Tran Jason, Gupta Arnav, Fabiano Nicholas, Dhir Vinita, Larose Katherine, Lasker Iris, Wong Stanley, Mohammad Ibrahim Y Z, Le Steven, Fiedorowicz Jess G, Shorr Risa, Zampieri Andrea, Bellato Alessio, Cortese Samuele, Solmi Marco
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Department of Medicine, University of Calgary, Calgary, AB, Canada.
Neurosci Appl. 2024 Mar 15;3:104057. doi: 10.1016/j.nsa.2024.104057. eCollection 2024.
Visual impairments are common in patients with bipolar disorder (BD), and the neuropathophysiology may suggest a potential influence on colour vision. This systematic review aimed to assess existing data of colour vision impairment, including chromatic discrimination and colour blindness in patients with BD. Comprehensive literature search compliant with PRISMA 2020 was conducted in Medline, Embase, and Google Scholar from inception to February 28th, 2023. Our inclusion criteria were: (1) patients with a diagnosis of bipolar I or II disorder based on DSM, ICD, or clinical diagnosis, and (2) study investigating colour vision (i.e., including colour blindness and discrimination), with (3) no restrictions on the condition of the comparator group. Study quality appraisal was performed using the NIH Study Quality Assessment Tool. Five studies from Brazil, Netherlands, and USA, with 338 patients were included. Three cross-sectional studies assessed chromatic discrimination and two case-series assessed colour blindness in patients with BD. The three cross-sectional studies support reduced chromatic discrimination during mild to moderate mania in BD when compared to healthy comparators. The latter two articles presented low evidence of an X-linked inheritance of BD. Our review indicates evidence of reduced chromatic discrimination in mild to moderate mania. However, further research is needed to validate these findings and to extend to other mood states in BD given current limitations. Future studies can benefit from further multi-institutional data, larger sample sizes, appropriate blinding, the use of biomarkers, and statistical adjustment to confounders to fully elucidate the role of chromatic discrimination in BD.
视力障碍在双相情感障碍（BD）患者中很常见，其神经病理生理学可能提示对色觉有潜在影响。本系统评价旨在评估双相情感障碍患者色觉损害的现有数据，包括色觉辨别和色盲情况。从创刊至2023年2月28日，我们在Medline、Embase和谷歌学术上进行了符合PRISMA 2020的全面文献检索。我们的纳入标准为：（1）根据DSM、ICD或临床诊断确诊为双相I型或II型障碍的患者，以及（2）研究色觉（即包括色盲和色觉辨别），且（3）对比较组的情况无限制。使用美国国立卫生研究院研究质量评估工具进行研究质量评估。纳入了来自巴西、荷兰和美国的五项研究，共338名患者。三项横断面研究评估了双相情感障碍患者的色觉辨别，两项病例系列研究评估了色盲情况。这三项横断面研究支持，与健康对照者相比，双相情感障碍患者在轻至中度躁狂发作期间色觉辨别能力下降。后两篇文章提供了双相情感障碍X连锁遗传的低证据。我们的评价表明，有证据显示双相情感障碍患者在轻至中度躁狂发作期间色觉辨别能力下降。然而，鉴于目前的局限性，需要进一步研究来验证这些发现，并将其扩展到双相情感障碍的其他情绪状态。未来的研究可以受益于更多的多机构数据、更大的样本量、适当的盲法、生物标志物的使用以及对混杂因素的统计调整，以充分阐明色觉辨别在双相情感障碍中的作用。
