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双相情感障碍中的神经进展与认知:对心境正常患者认知表现的系统评价

[Neuroprogression and cognition in Bipolar Disorders: A systematic review of cognitive performance in euthymic patients].

作者信息

Lolich María, Holtzman Jessica N, Rago Carlo M, Vázquez Gustavo H

机构信息

Centro de Investigación en Neurociencias y Neuropsicología Clínica, Facultad de Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina.

出版信息

Vertex. 2015 Jul-Aug;26(122):265-75.

Abstract

In recent years, investigators have begun to consider the possibility of explaining the physiopathology of bipolar disorder from a neuroprogressive perspective. The evidence that supports the feasibility of such an approach is varied, and arises from neuroimaging studies, batteries of neurocognitive evaluations, and tests to identify the specific biomarkers of the disorder. The present article seeks to perform a review of the research that investigates the cognitive deficits in bipolar disorder. A bibliographic revision was performed of articles published between 1990 and 2015. Levels of cognitive performance were explored in both cross-sectional and longitudinal studies. The compiled studies signal the presence of altered cognitive function, even during periods of euthymia. However, there are contradictory results as to whether bipolar disorder presents a degenerative course. New lines of investigation suggest that only a percentage of individuals with bipolar disorder are affected in a progressive manner. It is of paramount importance to perform new longitudinal studies in high-risk populations, so as to validate or refute a neuroprogressive model of cognitive deficits in patients with bipolar disorder.

摘要

近年来,研究人员已开始考虑从神经退行性的角度解释双相情感障碍的生理病理学的可能性。支持这种方法可行性的证据多种多样,来自神经影像学研究、一系列神经认知评估以及用于识别该疾病特定生物标志物的测试。本文旨在对研究双相情感障碍认知缺陷的研究进行综述。对1990年至2015年间发表的文章进行了文献回顾。在横断面研究和纵向研究中均探讨了认知表现水平。汇编的研究表明,即使在心境正常期间,认知功能也会发生改变。然而,关于双相情感障碍是否呈现退行性病程,存在相互矛盾的结果。新的研究方向表明,只有一定比例的双相情感障碍患者会以进行性方式受到影响。对高危人群进行新的纵向研究以验证或反驳双相情感障碍患者认知缺陷的神经退行性模型至关重要。

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