Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-18T17:36:40.208Z Has data issue: false hasContentIssue false

Impact of number of episodes on neurocognitive trajectory in bipolar disorder patients: a 5-year follow-up study

Published online by Cambridge University Press:  25 July 2018

Eva María Sánchez-Morla*
Affiliation:
Department of Psychiatry, Research Institute of Hospital 12 de Octubre (imas12), Madrid, Spain CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
Ana López-Villarreal
Affiliation:
Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
Estela Jiménez-López
Affiliation:
CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
Ana Isabel Aparicio
Affiliation:
CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
Vicente Martínez-Vizcaíno
Affiliation:
Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain Faculty of Health Sciences, Universidad Autónoma de Chile, Talca, Chile
Rodriguez-Jimenez Roberto
Affiliation:
Department of Psychiatry, Research Institute of Hospital 12 de Octubre (imas12), Madrid, Spain CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain CogPsy-Group, Universidad Complutense de Madrid (UCM), Madrid, Spain
Eduard Vieta
Affiliation:
CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain Department of Psychiatry, Hospital Clínic of Barcelona, University of Barcelona, IDIBAPS, Barcelona, Spain
José-Luis Santos
Affiliation:
CIBERSAM (Biomedical Research Networking Centre in Mental Health), Spain Department of Psychiatry, Hospital Virgen de La Luz, Cuenca, Spain
*
Author for correspondence: Eva María Sánchez-Morla, E-mail: [email protected]

Abstract

Background

The neurocognitive trajectory in bipolar disorder (BD) is variable, with controversial findings, and most evidence come from cross-sectional studies. We aimed to examine the course of neurocognitive functioning in a sample of euthymic BD patients in comparison with a control group during a 5-year follow-up.

Methods

Ninety-nine euthymic bipolar patients and 40 healthy controls were assessed using a comprehensive neurocognitive battery (six neurocognitive domains) at baseline (T1) and then at 5-year follow-up (T2) in a longitudinal study.

Results

No evidence of a progression in neurocognitive dysfunction was found either in cognitive composite index or in any of the neurocognitive domains for the whole cohort. However, there was a negative correlation between number of manic episodes and hospitalisations due to manic episodes and change in neurocognitive composite index (NCI) during the follow-up. Moreover, patients with higher number of manic and hypomanic episodes have a greater decrease in NCI, working memory and visual memory. History of psychotic symptoms was not related to the trajectory of neurocognitive impairment.

