181389 DOI: 10.1016/j.bbr.2022.113799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/21/2022] [Accepted: 02/12/2022] [Indexed: 11/21/2022]
Abstract
Bipolar disorder (BD) effects on cognition are confounded by the putative cognitive impact of its major pharmacological treatments, given the neurotrophic potential of mood stabilizers, particularly lithium. We examined the area of cognitive flexibility (CF), aiming to disentangle BD from medication effects, using translational methodology. CF was assessed by CANTAB-IED (intra- extra-dimensional shift; Study 1, euthymic BD participants) and its animal analogue (Study 2, rats). Both studies included groups (1) control, (2) lithium, chronic, current treatment (LI-CHRON-C, A: >2 years, N=32; B: 2 months, N=11); (3) valproate, chronic, current treatment (VPA-CHRON-C, A: >2 years, N=30; B: 2 months, N=12). Study 2 included 2 additional groups; Group 4: LI-CHRON-PAST (2 months, stopped 1 month pretest, N=13); Group 5: LI-ACUTE (LI on test days only, N=13). In Study 1, neither total nor stage (discrimination: D; reversal R; intra- extra-dimensional shifts: IED) IED errors differed between groups [(Kruskal-Wallis: H(2, N= 94) 0.95 > p > 0.65]. Similarly in Study 2, errors did not differentiate the 5 pharmacological groups. Differences emerged only between LI-ACUTE and Controls in response latencies (D, R, IED ANOVAS: 0.002 > p > 0.0003; contrasts D, R: p = 0.002, 0.0001). In conclusion, LI and VPA BD patients were indistinguishable from Controls in IED errors, as were animals treated with LI-CHRON, current or past, or VPA-CHRON-C vs Controls. LI-ACUTE treatment produced significant latency deficits vs. Controls. Within the limitations of translational comparisons, our results suggest that the normal CF noted in euthymic BDs is not attributable to mood stabilizer effects.
Collapse
|
7
|
Aranarochana A, Kaewngam S, Anosri T, Sirichoat A, Pannangrong W, Wigmore P, Welbat JU. Hesperidin Reduces Memory Impairment Associated with Adult Rat Hippocampal Neurogenesis Triggered by Valproic Acid. Nutrients 2021; 13:4364. [PMID: 34959916 PMCID: PMC8708262 DOI: 10.3390/nu13124364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/17/2022] Open
Abstract
Treatment with valproic acid (VPA) deteriorates hippocampal neurogenesis, which leads to memory impairment. Hesperidin (Hsd) is a plant-based bioflavonoid that can augment learning and memory. This study aimed to understand the effect of Hsd on the impairment of hippocampal neurogenesis and memory caused by VPA. The VPA (300 mg/kg) was administered by intraperitoneal injection twice daily for 14 days, and Hsd (100 mg/kg/day) was administered by oral gavage once a day for 21 days. All rats underwent memory evaluation using the novel object location (NOL) and novel object recognition (NOR) tests. Immunofluorescent staining of Ki-67, BrdU/NeuN, and doublecortin (DCX) was applied to determine hippocampal neurogenesis in cell proliferation, neuronal survival, and population of the immature neurons, respectively. VPA-treated rats showed memory impairments in both memory tests. These impairments resulted from VPA-induced decreases in the number of Ki-67-, BrdU/NeuN-, and DCX-positive cells in the hippocampus, leading to memory loss. Nevertheless, the behavioral expression in the co-administration group was improved. After receiving co-administration with VPA and Hsd, the numbers of Ki-67-, BrdU/NeuN-, and DCX-positive cells were improved to the normal levels. These findings suggest that Hsd can reduce the VPA-induced hippocampal neurogenesis down-regulation that results in memory impairments.
Collapse
Affiliation(s)
- Anusara Aranarochana
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
- Neuroscience Research Group, Department of Anatomy, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Soraya Kaewngam
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
- Neuroscience Research Group, Department of Anatomy, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Tanaporn Anosri
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
- Neuroscience Research Group, Department of Anatomy, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Apiwat Sirichoat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
- Neuroscience Research Group, Department of Anatomy, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wanassanun Pannangrong
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
| | - Peter Wigmore
- School of Life Sciences, Queen’s Medical Centre, Nottingham University, Nottingham NG7 2QL, UK;
| | - Jariya Umka Welbat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.A.); (S.K.); (T.A.); (A.S.); (W.P.)
- Neuroscience Research Group, Department of Anatomy, Khon Kaen University, Khon Kaen 40002, Thailand
| |
Collapse
|
8
|
Barnes-Scheufler CV, Passow C, Rösler L, Mayer JS, Oertel V, Kittel-Schneider S, Matura S, Reif A, Bittner RA. Transdiagnostic comparison of visual working memory capacity in bipolar disorder and schizophrenia. Int J Bipolar Disord 2021; 9:12. [PMID: 33797645 PMCID: PMC8018920 DOI: 10.1186/s40345-020-00217-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 12/22/2020] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Impaired working memory is a core cognitive deficit in both bipolar disorder and schizophrenia. Its study might yield crucial insights into the underpinnings of both disorders on the cognitive and neurophysiological level. Visual working memory capacity is a particularly promising construct for such translational studies. However, it has not yet been investigated across the full spectrum of both disorders. The aim of our study was to compare the degree of reductions of visual working memory capacity in patients with bipolar disorder (PBD) and patients with schizophrenia (PSZ) using a paradigm well established in cognitive neuroscience. METHODS 62 PBD, 64 PSZ, and 70 healthy controls (HC) completed a canonical visual change detection task. Participants had to encode the color of four circles and indicate after a short delay whether the color of one of the circles had changed or not. We estimated working memory capacity using Pashler's K. RESULTS Working memory capacity was significantly reduced in both PBD and PSZ compared to HC. We observed a small effect size (r = .202) for the difference between HC and PBD and a medium effect size (r = .370) for the difference between HC and PSZ. Working memory capacity in PSZ was also significantly reduced compared to PBD with a small effect size (r = .201). Thus, PBD showed an intermediate level of impairment. CONCLUSIONS These findings provide evidence for a gradient of reduced working memory capacity in bipolar disorder and schizophrenia, with PSZ showing the strongest degree of impairment. This underscores the importance of disturbed information processing for both bipolar disorder and schizophrenia. Our results are compatible with the cognitive manifestation of a neurodevelopmental gradient affecting bipolar disorder to a lesser degree than schizophrenia. They also highlight the relevance of visual working memory capacity for the development of both behavior- and brain-based transdiagnostic biomarkers.
Collapse
Affiliation(s)
- Catherine V Barnes-Scheufler
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Caroline Passow
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Lara Rösler
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany.,Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Viola Oertel
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany.,Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany
| | - Robert A Bittner
- Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany. .,Ernst Strüngmann Institute for Neuroscience (ESI) in Cooperation with Max Planck Society, Frankfurt am Main, Germany.
| |
Collapse
|
9
|
Díaz Ortiz AC, Upeguí CV, Ospina JPZ, Acevedo DCA, Pineda Zapata JA, Jaramillo CAL. Correlation Between Cognitive Performance and Structural Neuroanatomy in Patients with Type I Bipolar Affective Disorder Treated with and Without Lithium. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(20)30094-9. [PMID: 33735049 DOI: 10.1016/j.rcp.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/05/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Lithium treatment of bipolar disorder (BD) has been associated with less cognitive impairment and fewer changes in structural brain anatomy compared to other treatments. However, the studies are heterogeneous and few assess whether these effects are related. The objective of this study was to evaluate and relate cognitive performance and structural neuroanatomy in patients treated with and without lithium. METHODS Cross-sectional study that included 48 subjects with BD-I, of which 22 were treated with lithium and 26 without lithium. Performance was assessed on Wechsler III (WAIS III), TMT A and B (Trial Making Test) neuropsychological tests, California verbal learning test (CVLT), Rey complex figure test and Wisconsin card sorting test. Brain structures obtained by magnetic resonance imaging (MRI) were evaluated. The standardised mean difference (SMD) between both groups was calculated, adjusted for confounding variables using a propensity score, and the Spearman correlation coefficient (ρ) was used to assess the relationship between cognitive performance and neuroanatomical regions. RESULTS Compared to the group without lithium, the group with lithium had fewer perseverative errors in the Wisconsin test (SMD = -0.69) and greater left and right cortical areas (SMD = 0.85; SMD = 0.92); greater surface area in the left anterior cingulate (SMD = 1.32), right medial orbitofrontal cortex (SMD = 1.17), right superior frontal gyrus (SMD = 0.82), and right and left precentral gyrus (SMD = 1.33; SMD = 0.98); greater volume of the right amygdala (SMD = 0.57), right hippocampus (SMD = 0.66), right putamen (SMD = 0.87) and right thalamus (SMD=.67). In the lithium group, a correlation was found with these errors and the thickness of the left precentral gyrus (ρ = -0.78), the volume of the right thalamus (ρ =-0.44), and the right amygdala (ρ = 0.6). CONCLUSIONS The lithium group had better cognitive flexibility and greater dimension in some frontal and subcortical cortical regions. Furthermore, there was a moderate to high correlation between performance in this executive function and the thickness of the right precentral gyrus, and the volumes of the thalamus and the right amygdala. These findings could suggest a neuroprotective effect of lithium.
Collapse
Affiliation(s)
- Andrés Camilo Díaz Ortiz
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
| | - Cristian Vargas Upeguí
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Juan Pablo Zapata Ospina
- Instituto de Investigaciones Médicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | | | | | - Carlos Alberto López Jaramillo
- Grupo de Investigación en Psiquiatría (GIPSI), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| |
Collapse
|
10
|
Theory of mind deficits in bipolar disorder in remission. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.764012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Amiri S, Jafari-Sabet M, Keyhanfar F, Falak R, Shabani M, Rezayof A. Hippocampal and prefrontal cortical NMDA receptors mediate the interactive effects of olanzapine and lithium in memory retention in rats: the involvement of CAMKII-CREB signaling pathways. Psychopharmacology (Berl) 2020; 237:1383-1396. [PMID: 31984447 DOI: 10.1007/s00213-020-05465-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/16/2020] [Indexed: 12/20/2022]
Abstract
RATIONALE Treatment of bipolar disorder (BPD) with lithium and olanzapine concurrent administration is a major medicine issue with the elusive neurobiological mechanisms underlying the cognitive function. OBJECTIVE To clarify the precise mechanisms involved, the possible role of the hippocampus (HPC) and prefrontal cortical (PFC) NMDA receptors and CAMKII-CREB signaling pathway in the interactive effects of lithium and olanzapine in memory consolidation was evaluated. The dorsal hippocampal CA1 regions of adult male Wistar rats were bilaterally cannulated and a step-through inhibitory avoidance apparatus was used to assess memory consolidation. The changes in p-CAMKII/CAMKII and p-CREB/CREB ratio in the HPC and the PFC were measured by Western blot analysis. RESULTS Post-training administration of lithium (20, 30, and 40 mg/kg, i.p.) dose-dependently decreased memory consolidation whereas post-training administration olanzapine (2 and 5 mg/kg, i.p.) increased memory consolidation. Post-training administration of certain doses of olanzapine (1, 2, and 5 mg/kg, i.p.) dose-dependently improved lithium-induced memory impairment. Post-training administration of ineffective doses of the NMDA (10-5 and 10-4 μg/rat, intra-CA1) plus an ineffective dose of olanzapine (1 mg/kg, i.p.) dose-dependently improved the lithium-induced memory impairment. Post-training microinjection of ineffective doses of the NMDA (10-5 and 10-4 μg/rat, intra-CA1) dose-dependently potentiated the memory improvement induced by olanzapine (1 mg/kg, i.p.) on lithium-induced memory impairment which was associated with the enhancement of the levels of p-CAMKII and p-CREB in the HPC and the PFC. Post-training microinjection of ineffective doses of the noncompetitive NMDA receptor antagonist, MK-801 (0.0625 and 0.0125 μg/rat, intra-CA1), dose-dependently decreased the memory improvement induced by olanzapine (5 mg/kg, i.p.) on lithium-induced memory impairment which was related to the reduced levels of HPC and PFC CAMKII-CREB. CONCLUSION The results strongly revealed that there is a functional interaction among lithium and olanzapine through the HPC and the PFC NMDA receptor mechanism in memory consolidation which is mediated with the CAMKII-CREB signaling pathway.
