共病酒精使用障碍对双相情感障碍的影响：关注神经认知功能和炎症标志物。

Effects of comorbid alcohol use disorder on bipolar disorder: Focusing on neurocognitive function and inflammatory markers.

机构信息

Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Psychoneuroendocrinology. 2023 Jun;152:106083. doi: 10.1016/j.psyneuen.2023.106083. Epub 2023 Mar 13.

DOI:10.1016/j.psyneuen.2023.106083

PMID:36934699

Abstract

BACKGROUND

Alcohol use disorder (AUD) is a highly prevalent comorbid disorder in patients with bipolar disorder (BD). Both BD and AUD were found to be associated with inflammation and cognitive deficits, but few study has been done on BD comorbid with AUD (BD+AUD). We aimed to investigate the impacts of comorbid AUD and BD on cognitive function, inflammatory and neurotrophic markers.

METHOD

We recruited 641 BD patients, 150 patients with BD+AUD, and 185 healthy controls (HC). Neuropsychological tests [Wisconsin card sorting test (WCST), continuous performance test (CPT), and Wechsler memory scale - third edition (WMS-III)] and cytokine plasma levels [tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), interleukin-8 (IL-8), transforming growth factor-β1 (TGF-β1), and brain-derived neurotrophic factor (BDNF)] were assessed.

RESULTS

BD+AUD patients had worse cognitive performance than those without AUD. There was a significant difference in the plasma levels of TNF-α, IL-8, and BDNF (P < 0.001, <0.001, and 0.01, respectively) between the patients and the HC groups. Post hoc analysis showed that BD+AUD patients had higher levels of TNF-α and IL-8 than BD-only patients (P < 0.001). Additionally, plasma IL-8 levels were negatively associated with number of completed categories in WCST (P = 0.02), and TNF-α levels were negatively associated with visual immediate index in WMS-III (P = 0.05).

CONCLUSION

Our results suggest that comorbid AUD and BD might worsen cognitive impairments and inflammatory processes. Further longitudinal studies on BD+AUD may be needed.

摘要

背景

酒精使用障碍（AUD）是双相障碍（BD）患者中高度普遍的共病障碍。BD 和 AUD 均与炎症和认知缺陷有关，但针对 BD 合并 AUD（BD+AUD）的研究较少。我们旨在研究 AUD 和 BD 共病对认知功能、炎症和神经发生标志物的影响。

方法

我们招募了 641 名 BD 患者、150 名 BD+AUD 患者和 185 名健康对照者（HC）。进行了神经心理学测试[威斯康星卡片分类测试（WCST）、连续性能测试（CPT）和韦氏记忆量表-第三版（WMS-III）]和细胞因子血浆水平[肿瘤坏死因子-α（TNF-α）、C 反应蛋白（CRP）、白细胞介素-8（IL-8）、转化生长因子-β1（TGF-β1）和脑源性神经营养因子（BDNF）]评估。

结果

BD+AUD 患者的认知表现比无 AUD 的患者差。患者组与 HC 组之间 TNF-α、IL-8 和 BDNF 的血浆水平存在显著差异（P<0.001、<0.001 和 0.01）。事后分析显示，BD+AUD 患者的 TNF-α和 IL-8 水平高于仅 BD 患者（P<0.001）。此外，血浆 IL-8 水平与 WCST 中完成类别数呈负相关（P=0.02），TNF-α水平与 WMS-III 中的视觉即时指数呈负相关（P=0.05）。