Dissociable mechanisms for memory impairment in bipolar disorder and schizophrenia

2006 ◽  
Vol 36 (8) ◽  
pp. 1085-1095 ◽  
Author(s):  
DAVID C. GLAHN ◽  
JENNIFER BARRETT ◽  
CARRIE E. BEARDEN ◽  
JIM MINTZ ◽  
MICHAEL F. GREEN ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Memory Task ◽  
Cognitive Remediation ◽  
Memory Deficits ◽  
Absolute Level ◽  
Memory Impairments ◽  
Remediation Strategies ◽  
Organizational Dysfunction ◽  
Bipolar Patients

Background. Although memory deficits are consistently reported in schizophrenia and bipolar disorder, the mechanisms underlying these impairments are poorly understood. Clarifying the nature and degree of overlap in memory deficits between the two illnesses could help to distinguish brain systems disrupted in these illnesses, and indicate cognitive remediation strategies to improve patient outcomes.Method. We examined performance on a non-verbal memory task in clinically stable out-patients with bipolar disorder (n=40), schizophrenia (n=40), and healthy comparison subjects (n=40). This task includes conditions in which distinct mnemonic strategies – namely, using context to organize familiar stimuli or using holistic representation of novel stimuli – facilitate performance.Result. When compared to a reference condition, bipolar patients had deficits consistent with organizational dysfunction and poor detection of novel information. Although patients with schizophrenia performed worse than the other groups, they were only differentially impaired when organizational demands were significant. Task performance was not correlated with severity of clinical symptomatology.Conclusions. This pattern of distinct memory impairments implies disturbances in partially overlapping neural systems in bipolar disorder and schizophrenia. Evidence of impairment in detection of novel stimuli that is unique to bipolar disorder suggests that, while the absolute level of cognitive dysfunction is less severe in bipolar disorder as compared to schizophrenia, subtle disruptions in memory are present. These findings can be used to plan targeted cognitive remediation programs by helping patients to capitalize on intact functions and to learn new strategies that they do not employ without training.

scholarly journals Cognitive impact in bipolar disorder

2019 ◽  
pp. 052-058
Author(s):  
Bourin Michel
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Visual Memory ◽  
Age Of Onset ◽  
Cognitive Difficulties ◽  
Speed Of Information Processing ◽  
History Of ◽  
Bipolar Patients ◽  
Disability Severity ◽  
Depressive Episodes

It appears that bipolar patients suffer from cognitive difficulties whereas they are in period of thymic stability. These intercritical cognitive difficulties are fairly stable and their severity is correlated with the functional outcome of patients. Nevertheless, the profile of cognitive impairment varies significantly from study to study quantitatively and qualitatively. According to the studies, the authors find difficulties in terms of learning, verbal memory, visual memory, working memory, sustained attention, speed of information processing, functions executive. On the other hand, deficits of general intelligence, motor functions, selective attention, and language are not usually found. One of the reasons for the heterogeneity of results is the difficulty of exploring cognition in bipolar disorder. Many factors must be taken into account, such as the presence of residual mood symptoms, the longitudinal history of the disorder (age of onset, number of episodes due, among others, the neurotoxic impact of depressive episodes and deleterious cognitive effects). (length of hospitalization), level of disability severity, comorbidities (particularly addictive).

scholarly journals Organizational Learning Strategies and Verbal Memory Deficits in Bipolar Disorder

2017 ◽  
Vol 23 (4) ◽  
pp. 358-366 ◽  
Author(s):  
George C. Nitzburg ◽  
Armando Cuesta-Diaz ◽  
Luz H. Ospina ◽  
Manuela Russo ◽  
Megan Shanahan ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Learning Strategies ◽  
Verbal Memory ◽  
Verbal Learning ◽  
Diagnostic Category ◽  
Exact Nature ◽  
Organizational Strategies ◽  
Learning Differences ◽  
Mnemonic Devices ◽  
Bipolar Patients