Collapse
Affiliation(s)
- Shiva Amiri
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Jafari-Sabet
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Razi Drug Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Fariborz Keyhanfar
- Department of Pharmacology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Immunology Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Shabani
- Kerman Neuroscience Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran
| | - Ameneh Rezayof
- Department of Animal Biology, School of Biology and Center of Excellence in Phylogeny of Living Organisms, College of Science, University of Tehran, Tehran, Iran
| |
Collapse
|
12
|
Daglas R, Cotton S, Allott K, Yücel M, Macneil C, Hasty M, Murphy B, Pantelis C, Hallam K, Henry L, Conus P, Ratheesh A, Kader L, Wong M, McGorry P, Berk M. A single-blind, randomised controlled trial on the effects of lithium and quetiapine monotherapy on the trajectory of cognitive functioning in first episode mania: A 12-month follow-up study. Eur Psychiatry 2020; 31:20-8. [DOI: 10.1016/j.eurpsy.2015.09.460] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/25/2015] [Accepted: 09/27/2015] [Indexed: 11/30/2022] Open
Abstract
AbstractBackgroundCognitive deficits have been reported during the early stages of bipolar disorder; however, the role of medication on such deficits remains unclear. The aim of this study was to compare the effects of lithium and quetiapine monotherapy on cognitive performance in people following first episode mania.MethodsThe design was a single-blind, randomised controlled trial on a cohort of 61 participants following first episode mania. Participants received either lithium or quetiapine monotherapy as maintenance treatment over a 12-month follow-up period. The groups were compared on performance outcomes using an extensive cognitive assessment battery conducted at baseline, month 3 and month 12 follow-up time-points.ResultsThere was a significant interaction between group and time in phonemic fluency at the 3-month and 12-month endpoints, reflecting greater improvements in performance in lithium-treated participants relative to quetiapine-treated participants. After controlling for multiple comparisons, there were no other significant interactions between group and time for other measures of cognition.ConclusionAlthough the effects of lithium and quetiapine treatment were similar for most cognitive domains, the findings imply that early initiation of lithium treatment may benefit the trajectory of cognition, specifically verbal fluency in young people with bipolar disorder. Given that cognition is a major symptomatic domain of bipolar disorder and has substantive effects on general functioning, the ability to influence the trajectory of cognitive change is of considerable clinical importance.
Collapse
|
13
|
Pigoni A, Mandolini GM, Delvecchio G, Bressi C, Soares JC, Brambilla P. A focus on valproate and cognitive deficits in Bipolar Disorders: A mini-review: Special Section on "Translational and Neuroscience Studies in Affective Disorders" Section Editor, Maria Nobile MD, PhD. J Affect Disord 2020; 261:277-281. [PMID: 31421858 DOI: 10.1016/j.jad.2019.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/01/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Cognitive deficits represent a core feature of Bipolar Disorder (BD), which seem to characterize this disorder regardless of the mood phase. However, the role of pharmacological treatment in determining cognitive alterations is still not clear. Indeed, although drugs improve cognition by targeting mood symptoms, they could also carry their own cognitive side effects. This is true especially for mood stabilizers as they are the most commonly prescribed drugs in patients affected by BD and they are usually administered also during euthymic phases. METHODS In this context, the present review aimed at summarizing the results of the studies evaluating the impact of valproate on cognitive functions in patients suffering from BD, as primary or secondary results. The inclusion criteria were met by ten studies. Specifically, we included one double-blind quasi-randomized study and nine cross-sectional or naturalistic studies, which a) used healthy subjects as control group (N = 1), b) compared valproate treated patients with healthy individuals and other treatments (N = 5), and c) compared valproate treated patients just with other treatments, with a specific focus on lithium (N = 3). RESULTS Overall the results suggested a negative effect of valproate on cognitive functions in chronically-treated patients affected by BD. Notably, it has been found that the working memory was the most affected cognitive domain. LIMITATIONS Few studies directly explored the effect of valproate on cognition in BD. CONCLUSIONS These findings seem to suggest that valproate might have a negative effect on cognitive functions, especially on working memory domain. However, the results should be taken cautiously since the limited number of available studies published so far. In conclusion, these evidences seem to point out that the possible cognitive side effects of pharmacological treatments should be carefully taken into account, especially in chronic patients.
Collapse
Affiliation(s)
- A Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G M Mandolini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - G Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - C Bressi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - J C Soares
- Department of Psychiatry and Behavioural Sciences, UT Houston Medical School, Houston, TX, USA
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| |
Collapse
|
14
|
Abstract
Bipolar disorder is an illness characterised by periods of elated and depressed mood. These mood episodes are associated with changes in cognitive function and there is evidence to suggest that cognitive dysfunction persists during euthymia. The extent to which this is a function of the illness or a result of treatment is less clear. In this narrative review, we explore the impact of commonly used medications for bipolar disorder on cognitive function. Specific impairments in executive function and verbal memory have been noted in bipolar disorder. The impact of pharmacological treatments upon cognitive function is mixed with a number of studies reporting conflicting results. Interpretation of the data is further complicated by the variety of cognitive tests employed, study design, the relatively small numbers of patients included and confounding by indication. Overall, there is some evidence that while lithium improves some cognitive domains, it impedes others. Antipsychotics may be deleterious to cognition, although this may relate to the patient population in which they are prescribed. Sodium valproate is also associated with worse cognitive outcomes, while the impact of other antiepileptics is unclear. Overall the quality of evidence is poor and is derived from a relatively small number of studies that often do not account for the significant heterogeneity of the disorder or common comorbidities. The use of consistent methodologies and measures of cognition across studies, as well as in naturalistic settings, would enable more certain conclusions to be drawn.
Collapse
|
15
|
Neurocognitive impairment and evidence-based treatment options in Bipolar disorder. Ann Gen Psychiatry 2020; 19:54. [PMID: 32983247 PMCID: PMC7513501 DOI: 10.1186/s12991-020-00304-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 09/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The current paper briefly summarizes the literature on the neurocognitive deficit and its treatment in BD patients. METHODS The material was chosen on the basis of previous systematic reviews the author has taken part in. RESULTS The data so far suggest that the deficit is qualitatively similar but quantitatively milder in comparison to schizophrenia, it is present already since the first episode, is weakly related to mood symptoms and somewhat stronger to psychotic symptoms, it probably determines much of the disability and treatment is problematic. This deficit is also present during periods of euthymia. The possible adverse effect of psychotropic medication is rather small if any at all and is confounded by the specific clinical symptoms, for which medication is used for their treatment. This is especially true concerning antipsychotics and psychotic symptoms. The origin and the etiopathogenesis of the core neurocognitive impairment remain elusive. The presence of a neurodegenerative and of a neurodevelopmental component has both data in favor and against and they are both the focus of debate. CONCLUSIONS Treatment of the neurocognitive deficit and restoration of functioning is problematic. The data are limited and treatment options are few and with a weak overall effect. Pharmacological treatments, ECT and rTMS present some hard data, while the literature is inconclusive concerning psychotherapeutic interventions.
Collapse
|
16
|
Pannangrong W, Sirichoat A, Wongsiri T, Wigmore P, Welbat JU. Valproic acid withdrawal ameliorates impairments of hippocampal-spatial working memory and neurogenesis. J Zhejiang Univ Sci B 2019; 20:253-263. [PMID: 30829012 DOI: 10.1631/jzus.b1800340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Valproic acid (VPA), an agent that is used to treat epileptic seizures, can cause spatial memory impairment in adults and children. This effect is thought to be due to the ability of VPA to inhibit neurogenesis in the hippocampus, which is required for learning. We have previously used an animal model to show that VPA significantly impairs hippocampal-spatial working memory and inhibits neuronal generation in the sub-granular zone of the dentate gyrus. As there are patient reports of improvements in memory after discontinuing VPA treatment, the present study investigated the recovery of both spatial memory and hippocampal neurogenesis at two time points after withdrawal of VPA. Male Wistar rats were given intraperitoneal injections of 0.9% normal saline or VPA (300 mg/kg) twice a day for 10 d. At 1, 30, or 45 d after the drug treatment, the novel object location (NOL) test was used to examine spatial memory; hippocampal cell division was counted using Ki67 immunohistochemistry, and levels of brain-derived neurotrophic factor (BDNF) and Notch1 were measured using western immunoblotting. Spatial working memory was impaired 1 and 30 d after the final administration, but was restored to control levels by 45 d. Cell proliferation had increased to control levels at 30 and 45 d. Both markers of neurogenesis (BDNF and Notch1 levels) had returned to control levels at 45 d. These results demonstrate that memory recovery occurs over a period of six weeks after discontinuing VPA treatment and is preceded by a return of hippocampal neurogenesis to control levels.
