Bora Emre, Vahip Simavi, Akdeniz Fisun
University of Melbourne, Melbourne Neuropsychiatry Centre, Melbourne.
Turk Psikiyatri Derg. 2008 Spring;19(1):81-93.
Our aim was to review evidence of the role of cognitive deficits in bipolar disorder and their relationship to other factors, such as disorder variables, treatment, additional diagnoses, genetic risk, and brain imaging findings.
Studies that examined cognitive dysfunction in bipolar disorder and its relationship to the variables of clinical, genetic, and bipolar disorder subtypes, as well as neuro-anatomical and neuro-functional evidence have been reviewed. Findings from our own studies have also been used while conducting the review.
In bipolar disorder, deficits in executive functions, memory, and attention persist in the euthymic state. The number of episodes and the course of the disorder seem to be related to the severity of memory dysfunction and psychomotor slowness. However, symptoms of cognitive dysfunction are present at the onset of the disorder. Moreover, cognitive dysfunction has been observed in the healthy relatives of bipolar disorder patients. Cognitive dysfunction in bipolar disorder is associated with functional and possibly structural anomalies in some parts of the brain, such as the frontal and cingulate cortex. Some recent studies reported a relationship between symptoms of cognitive dysfunction and genetic variations in bipolar disorder.
Today, the presence of cognitive deficits in bipolar disorder is widely accepted; however, evidence of the neurobiological and clinical correlates of cognitive symptoms is still limited. More studies are needed to investigate the relationship between cognitive dysfunction in bipolar disorder and risk. Genetic studies are just now amending our body of knowledge. There have been many conflicting results reported by brain imaging studies. Different brain imaging approaches and genetic methods should be used with more specific cognitive and social-emotional tasks for increasing our knowledge about the nature of cognitive deficit in bipolar disorder.
我们的目的是回顾认知缺陷在双相情感障碍中的作用证据，以及它们与其他因素的关系，如疾病变量、治疗、附加诊断、遗传风险和脑成像结果。
回顾了研究双相情感障碍认知功能障碍及其与临床、遗传和双相情感障碍亚型变量关系的研究，以及神经解剖学和神经功能证据。在进行综述时也使用了我们自己研究的结果。
在双相情感障碍中，执行功能、记忆和注意力缺陷在心境正常状态下持续存在。发作次数和疾病病程似乎与记忆功能障碍和精神运动迟缓的严重程度有关。然而，认知功能障碍症状在疾病发作时就已存在。此外，在双相情感障碍患者的健康亲属中也观察到了认知功能障碍。双相情感障碍中的认知功能障碍与大脑某些部位的功能和可能的结构异常有关，如额叶和扣带回皮质。最近的一些研究报告了双相情感障碍中认知功能障碍症状与基因变异之间的关系。
如今，双相情感障碍中存在认知缺陷已被广泛接受；然而，认知症状的神经生物学和临床相关性证据仍然有限。需要更多研究来调查双相情感障碍中认知功能障碍与风险之间的关系。基因研究刚刚开始完善我们的知识体系。脑成像研究报告了许多相互矛盾的结果。应该使用不同的脑成像方法和基因方法，并结合更具体的认知和社会情感任务，以增加我们对双相情感障碍认知缺陷本质的了解。
