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）：曾经认为躁郁症患者（BPD）可以实现完全的情节间恢复，尤其是在认知功能障碍方面。最新的数据表明，即使在情感缓解期间，BPD中神经认知障碍的持久性特征模式也是如此。在小组级别上，这些缺陷的严重程度为3/4至1个完整的标准偏差低于平均水平，其严重程度明显低于精神分裂症（SZ）中指出的缺陷。然而，最近的证据表明，正式BPD患者认知障碍的频率约为40-60％，其中很大一部分的患者被认知保存。这与SZ中该表型的相对同质性形成对比，在SZ中，> 90％的患者表现出严重的损害。更好地了解BPD的认知异质性，为什么有些患者出现严重的认知困难而另一些患者却没有，这对于优化Patiets的生活质量至关重要。当前的提案旨在使用一种新方法来确定350例BPD患者认知障碍的临床和生物学预测因子。我们将在基于样本的神经认知性能中的经验测试均质亚组，并测试临床特征和生物标志物的盒式盒子，作为潜在的损害预测指标。我们还将研究职业，社会和独立生活能力领域的神经认知功能与日常功能能力之间的关系。数据将提供有关BPD中神经认知基础结构及其病因的重要信息，从而指导未来的努力，以通过治疗针对这些残疾症状。