Collapse
Affiliation(s)
- Wanassanun Pannangrong
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Apiwat Sirichoat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Trai Wongsiri
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Peter Wigmore
- School of Life Sciences, Medical School, Queen's Medical Centre, Nottingham University, Nottingham NG7 2UH, UK
| | - Jariya Umka Welbat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.,Neuroscience Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
| |
Collapse
|
17
|
Protective effects of melatonin against valproic acid-induced memory impairments and reductions in adult rat hippocampal neurogenesis. Neuroscience 2019; 406:580-593. [DOI: 10.1016/j.neuroscience.2019.02.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 01/12/2023]
|
18
|
Fateh AA, Long Z, Duan X, Cui Q, Pang Y, Farooq MU, Nan X, Chen Y, Sheng W, Tang Q, Chen H. Hippocampal functional connectivity-based discrimination between bipolar and major depressive disorders. Psychiatry Res Neuroimaging 2019; 284:53-60. [PMID: 30684896 DOI: 10.1016/j.pscychresns.2019.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 01/11/2019] [Accepted: 01/11/2019] [Indexed: 01/14/2023]
Abstract
Despite the impressive advancements in the neuropathology of mood disorders, patients with bipolar disorder (BD) are often misdiagnosed on the initial presentation with major depressive disorder (MDD). With supporting evidence from neuroimaging studies, the abnormal functional connectivity (FC) of the hippocampus has been associated with various mood disorders, including BD and MDD. However, the features of the hippocampal FC underlying MDD and BD have not been directly compared. This study aims to investigate the hippocampal resting-state FC (rsFC) analyses to distinguish these two clinical conditions. Resting-state functional magnetic resonance imaging (fMRI) data was collected from a sample group of 30 patients with BD, 29 patients with MDD and 30 healthy controls (HCs). One-way ANOVA was employed to assess the potential differences of the hippocampus FC across all subjects. BD patients exhibited increased FC of the bilateral anterior/posterior hippocampus with lingual gyrus and inferior frontal gyrus (IFG) relative to patients MDD patients. In comparison with HCs, patients with BD and MDD had an increased FC between the right anterior hippocampus and lingual gyrus and a decreased FC between the right posterior hippocampus and right IFG. The results revealed a distinct hippocampal FC in MDD patients compared with that observed in BD patients. These findings may assist investigators in attempting to distinguish mood disorders by using fMRI data.
Collapse
Affiliation(s)
- Ahmed Ameen Fateh
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhiliang Long
- Sleep and Neuroimaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Muhammad Umar Farooq
- Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, China
| | - Xiaoyu Nan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China; School of Political Science and Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuro-Information, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China.
| |
Collapse
|
19
|
Coppola F, Courtet P, Olié E. [Neuropsychological Profile and Working Memory in Bipolar Disorder]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63:314-321. [PMID: 29186974 PMCID: PMC5912298 DOI: 10.1177/0706743717744777] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
According to the World Health Organization (WHO), the bipolar disorder is one of the ten costliest and most incapacitating diseases in the world. Management of this pathology usually involves a psychiatric follow-up at a pace adapted to the thymic state, and the initiating of a mood-stabilizing treatment. However, what will become of patients with bipolar disorder remains unsatisfying. Psychosocial impacts, increased by often present physical and psychological comorbidities are important (Bonnin et al., 2010) and can be incapacitating: socioprofessional deintegration, social withdrawal, family-related repercussions, low socioeconomic status, lesser quality of life. A functional impairment is found in acute decompensation phases, but also in intercritical periods where different factors might be involved: thymic or cognitive residual symptomatology, as episode consequences, presence of comorbidities…Actually, in this stage of the disease, 30% of bipolar patients present cognitive impairments, that neuropsychological testing can objectify (Gualtieri and Morgan, 2008). Almost 2 thirds present subjective cognitive complaints (Martinez-Aran et al., 2005) that are negatively correlated with quality of life. Among these impairments, harm to working memory is reported in several studies (Bora et al., 2009; Robinson et al., 2006), and seems to play a leading role in functional impairment. Managing cognitive impairments seems an important issue to improve patient functioning, quality of life and disorder stability. However, cognitive remediation techniques, largely developed for patients with schizophrenia, remain limited in bipolar disorder, in spite of the great impact of cognitive impairments in this disorder. This objective of this article was an update on bipolar patient neuropsychological profile in an intercritical period, while putting forward working memory critical role in functional impairment. We will also discuss current therapeutic advances allowing to manage these impairments and improve patient functioning.
Collapse
Affiliation(s)
- Frédéric Coppola
- 1 Département Urgences et Post-Urgences Psychiatriques, Montpellier, France
| | - Philippe Courtet
- 1 Département Urgences et Post-Urgences Psychiatriques, Montpellier, France.,2 INSERM U1061, Université-Montpellier, Montpellier, France
| | - Emilie Olié
- 1 Département Urgences et Post-Urgences Psychiatriques, Montpellier, France.,2 INSERM U1061, Université-Montpellier, Montpellier, France
| |
Collapse
|
20
|
Nguyen T, Fan T, George SR, Perreault ML. Disparate Effects of Lithium and a GSK-3 Inhibitor on Neuronal Oscillatory Activity in Prefrontal Cortex and Hippocampus. Front Aging Neurosci 2018; 9:434. [PMID: 29375364 PMCID: PMC5770585 DOI: 10.3389/fnagi.2017.00434] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 12/15/2017] [Indexed: 12/11/2022] Open
Abstract
Glycogen synthase kinase-3 (GSK-3) plays a critical role in cognitive dysfunction associated with Alzheimer’s disease (AD), yet the mechanism by which GSK-3 alters cognitive processes in other disorders, such as schizophrenia, remains unknown. In the present study, we demonstrated a role for GSK-3 in the direct regulation of neuronal oscillations in hippocampus (HIP) and prelimbic cortex (PL). A comparison of the GSK-3 inhibitors SB 216763 and lithium demonstrated disparate effects of the drugs on spatial memory and neural oscillatory activity in HIP and PL. SB 216763 administration improved spatial memory whereas lithium treatment had no effect. Analysis of neuronal local field potentials in anesthetized animals revealed that whereas both repeated SB 216763 (2.5 mg/kg) and lithium (100 mg/kg) induced a theta frequency spike in HIP at approximately 10 Hz, only SB 216763 treatment induced an overall increase in theta power (4–12 Hz) compared to vehicle. Acute administration of either drug suppressed slow (32–59 Hz) and fast (61–100 Hz) gamma power. In PL, both drugs induced an increase in theta power. Repeated SB 216763 increased HIP–PL coherence across all frequencies except delta, whereas lithium selectively suppressed delta coherence. These findings demonstrate that GSK-3 plays a direct role in the regulation of theta oscillations in regions critically involved in cognition, and highlight a potential mechanism by which GSK-3 may contribute to cognitive decline in disorders of cognitive dysfunction.
Collapse
Affiliation(s)
- Tuan Nguyen
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Theresa Fan
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Susan R George
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Melissa L Perreault
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
21
|
Şentürk Cankorur V, Demirel H, Atbaşoğlu C. Cognitive Functioning in Euthymic Bipolar Patients on Monotherapy with Novel Antipsychotics or Mood Stabilizers. ACTA ACUST UNITED AC 2017; 54:244-250. [PMID: 29033637 DOI: 10.5152/npa.2017.15883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/11/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Bipolar disorder is associated with cognitive dysfunction in several domains. Medication effect is a potential confounder that can only be statistically controlled in many studies. The cognitive profile in bipolar disorder during remission on maintenance antipsychotics or mood stabilizers medication has not been compared before. METHODS We compared the cognitive profile of bipolar disorder patients euthymic for 2 month or more on monotherapy with novel antipsychotics (AP) (n=16), lithium carbonate (Li) (n=25) or valproic acid (VPA; n=26). Forty-two individuals were assessed as controls. The cognitive battery included Wechsler Adult Intelligence Scale-Revised (WAIS-R) subtests, the Wechsler Memory Scale (WMS), and Wisconsin Card Sorting Test (WCST). RESULTS All three patient groups compared to controls performed poorly on the working memory and verbal memory tasks (F=3.59, df=3, p=0.02 for WAIS-R Arithmetic and F=123.64, df=3, p<0.01 for WMS Logical Memory). The differences remained significant after controlling for age. Across patients, the only significant difference was between the Li and AP groups in terms of working memory. The Li group performed better (F=3.59, df=2, p=0.02) and the difference survived correction for age and clinical features. CONCLUSIONS The findings of this study suggest that working memory impairment in bipolar patients on monotherapy with atypical AP, whereas verbal memory impairment might be related to bipolar disorder itself. Working memory might be a state marker, whereas verbal memory could be a trait marker of bipolar disorder. Atypical AP might have an adverse effect on cognition in bipolar disorder. These findings cannot be generalized to all bipolar patients, particularly the poor responders to monotherapy.
Collapse
Affiliation(s)
| | | | - Cem Atbaşoğlu
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| |
Collapse
|
22
|
Tournikioti K, Ferentinos P, Michopoulos I, Alevizaki M, Soldatos CR, Dikeos D, Douzenis A. Clinical and treatment-related predictors of cognition in bipolar disorder: focus on visual paired associative learning. Eur Arch Psychiatry Clin Neurosci 2017; 267:661-669. [PMID: 27783216 DOI: 10.1007/s00406-016-0743-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Abstract
Bipolar disorder (BD) is associated with impairment in cognitive domains such as verbal memory and executive functions. However, visual paired associative learning (PAL) has been far less researched. Neurocognitive dysfunction in BD patients has been related to several clinical factors, but data on the effect of medication are relatively scarce and inconsistent. The aim of our study was to explore the effect of clinical and treatment-related parameters on executive functions and visual memory/learning, including PAL, in BD. Cognitive performance of 60 bipolar I patients and 30 healthy subjects was evaluated by using CANTAB battery tasks targeting spatial recognition memory, PAL and executive functions (set shifting, planning, inhibitory control). Bipolar patients showed poorer performance in PAL, set shifting, planning and inhibitory control than healthy subjects; however, only differences in PAL and planning survived correction for multiple comparisons. Number of previous manic episodes and illness duration predicted worse performance in set shifting and PAL, respectively, whereas current treatment with valproate predicted better performance in PAL. This is one of the first studies to assess clinical and treatment-related predictors of PAL in BD. We report a possibly beneficial effect of valproate on PAL, which warrants further investigation.
Collapse
Affiliation(s)
- Kalliopi Tournikioti
- 2nd Department of Psychiatry, Attikon General Hospital, University of Athens, Medical School, Rimini 1, 12462, Athens, Greece.
