Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications.
Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications.
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DOI：
10.1017/s0033291714000439
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发表时间：
2014-10
影响因子：
6.9
通讯作者：
Malhotra AK
中科院分区：
文献类型：
--
作者：
Burdick KE;Russo M;Frangou S;Mahon K;Braga RJ;Shanahan M;Malhotra AK
最近的数据表明，双相情感障碍（BPD）中的特征样神经认知障碍，缺陷约为1 s.D.。低于平均水平，比精神分裂症的缺陷严重。BPD的显著损害的频率约为60%，其中40%的患者的特征为认知保留。这与精神分裂症中更同质的表现形成对比。目前还不清楚为什么有些BPD患者会出现缺陷，而另一些则不会。共有136例BPD患者完成了MATRICS共识认知成套测验，并将数据输入分层聚类分析，以：（1）确定适合样本的聚类（亚组）的最佳数量;（2）根据个体特征将受试者分配到特定聚类。然后，我们比较了几个临床因素和现实世界社区功能的亚组。结果发现三个不同的神经认知亚组：（1）完整组在所有领域的表现与健康对照相当，但具有上级社会认知：（2）选择性损害组在加工速度、注意、言语学习和社会认知方面有中度缺陷，而在其他领域功能正常;和（3）在所有认知领域都有严重缺陷的整体损伤组，与精神分裂症的缺陷相当。这些结果表明，存在多个认知亚组的BPD与独特的档案和开始，以解决这些亚组之间的关系，几个临床因素和功能的结果。下一步将包括使用这些数据来帮助指导未来的努力，以针对这些致残症状进行治疗。
Recent data suggest trait-like neurocognitive impairments in bipolar disorder (BPD), with deficits about 1 s.D. below average, less severe than deficits noted in schizophrenia. The frequency of significant impairment in BPD is approximately 60%, with 40% of patients characterized as cognitively spared. This contrasts with a more homogeneous presentation in schizophrenia. It is not understood why some BPD patients develop deficits while others do not. A total of 136 patients with BPD completed the MATRICS Consensus Cognitive Battery and data were entered into hierarchical cluster analyses to: (1) determine the optimal number of clusters (subgroups) that fit the sample; and (2) assign subjects to a specific cluster based on individual profiles. We then compared subgroups on several clinical factors and real-world community functioning. Three distinct neurocognitive subgroups were found: (1) an intact group with performance comparable with healthy controls on all domains but with superior social cognition; (2) a selective impairment group with moderate deficits on processing speed, attention, verbal learning and social cognition and normal functioning in other domains; and (3) a global impairment group with severe deficits across all cognitive domains comparable with deficits in schizophrenia. These results suggest the presence of multiple cognitive subgroups in BPD with unique profiles and begin to address the relationships between these subgroups, several clinical factors and functional outcome. Next steps will include using these data to help guide future efforts to target these disabling symptoms with treatment.