Strawbridge Rebecca, Carter Rowena, Saldarini Francesco, Tsapekos Dimosthenis, Young Allan H
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
National Affective Disorders Service, South London & Maudsley NHS Foundation Trust, UK.
BJPsych Open. 2021 Jul 9;7(4):e126. doi: 10.1192/bjo.2021.966.
Neurobiological research frequently implicates inflammatory and neurogenic components with core aspects of bipolar disorder. Even in periods of symptom remission (euthymia), individuals with bipolar disorder experience cognitive impairments, which are increasingly being proposed as an outcome for interventions; identifying biomarkers associated with cognitive impairment in people with bipolar disorder could advance progress in this therapeutic field through identifying biological treatment targets.
We aimed to identify proteomic biomarker correlates of cognitive impairment in individuals with euthymic bipolar disorder.
Forty-four adults with a bipolar disorder diagnosis in euthymia underwent a battery of cognitive assessments and provided blood for biomarkers. We examined a comprehensive panel of inflammatory and trophic proteins as putative cross-sectional predictors of cognition, conceptualised according to recommended definitions of clinically significant cognitive impairment (binary construct) and global cognitive performance (continuous measure).
A total of 48% of the sample met the criteria for cognitive impairment. Adjusting for potentially important covariates, regression analyses identified lower levels of three proteins as significantly and independently associated with cognitive deficits, according to both binary and continuous definitions (interleukin-7, vascular endothelial growth factor C and placental growth factor), and one positively correlated with (continuous) global cognitive performance (basic fibroblast growth factor).
This study identifies four candidate markers of cognitive impairment in bipolar disorder, none of which have been previously compared with cognitive function in participants with bipolar disorder. Pending replication in larger samples and support from longitudinal studies, these markers could have implications for treating cognitive dysfunction in this patient population.
神经生物学研究经常将炎症和神经源性成分与双相情感障碍的核心方面联系起来。即使在症状缓解期(心境正常),双相情感障碍患者也会经历认知障碍,越来越多的人提出将其作为干预的结果;确定与双相情感障碍患者认知障碍相关的生物标志物,通过确定生物治疗靶点,可推动该治疗领域的进展。
我们旨在确定心境正常的双相情感障碍患者认知障碍的蛋白质组学生物标志物相关性。
44名诊断为双相情感障碍且处于心境正常状态的成年人接受了一系列认知评估,并提供血液用于生物标志物检测。我们检查了一组全面的炎症和营养蛋白,作为认知的假定横断面预测指标,根据临床上显著认知障碍(二元结构)和整体认知表现(连续测量)的推荐定义进行概念化。
共有48%的样本符合认知障碍标准。在调整了潜在的重要协变量后,回归分析确定,根据二元和连续定义,三种蛋白质水平较低与认知缺陷显著且独立相关(白细胞介素-7、血管内皮生长因子C和胎盘生长因子),一种蛋白质与(连续的)整体认知表现呈正相关(碱性成纤维细胞生长因子)。
本研究确定了双相情感障碍中认知障碍的四个候选标志物,此前均未与双相情感障碍患者的认知功能进行比较。在更大样本中进行重复验证并得到纵向研究支持之前,这些标志物可能对治疗该患者群体的认知功能障碍有影响。