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Attikon General Hospital, University of Athens, Medical School, Rimini 1, 12462, Athens, Greece
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, Attikon General Hospital, University of Athens, Medical School, Rimini 1, 12462, Athens, Greece
| | - Maria Alevizaki
- Endocrine Unit, Department of Medical Therapeutics, Alexandra Hospital, University of Athens, Medical School, Athens, Greece
| | - Constantin R Soldatos
- Mental Health Care Unit, Evgenidion Hospital, University of Athens, Medical School, Athens, Greece
| | - Dimitris Dikeos
- 1st Department of Psychiatry, Eginition Hospital, University of Athens, Medical School, Athens, Greece
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, Attikon General Hospital, University of Athens, Medical School, Rimini 1, 12462, Athens, Greece
| |
Collapse
|
23
|
Al-Amoudi WM. Protective effects of fennel oil extract against sodium valproate-induced hepatorenal damage in albino rats. Saudi J Biol Sci 2017; 24:915-924. [PMID: 28490965 PMCID: PMC5415150 DOI: 10.1016/j.sjbs.2016.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/16/2016] [Accepted: 10/23/2016] [Indexed: 12/22/2022] Open
Abstract
Foeniculum vulgare (Apiaceae) is commonly known as fennel. This herb is well-known worldwide and traditionally used as curative herbal therapy for the treatment of epileptic disease, seizurescarminative, digestive, lactogogue, diuretic, treating respiratory and gastrointestinal disorders. The aim of present study is to investigate the possible effect of fennel oil against the toxicity of Sodium-Valproic (SVP) in albino rats. In order to assess the protection of fennel oil on SVP induced hepato- and nephro-toxicity, male albino rats were treated with 1 ml/kg b.w fennel oil 3 days/week for 6 weeks. The biochemical analyses of hepatic enzymes were evaluated by estimating blood biomarkers of liver and renal damage along with histological examination. The results obtained from this work showed that treating animals with SVP lead to many histopathological alterations in the liver and kidney tissues. The effect appeared in the liver tissue include leukocyte infiltrations, cytoplasmic vacuolization of the hepatocytes, fatty degeneration and congestion of blood vessels. This commonly used chemical (SVP) caused some unwanted effects on the kidney cortex which histologically observed as degeneration in renal tubules, atrophy of the glomeruli and edema. Biochemical results also revealed an abnormal increase in the enzyme level of AST, SAT, ALP, bilirubin, creatinine and urea-nitrogen, with a noticed decrease in total protein content. However, the results of treated rats with SVP plus fennel oil showed some positive histopathological changes in both the liver and kidney tissues. These results have confirmed that fennel oil has positive effects on the histological structure of the liver and kidney and the biochemical levels of AST, ALT, ALP, bilirubin, total proteins, creatinine and urea. It is concluded that fennel oil has various pharmacological properties including antioxidant, anti-cancer activity, anti-inflammatory. These valuable effects might be due to the presence of aromatic compounds trans-anethole. This useful properties of fennel plant could be due to its antioxidant activity that prevents the toxicity of SVP.
Collapse
|
24
|
Abstract
Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, working memory, intellectual functioning, verbal memory, visual memory, and executive functioning by reviewing the published empirical literature. Any impact of hypothyroidism and lithium toxicity was also examined. The literature supports the conclusion that lithium has a distinct impact on psychomotor speed in participants with bipolar disorder. In contrast, there appears to be no impact on attention. Any impact of lithium on memory in patients with bipolar disorder is unclear as the literature is contradictory and any such effect may be overshadowed by the greater impact of residual mood symptoms. The impact on processing speed, intellectual abilities, and executive functioning also remains unclear. Several clinical management strategies are recommended.
Collapse
|
25
|
Fountoulakis KN, Yatham L, Grunze H, Vieta E, Young A, Blier P, Kasper S, Moeller HJ. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm. Int J Neuropsychopharmacol 2017; 20:121-179. [PMID: 27816941 PMCID: PMC5409012 DOI: 10.1093/ijnp/pyw100] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/29/2016] [Accepted: 11/03/2016] [Indexed: 02/05/2023] Open
Abstract
Background The current paper includes a systematic search of the literature, a detailed presentation of the results, and a grading of treatment options in terms of efficacy and tolerability/safety. Material and Methods The PRISMA method was used in the literature search with the combination of the words 'bipolar,' 'manic,' 'mania,' 'manic depression,' and 'manic depressive' with 'randomized,' and 'algorithms' with 'mania,' 'manic,' 'bipolar,' 'manic-depressive,' or 'manic depression.' Relevant web pages and review articles were also reviewed. Results The current report is based on the analysis of 57 guideline papers and 531 published papers related to RCTs, reviews, posthoc, or meta-analysis papers to March 25, 2016. The specific treatment options for acute mania, mixed episodes, acute bipolar depression, maintenance phase, psychotic and mixed features, anxiety, and rapid cycling were evaluated with regards to efficacy. Existing treatment guidelines were also reviewed. Finally, Tables reflecting efficacy and recommendation levels were created that led to the development of a precise algorithm that still has to prove its feasibility in everyday clinical practice. Conclusions A systematic literature search was conducted on the pharmacological treatment of bipolar disorder to identify all relevant random controlled trials pertaining to all aspects of bipolar disorder and graded the data according to a predetermined method to develop a precise treatment algorithm for management of various phases of bipolar disorder. It is important to note that the some of the recommendations in the treatment algorithm were based on the secondary outcome data from posthoc analyses.
Collapse
Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Lakshmi Yatham
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Heinz Grunze
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Eduard Vieta
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Allan Young
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Pierre Blier
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Siegfried Kasper
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| | - Hans Jurgen Moeller
- 3rd Department of Psychiatry, School of Medicine, Aristotle University, Thessaloniki, Greece; Department of Psychiatry, University of British Columbia, Mood Disorders Centre of Excellence, Djavad Mowafaghian Centre for Brain Health, Canada; Paracelsus Medical University, Salzburg, Austria; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, United Kingdom; The Royal Institute of Mental Health Research, Department of Psychiatry, University of Ottawa, Ottawa, Canada; Department of Psychiatry and Psychotherapy, Medical University Vienna, MUV, AKH, Vienna, Austria; Psychiatric Department Ludwig Maximilians University, Munich, Germany
| |
Collapse
|
26
|
Atagun MI, Balaban OD, Lordoglu DY, Evren EC. Lithium and Valproate May Affect Motor and Sensory Speed in Patients with Bipolar Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20130304010158] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Murat Ilhan Atagun
- Yildirim Beyazit University, Faculty of Medicine, Department of Psychiatry, Ankara - Turkey
| | - Ozlem Devrim Balaban
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul - Turkey
| | - Dilek Yesilbas Lordoglu
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul - Turkey
| | - Ekrem Cuneyt Evren
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Alcohol and Drug Research, Treatment and Training Center (AMATEM), Istanbul - Turkey
| |
Collapse
|
27
|
Mora E, Portella MJ, Forcada I, Vieta E, Mur M. A preliminary longitudinal study on the cognitive and functional outcome of bipolar excellent lithium responders. Compr Psychiatry 2016; 71:25-32. [PMID: 27592139 DOI: 10.1016/j.comppsych.2016.07.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 07/14/2016] [Accepted: 07/20/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Neurocognitive dysfunction in bipolar disorder represents a possible marker of underlying pathophysiology, but to date, most studies are cross-sectional and heterogeneous with regard to pharmacological treatments. In the present study we investigated the 6-year cognitive and functional outcome of a sample of euthymic excellent lithium responders (ELR). METHOD A total sample of twenty subjects was assessed at baseline and 6years later: ten diagnosed of bipolar disorder according to DSM-IV criteria and ten healthy matched controls. The sample size was enough to find statistical differences between groups, with a statistical power of 0.8. Bipolar patients were on lithium treatment during all this follow-up period and fulfilled ELR criteria as measured by the Alda scale. A neuropsychological test battery tapping into the main cognitive domains was used at baseline and at after 6-year of follow-up. Functional outcome was evaluated by means of the Functioning Assessment Short Test at study endpoint. RESULTS Repeated measures multivariate analyses of variance showed that bipolar patients were cognitively impaired in the executive functioning, inhibition, processing speed and verbal memory domains (p<0.03) compared to controls and such deficits were stable over time. Longer duration of illness and lower psychosocial outcome were significantly related to cognitive impairment (p<0.05). CONCLUSIONS Cognitive dysfunction was present even in euthymic ELR. These deficits remain stable over the long term, and are basically associated with greater symptoms and poorer psychosocial adjustment.
Collapse
Affiliation(s)
- E Mora
- Psychiatric Service, Hospital Universitari de Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Catalonia, Spain; Child and Adolescent Mental Health Centre, Sant Joan de Déu Lleida, Lleida, Catalonia, Spain
| | - M J Portella
- Psychiatric Service, Research Institute, Hospital de Santa Creu i Sant Pau, Autonomous University of Barcelona, CIBERSAM, Barcelona, Catalonia, Spain
| | - I Forcada
- Psychiatric Service, Hospital Universitari de Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Catalonia, Spain
| | - E Vieta
- Bipolar Disorder Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - M Mur
- Psychiatric Service, Hospital Universitari de Santa Maria, University of Lleida, IRBLleida (Biomedicine Research Institute), Lleida, Catalonia, Spain.
| |
Collapse
|
28
|
Welbat JU, Sangrich P, Sirichoat A, Chaisawang P, Chaijaroonkhanarak W, Prachaney P, Pannangrong W, Wigmore P. Fluoxetine prevents the memory deficits and reduction in hippocampal cell proliferation caused by valproic acid. J Chem Neuroanat 2016; 78:112-118. [PMID: 27619060 DOI: 10.1016/j.jchemneu.2016.09.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 11/24/2022]
Abstract
Valproic acid (VPA), a commonly used antiepileptic drug, has been reported to cause cognitive impairments in patients. In a previous study, using a rodent model, we showed that VPA treatment impaired cognition which was associated with a reduction in the cell proliferation required for hippocampal neurogenesis. The antidepressant fluoxetine has been shown to increase hippocampal neurogenesis and to reverse the memory deficits found in a number of pathological conditions. In the present study we investigated the protective effects of fluoxetine treatment against the impairments in memory and hippocampal cell proliferation produced by VPA. Male Sprague Dawley rats received daily treatment with fluoxetine (10mg/kg) by oral gavage for 21days. Some rats were co-administered with VPA (300mg/kg, twice daily i.p. injections) for 14days from day 8 to day 21 of the fluoxetine treatment. Spatial memory was tested using the novel object location (NOL) test. The number of proliferating cells present in the sub granular zone of the dentate gyrus was quantified using Ki67 immunohistochemistry at the end of the experiment. Levels of the receptor Notch1, the neurotrophic factor BDNF and the neural differentiation marker DCX were determined by Western blotting. VPA-treated rats showed memory deficits, a decrease in the number of proliferating cells in the sub granular zone and decreases in the levels of Notch1 and BDNF but not DCX compared to control animals. These changes in behavior, cell proliferation and Notch1 and BDNF were prevented in animals which had received both VPA and fluoxetine. Rats receiving fluoxetine alone did not show a significant difference in the number of proliferating cells or behavior compared to controls. These results demonstrated that the spatial memory deficits and reduction of cell proliferation produced by VPA can be ameliorated by the simultaneous administration of the antidepressant fluoxetine.
