a Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience , King's College London , London , UK.
b Departamento de Clínicas, Facultad de Medicina , Universidad Católica del Norte , Coquimbo , Chile.
World J Biol Psychiatry. 2018 Dec;19(8):633-644. doi: 10.1080/15622975.2017.1298838. Epub 2017 Mar 27.
Neurocognitive impairment has been found in bipolar patients. Hypercortisolemia is one possible cause but there has been no agreement on this. Previous sampling methods assessed only acute cortisol levels, whereas the association between cortisol and psychopathology might be better understood by investigating chronic levels. Fingernails are a novel method for measuring chronic cortisol concentration (CCC). Here, we measured CCC in euthymic bipolar disorder I (BD-I) patients and healthy controls using fingernails to investigate whether differences in CCC influenced neurocognitive performance. We also investigated whether differences in clinical illness variables influenced CCC in euthymic BD-I patients.
A previous study demonstrated neurocognitive impairment in euthymic BD-I patients. The current study included a portion of this sample: 40 BD-I versus 42 matched controls who provided fingernail samples.
There was no statistically significant difference in CCC between controls and BD-I (P = .09). Logistic regression analyses revealed that euthymic bipolar I subjects with more than five years of current euthymia had decreased odds of having higher fingernail cortisol concentration (>71.2 pg/mg) compared to those with less than 1.5 years (P = .04). There was no association between CCC and cognitive impairment in all domains before and after adjustment for age and sex.
The current evidence suggests CCC is not a trait biomarker in euthymic BD-I (BD-I). Longer periods of stability in affective disorders are associated with lower CCC. Fingernail cortisol does not seem to be implicated in neurocognitive impairment and BD-I. Future studies may investigate CCC in different illness phases of BD-I.
已发现双相情感障碍患者存在神经认知障碍。皮质醇过多症是一个可能的原因，但对此尚未达成共识。以前的采样方法仅评估了急性皮质醇水平，而通过研究慢性皮质醇水平，可能会更好地了解皮质醇与精神病理学之间的关系。指甲是测量慢性皮质醇浓度（CCC）的一种新方法。在这里，我们使用指甲测量了病情稳定的双相情感障碍 I 型（BD-I）患者和健康对照者的 CCC，以调查 CCC 是否会影响神经认知表现。我们还研究了病情稳定的 BD-I 患者中临床疾病变量的差异是否会影响 CCC。
先前的研究表明，病情稳定的 BD-I 患者存在神经认知障碍。本研究包括该研究的一部分样本：40 名 BD-I 患者与 42 名匹配的对照者提供了指甲样本。
对照者和 BD-I 之间的 CCC 无统计学差异（P = .09）。逻辑回归分析显示，与当前处于缓解期不足 1.5 年的患者相比，当前处于缓解期超过 5 年的双相情感障碍 I 型患者指甲皮质醇浓度较高（>71.2 pg/mg）的可能性降低（P = .04）。在调整年龄和性别后，所有认知域的 CCC 与认知障碍均无关联。
目前的证据表明，在病情稳定的 BD-I 中，CCC 不是一种特质生物标志物。情感障碍的稳定性时间越长，与较低的 CCC 相关。指甲皮质醇似乎与神经认知障碍和 BD-I 无关。未来的研究可能会在不同的 BD-I 疾病阶段研究 CCC。
