University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States.
University of Utah School of Medicine, Department of Psychiatry, 383 Colorow Drive, Salt Lake City, UT 84108, United States; Veterans Affairs VISN 19 Mental Illness Research, Education and Clinical Center, Salt Lake City, UT, United States.
J Affect Disord. 2018 Jan 1;225:71-78. doi: 10.1016/j.jad.2017.07.052. Epub 2017 Aug 1.
Although cognitive deficits in bipolar disorder (BD) have been repeatedly observed, our understanding of these impairments at a mechanistic level remains limited. Few studies that investigated cognitive impairments in bipolar illness have examined the association with brain biochemistry. This pilot study utilized proton magnetic resonance spectroscopy (H-MRS) to evaluate the relationship between neurocognitive performance and brain metabolites in youth with BD.
Thirty participants, twenty depressed BD participants and ten healthy comparison participants, ages 13-21, completed mood and executive function measures. H-MRS data were also acquired from the anterior cingulate cortex (ACC) using two-dimensional (2D) J-resolved H-MRS sequence. Proton metabolites including N-acetyl aspartate (NAA) and gamma-aminobutyric acid (GABA) were quantified for both groups.
Participants with BD performed significantly lower on executive functioning measures than comparison participants. There were significant positive correlations between Wisconsin Card Sorting Test (WCST) performance and NAA (p < .001) and GABA (p < .01) in the ACC in bipolar youth, such that as WCST performance increased, both NAA and GABA levels increased.
Small sample size and lack of control for medications.
These findings build on previous observations of biochemical alterations associated with BD and indicate that executive functioning deficits in bipolar youth are correlated with NAA and GABA. These results suggest that cognitive deficits occur early in the course of illness and may reflect risk factors associated with altered neurochemistry. Further investigation of the relationship between brain metabolites and cognition in BD may lead to important information for developing novel, targeted interventions.
尽管双相情感障碍（BD）患者存在认知缺陷已被反复观察到，但我们对这些损伤的机制理解仍很有限。少数研究探讨了双相情感障碍患者的认知损伤与大脑生物化学之间的关系。本研究采用质子磁共振波谱（H-MRS）来评估青少年双相情感障碍患者的神经认知表现与大脑代谢物之间的关系。
共有 30 名参与者，包括 20 名抑郁发作的双相情感障碍患者和 10 名健康对照者，年龄在 13-21 岁之间，完成了情绪和执行功能测量。还使用二维（2D）J 分辨 H-MRS 序列从前扣带回皮质（ACC）采集 H-MRS 数据。对两组的质子代谢物（包括 N-乙酰天冬氨酸（NAA）和γ-氨基丁酸（GABA））进行了量化。
与对照组相比，BD 患者在执行功能测量上的表现明显较低。双相情感障碍青少年的威斯康星卡片分类测验（WCST）表现与 ACC 中的 NAA（p <.001）和 GABA（p <.01）呈显著正相关，即随着 WCST 表现的提高，NAA 和 GABA 水平都增加。
样本量小，未控制药物。
这些发现建立在先前观察到的与 BD 相关的生化改变的基础上，并表明双相情感障碍青少年的执行功能缺陷与 NAA 和 GABA 相关。这些结果表明认知缺陷在疾病早期就出现了，可能反映了与神经化学改变相关的风险因素。进一步研究双相情感障碍患者大脑代谢物与认知之间的关系可能会为开发新的、有针对性的干预措施提供重要信息。
