Department of Psychiatry, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA.
Neuropsychopharmacology. 2011 Jul;36(8):1587-92. doi: 10.1038/npp.2011.36. Epub 2011 Mar 30.
The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative was devised to identify a neurocognitive battery to be used in clinical trials targeting cognition in schizophrenia, a process, which resulted in the MATRICS Consensus Cognitive Battery (MCCB). The MCCB has been selected by the United States Food and Drug Administration to be used as the primary outcome measure in registry trials for cognitive agents in schizophrenia. Given the clinical and cognitive overlap between schizophrenia and bipolar disorder (BPD), it is likely that any compound shown to have cognitive benefits in schizophrenia will subsequently be tested in BPD. Unlike the MCCB for schizophrenia, there remains no consensus regarding outcome measures if cognitive trials were to be undertaken in BPD. The utility of the MCCB in BPD has not yet been systematically investigated. We administered the MCCB to 80 bipolar I patients; 37 were strictly euthymic and 43 were symptomatic. We compared their performance with a demographically matched healthy sample (n=148) on seven MCCB domains, and the composite. BPD patients were statistically significantly impaired on five of seven MCCB domains at levels consistent with meta-analytic studies of cognition in BPD. In contrast, patients' performance was less impaired on the Reasoning and Problem-solving and Social Cognition domains, differences that did not survive statistical correction for multiple testing. Symptomatic status only modestly influenced performance. These data suggest that the MCCB, devised for use in schizophrenia, may also represent a useful outcome measure in cognitive trials for BPD. Additional studies should address important psychometric features such as repeatability and potential practice and/or ceiling effects.
改善精神分裂症认知的测量和治疗研究 (MATRICS) 计划旨在确定一套用于针对精神分裂症认知的临床试验的神经认知测试工具，这一过程促成了 MATRICS 共识认知测试工具包 (MCCB) 的诞生。美国食品和药物管理局选择 MCCB 作为精神分裂症认知药物注册试验的主要结果测量指标。鉴于精神分裂症和双相情感障碍 (BPD) 在临床和认知上存在重叠，任何被证明对精神分裂症有认知益处的化合物很可能随后会在 BPD 中进行测试。与精神分裂症的 MCCB 不同，如果要在 BPD 中进行认知试验，目前仍没有关于结果测量的共识。MCCB 在 BPD 中的效用尚未得到系统研究。我们对 80 名双相情感障碍 I 型患者进行了 MCCB 测试；其中 37 名患者处于严格的稳定期，43 名患者处于症状期。我们将他们在七个 MCCB 领域和综合测试中的表现与年龄和性别相匹配的健康对照组（n=148）进行了比较。BPD 患者在七个 MCCB 领域中的五个领域的表现明显受损，其受损程度与 BPD 认知的荟萃分析研究一致。相比之下，患者在推理和解决问题以及社会认知领域的表现受损程度较轻，这些差异在经过多次测试校正后并不显著。症状状态仅对表现产生了适度影响。这些数据表明，MCCB 是为精神分裂症设计的，也可能成为 BPD 认知试验的有用结果测量指标。进一步的研究应该解决重要的心理测量特征，如重复性以及潜在的练习和/或天花板效应。