Collapse
Affiliation(s)
- Jariya Umka Welbat
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Neuroscience Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand; Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Preeyanuch Sangrich
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Apiwat Sirichoat
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pornthip Chaisawang
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | | | - Parichat Prachaney
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Wanassanun Pannangrong
- Department of Anatomy, Faculty of medicine, Khon Kaen University, Khon Kaen 40002, Thailand; Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Peter Wigmore
- School of Life Sciences, Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
| |
Collapse
|
29
|
Tsai PS, Liu IC, Chiu CH, Huang CJ, Wang MY. Effect of valproic acid on dementia onset in patients with bipolar disorder. J Affect Disord 2016; 201:131-6. [PMID: 27208500 DOI: 10.1016/j.jad.2016.05.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/29/2016] [Accepted: 05/09/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND Valproic acid (VPA) is widely used for treating patients with bipolar disorder; however, it has adverse effects on cognitive function. This study investigated the effect of VPA on the risk of dementia in patients with bipolar disorder. METHODS We analyzed data from Taiwan's Longitudinal Health Insurance Database 2010. Patients with bipolar disorder who were prescribed VPA for 28 days or at least once per month for 3 consecutive months after the index date were classified as the VPA-treated group, whereas those who did not receive VPA were classified as the VPA-untreated group. Both groups were tracked until the end of 2013 or until loss to follow-up to identify new-onset dementia events. Multivariable Cox proportional hazards models were used to estimate the hazard ratio (HR) of subsequent dementia associated with VPA treatment after adjustment for confounding variables. RESULTS The study comprised 5158 patients with bipolar disorder. The multivariable-adjusted HR for newly diagnosed dementia was 1.73 (95% confidence interval [CI], 1.24-2.41, P=0.001) for the VPA-treated group compared with the VPA-untreated group after adjustment for potential confounders. The VPA-treated group had a higher risk than did the VPA-untreated group after propensity score adjustment (HR=1.95, 95% CI=1.42-2.67, P<0.001). LIMITATION Certain variables that may affect the incidence of dementia were unavailable in the claims database and thus could not be considered. CONCLUSION Treating bipolar disorder with VPA increases the risk of dementia by 73-95%.
Collapse
Affiliation(s)
- Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - I-Chao Liu
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Huan Chiu
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of General Psychiatry, Taipei City Psychiatric Center, Taipei, Taiwan
| | - Chun-Jen Huang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, 289, Jian Gou Road, Sindian District, New Taipei City 23142, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Mei-Yeh Wang
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, 112, Minzu Road, Sindian District, New Taipei City 23143, Taiwan.
| |
Collapse
|
30
|
Zhang Q, Yang F, Hu Z, Zhang Z, Xu Q, Dante M, Wu H, Li Z, Li Q, Li K, Lu G. Resting-state fMRI revealed different brain activities responding to valproic acid and levetiracetam in benign epilepsy with central-temporal spikes. Eur Radiol 2016; 27:2137-2145. [DOI: 10.1007/s00330-016-4531-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/12/2016] [Accepted: 07/21/2016] [Indexed: 02/04/2023]
|
31
|
Umka Welbat J, Sirichoat A, Chaijaroonkhanarak W, Prachaney P, Pannangrong W, Pakdeechote P, Sripanidkulchai B, Wigmore P. Asiatic Acid Prevents the Deleterious Effects of Valproic Acid on Cognition and Hippocampal Cell Proliferation and Survival. Nutrients 2016; 8:nu8050303. [PMID: 27213437 PMCID: PMC4882715 DOI: 10.3390/nu8050303] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/17/2022] Open
Abstract
Valproic acid (VPA) is commonly prescribed as an anticonvulsant and mood stabilizer used in the treatment of epilepsy and bipolar disorder. A recent study has demonstrated that VPA reduces histone deacetylase (HDAC) activity, an action which is believed to contribute to the effects of VPA on neural stem cell proliferation and differentiation which may explain the cognitive impairments produced in rodents and patients. Asiatic acid is a triterpenoid derived from the medicinal plant Centella asiatica. Our previous study has shown that Asiatic acid improves working spatial memory and increases cell proliferation in the sub granular zone of the hippocampal dentate gyrus. In the present study we investigate the effects of Asiatic acid in preventing the memory and cellular effects of VPA. Male Spraque-Dawley rats were orally administered Asiatic acid (30 mg/kg/day) for 28 days, while VPA-treated animals received injections of VPA (300 mg/kg) twice a day from Day 15 to Day 28 for 14 days. Spatial memory was determined using the novel object location (NOL) test and hippocampal cell proliferation and survival was quantified by immuostaining for Ki-67 and Bromodeoxyuridine (BrdU), respectively. The results showed that VPA-treated animals were unable to discriminate between objects in familiar and novel locations. Moreover, VPA significantly reduced numbers of Ki-67 and BrdU positive cells. These results indicate that VPA treatment caused impairments of spatial working memory, cell proliferation and survival in the subgranular zone (SGZ) of the hippocampal dentate gyrus (DG). However, these abnormalities were restored to control levels by co-treatment with Asiatic acid. These data demonstrate that Asiatic acid could prevent the spatial memory and neurogenesis impairments caused by VPA.
Collapse
Affiliation(s)
- Jariya Umka Welbat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
- Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand.
- Neuroscience Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Apiwat Sirichoat
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | | | - Parichat Prachaney
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Wanassanun Pannangrong
- Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
- Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Poungrat Pakdeechote
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Bungorn Sripanidkulchai
- Center for Research and Development of Herbal Health Products, Khon Kaen University, Khon Kaen 40002, Thailand.
| | - Peter Wigmore
- School of Life Sciences, Medical School, Queen's Medical Centre, Nottingham University, Nottingham NG7 2UH, UK.
| |
Collapse
|
32
|
Vreeker A, Boks MP, Abramovic L, Verkooijen S, van Bergen AH, Hillegers MH, Spijker AT, Hoencamp E, Regeer EJ, Riemersma-Van der Lek RF, Stevens AW, Schulte PF, Vonk R, Hoekstra R, van Beveren NJ, Kupka RW, Brouwer RM, Bearden CE, MacCabe JH, Ophoff RA. High educational performance is a distinctive feature of bipolar disorder: a study on cognition in bipolar disorder, schizophrenia patients, relatives and controls. Psychol Med 2016; 46:807-818. [PMID: 26621616 PMCID: PMC5824688 DOI: 10.1017/s0033291715002299] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Schizophrenia is associated with lower intelligence and poor educational performance relative to the general population. This is, to a lesser degree, also found in first-degree relatives of schizophrenia patients. It is unclear whether bipolar disorder I (BD-I) patients and their relatives have similar lower intellectual and educational performance as that observed in schizophrenia. METHOD This cross-sectional study investigated intelligence and educational performance in two outpatient samples [494 BD-I patients, 952 schizophrenia spectrum (SCZ) patients], 2231 relatives of BD-I and SCZ patients, 1104 healthy controls and 100 control siblings. Mixed-effects and regression models were used to compare groups on intelligence and educational performance. RESULTS BD-I patients were more likely to have completed the highest level of education (odds ratio 1.88, 95% confidence interval 1.66-2.70) despite having a lower IQ compared to controls (β = -9.09, S.E. = 1.27, p < 0.001). In contrast, SCZ patients showed both a lower IQ (β = -15.31, S.E. = 0.86, p < 0.001) and lower educational levels compared to controls. Siblings of both patient groups had significantly lower IQ than control siblings, but did not differ on educational performance. IQ scores did not differ between BD-I parents and SCZ parents, but BD-I parents had completed higher educational levels. CONCLUSIONS Although BD-I patients had a lower IQ than controls, they were more likely to have completed the highest level of education. This contrasts with SCZ patients, who showed both intellectual and educational deficits compared to healthy controls. Since relatives of BD-I patients did not demonstrate superior educational performance, our data suggest that high educational performance may be a distinctive feature of bipolar disorder patients.
Collapse
Affiliation(s)
- Annabel Vreeker
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Marco P.M. Boks
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Lucija Abramovic
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Sanne Verkooijen
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Annet H. van Bergen
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Manon H.J. Hillegers
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Annet T. Spijker
- Department of Mood Disorders, PsyQ, The Hague, The Netherlands
- Department of Mood Disorder, PsyQ Rijnmond, Rotterdam, The Netherlands
| | - Erik Hoencamp
- Parnassia BAVO Group, The Hague, The Netherlands
- Leiden University, Institute of Psychology, Leiden, The Netherlands
| | - Eline J. Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
| | | | | | | | - Ronald Vonk
- Reinier van Arkel Group, ‘s-Hertogenbosch, The Netherlands
| | - Rocco Hoekstra
- Delta Center for Mental Health Care, Rotterdam, The Netherlands
| | - Nico J.M. van Beveren
- Delta Center for Mental Health Care, Rotterdam, The Netherlands
- Erasmus University Medical Center, Department of Psychiatry, Rotterdam, The Netherlands
- Erasmus University Medical Center, Department of Neuroscience, Rotterdam, The Netherlands
| | - Ralph W. Kupka
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
- VU University Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - Rachel M. Brouwer
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Carrie E. Bearden
- Semel Institute For Neuroscience and Human Behavior, University of California-Los Angeles, Los Angeles, California USA
- Department of Psychology, University of California-Los Angeles, Los Angeles, California USA
| | - James H. MacCabe
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Roel A. Ophoff
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California USA
| | - GROUP investigators
- Corresponding author: René S. Kahn, MD, PhD, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Heidelberglaan 100, 3508 GA Utrecht, PO box 85500, tel: 0031887556025, fax: 0031887555443 ()
| |
Collapse
|
33
|
de Souza Gomes JA, de Souza GC, Berk M, Cavalcante LM, de Sousa FCF, Budni J, de Lucena DF, Quevedo J, Carvalho AF, Macêdo D. Antimanic-like activity of candesartan in mice: Possible involvement of antioxidant, anti-inflammatory and neurotrophic mechanisms. Eur Neuropsychopharmacol 2015; 25:2086-97. [PMID: 26321203 DOI: 10.1016/j.euroneuro.2015.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 04/13/2015] [Accepted: 08/07/2015] [Indexed: 01/27/2023]
Abstract
Activation of the brain angiotensin II type 1 receptor (AT1R) triggers pro-oxidant and pro-inflammatory mechanisms which are involved in the neurobiology of bipolar disorder (BD). Candesartan (CDS) is an AT1 receptor antagonist with potential neuroprotective properties. Herein we investigated CDS effects against oxidative, neurotrophic inflammatory and cognitive effects of amphetamine (AMPH)-induced mania. In the reversal protocol adult mice were given AMPH 2 mg/kg i.p. or saline and between days 8 and 14 received CDS 0.1, 0.3 or 1 mg/kg orally, lithium (Li) 47.5 mg/kg i.p., or saline. In the prevention treatment, mice were pretreated with CDS, Li or saline prior to AMPH. Locomotor activity and working memory performance were assessed. Glutathione (GSH), thiobarbituric acid-reactive substance (TBARS) and TNF-α levels were evaluated in the hippocampus (HC) and cerebellar vermis (CV). Brain-derived neurotrophic factor (BDNF) and glycogen synthase kinase 3-beta (GSK-3beta) levels were measured in the HC. CDS and Li prevented and reversed the AMPH-induced increases in locomotor activity. Only CDS prevented and reversed AMPH-induced working memory deficits. CDS prevented AMPH-induced alterations in GSH (HC and CV), TBARS (HC and CV), TNF-α (HC and CV) and BDNF (HC) levels. Li prevented alterations in BDNF and phospho-Ser9-GSK3beta. CDS reversed AMPH-induced alterations in GSH (HC and CV), TBARS (HC), TNF-α (CV) and BDNF levels. Li reversed AMPH-induced alterations in TNF-α (HC and CV) and BDNF (HC) levels. CDS is effective in reversing and preventing AMPH-induced behavioral and biochemical alterations, providing a rationale for the design of clinical trials investigating CDS׳s possible therapeutic effects.