Conclusions

Our results suggest that, although the progression of cognitive decline is not a general rule in BD, BD patients who have a greater number of manic or hypomanic episodes may constitute a subgroup characterised by the progression of neurocognitive impairment. Prevention of manic and hypomanic episodes could have a positive impact on the trajectory of cognitive function.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abé, C, Ekman, C-J, Sellgren, C, Petrovic, P, Ingvar, M and Landén, M (2015) Manic episodes are related to changes in frontal cortex: a longitudinal neuroimaging study of bipolar disorder 1. Brain 138, 34403448.Google Scholar
Balanzá-Martínez, V, Selva, G, Martínez-Arán, A, Prickaerts, J, Salazar, J, González-Pinto, A, Vieta, E and Tabarés-Seisdedos, R (2010) Neurocognition in bipolar disorders – a closer look at comorbidities and medications. European Journal of Pharmacology 626, 8796.Google Scholar
Balanzá-Martínez, V, Tabarés-Seisdedos, R, Selva-Vera, G, Martínez-Arán, A, Torrent, C, Salazar-Fraile, J, Leal-Cercós, C, Vieta, E and Gómez-Beneyto, M (2005) Persistent cognitive dysfunctions in bipolar I disorder and schizophrenic patients: a 3-year follow-up study. Psychotherapy and Psychosomatics 74, 113119.Google Scholar
Basso, MR, Bornstein, RA and Lang, JM (1999) Practice effects on commonly used measures of executive function across twelve months. The Clinical Neuropsychologist 13, 283292.Google Scholar
Basso, MR, Lowery, N, Bornstein, RA and Ghormley, C (2001) Practice effects on the Wisconsin Card Sorting Test-64 card version across 12 months. The Clinical Neuropsychologist 15, 471478.Google Scholar
Bombin, I, Mayoral, M, Castro-Fornieles, J, Gonzalez-Pinto, A, de la Serna, E, Rapado-Castro, M, Barbeito, S, Parellada, M, Baeza, I, Graell, M, Payá, B and Arango, C (2013) Neuropsychological evidence for abnormal neurodevelopment associated with early-onset psychoses. Psychological Medicine 43, 757768.Google Scholar
Bora, E (2018) Neurocognitive features in clinical subgroups of bipolar disorder: a meta-analysis. Journal of Affective Disorders 229, 125134.Google Scholar
Bora, E and Özerdem, A (2017) Meta-analysis of longitudinal studies of cognition in bipolar disorder: comparison with healthy controls and schizophrenia. Psychological Medicine 47, 27532766.Google Scholar
Bora, E and Pantelis, C (2015) Meta-analysis of cognitive impairment in first-episode bipolar disorder: comparison with first-episode schizophrenia and healthy controls. Schizophrenia Bulletin 41, 10951104.Google Scholar
Braw, Y, Erez, G, Sela, T, Gvirts, HZ, Hare, EV, Bloch, Y and Levkovitz, Y (2013) A longitudinal study of cognition in asymptomatic and mildly symptomatic bipolar disorder patients. Psychiatry Research 210, 842849.Google Scholar
Burdick, KE, Russo, M, Frangou, S, Mahon, K, Braga, RJ, Shanahan, M and Malhotra, AK (2014) Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications. Psychological Medicine 44, 30833096.Google Scholar
Cao, B, Passos, IC, Mwangi, B, Bauer, IE, Zunta-Soares, GB, Kapczinski, F and Soares, JC (2016) Hippocampal volume and verbal memory performance in late-stage bipolar disorder. Journal of Psychiatric Research 73, 102107.Google Scholar
Cardoso, T, Bauer, IE, Meyer, TD, Kapczinski, F and Soares, JC (2015) Neuroprogression and cognitive functioning in bipolar disorder: a systematic review. Current Psychiatry Reports 17, 75.Google Scholar
Colom, F, Vieta, E, Martínez-Arán, A, Garcia-Garcia, M, Reinares, M, Torrent, C, Goikolea, JM, Banús, S and Salamero, M (2002) Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale. Medicina Clinica 119, 366371.Google Scholar
