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. 2024 Dec 16;54(16):1-6.
doi: 10.1017/S0033291724003210. Online ahead of print.

Neurodevelopment as an alternative to neuroprogression to explain cognitive functioning in bipolar disorder

Diego J Martino  1   2
Affiliations

Neurodevelopment as an alternative to neuroprogression to explain cognitive functioning in bipolar disorder

Diego J Martino. Psychol Med. .
No abstract available

Keywords: bipolar disorder; cognitive impairmets; neurocognition; neurodevelopment; neuroprogression.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Schematic diagram of the lifetime clinical course of a hypothetical sample of 6 patients with bipolar disorder under the assumption that recurrence of mood episodes (represented by black columns) and cognitive impairment (represented by gray bar with dotted line) is stable from illness onset. The cognitive impairment after a first mood episode is the average of the 6 patients (absent in patients 1–2, moderate in 3–4, and severe in 5–6), but after a third episode it is that of patients 3–6 and after a fifth episode it is that of patients 5–6. Thus comparing cognitive impairment in patients with many v. few episodes can lead to the misinterpretation that these features increase with successive episodes even though they were stable. The same positive results would be obtained in correlation analysis between cognitive deficits and number of mood episodes and, therefore, they should not be used as evidence of neuroprogression.
Figure 2.
Figure 2.
Schematic profiles of bipolar patients with and without neurodevelopmental abnormalities. (a) Patients without neurodevelopmental abnormalities do not have premorbid disturbances or neurocognitive dysfunction (gray bar with dotted line) before or after the onset of the illness. In the postmorbid stage, they have a more benign clinical course with a lower density of mood episodes (black columns) and better functional outcome similar – in some cases – to healthy subjects. (b) Patients with neurodevelopmental abnormalities have different premorbid disturbances such as socialization and academic problems or comorbidities (e.g. schizoid or ADHD). Even though they have normal-low IQ, they may show impairment in measures of verbal memory, attention or executive functions (gray bar with dotted line) in the premorbid stage that are maintained after the illness onset. In the postmorbid stage, they have a higher density of mood episodes (black columns) and worse functional outcome similar – in some cases – to subjects with schizophrenia.
See this image and copyright information in PMC

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