Neurocognition in Children At Risk for Bipolar Disorder

描述(申请人提供)：本次修订的NIMH小额补助金(R03)奖励申请是为了支持对具有双相情感障碍(BPD)遗传风险的儿童的执行功能能力的初步调查。儿童和青少年的BPD越来越被认为是一种常见的疾病，具有显著的发病率和死亡率。有人提出，患有BPD的儿童可能有很强的遗传脆弱性，容易患上这种疾病，也可能表现出一种特别致命的疾病形式。除了情绪症状，有强有力的证据表明，BPD患者表现出认知功能障碍。此外，少数报告表明，具有BPD遗传风险但在评估时尚未出现情绪综合征的成人和儿童存在明显的认知缺陷。认知缺陷具有直接的临床相关性，因为已知它们与完成成功的日常功能所需的活动(包括学术和职业活动)的障碍有关。此外，具有BPD遗传风险的个体的认知功能障碍具有很强的理论重要性，因为它可能提供关于情绪综合征遗传特征的信息，为关于情绪障碍的神经生理学基础的理论提供信息，并可能在未来被评估为一个可能有助于早期发现最有可能患BPD的个体的标志物。我们实验室以前的工作表明，具有BPD遗传风险的儿童存在执行功能缺陷，包括计划、解决问题和抑制方面的障碍。这项拟议的研究将比较有情绪综合症的高危儿童、没有情绪综合症的高危儿童，以及父母没有情绪障碍的对照组儿童在执行功能特定组成部分过程的测试中的能力。这项研究的第二个目的是通过家长和教师的评分，检查患有和不患有情绪综合征的BPD风险儿童是否在日常生活活动中表现出损害，这些活动被认为依赖于执行功能技能的完整性，并检查这些功能缺陷与执行能力的神经心理测试表现之间的关系。

DESCRIPTION (provided by applicant): This revised NIMH Small Grant (R03) Award application is to support a preliminary investigation of executive functioning ability in children genetically at risk to develop bipolar disorder (BPD). BPD in children and adolescents is increasingly recognized as a common disorder with significant morbidity and mortality. It has been suggested that children with BPD may have a strong genetic vulnerability to develop this disorder and also may exhibit a particularly virulent form of the disorder. In addition to their mood symptoms, there is strong evidence that patients with BPD demonstrate cognitive dysfunction. Furthermore, a small number of reports suggest that cognitive deficits are evident in adults and children who are at genetic risk for BPD but who, at the time of evaluation, have not developed mood syndromes. Cognitive deficits are of direct clinical relevance because they are known to be associated with impairment in completing activities required for successful everyday functioning, including academic and vocational activities. In addition, cognitive dysfunction in individuals who are genetically at risk for BPD has strong theoretical importance because it may provide information about inherited features of mood syndromes, inform theories about the neurophysiological basis of mood disorders, and may potentially be evaluated in the future as one marker that could contribute to the early detection of individuals who are at the strongest risk of developing BPD. Previous work from our laboratory suggests that children at genetic risk for BPD have executive functioning deficits, including impairment in planning, problem-solving, and inhibition. The proposed study will compare the abilities of at-risk children who have mood syndromes, at-risk children without mood syndromes, and a control group of children of parents without a mood disorder on tests of specific component processes of executive functioning. A secondary aim of the study is examine, through parent and teacher ratings, whether children at risk for BPD with and without mood syndromes exhibit impairment in activities of daily living that are thought to be dependent on the integrity of executive functioning skills, and to examine the relationship between these functional deficits and performance on neuropsychological tests of executive ability.