Collapse
Affiliation(s)
- Júlia Ariana de Souza Gomes
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Greicy Coelho de Souza
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Michael Berk
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Vic., Australia; Florey Institute of Neuroscience and Mental Health, Australia; Orygen Youth Health Research Centre, University of Melbourne, Parkville, Vic., Australia
| | - Lígia Menezes Cavalcante
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Francisca Cléa F de Sousa
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Josiane Budni
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil
| | - David Freitas de Lucena
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil
| | - João Quevedo
- Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil; Center for Experimental Models in Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA
| | - André F Carvalho
- Translational Psychiatry Research Group, Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Danielle Macêdo
- Neuropharmacology Laboratory, Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil.
| |
Collapse
|
34
|
van Enkhuizen J, Geyer MA, Minassian A, Perry W, Henry BL, Young JW. Investigating the underlying mechanisms of aberrant behaviors in bipolar disorder from patients to models: Rodent and human studies. Neurosci Biobehav Rev 2015; 58:4-18. [PMID: 26297513 DOI: 10.1016/j.neubiorev.2015.08.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/03/2015] [Accepted: 08/16/2015] [Indexed: 11/18/2022]
Abstract
Psychiatric patients with bipolar disorder suffer from states of depression and mania, during which a variety of symptoms are present. Current treatments are limited and neurocognitive deficits in particular often remain untreated. Targeted therapies based on the biological mechanisms of bipolar disorder could fill this gap and benefit patients and their families. Developing targeted therapies would benefit from appropriate animal models which are challenging to establish, but remain a vital tool. In this review, we summarize approaches to create a valid model relevant to bipolar disorder. We focus on studies that use translational tests of multivariate exploratory behavior, sensorimotor gating, decision-making under risk, and attentional functioning to discover profiles that are consistent between patients and rodent models. Using this battery of translational tests, similar behavior profiles in bipolar mania patients and mice with reduced dopamine transporter activity have been identified. Future investigations should combine other animal models that are biologically relevant to the neuropsychiatric disorder with translational behavioral assessment as outlined here. This methodology can be utilized to develop novel targeted therapies that relieve symptoms for more patients without common side effects caused by current treatments.
Collapse
Affiliation(s)
- Jordy van Enkhuizen
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands
| | - Mark A Geyer
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States
| | - William Perry
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States
| | - Brook L Henry
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States
| | - Jared W Young
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, United States; Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| |
Collapse
|
35
|
Riepe MW, Walther B, Vonend C, Beer AJ. Drug-induced cerebral glucose metabolism resembling Alzheimer's Disease: a case study. BMC Psychiatry 2015; 15:157. [PMID: 26163145 PMCID: PMC4498558 DOI: 10.1186/s12888-015-0531-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 06/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With aging of society the absolute number and the proportion of patients with cognitive deficits increase. Multiple disorders and diseases can foster cognitive impairment, e.g., Alzheimer's disease (AD), depressive disorder, or polypharmacy. CASE PRESENTATION A 74 year old man presented to the Old Age Psychiatry Service with cognitive deficits while being treated for recurrent depressive episodes and essential tremor with Venlafaxine, Lithium, and Primidone. Neuropsychological testing revealed a medio-temporal pattern of deficits with pronounced impairment of episodic memory, particularly delayed recall. Likewise, cognitive flexibility, semantic fluency, and attention were impaired. Positron emission tomography (PET) with fluorodeoxyglucose was performed and revealed a pattern of glucose utilization deficit resembling AD. On cessation of treatment with Lithium and Primidone, cognitive performance improved, particularly episodic memory performance and cognitive flexibility. Likewise, glucose metabolism normalized. Despite normalization of both, clinical symptoms and glucose utilization, the patient remained worried about possible underlying Alzheimer's disease pathology. To rule this out, an amyloid-PET was performed. No cortical amyloid was observed. CONCLUSION Pharmacological treatment of older subjects may mimic glucose metabolism and clinical symptoms of Alzheimer's disease. In the present case both, imaging and clinical findings, reversed to normal on change of treatment. Amyloid PET is a helpful tool to additionally rule out underlying Alzheimer's disease in situations of clinical doubt even if clinical or other imaging findings are suggestive of Alzheimer's disease.
Collapse
Affiliation(s)
- Matthias W. Riepe
- Division of Mental Health & Old Age Psychiatry, Psychiatry II, University of Ulm, Ludwig-Heilmeyer-Strasse 2, D-89312 Günzburg, Germany
| | - Britta Walther
- Division of Mental Health & Old Age Psychiatry, Psychiatry II, University of Ulm, Ludwig-Heilmeyer-Strasse 2, D-89312, Günzburg, Germany.
| | - Catharina Vonend
- Department of Nuclear Medicine, Ulm University, Albert-Einstein Allee 23, D-89081, Ulm, Germany.
| | - Ambros J. Beer
- Division of Mental Health & Old Age Psychiatry, Psychiatry II, University of Ulm, Ludwig-Heilmeyer-Strasse 2, D-89312 Günzburg, Germany
| |
Collapse
|
36
|
Vreeker A, van Bergen AH, Kahn RS. Cognitive enhancing agents in schizophrenia and bipolar disorder. Eur Neuropsychopharmacol 2015; 25:969-1002. [PMID: 25957798 DOI: 10.1016/j.euroneuro.2015.04.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 04/10/2015] [Indexed: 12/20/2022]
Abstract
Cognitive dysfunction is a core feature of schizophrenia and is also present in bipolar disorder (BD). Whereas decreased intelligence precedes the onset of psychosis in schizophrenia and remains relatively stable thereafter; high intelligence is a risk factor for bipolar illness but cognitive function decreases after onset of symptoms. While in schizophrenia, many studies have been conducted on the development of cognitive enhancing agents; in BD such studies are almost non-existent. This review focuses on the pharmacological agents with putative effects on cognition in both schizophrenia and bipolar illness; specifically agents targeting the dopaminergic, cholinergic and glutamatergic neurotransmitter pathways in schizophrenia and the cognitive effects of lithium, anticonvulsants and antipsychotics in BD. In the final analysis we conclude that cognitive enhancing agents have not yet been produced convincingly for schizophrenia and have hardly been studied in BD. Importantly, studies should focus on other phases of the illness. To be able to treat cognitive deficits effectively in schizophrenia, patients in the very early stages of the illness, or even before - in the ultra-high risk stages - should be targeted. In contrast, cognitive deficits occur later in BD, and therefore drugs should be tested in BD after the onset of illness. Hopefully, we will then find effective drugs for the incapacitating effects of cognitive deficits in these patients.
Collapse
Affiliation(s)
- Annabel Vreeker
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - Annet H van Bergen
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands
| | - René S Kahn
- University Medical Center Utrecht, Department of Psychiatry, Brain Center Rudolf Magnus, The Netherlands.
| |
Collapse
|
37
|
Chakrabarty T, Kozicky JM, Torres IJ, Lam RW, Yatham LN. Verbal memory impairment in new onset bipolar disorder: Relationship with frontal and medial temporal morphology. World J Biol Psychiatry 2015; 16:249-60. [PMID: 25708742 DOI: 10.3109/15622975.2014.1000373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Verbal memory (VM) impairment is a trait feature of bipolar I disorder (BDI) that is present at illness onset and associated with functional outcome. However, little is known about the morphological abnormalities underlying this deficit early in the disease course. This study examined the neurobiological correlates of VM impairment in euthymic newly diagnosed patients, with attention to frontal and medial temporal (MT) structures known to contribute to VM. METHODS Euthymic patients with BDI recently recovered from their first episode of mania (n = 42) were compared with healthy subjects (n = 37) using measures of the California Verbal Learning Test (CVLT-II) associated with frontal and MT functioning. A subset of participants had 3T MRI scan (n = 31 patient group, n = 30 healthy subject group). Hippocampal and prefrontal volumes were analyzed using FreeSurfer 5.1 and correlated with their corresponding CVLT-II subscores. RESULTS Patients showed decreased performance in total learning as well as short and long delay verbal recall. Consistent with MT dysfunction, they also showed deficits in recognition discriminability and learning slope. In the patient group only, left hippocampal volumes were negatively correlated with these measures. CONCLUSIONS These results suggest that anomalous MT functioning is involved with VM impairment early in the course of BDI.
Collapse
Affiliation(s)
- Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia , Vancouver, BC , Canada
| | | | | | | | | |
Collapse
|
38
|
Muralidharan K, Kozicky JM, Bücker J, Silveira LE, Torres IJ, Yatham LN. Are cognitive deficits similar in remitted early bipolar I disorder patients treated with lithium or valproate? Data from the STOP-EM study. Eur Neuropsychopharmacol 2015; 25:223-30. [PMID: 25261261 DOI: 10.1016/j.euroneuro.2014.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Revised: 07/29/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
In bipolar disorder (BD), lithium and valproate are both reportedly associated with mild cognitive deficits with impaired psychomotor speed and verbal memory ascribed to both while impairments in learning and attention are mainly attributed to valproate. However, there are few direct comparisons of the impact of lithium and valproate on cognitive function in early BD. Using data from the STOP-EM study, we compared neurocognitive functioning in BD patients, who had recently recovered from a first episode of mania, and were on treatment with lithium (n = 34) or valproate (n = 38), to a comparable sample of healthy controls (HC; n = 40), on the domains of processing speed, attention, verbal memory, nonverbal memory, working memory and executive functions. The three groups were comparable on socio-demographic (all p > 0.12) and clinical variables (all p > 0.08). MANOVA revealed a significant difference between the three groups on overall cognitive functioning (Wilk's lambda = 0.644; F = 3.775; p < 0.001). On post-hoc Tukey test, the valproate group performed poorer on working memory compared to the lithium (p = 0.001) and HC groups (p < 0.001). There was no significant difference between the lithium and valproate groups on other cognitive domains (all p > 0.13). Treatment with valproate and not lithium may be associated with working memory deficits early in the course of BD.
