Understanding the Neurocognitive Heterogeneity in Bipolar Disorder

了解双相情感障碍的神经认知异质性

基本信息

批准号：
8596131
负责人：
Katherine Elizabeth Burdick
金额：
$ 42.38万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-05 至 2018-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8596131
关键词：
Activities of Daily Living Acute Address Affective Affective Symptoms Alcohol or Other Drugs use Anxiety Disorders Architecture Area Attention Biological Biological Assay Biological Markers Bipolar Disorder Blood specimen Brain-Derived Neurotrophic Factor Child Abuse Circadian Rhythms Clinical Clinical Markers Cluster Analysis Cognitive Communities Comorbidity Data Development Diagnostic Disease Disease remission Etiology Evaluation Frequencies Future Heterogeneity Impaired cognition Impairment Independent Living Individual Interleukin-12 Interleukin-2 Measures Mediator of activation protein Medical Modeling Neurocognition Neurocognitive Neurocognitive Deficit Occupational Outcome Patients Pattern Performance Peripheral Phenotype Psychotic Disorders Quality of life Recording of previous events Recovery Relative (related person)Research Risk Role Sampling Schizophrenia Severities Sleep Structure Subgroup Symptoms Testing Tumor Necrosis Factor-alpha Verbal Learning abuse neglect base cohort cytokine design effective therapy executive function functional disability functional outcomes human TNF protein inflammatory marker insight neurotrophic factor novel novel strategies pediatric trauma performance tests public health relevance social trait

项目摘要

DESCRIPTION (provided by applicant): Patients with bipolar disorder (BPD) were once thought to achieve complete inter-episode recovery, particularly with regard to cognitive dysfunction. More recent data suggest a persistent, trait-like pattern of neurocognitive impairments in BPD, even during periods of affective remission. At the group level, the severity of these deficits is 3/4 to 1 full standard deviation below average, which is significantly less severe than deficits noted in schizophrenia (SZ). Recent evidence, however, suggests that the frequency of cognitive impairment in euthymic BPD patients is ~40-60%, with a substantial proportion of patients characterized as cognitively- spared. This contrasts with the relative homogeneity of this phenotype in SZ where > 90% of patients demonstrates significant impairment. A better understanding of the cognitive heterogeneity in BPD, why some patients develop significant cognitive difficulties while others do not, is critical toward optimizing patiets' quality of life. The current proposal aims to determine the clinical and biological predictors of cognitive impairment in 350 patients with BPD using a novel approach. We will empirically test for homogeneous subgroups within the sample based neurocognitive performance and test a cassette of clinical features and biomarkers as potential predictors of impairment. We will also investigate the relationship between neurocognitive functioning and everyday functional capacity in the areas of occupational, social and independent living ability. Data will provide important information on the underlying structure of neurocognition in BPD and its etiology, guiding future efforts to target these disabling symptoms with treatment.

描述（由申请人提供）：双相情感障碍（BPD）患者曾经被认为能够在发作间期完全恢复，特别是在认知功能障碍方面。最近的数据表明，即使在情感缓解期间，BPD 也存在持续的、类似特征的神经认知损伤模式。在群体水平上，这些缺陷的严重程度比平均水平低 3/4 到 1 个完整标准差，明显低于精神分裂症 (SZ) 中注意到的缺陷严重程度。然而，最近的证据表明，情绪正常的 BPD 患者出现认知障碍的频率约为 40-60%，其中相当大比例的患者具有认知障碍。这与 SZ 中该表型的相对同质性形成鲜明对比，其中 > 90% 的患者表现出显着的损伤。更好地理解边缘性人格障碍的认知异质性，以及为什么一些患者会出现明显的认知困难而另一些患者则不会的原因，对于优化患者的生活质量至关重要。目前的提案旨在使用一种新方法确定 350 名 BPD 患者认知障碍的临床和生物学预测因子。我们将根据经验测试样本中基于神经认知表现的同质亚组，并测试一系列临床特征和生物标志物作为潜在的损伤预测因子。我们还将研究神经认知功能与职业、社交和独立生活能力领域日常功能能力之间的关系。数据将提供有关 BPD 神经认知的基本结构及其病因学的重要信息，指导未来针对这些致残症状的治疗。