Lin Kangguang, Lu Rui, Chen Kun, Li Ting, Lu Weicong, Kong Jiehua, Xu Guiyun
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Laboratory of Emotion and Cognition, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Department of Affective Disorders, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Laboratory of Emotion and Cognition, Guangzhou Brain Hospital, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
J Psychiatr Res. 2017 Aug;91:177-183. doi: 10.1016/j.jpsychires.2017.05.005. Epub 2017 May 10.
Little is known about the development of cognitive deficits prior to the official onset of bipolar disorder (BP). The aim of this study was to investigate neurocognitive performance in two early stages of BP. This high-risk design study recruited a group of offspring of parents with BP (n = 58), aged 8-28 years. Based on the subthreshold syndromes, the "unaffected" offspring were further divided into high-risk (HR) and ultra-high-risk (UHR) stages. For comparison, a group of individuals with subthreshold symptoms but without family history of psychiatric disorder (n = 17) and 48 healthy controls (HCs) were included. The MATRICS Consensus Cognitive Battery (MCCB) and Tower of London task were applied to assess neuropsychological performance. The HR offspring performed significantly poorer on verbal learning and memory when compared with HCs, indicating that the deficits may serve as neurocognitive endophenotypes for BP. Deficits in working memory, visual-spatial memory, and cognitive planning were observed in the UHR offspring when compared with HCs, suggestive of risk of developing BP. The deficits observed in the UHR offspring were absent in the individuals with subthreshold symptoms without psychiatric family history. Our data suggest that cognitive deficits become apparent prior to the official onset of BP, with specific deficits observable in different early stages. These results nonetheless are based on small sample size and a cross-sectional design. Given this and the heterogeneity of bipolar disorders, these findings should be interpreted cautiously and require replication.
关于双相情感障碍（BP）正式发作之前认知缺陷的发展情况，人们所知甚少。本研究的目的是调查双相情感障碍两个早期阶段的神经认知表现。这项高风险设计研究招募了一组父母患有双相情感障碍的后代（n = 58），年龄在8至28岁之间。根据阈下综合征，将“未受影响”的后代进一步分为高风险（HR）和超高风险（UHR）阶段。为作比较，纳入了一组有阈下症状但无精神疾病家族史的个体（n = 17）以及48名健康对照者（HCs）。采用MATRICS共识认知成套测验（MCCB）和伦敦塔任务来评估神经心理学表现。与健康对照者相比，高风险后代在言语学习和记忆方面表现明显更差，这表明这些缺陷可能是双相情感障碍的神经认知内表型。与健康对照者相比，超高风险后代在工作记忆、视觉空间记忆和认知规划方面存在缺陷，提示有患双相情感障碍的风险。在无精神疾病家族史的阈下症状个体中未观察到超高风险后代中出现的这些缺陷。我们的数据表明，认知缺陷在双相情感障碍正式发作之前就已明显，且在不同的早期阶段可观察到特定的缺陷。然而，这些结果是基于小样本量和横断面设计得出的。鉴于此以及双相情感障碍的异质性，这些发现应谨慎解读且需要重复验证。
