Evidence for disruption in prefrontal cortical functions in juvenile bipolar disorder
Evidence for disruption in prefrontal cortical functions in juvenile bipolar disorder
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DOI：
10.1111/j.1399-5618.2007.00453.x
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发表时间：
2007-06-01
影响因子：
5.4
通讯作者：
Soares, Jair C.
中科院分区：
文献类型：
--
作者：
Bearden, Carrie E.;Glahn, David C.;Soares, Jair C.
目的：执行功能过程的系统解析对于开发更具体的神经生物学过程模型至关重要，该模型介导双相情感障碍（BPD）青年的认知障碍。33例儿童和青少年双相I型障碍（BPD I）样本（平均年龄12.1 ± 3.0岁，39%为女性）和44名人口统计学匹配的健康受试者（平均年龄12.9 +/-2.8岁，50%女性）完成了神经认知成套测验，包括旨在检测前额叶皮质回路中断的测量（即，结果：与健康对照组相比，BPD I儿童在空间工作记忆、视觉排序和扫描、言语流畅性和抽象问题解决方面存在显著缺陷，尤其是当涉及记忆成分时。在我们的空间延迟反应任务中，记忆集大小是参数变化的; BPD I儿童的表现模式表明短期记忆编码和/或存储的缺陷，而不是空间工作记忆的容量限制。早期发病年龄和抗精神病药物的使用与快速信息处理任务的表现较差相关;然而，心境障碍的严重程度和与破坏性行为障碍的合并症与任务表现无关。这些结果表明，青少年BPD I患者的前额叶皮质功能障碍与成人BPD I患者相似，并暗示腹侧和背外侧前额叶皮层是青少年BPD的病理部位。由于这些缺陷与临床状态或与其他疾病的合并症无关，它们可能反映了性状相关的损伤，这一假设将在纵向研究中进一步探讨。
Objectives: Systematic parsing of executive function processes is critical for the development of more specific models of neurobiological processes mediating disturbed cognition in youth with bipolar disorder (BPD).Methods: A sample of 33 children and adolescents with bipolar I disorder (BPD I) (mean age 12.1 +/- 3.0 years, 39% female) and 44 demographically matched healthy participants (mean age 12.9 +/- 2.8 years, 50% female) completed a neurocognitive battery including measures aimed at detection of disruption in prefrontal cortical circuitry (i.e., working memory, set shifting, and rule attainment).Results: Compared to healthy controls, BPD I children exhibited significant deficits in spatial working memory, visual sequencing and scanning, verbal fluency and abstract problem solving, particularly when a memory component was involved. In our spatial delayed response task, memory set size was parametrically varied; the performance pattern in BPD I children suggested deficits in short-term memory encoding and/or storage, rather than capacity limitations in spatial working memory. Earlier age at onset of illness and antipsychotic medication usage were associated with poorer performance on speeded information-processing tasks; however, severity of mood symptomatology and comorbidity with disruptive behavior disorders were not associated with task performance.Conclusions: These results suggest impairment in measures of prefrontal cortical function in juvenile BPD I that are similar to those seen in the adult form of the illness, and implicate both the ventral and dorsolateral prefrontal cortex as loci of pathology in juvenile BPD. As these deficits were not associated with clinical state or comorbidity with other disorders, they may reflect trait-related impairments, a hypothesis that will be pursued further in longitudinal studies.