Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
Bipolar Disord. 2010 Sep;12(6):647-56. doi: 10.1111/j.1399-5618.2010.00857.x.
Impairments in executive function and memory have been reported in relatives of patients with bipolar disorder, suggesting that they could be potential endophenotypes for genetic studies, but the findings are inconsistent. In this study, neuropsychological performance in unaffected siblings of probands with family loading for bipolar disorder is compared to that of individually matched healthy controls. We hypothesized that performance on tests of executive functions and memory would be impaired in unaffected siblings of probands with bipolar disorder compared to matched healthy controls.
We evaluated 30 unaffected siblings of probands with bipolar I disorder and 30 individually matched healthy controls using tests of attention, executive function, and memory. Unaffected siblings and healthy control subjects did not differ with respect to gender, age, and years of education.
Unaffected siblings performed poorly on the Tower of London test (TOL), the Rey's auditory verbal learning test (RAVLT), and the Rey's complex figure test. In the multivariate analysis, significance was noted for the TOL, total number of moves (p = 0.007) and the RAVLT total learning score (p = 0.001).
Our study suggests that the deficits in verbal learning and memory and executive functions (planning) could be potential endophenotypes in bipolar disorder. These deficits are consistent with the proposed neurobiological model of bipolar disorder involving the frontotemporal and subcortical circuits. Future studies could couple cognitive and imaging strategies and genomics to identify neurocognitive endophenotypes in bipolar disorder.
有研究报道双相障碍患者的亲属存在执行功能和记忆损伤,这表明它们可能是遗传研究的潜在内表型,但研究结果并不一致。本研究比较了有双相障碍家族史的未受影响的先证者的兄弟姐妹与个体匹配的健康对照者的神经心理学表现。我们假设与匹配的健康对照组相比,有双相障碍先证者的未受影响的兄弟姐妹在执行功能和记忆测试中的表现会受损。
我们使用注意力、执行功能和记忆测试评估了 30 名有双相 I 障碍先证者的未受影响的兄弟姐妹和 30 名个体匹配的健康对照者。未受影响的兄弟姐妹和健康对照者在性别、年龄和受教育年限方面没有差异。
未受影响的兄弟姐妹在伦敦塔测试(TOL)、雷氏听觉言语学习测试(RAVLT)和雷氏复杂图形测试中表现不佳。在多变量分析中,TOL 的总移动次数(p=0.007)和 RAVLT 的总学习得分(p=0.001)具有统计学意义。
我们的研究表明,言语学习和记忆以及执行功能(计划)的缺陷可能是双相障碍的潜在内表型。这些缺陷与涉及额颞叶和皮质下回路的双相障碍的神经生物学模型一致。未来的研究可以结合认知和成像策略以及基因组学,以确定双相障碍的神经认知内表型。