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拉莫三嗪治疗儿童双相障碍后的工作记忆和言语记忆增强。

Enhanced working and verbal memory after lamotrigine treatment in pediatric bipolar disorder.

机构信息

Center for Cognitive Medicine, University of Illinois Medical Center at Chicago, Chicago, IL 60612, USA.

出版信息

Bipolar Disord. 2010 Mar;12(2):213-20. doi: 10.1111/j.1399-5618.2010.00792.x.

Abstract

OBJECTIVE

To examine the treatment impact of lamotrigine on the neurocognitive profile of patients with pediatric bipolar disorder (PBD).

METHOD

Healthy controls (HC) (n = 24; mean age = 12.4 +/- 3.3 years) and unmedicated PBD patients with manic, mixed, or hypomanic episodes (n = 34; mean age = 13 +/- 3.1 years) were matched for IQ, age, sex, race, and socioeconomic status. A neurocognitive battery was administered at baseline and again after 14 weeks, during which PBD patients were treated with lamotrigine.

RESULTS

Clinical symptoms improved with treatment in the patient group with significant change from baseline to follow-up on the Young Mania Rating Scale (p < 0.001) and the Children's Depression Rating Scale-Revised (p < 0.001). Global neurocognitive function improved with lamotrigine in PBD patients over time relative to that in HC, although overall performance remained impaired. Working memory and verbal memory significantly improved with treatment in patients, and deficits in these domains were no longer significantly impaired relative to HC at follow-up. Executive function significantly improved with treatment in the patient group but still lagged behind HC at follow-up. Performance on attention tests did not improve with treatment.

CONCLUSIONS

There appears to be significant improvement in cognitive abilities in PBD patients treated with lamotrigine that is most prominent in the areas of working memory and verbal memory and that occurs along with mood stabilization.

摘要

目的

研究拉莫三嗪对儿科双相障碍(PBD)患者神经认知特征的治疗作用。

方法

健康对照组(HC)(n=24;平均年龄=12.4±3.3 岁)和未经治疗的伴有躁狂、混合或轻躁狂发作的 PBD 患者(n=34;平均年龄=13±3.1 岁),两组按智商、年龄、性别、种族和社会经济地位进行匹配。在基线时和 14 周时(PBD 患者在此期间接受拉莫三嗪治疗),对患者进行神经认知测试。

结果

在患者组中,临床症状随着治疗而改善,在 Young 躁狂评定量表(p<0.001)和儿童抑郁评定量表修订版(p<0.001)上,从基线到随访均有显著变化。与 HC 相比,随着时间的推移,拉莫三嗪治疗使 PBD 患者的整体神经认知功能得到改善,尽管总体表现仍受损。工作记忆和言语记忆在患者中随治疗而显著改善,且在随访时,这些领域的缺陷与 HC 相比不再显著受损。在患者组中,执行功能随治疗而显著改善,但在随访时仍落后于 HC。注意力测试的表现并未随治疗而改善。

结论

接受拉莫三嗪治疗的 PBD 患者的认知能力似乎有显著改善,在工作记忆和言语记忆方面最为明显,且与情绪稳定同时发生。

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