Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA 90095, USA.
Curr Psychiatry Rep. 2010 Dec;12(6):499-504. doi: 10.1007/s11920-010-0151-5.
Historically, bipolar disorder has been conceptualized as a disease involving episodic rather than chronic dysfunction. However, increasing evidence indicates that bipolar disorder is associated with substantial inter-episode psychosocial and vocational impairment. Here we review the contributions of neurocognitive deficits and structural and functional neuroanatomic alterations to the observed functional impairments. In particular, compelling evidence now suggests that neurocognitive impairments, particularly in the areas of attention, processing speed, and memory, are associated with functional outcome. Although investigation of the neural correlates of functional disability in bipolar disorder is only in its nascent stages, preliminary evidence suggests that white matter abnormalities may be predictive of poor outcome. A better understanding of the relationship between neurocognitive and neuroimaging assays and functional outcome has the potential to improve current treatment options and provide targets for new treatment strategies in bipolar disorder.
从历史上看，双相情感障碍被认为是一种涉及发作性而非慢性功能障碍的疾病。然而，越来越多的证据表明，双相情感障碍与发作间期的心理社会和职业功能损害密切相关。在这里，我们回顾了神经认知缺陷以及结构和功能神经影像学改变对观察到的功能障碍的贡献。特别是，目前有确凿的证据表明，神经认知缺陷，特别是在注意力、处理速度和记忆方面，与功能结果相关。尽管对双相情感障碍患者的功能障碍的神经相关性的研究还处于起步阶段，但初步证据表明，白质异常可能是预后不良的预测指标。更好地理解神经认知和神经影像学检测与功能结果之间的关系，有可能改善当前的治疗选择，并为双相情感障碍的新治疗策略提供靶点。
