Division of Geriatric Psychiatry, University Hospitals of Geneva, Switzerland.
Int J Geriatr Psychiatry. 2011 Dec;26(12):1309-18. doi: 10.1002/gps.2683. Epub 2011 Mar 10.
Cross-sectional studies in bipolar disorder (BD) suggested the presence of cognitive deficits and subtle magnetic resonance imaging (MRI) changes in limbic areas that may persist at euthymic stages. Whether or not cognitive and MRI changes represent stable attributes of BD or evolve with time is still matter of debate. To address this issue, we performed a 2-year longitudinal study including detailed neuropsychological and magnetic resonance imaging (MRI) analyses of 15 euthymic older BD patients and 15 controls.
Neuropsychological evaluation concerned working memory, episodic memory, processing speed, and executive functions. MRI analyses included voxel-based morphometry (VBM) analysis of gray matter including region of interest (ROI) analysis and tract-based spatial statistics (TBSS) analysis of white matter of diffusion tensor imaging derived fractional anisotropy (FA).
BD patients displayed significantly lower performances in processing speed and episodic memory but not in working memory and executive functions compared to controls. However, BD patients did not differ from controls in the mean trajectory of cognitive changes during the 2 years follow-up. In the same line, longitudinal gray matter (VBM, ROI) and white matter (TBSS FA) changes did not differ between BD patients and controls.
The lack of distinction between BD patients and controls in respect to the 2-year changes in cognition and MRI findings supports the notion that this disorder does not have a significant adverse impact on cognitive and brain aging. From this point of view, the present results convey a message of hope for patients suffering from BD.
横断面研究表明，双相情感障碍（BD）患者存在认知缺陷和边缘区域的细微磁共振成像（MRI）变化，这些变化可能在病情稳定期持续存在。认知和 MRI 变化是否代表 BD 的稳定特征，或者是否随时间演变，仍存在争议。为了解决这个问题，我们进行了一项为期 2 年的纵向研究，对 15 名病情稳定的老年 BD 患者和 15 名对照者进行了详细的神经心理学和磁共振成像（MRI）分析。
神经心理学评估包括工作记忆、情景记忆、处理速度和执行功能。MRI 分析包括基于体素的形态学（VBM）分析，包括灰质的感兴趣区（ROI）分析和基于扩散张量成像的白质纤维束空间统计学（TBSS）分析的分数各向异性（FA）。
与对照组相比，BD 患者在处理速度和情景记忆方面的表现明显较差，但在工作记忆和执行功能方面没有差异。然而，BD 患者在 2 年的随访期间认知变化的平均轨迹与对照组没有差异。同样，BD 患者和对照组之间的纵向灰质（VBM、ROI）和白质（TBSS FA）变化没有差异。
BD 患者和对照组在认知和 MRI 变化方面没有区别，这支持了这种疾病对认知和大脑老化没有显著不利影响的观点。从这个角度来看，目前的结果为患有 BD 的患者带来了希望。
