Gourovitch M L, Torrey E F, Gold J M, Randolph C, Weinberger D R, Goldberg T E
Clinical Brain Disorders Branch, NIMH, NIH, Washington, DC 20032, USA.
Biol Psychiatry. 1999 Mar 1;45(5):639-46. doi: 10.1016/s0006-3223(98)00148-6.
A paradigm that involves cognitive assessment of monozygotic (MZ) twins discordant for a neuropsychiatric disorder (here bipolar illness) allows for the examination of both disease-specific impairments (in the comparison of affected to unaffected twins) and risk factors (in the comparison of unaffected twins to normal twins).
Neuropsychological functions were evaluated in seven MZ twin pairs discordant for bipolar illness and seven pairs of normal MZ twins in an attempt to highlight cognitive abilities associated with manifestations of disease and genetic risk factors. At the time of testing, 3 of the affected twins were euthymic, 2 had depressive symptoms, and 2 had manic symptoms; all were receiving medication. All twins receive neuropsychological tests to evaluate intelligence, attention, visuospatial skills, language, learning and memory, and problem solving.
Statistical analyses revealed that the affected twins were significantly impaired as compared to the unaffected (and normal) twins on some measures of visuospatial functioning and some verbal memory measures. In contrast to a sample of MZ twins discordant for schizophrenia studied previously, the cognitive impairments we observed in bipolar twins were mild in nature and fairly circumscribed. The unaffected twins performed significantly worse than normal controls on a Brown-Petersen memory task, verbal list learning, and overall Wechsler Memory Quotient.
These data suggest that while some visuospatial deficits and verbal memory deficits may be features of bipolar disorder related to disease parameters, mild attenuations in overall memory or retrieval function may be related to genetic factors associated with the illness.
一种涉及对患有神经精神疾病（此处为双相情感障碍）的同卵双胞胎进行认知评估的范例，使得我们能够同时考察疾病特异性损伤（通过比较患病双胞胎与未患病双胞胎）以及风险因素（通过比较未患病双胞胎与正常双胞胎）。
对七对患有双相情感障碍的同卵双胞胎和七对正常同卵双胞胎进行神经心理学功能评估，以突出与疾病表现和遗传风险因素相关的认知能力。在测试时，3名患病双胞胎处于心境正常状态，2名有抑郁症状，2名有躁狂症状；所有人都在接受药物治疗。所有双胞胎都接受神经心理学测试，以评估智力、注意力、视觉空间技能、语言、学习与记忆以及解决问题的能力。
统计分析显示，在一些视觉空间功能测量和一些言语记忆测量方面，患病双胞胎与未患病（以及正常）双胞胎相比存在显著损伤。与先前研究的一组患有精神分裂症的同卵双胞胎样本不同，我们在双相情感障碍双胞胎中观察到的认知损伤性质较轻且范围较局限。在布朗 - 彼得森记忆任务、言语列表学习以及整体韦氏记忆商数方面，未患病双胞胎的表现明显比正常对照组差。
这些数据表明，虽然一些视觉空间缺陷和言语记忆缺陷可能是双相情感障碍与疾病参数相关的特征，但整体记忆或检索功能的轻度减弱可能与该疾病相关的遗传因素有关。