Duff, K (2012) Evidence-based indicators of neuropsychological change in the individual patient: relevant concepts and methods. Archives of Clinical Neuropsychology 27, 248261.Google Scholar
Fuentes Durá, I, Romero Peris, M, Dasí Vivó, C and Ruiz Ruiz, JC (2010) Short form of the WAIS-III for use with patients with schizophrenia. Psicothema 22, 202207.Google Scholar
Gildengers, AG, Chisholm, D, Butters, MA, Anderson, SJ, Begley, A, Holm, M, Rogers, JC, Reynolds, CF and Mulsant, BH (2013) Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression? Psychological Medicine 43, 801811.Google Scholar
Heinrichs, RW and Zakzanis, KK (1998) Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12, 426445.Google Scholar
Hibar, DP, Westlye, LT, Doan, NT, Jahanshad, N, Cheung, JW, Ching, CRK, Versace, A, Bilderbeck, AC, Uhlmann, A, Mwangi, B, Krämer, B, Overs, B, Hartberg, CB, Abé, C, Dima, D, Grotegerd, D, Sprooten, E, Bøen, E, Jimenez, E, Howells, FM, Delvecchio, G, Temmingh, H, Starke, J, Almeida, JRC, Goikolea, JM, Houenou, J, Beard, LM, Rauer, L, Abramovic, L, Bonnin, M, Ponteduro, MF, Keil, M, Rive, MM, Yao, N, Yalin, N, Najt, P, Rosa, PG, Redlich, R, Trost, S, Hagenaars, S, Fears, SC, Alonso-Lana, S, van Erp, TGM, Nickson, T, Chaim-Avancini, TM, Meier, TB, Elvsåshagen, T, Haukvik, UK, Lee, WH, Schene, AH, Lloyd, AJ, Young, AH, Nugent, A, Dale, AM, Pfennig, A, McIntosh, AM, Lafer, B, Baune, BT, Ekman, CJ, Zarate, CA, Bearden, CE, Henry, C, Simhandl, C, McDonald, C, Bourne, C, Stein, DJ, Wolf, DH, Cannon, DM, Glahn, DC, Veltman, DJ, Pomarol-Clotet, E, Vieta, E, Canales-Rodriguez, EJ, Nery, FG, Duran, FLS, Busatto, GF, Roberts, G, Pearlson, GD, Goodwin, GM, Kugel, H, Whalley, HC, Ruhe, HG, Soares, JC, Fullerton, JM, Rybakowski, JK, Savitz, J, Chaim, KT, Fatjó-Vilas, M, Soeiro-de-Souza, MG, Boks, MP, Zanetti, MV, Otaduy, MCG, Schaufelberger, MS, Alda, M, Ingvar, M, Phillips, ML, Kempton, MJ, Bauer, M, Landén, M, Lawrence, NS, van Haren, NEM, Horn, NR, Freimer, NB, Gruber, O, Schofield, PR, Mitchell, PB, Kahn, RS, Lenroot, R, Machado-Vieira, R, Ophoff, RA, Sarró, S, Frangou, S, Satterthwaite, TD, Hajek, T, Dannlowski, U, Malt, UF, Arolt, V, Gattaz, WF, Drevets, WC, Caseras, X, Agartz, I, Thompson, PM, Andreassen, OA (2018) Cortical abnormalities in bipolar disorder: an MRI analysis of 6503 individuals from the ENIGMA Bipolar Disorder Working Group. Molecular Psychiatry 23, 932942.Google Scholar
Jiménez-López, E, Aparicio, AI, Sánchez-Morla, EM, Rodriguez-Jimenez, R, Vieta, E and Santos, JL (2017) Neurocognition in patients with psychotic and non-psychotic bipolar I disorder. A comparative study with individuals with schizophrenia. Journal of Affective Disorders 222, 169176.Google Scholar
Kapczinski, NS, Mwangi, B, Cassidy, RM, Librenza-Garcia, D, Bermudez, MB, Kauer-Sant'anna, M, Kapczinski, F and Passos, IC (2017) Neuroprogression and illness trajectories in bipolar disorder. Expert Review of Neurotherapeutics 17, 277285.Google Scholar
Kremen, WS, Seidman, LJ, Faraone, SV, Toomey, R and Tsuang, MT (2000) The paradox of normal neuropsychological function in schizophrenia. Journal of Abnormal Psychology 109, 743752.Google Scholar
Lera-Miguel, S, Andrés-Perpiñá, S, Fatjó-Vilas, M, Fañanás, L and Lázaro, L (2015) Two-year follow-up of treated adolescents with early-onset bipolar disorder: changes in neurocognition. Journal of Affective Disorders 172, 4854.Google Scholar
Lezak, MD, Howieson, DB, Bigler, ED and Tranel, D (2012) Neuropsychological Assessment, 5th Edn. New York, NY: Oxford University Press.Google Scholar
