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轻躁狂双相情感障碍患者及其健康亲属中作为神经认知内表型的手动运动速度功能障碍。一项5年随访研究的证据。

Manual motor speed dysfunction as a neurocognitive endophenotype in euthymic bipolar disorder patients and their healthy relatives. Evidence from a 5-year follow-up study.

作者信息

Correa-Ghisays P, Balanzá-Martínez V, Selva-Vera G, Vila-Francés J, Soria-Olivas E, Vivas-Lalinde J, San Martín C, Borrás A M, Ayesa-Arriola R, Sanchez-Moreno J, Sánchez-Ort J, Crespo-Facorro B, Vieta E, Tabarés-Seisdedos R

机构信息

Centro Investigacion Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Faculty of Psychology, University of Valencia, Valencia, Spain.

Centro Investigacion Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Service of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain.

出版信息

J Affect Disord. 2017 Jun;215:156-162. doi: 10.1016/j.jad.2017.03.041. Epub 2017 Mar 16.

Abstract

BACKGROUND

Few studies have examined Manual Motor Speed (MMS) in bipolar disorder (BD). The aim of this longitudinal, family study was to explore whether dysfunctional MMS represents a neurocognitive endophenotype of BD.

METHODS

A sample of 291 subjects, including 131 BD patients, 77 healthy first-degree relatives (BD-Rel), and 83 genetically-unrelated healthy controls (HC), was assessed with the Finger-Tapping Test (FTT) on three occasions over a 5-year period. Dependence of FTT on participants´ age was removed by means of a lineal model of HC samples, while correcting simultaneously the time and learning effect. Differences between groups were evaluated with an ANOVA test.

RESULTS

The patients' performance was significantly worse than that of HC over time (p≤0.006), and these deficits remained when non-euthymic BD patients (n=9) were excluded from analysis. Some significant differences between BD patients and BD-Rel (p≤0.037) and between BD-Rel and HC (p≤0.033) were found, but they tended to disappear as time progressed (p≥0.057). Performance of the BD-Rel group was intermediate to that of BD and HC. Most sociodemographic and clinical variables did not affect these results in patients. (p≥0.1). However, treatment with carbamazepine and benzodiazepines may exert a iatrogenic effect on MMS performance (p≤0.006).

LIMITATIONS

Only right-handed subjects were included in this study. Substantial attrition over time was detected.

CONCLUSIONS

There were significant differences between the patients´ MMS performance and that of healthy relatives and controls, regardless of most clinical and sociodemographic variables. Dysfunctional MMS could be considered an endophenotype of BD. Further studies are needed to rule out possible iatrogenic effects of some psychopharmacological treatments.

摘要

背景

很少有研究探讨双相情感障碍(BD)中的手动运动速度(MMS)。这项纵向家庭研究的目的是探讨功能失调的MMS是否代表BD的一种神经认知内表型。

方法

对291名受试者进行了研究,其中包括131名BD患者、77名健康的一级亲属(BD-Rel)和83名无血缘关系的健康对照者(HC),在5年时间里分三次通过手指敲击测试(FTT)进行评估。通过HC样本的线性模型消除FTT对参与者年龄的依赖性,同时校正时间和学习效应。采用方差分析测试评估组间差异。

结果

随着时间的推移,患者的表现明显比HC差(p≤0.006),在分析中排除非心境正常的BD患者(n = 9)后,这些缺陷依然存在。BD患者与BD-Rel之间(p≤0.037)以及BD-Rel与HC之间(p≤0.033)存在一些显著差异,但随着时间的推移这些差异趋于消失(p≥0.057)。BD-Rel组的表现介于BD组和HC组之间。大多数社会人口统计学和临床变量对患者的这些结果没有影响(p≥0.1)。然而,卡马西平和苯二氮䓬类药物治疗可能对MMS表现产生医源性影响(p≤0.006)。

局限性

本研究仅纳入了右利手受试者。随着时间的推移检测到大量失访情况。

结论

无论大多数临床和社会人口统计学变量如何,患者的MMS表现与健康亲属及对照者之间存在显著差异。功能失调的MMS可被视为BD的一种内表型。需要进一步研究以排除某些精神药物治疗可能的医源性影响。

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