Collapse
Affiliation(s)
- Kesavan Muralidharan
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, India; Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1
| | - Jan-Marie Kozicky
- Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1
| | - Joana Bücker
- Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1; Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre, and INCT for Translational Medicine, Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, Universidade Federal do Rio Grande do Sul, UFRGS, Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil
| | - Leonardo E Silveira
- Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1; Laboratory of Molecular Psychiatry, Centro de Pesquisas Experimentais, Hospital de Clínicas de Porto Alegre, and INCT for Translational Medicine, Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina: Psiquiatria, Universidade Federal do Rio Grande do Sul, UFRGS, Rua Ramiro Barcelos, 2350 Porto Alegre, RS, Brazil
| | - Ivan J Torres
- Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1
| | - Lakshmi N Yatham
- Mood Disorders Centre, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T2A1.
| |
Collapse
|
39
|
O'Leary O, Nolan Y. Glycogen synthase kinase-3 as a therapeutic target for cognitive dysfunction in neuropsychiatric disorders. CNS Drugs 2015; 29:1-15. [PMID: 25380674 DOI: 10.1007/s40263-014-0213-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The serine/threonine kinase glycogen synthase kinase-3 (GSK-3) is involved in a broad range of cellular processes including cell proliferation, apoptosis and inflammation. It is now also increasingly acknowledged as having a role to play in cognitive-related processes such as neurogenesis, synaptic plasticity and neural cell survival. Cognitive impairment represents a major debilitating feature of many neurodegenerative and psychiatric disorders, including Alzheimer's disease, mood disorders, schizophrenia and fragile X syndrome, as well as being a result of traumatic brain injury or cranial irradiation. Accordingly, GSK-3 has been identified as an important therapeutic target for cognitive impairment, and recent preclinical studies have yielded important evidence demonstrating that GSK-3 inhibitors may be useful therapeutic interventions for restoring cognitive function in some of these brain disorders. The current review summarises the role of GSK-3 as a regulator of cognitive-dependent functions, examines current preclinical and clinical evidence of the potential of GSK-3 inhibitors as therapeutic agents for cognitive impairments in neuropsychiatric disorders, and offers some insight into the current obstacles that are impeding the clinical use of selective GSK-3 inhibitors in the treatment of cognitive impairment.
Collapse
Affiliation(s)
- Olivia O'Leary
- Department of Anatomy and Neuroscience, Western Gateway Building, University College Cork, Room 4.10, Cork, Ireland
| | | |
Collapse
|
40
|
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.
Collapse
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
| |
Collapse
|
41
|
Abstract
About one-third of lithium-treated, bipolar patients are excellent lithium responders; that is, lithium monotherapy totally prevents further episodes of bipolar disorder for ten years and more. These patients are clinically characterized by an episodic clinical course with complete remission, a bipolar family history, low psychiatric comorbidity, mania-depression episode sequences, a moderate number of episodes, and a low number of hospitalizations in the pre-lithium period. Recently, it has been found that temperamental features of hypomania (a hyperthymic temperament) and a lack of cognitive disorganization predict the best results of lithium prophylaxis. Lithium exerts a neuroprotective effect, in which increased expression of brain-derived neurotrophic factor (BDNF) and inhibition of the glycogen synthase kinase-3 (GSK-3) play an important role. The response to lithium has been connected with the genotype of the BDNF gene and serum BDNF levels. A better response to lithium is connected with the Met allele of the BDNF Val/Met polymorphism, as is a hyperthymic temperament. Excellent lithium responders have normal cognitive functions and serum BDNF levels, even after long-term duration of the illness. The preservation of cognitive functions in long-term lithium-treated patients may be connected with the stimulation of the BDNF system, with the resulting prevention of affective episodes exerting deleterious cognitive effects, and possibly also with lithium's antiviral effects. A number of candidate genes that are related to neurotransmitters, intracellular signaling, neuroprotection, circadian rhythms, and other pathogenic mechanisms of bipolar disorder were found to be associated with the lithium prophylactic response. The Consortium on Lithium Genetics (ConLiGen) has recently performed the first genome-wide association study on the lithium response in bipolar disorder.
Collapse
|
42
|
Cholet J, Sauvaget A, Vanelle JM, Hommet C, Mondon K, Mamet JP, Camus V. Using the Brief Assessment of Cognition in Schizophrenia (BACS) to assess cognitive impairment in older patients with schizophrenia and bipolar disorder. Bipolar Disord 2014; 16:326-36. [PMID: 24383665 DOI: 10.1111/bdi.12171] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 07/28/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A growing body of evidence suggests that impairment in cognitive functioning is an important clinical feature of both schizophrenia and bipolar disorder, and that these cognitive alterations worsen with age. Although cognitive assessments are increasingly becoming a part of research and clinical practice in schizophrenia, a standardized and easily administered test battery for elderly patients with bipolar disorder is still lacking. The Brief Assessment of Cognition in Schizophrenia (BACS) captures those domains of cognition that are the most severely affected in patients with schizophrenia and the most strongly correlated with functional outcome. The primary aim of our study was to investigate the clinical usefulness of the BACS in assessing cognitive functioning in elderly euthymic patients with bipolar disorder, and to compare their cognitive profile to that of elderly patients with schizophrenia. METHODS Elderly euthymic patients with bipolar disorder or schizophrenia were assessed using the BACS and a standard cognitive test battery. RESULTS Fifty-seven elderly patients (aged 60 years and older) with bipolar disorder (n = 42) or schizophrenia (n = 15) were invited to participate. All of the patients were assessed by the BACS as being cognitively impaired. The patients with bipolar disorder scored significantly higher on the global scale and the verbal memory and attention sub-scores of the BACS than the patients with schizophrenia. DISCUSSION The BACS appears to be a feasible and informative cognitive assessment tool for elderly patients with bipolar disorder. We believe that these preliminary results merit further investigation.
Collapse
Affiliation(s)
- Jennyfer Cholet
- Pôle Universitaire d'Addictologie et de Psychiatrie, CHU de Nantes, Université de Nantes, Nantes, France
| | | | | | | | | | | | | |
Collapse
|
43
|
Honarmand AR, Pourtabatabaei N, Rahimi N, Dehpour AR, Javadi-Paydar M. Suppression of memory acquisition following co-administration of lithium and atorvastatin through nitric oxide pathway in mice. Pharmacol Biochem Behav 2014; 122:203-11. [PMID: 24708995 DOI: 10.1016/j.pbb.2014.03.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 02/28/2014] [Accepted: 03/27/2014] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of this study was to investigate the interactive effect of lithium and atorvastatin on cognitive performance and the role of NO as a potential mechanism involved in this interaction. MATERIALS AND METHODS Memory performance was evaluated in a two-trial recognition Y-maze test and a step-through passive avoidance task in mice. Lithium (5, 10, 20 or 40 mg/kg, i.p.) and atorvastatin (1 mg/kg, p.o.) were administered 1 h before each trial, L-NAME, a non-specific NO synthase inhibitor (3, 10 mg/kg, i.p.); aminoguanidine, a specific inducible NO synthase (iNOS) inhibitor (100 mg/kg); and L-arginine, a NO precursor (750 mg/kg) were administered 30 min before training sessions. The level of plasma NO end-products (NOx) was determined using Griess reagent protocol. RESULTS 1) Lithium (40 mg/kg) impaired the acquisition of spatial recognition memory; 2) lithium did not affect the retrieval phase of spatial memory; 3) atorvastatin (1 mg/kg) significantly impaired the memory performance, when co-administered with the sub-effective dose of lithium (10 mg/kg), but did not affect the status when administered with lithium (5 mg/kg); 4) L-NAME (10 mg/kg) and aminoguanidine (100 mg/kg) dramatically decreased memory performance in mice received sub-effective doses of both lithium (5 mg/kg) and atorvastatin (1 mg/kg); 5) L-arginine (750 mg/kg) improved the memory acquisition in mice administered lithium (10 mg/kg) and atorvastatin (1 mg/kg); 6) lithium did not affect the cognitive performance in the passive avoidance test. All results were compatible and confirmed with in vitro determination of plasma NOx levels. CONCLUSIONS Lithium, dose dependently, impaired acquisition phase of spatial recognition memory. Lithium and atorvastatin co-administration impaired spatial recognition memory mediating by nitrergic pathway. In addition to L-arginine, our data from L-NAME and aminoguanidine also support the involvement of NO pathway in this interaction.
Collapse
Affiliation(s)
- Amir Reza Honarmand
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran
| | - Nasim Pourtabatabaei
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran
| | - Nastaran Rahimi
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Dehpour
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Experimental Medicine Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrak Javadi-Paydar
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Iran; Brain and Spinal Cord Injury Repair Research Center, Tehran University of Medical Sciences, Iran.
| |
Collapse
|
44
|
Torres IJ, Kozicky J, Popuri S, Bond DJ, Honer WG, Lam RW, Yatham LN. 12-month longitudinal cognitive functioning in patients recently diagnosed with bipolar disorder. Bipolar Disord 2014; 16:159-71. [PMID: 24636366 DOI: 10.1111/bdi.12154] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 06/29/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Although cognitive deficits are observed in the early stages of bipolar disorder, the longitudinal course of neuropsychological functioning during this period is unknown. Such knowledge could provide etiologic clues into the cognitive deficits associated with the illness, and could inform early treatment interventions. The purpose of the present study was to evaluate cognitive change in bipolar disorder in the first year after the initial manic episode. METHODS From an initial pool of 65 newly diagnosed patients with bipolar disorder (within three months of the end of the first manic or mixed episode) and 36 demographically similar healthy participants, 42 patients [mean age 22.9 years, standard deviation (SD) = 4.0] and 23 healthy participants [mean age 22.9 years (SD = 4.9)] completed baseline, six-month, and one-year neuropsychological assessments of multiple domains including processing speed, attention, verbal and nonverbal memory, working memory, and executive function. Patients also received clinical assessments, including mood ratings. RESULTS Although patients showed consistently poorer cognitive performance than healthy individuals in most cognitive domains, patients showed a linear improvement over time in processing speed (p = 0.008) and executive function (p = 0.004) relative to the comparison group. Among patients, those without a history of alcohol/substance abuse or who were taken off an antipsychotic treatment during the study showed better improvement. CONCLUSIONS The early course of cognitive functioning in bipolar disorder is likely influenced by multiple factors. Nevertheless, patients with bipolar disorder showed select cognitive improvements in the first year after resolution of their initial manic episode. Several clinical variables were associated with better recovery, including absence of substance abuse and discontinuation of antipsychotic treatment during the study. These and other factors require further investigation to better understand their contributions to longitudinal cognitive functioning in early bipolar disorder.