López-Jaramillo, C, Lopera-Vásquez, J, Gallo, A, Ospina-Duque, J, Bell, V, Torrent, C, Martínez-Arán, A and Vieta, E (2010) Effects of recurrence on the cognitive performance of patients with bipolar I disorder: implications for relapse prevention and treatment adherence. Bipolar Disorders 12, 557567.Google Scholar
Maggioni, E, Altamura, AC and Brambilla, P (2017) Exploring the neuroanatomical bases of psychotic features in bipolar disorder. Epidemiology and Psychiatric Sciences 26, 358363.Google Scholar
Mann-Wrobel, MC, Carreno, JT and Dickinson, D (2011) Meta-analysis of neuropsychological functioning in euthymic bipolar disorder: an update and investigation of moderator variables. Bipolar Disorders 13, 334342.Google Scholar
Martínez-Arán, A, Vieta, E, Colom, F, Torrent, C, Sanchez-Moreno, J, Reinares, M, Benabarre, A, Goikolea, J, Brugue, E, Daban, C and Salamero, M (2004 a) Cognitive impairment in euthymic bipolar patients: implications for clinical and functional outcome. Bipolar Disorders 6, 224232.Google Scholar
Martínez-Arán, A, Vieta, E, Reinares, M, Colom, F, Torrent, C, Sánchez-Moreno, J, Benabarre, A, Goikolea, JM, Comes, M and Salamero, M (2004 b) Cognitive function across manic or hypomanic, depressed, and euthymic states in bipolar disorder. American Journal of Psychiatry 161, 262270.Google Scholar
Martínez-Arán, A, Vieta, E, Torrent, C, Sanchez-Moreno, J, Goikolea, J, Salamero, M, Malhi, G, Gonzalez-Pinto, A, Daban, C, Alvarez-Grandi, S, Fountoulakis, K, Kaprinis, G, Tabares-Seisdedos, R and Ayuso-Mateos, J (2007) Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disorders 9, 103113.Google Scholar
Martino, DJ, Igoa, A, Marengo, E, Scápola, M and Strejilevich, SA (2018) Longitudinal relationship between clinical course and neurocognitive impairments in bipolar disorder. Journal of Affective Disorders 225, 250255.Google Scholar
Mora, E, Portella, MJ, Forcada, I, Vieta, E and Mur, M (2013) Persistence of cognitive impairment and its negative impact on psychosocial functioning in lithium-treated, euthymic bipolar patients: a 6-year follow-up study. Psychological Medicine 43, 11871196.Google Scholar
Mora, E, Portella, MJ, Forcada, I, Vieta, E and Mur, M (2016) A preliminary longitudinal study on the cognitive and functional outcome of bipolar excellent lithium responders. Comprehensive Psychiatry 71, 2532.Google Scholar
Mur, M, Portella, MJ, Martínez-Arán, A, Pifarré, J and Vieta, E (2008) Neuropsychological profile in bipolar disorder: a preliminary study of monotherapy lithium-treated euthymic bipolar patients evaluated at a 2-year interval. Acta Psychiatrica Scandinavica 118, 373381.Google Scholar
Nuechterlein, KH, Barch, DM, Gold, JM, Goldberg, TE, Green, MF and Heaton, RK (2004) Identification of separable cognitive factors in schizophrenia. Schizophrenia Research 72, 2939.Google Scholar
Passos, IC, Mwangi, B, Vieta, E, Berk, M and Kapczinski, F (2016) Areas of controversy in neuroprogression in bipolar disorder. Acta Psychiatrica Scandinavica 134, 91103.Google Scholar
Post, RM, Fleming, J and Kapczinski, F (2012) Neurobiological correlates of illness progression in the recurrent affective disorders. Journal of Psychiatric Research 46, 561573.Google Scholar
Ramos-Brieva, JA and Cordero-Villafafila, A (1988) A new validation of the Hamilton Rating Scale for Depression. Journal of Psychiatric Research 22, 2128.Google Scholar
Robinson, LJ and Ferrier, IN (2006) Evolution of cognitive impairment in bipolar disorder: a systematic review of cross-sectional evidence. Bipolar Disorders 8, 103116.Google Scholar
Russo, M, Van Rheenen, TE, Shanahan, M, Mahon, K, Perez-Rodriguez, MM, Cuesta-Diaz, A, Larsen, E, Malhotra, AK and Burdick, KE (2017) Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings. Psychological Medicine 47, 28922905.Google Scholar
