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Comparative Study
. 2010 May;122(3):285-93.
doi: 10.1016/j.jad.2009.08.018. Epub 2009 Oct 1.

Intermediate: cognitive phenotypes in bipolar disorder

Scott A Langenecker  1 , Erika F H Saunders, Allison M Kade, Michael T Ransom, Melvin G McInnis
Affiliations
Comparative Study

Intermediate: cognitive phenotypes in bipolar disorder

Scott A Langenecker et al. J Affect Disord. 2010 May.

Abstract

Background: Intermediate cognitive phenotypes (ICPs) are measurable and quantifiable states that may be objectively assessed in a standardized method, and can be integrated into association studies, including genetic, biochemical, clinical, and imaging based correlates. The present study used neuropsychological measures as ICPs, with factor scores in executive functioning, attention, memory, fine motor function, and emotion processing, similar to prior work in schizophrenia.

Methods: Healthy control subjects (HC, n=34) and euthymic (E, n=66), depressed (D, n=43), or hypomanic/mixed (HM, n=13) patients with bipolar disorder (BD) were assessed with neuropsychological tests. These were from eight domains consistent with previous literature; auditory memory, visual memory, processing speed with interference resolution, verbal fluency and processing speed, conceptual reasoning and set-shifting, inhibitory control, emotion processing, and fine motor dexterity.

Results: Of the eight factor scores, the HC group outperformed the E group in three (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity), the D group in seven (all except Inhibitory Control), and the HM group in four (Inhibitory Control, Processing Speed with Interference Resolution, Fine Motor Dexterity, and Auditory Memory).

Limitations: The HM group was relatively small, thus effects of this phase of illness may have been underestimated. Effects of medication could not be fully controlled without a randomized, double-blind, placebo-controlled study.

Conclusions: Use of the factor scores can assist in determining ICPs for BD and related disorders, and may provide more specific targets for development of new treatments. We highlight strong ICPs (Processing Speed with Interference Resolution, Visual Memory, Fine Motor Dexterity) for further study, consistent with the existing literature.

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Figures

Figure 1
Figure 1
Factor Scores by Diagnosis and Phase aHealthy Control group performed significantly better than all the Bipolar participant groups. bEuthymic bipolar group performed significantly better than the Depressed group. cHealthy Control group performed better than the Euthymic and Depressed bipolar participant groups. dThe Healthy Control group performed better than the Depressed bipolar group. eThe Healthy Control group performed better than the Hypomanic/Mixed bipolar group.
Figure 2
Figure 2
Disease Severity and Chronicity Variables Predict Declining Cognitive Function Panel A. Scatterplot and regression line of total number of psychiatric hospitalizations by the Sum of All Factor Scores. Mean of the control group (+/− SEM) is shown on the left of the scatterplot. Panel B. Scatterplot of the number of years since onset of illness by Processing Speed with Interference Resolution. Mean of the control group (+/− SEM) is shown on the left of the scatterplot.
See this image and copyright information in PMC

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