Collapse
Affiliation(s)
- Ivan J Torres
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
- British Columbia Mental Health and Addictions Services; Vancouver BC Canada
| | - Jan Kozicky
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
| | - Swetha Popuri
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
| | - David J Bond
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
| | - William G Honer
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
- British Columbia Mental Health and Addictions Services; Vancouver BC Canada
| | - Raymond W Lam
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
| | - Lakshmi N Yatham
- Department of Psychiatry; University of British Columbia; Vancouver BC Canada
| |
Collapse
|
45
|
Erol A, Kosger F, Putgul G, Ersoy B. Ventral prefrontal executive function impairment as a potential endophenotypic marker for bipolar disorder. Nord J Psychiatry 2014; 68:18-23. [PMID: 23293900 DOI: 10.3109/08039488.2012.756062] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Patients with remitted bipolar disorder have cognitive impairments, particularly in executive functions. However, the findings of studies that investigated cognitive functions in unaffected relatives of patients with bipolar disorder are conflicting. AIMS The aim of this study is to investigate executive functions in healthy parents of patients with bipolar I disorder, along with bipolar I disorder patients and matched controls. It has been hypothesized that both patients with bipolar I disorder and their parents would have executive function impairments compared with controls. METHODS 25 patients with bipolar I disorder, in full remission, 25 healthy controls that matched the patients with respect to age, gender and education, 50 healthy parents of those patients and 50 healthy controls that matched the parents for age, gender and education were included in the study. All the participants were interviewed with Structured Clinical Interview for DSM-IV-Axis I (SCID-I). Executive functions were assessed using the Verbal Fluency Test (VFT), Trail Making Test (TMT), Wisconsin Card Sorting Test (WCST) and Stroop Test. RESULTS Patients performed significantly worse than their matched controls on the VFT, TMT and Stroop tests, but not on the WCST. Parents performed significantly worse than their matched controls on the TMT and Stroop tests, but not on the VFT and WCST. CONCLUSIONS Our results bring more evidence that deficits in ventral, but not dorsal prefrontal executive functions are associated with familial vulnerability to bipolar disorder and ventral prefrontal executive function impairments may represent a potential endophenotype for bipolar disorder.
Collapse
Affiliation(s)
- Almila Erol
- Clinic of Psychiatry, Ataturk Education and Research Hospital , Izmir , Turkey
| | | | | | | |
Collapse
|
46
|
Lex C, Meyer TD. Is there evidence for an emotion-related bias in verbal learning or memory in individuals putatively high at risk for mania? Psychiatry Res 2013; 210:891-5. [PMID: 23809462 DOI: 10.1016/j.psychres.2013.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 04/24/2013] [Accepted: 05/04/2013] [Indexed: 11/19/2022]
Abstract
There is broad evidence that individuals with bipolar disorder show deficits in verbal memory and learning. Such deficits seem to be independent of acute mood episodes and to manifest after the onset of the disorder. Less research has been conducted in relation to more specific memory functions, particularly to verbal memory and learning for emotional information. Therefore, the objective of the present study is to investigate if there is evidence for an affective memory bias in at-risk individuals before the onset of affective disorder. We applied the Emotional Auditive Verbal Learning Test to individuals at risk for mania and at risk for depression, as well as to a control group. We hypothesized a mania-related memory bias for individuals at risk of mania. We found no evidence for an overall learning or memory deficit in the high-risk groups. All groups performed better learning and remembering neutral words compared to emotionally valenced words, however, contrary to our hypothesis there was no specific emotion-related learning or memory bias in the two high-risk groups. There was no evidence of impairments in verbal learning and memory overall and for emotional contents before the onset of affective disorders.
Collapse
Affiliation(s)
- Claudia Lex
- Department of Psychiatry, Villach General Hospital, Nikolaigasse 43, 9500 Villach, Austria.
| | | |
Collapse
|
47
|
Monotherapy with lithium or valproate or respectively combination therapy with quetiapine have similar effect on cognitive functions in Chinese euthymic patients with bipolar disorder: a cross-sectional survey. J Clin Psychopharmacol 2013; 33:817-9. [PMID: 23963059 DOI: 10.1097/jcp.0b013e31829c96e9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
48
|
Bourne C, Aydemir Ö, Balanzá-Martínez V, Bora E, Brissos S, Cavanagh JTO, Clark L, Cubukcuoglu Z, Dias VV, Dittmann S, Ferrier IN, Fleck DE, Frangou S, Gallagher P, Jones L, Kieseppä T, Martínez-Aran A, Melle I, Moore PB, Mur M, Pfennig A, Raust A, Senturk V, Simonsen C, Smith DJ, Bio DS, Soeiro-de-Souza MG, Stoddart SDR, Sundet K, Szöke A, Thompson JM, Torrent C, Zalla T, Craddock N, Andreassen OA, Leboyer M, Vieta E, Bauer M, Worhunsky PD, Tzagarakis C, Rogers RD, Geddes JR, Goodwin GM. Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis. Acta Psychiatr Scand 2013; 128:149-62. [PMID: 23617548 DOI: 10.1111/acps.12133] [Citation(s) in RCA: 426] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVE An association between bipolar disorder and cognitive impairment has repeatedly been described, even for euthymic patients. Findings are inconsistent both across primary studies and previous meta-analyses. This study reanalysed 31 primary data sets as a single large sample (N = 2876) to provide a more definitive view. METHOD Individual patient and control data were obtained from original authors for 11 measures from four common neuropsychological tests: California or Rey Verbal Learning Task (VLT), Trail Making Test (TMT), Digit Span and/or Wisconsin Card Sorting Task. RESULTS Impairments were found for all 11 test-measures in the bipolar group after controlling for age, IQ and gender (Ps ≤ 0.001, E.S. = 0.26-0.63). Residual mood symptoms confound this result but cannot account for the effect sizes found. Impairments also seem unrelated to drug treatment. Some test-measures were weakly correlated with illness severity measures suggesting that some impairments may track illness progression. CONCLUSION This reanalysis supports VLT, Digit Span and TMT as robust measures of cognitive impairments in bipolar disorder patients. The heterogeneity of some test results explains previous differences in meta-analyses. Better controlling for confounds suggests deficits may be smaller than previously reported but should be tracked longitudinally across illness progression and treatment.
Collapse
Affiliation(s)
- C Bourne
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Maekawa T, Katsuki S, Kishimoto J, Onitsuka T, Ogata K, Yamasaki T, Ueno T, Tobimatsu S, Kanba S. Altered visual information processing systems in bipolar disorder: evidence from visual MMN and P3. Front Hum Neurosci 2013; 7:403. [PMID: 23898256 PMCID: PMC3724050 DOI: 10.3389/fnhum.2013.00403] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/09/2013] [Indexed: 12/13/2022] Open
Abstract
Objective: Mismatch negativity (MMN) and P3 are unique ERP components that provide objective indices of human cognitive functions such as short-term memory and prediction. Bipolar disorder (BD) is an endogenous psychiatric disorder characterized by extreme shifts in mood, energy, and ability to function socially. BD patients usually show cognitive dysfunction, and the goal of this study was to access their altered visual information processing via visual MMN (vMMN) and P3 using windmill pattern stimuli. Methods: Twenty patients with BD and 20 healthy controls matched for age, gender, and handedness participated in this study. Subjects were seated in front of a monitor and listened to a story via earphones. Two types of windmill patterns (standard and deviant) and white circle (target) stimuli were randomly presented on the monitor. All stimuli were presented in random order at 200-ms durations with an 800-ms inter-stimulus interval. Stimuli were presented at 80% (standard), 10% (deviant), and 10% (target) probabilities. The participants were instructed to attend to the story and press a button as soon as possible when the target stimuli were presented. Event-related potentials (ERPs) were recorded throughout the experiment using 128-channel EEG equipment. vMMN was obtained by subtracting standard from deviant stimuli responses, and P3 was evoked from the target stimulus. Results: Mean reaction times for target stimuli in the BD group were significantly higher than those in the control group. Additionally, mean vMMN-amplitudes and peak P3-amplitudes were significantly lower in the BD group than in controls. Conclusions: Abnormal vMMN and P3 in patients indicate a deficit of visual information processing in BD, which is consistent with their increased reaction time to visual target stimuli. Significance: Both bottom-up and top-down visual information processing are likely altered in BD.
Collapse
Affiliation(s)
- Toshihiko Maekawa
- Department of Neuropsychiatry, Faculty of Medical Sciences, Kyushu University Fukuoka, Japan ; Departments of Clinical Neurophysiology, Faculty of Medical Sciences, Kyushu University Fukuoka, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Ekinci S, Özdel K, Öncü B, Çolak B, Kandemir H, Canat S. Temperamental characteristics in adults with attention-deficit hyperactivity disorder: a comparison with bipolar disorder and healthy control groups. Psychiatry Investig 2013; 10:137-42. [PMID: 23798961 PMCID: PMC3687047 DOI: 10.4306/pi.2013.10.2.137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 12/03/2012] [Accepted: 01/15/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To date, the affective temperamental characteristics of adults with attention-deficit hyperactivity disorder (ADHD) have not been studied. The aim of this study is to explore those temperamental characteristics for adults diagnosed with ADHD as measured by the TEMPS-A and then to compare those results with results for individuals diagnosed with bipolar disorder (BD) and with healthy controls. METHODS Forty adults with ADHD, 40 patients with BD, and 40 healthy controls were enrolled in this study. The groups were matched by age and gender. All patients were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Young Mania Rating Scale and the Wender Utah Rating Scale. Subjects' temperamental characteristics were examined using the Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A). RESULTS Ten subjects (25%) in the ADHD group and 15 subjects (30%) in the bipolar group had at least one dominant temperament. There was no identifiable dominant temperament in the control group. Compared to the control group, the ADHD group scored higher than other groups on all domains of the TEMPS-A: depressive cyclothymic, irritable and anxious. However, the hyperthymic domain was not higher for this group. Adults with ADHD scored higher on the irritable temperament scale as compared to the BD group. The ADHD and BD groups had similar mean scores for each of the other four temperaments. CONCLUSION The adults diagnosed with ADHD in this study had different temperamental characteristics from the control group, and these temperamental characteristics were similar to those of the bipolar patients. Recognizing the role of temperamental characteristics in adults with ADHD may increase our understanding of ADHD.
Collapse
Affiliation(s)
- Suat Ekinci
- Department of Psychiatry, Balikli Rum Hospital, Istanbul, Turkey
| | - Kadir Özdel
- Department of Psychiatry, Diskapi Research and Training Hospital, Ankara, Turkey
| | - Bedriye Öncü
- Department of Psychiatry, Ankara University, Ankara, Turkey
| | - Burçin Çolak
- Department of Psychiatry, Ankara University, Ankara, Turkey
| | - Hasan Kandemir
- Department of Psychiatry, Harran University, Şanlıurfa, Turkey
| | - Saynur Canat
- Department of Psychiatry, Ankara University, Ankara, Turkey
| |
Collapse
|