Ryan, KA, Assari, S, Pester, BD, Hinrichs, K, Angers, K, Baker, A, Marshall, DF, Stringer, D, Saunders, EFH, Kamali, M, McInnis, MG and Langenecker, SA (2016) Similar trajectory of executive functioning performance over 5 years among individuals with bipolar disorder and unaffected controls using latent growth modeling. Journal of Affective Disorders 199, 8794.Google Scholar
Samamé, C, Martino, DJ and Strejilevich, SA (2014) Longitudinal course of cognitive deficits in bipolar disorder: a meta-analytic study. Journal of Affective Disorders 164, 130138.Google Scholar
Sánchez-Morla, EM, García-Jiménez, MA, Barabash, A, Martínez-Vizcaíno, V, Mena, J, Cabranes-Díaz, JA, Baca-Baldomero, E and Santos, JL (2008) P50 sensory gating deficit is a common marker of vulnerability to bipolar disorder and schizophrenia. Acta Psychiatrica Scandinavica 117, 313318.Google Scholar
Santos, JL, Aparicio, A, Bagney, A, Sánchez-Morla, EM, Rodríguez-Jiménez, R, Mateo, J and Jiménez-Arriero, (2014) A five-year follow-up study of neurocognitive functioning in bipolar disorder. Bipolar Disorders 16, 722731.Google Scholar
Schouws, SNTM, Comijs, HC, Dols, A, Beekman, ATF and Stek, ML (2016) Five-year follow-up of cognitive impairment in older adults with bipolar disorder. Bipolar Disorders 18, 148154.Google Scholar
Solé, B, Bonnin, CM, Jiménez, E, Torrent, C, Torres, I, Varo, C, Valls, E, Montejo, L, Gómez-Ocaña, C, Tomioka, Y, Vieta, E, Martinez-Aran, A and Reinares, M (2018) Heterogeneity of functional outcomes in patients with bipolar disorder: a cluster-analytic approach. Acta Psychiatrica Scandinavica 137, 516527. Available at http://www.ncbi.nlm.nih.gov/pubmed/29508379 (Accessed 20 May 2018).Google Scholar
Solé, B, Jiménez, E, Torrent, C, del Mar Bonnin, C, Torres, I, Reinares, M, Priego, Á, Salamero, M, Colom, F, Varo, C, Vieta, E and Martínez-Arán, A (2016) Cognitive variability in bipolar II disorder: who is cognitively impaired and who is preserved. Bipolar Disorders 18, 288299.Google Scholar
Strakowski, SM, DelBello, MP, Zimmerman, ME, Getz, GE, Mills, NP, Ret, J, Shear, P and Adler, CM (2002) Ventricular and periventricular structural volumes in first- versus multiple-episode bipolar disorder. American Journal of Psychiatry 159, 18411847.Google Scholar
Szöke, A, Trandafir, A, Dupont, M-E, Méary, A, Schürhoff, F and Leboyer, M (2008) Longitudinal studies of cognition in schizophrenia: meta-analysis. British Journal of Psychiatry 192, 248257.Google Scholar
Tabarés-Seisdedos, R, Balanzá-Martínez, V, Sánchez-Moreno, J, Martinez-Aran, A, Salazar-Fraile, J, Selva-Vera, G, Rubio, C, Mata, I, Gómez-Beneyto, M and Vieta, E (2008) Neurocognitive and clinical predictors of functional outcome in patients with schizophrenia and bipolar I disorder at one-year follow-up. Journal of Affective Disorders 109, 286299.Google Scholar
Torres, IJ, Kozicky, J, Popuri, S, Bond, DJ, Honer, WG, Lam, RW and Yatham, LN (2014) 12-month longitudinal cognitive functioning in patients recently diagnosed with bipolar disorder. Bipolar Disorders 16, 159171.Google Scholar
Van Gorp, WG, Altshuler, L, Theberge, DC, Wilkins, J and Dixon, W (1998) Cognitive impairment in euthymic bipolar patients with and without prior alcohol dependence. A preliminary study. Archives of General Psychiatry 55, 4146.Google Scholar
Vieta, E, Salagre, E, Grande, I, Carvalho, AF, Fernandes, BS, Berk, M, Birmaher, B, Tohen, M and Suppes, T (2018) Early intervention in bipolar disorder. American Journal of Psychiatry 175, 411426.Google Scholar