AbstractBackground: Verbal memory (VM) impairment is prominent in bipolar disorder (BD) and is linked to functional outcomes. However, the intricacies of VM impairment have not yet been studied in a large sample of BD patients. Moreover, some have proposed VM deficits that may be mediated by organizational strategies, such as semantic or serial clustering. Thus, the exact nature of VM break-down in BD patients is not well understood, limiting remediation efforts. We investigated the intricacies of VM deficits in BD patients versus healthy controls (HCs) and examined whether verbal learning differences were mediated by use of clustering strategies. Methods: The California Verbal Learning Test (CVLT) was administered to 113 affectively stable BD patients and 106 HCs. We compared diagnostic groups on all CVLT indices and investigated whether group differences in verbal learning were mediated by clustering strategies. Results: Although BD patients showed significantly poorer attention, learning, and memory, these indices were only mildly impaired. However, BD patients evidenced poorer use of effective learning strategies and lower recall consistency, with these indices falling in the moderately impaired range. Moreover, relative reliance on semantic clustering fully mediated the relationship between diagnostic category and verbal learning, while reliance on serial clustering partially mediated this relationship. Conclusions: VM deficits in affectively stable bipolar patients were widespread but were generally mildly impaired. However, patients displayed inadequate use of organizational strategies with clear separation from HCs on semantic and serial clustering. Remediation efforts may benefit from education about mnemonic devices or “chunking” techniques to attenuate VM deficits in BD. (JINS, 2017, 23, 358–366)

scholarly journals Verbal memory impairments in bipolar disorder: Effect of type of word learning tasks

2017 ◽  
Vol 71 (8) ◽  
pp. 570-571 ◽  
Author(s):  
Tomiki Sumiyoshi ◽  
Atsuhito Toyomaki ◽  
Naoko Kawano ◽  
Tomoko Kitajima ◽  
Ichiro Kusumi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Word Learning ◽  
Verbal Memory ◽  
Memory Impairments ◽  
Learning Tasks ◽  
Disorder Effect

The Effect of Gender on Neurocognitive Functioning in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S213-S213 ◽  
Author(s):  
K. Tournikioti ◽  
P. Ferentinos ◽  
I. Michopoulos ◽  
D. Dikeos ◽  
C. Soldatos ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Executive Functions ◽  
Associative Learning ◽  
Verbal Memory ◽  
Visual Memory ◽  
Fixed Effects ◽  
Gender Effects ◽  
Analysis Of Covariance ◽  
Healthy Controls ◽  
Bipolar Patients

IntroductionBipolar disorder (BD) is frequently associated with cognitive deficits in attention, verbal memory and executive functions that have been related to various clinical characteristics of the disorder.ObjectivesHowever, few studies have examined the effect of gender on cognition despite its clinical relevance.AimsThe aim of our study was to investigate potential diagnosis-specific gender effects on visual memory/learning and executive functions in BD.MethodsCognitive performance of 60 bipolar-I patients and 30 healthy controls was evaluated by using CANTAB battery tasks targeting spatial memory (SRM), paired associative learning (PAL), executive functions (ID/ED, SOC). A multivariate analysis of covariance (MANCOVA) of neuropsychological parameters was performed with gender and diagnosis as fixed effects and age and education as covariates. Following univariate analyses of covariance (ANCOVA) were undertaken to examine the effect of gender on each neuropsychological task.ResultsBipolar patients showed significantly poorer performance in paired associative learning (PAL), set shifting (ID/ED) and planning (SOC). Moreover, a diagnosis specific gender effect was observed for cognitive functioning in BD (gender × diagnosis interaction P = 0.029). Specifically, male healthy controls outperformed healthy females in tasks of visual memory/learning but this pattern was not sustained (SRM) or was even reversed (PAL) in BD patients.ConclusionsThe present study is one of the few studies that have examined the effect of gender on neurocognitive function in BD. Our findings indicate that the gender-related variation observed in healthy subjects is disrupted in BD. Moreover, they suggest that gender may modulate the degree of frontotemporal dysregulation observed in BD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Associations between mood instability and emotional processing in a large cohort of bipolar patients

2016 ◽  
Vol 46 (15) ◽  
pp. 3151-3160 ◽  
Author(s):  
A. C. Bilderbeck ◽  
Z. E. Reed ◽  
H. C. McMahon ◽  
L. Z. Atkinson ◽  
J. Price ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Emotional Processing ◽  
Memory Task ◽  
Large Cohort ◽  
Mood Variability ◽  
Manic Symptoms ◽  
Mood Instability ◽  
Current Medication ◽  
Emotional Bias ◽  
Bipolar Patients

BackgroundAberrant emotional biases have been reported in bipolar disorder (BD), but results are inconsistent. Despite the clinical relevance of chronic mood variability in BD, there is no previous research investigating how the extent of symptom fluctuations in bipolar disorder might relate to emotional biases. This exploratory study investigated, in a large cohort of bipolar patients, whether instability in weekly mood episode symptoms and other clinical and demographic factors were related to emotional bias as measured in a simple laboratory task.MethodParticipants (N = 271, BDI = 206, BDII = 121) completed an ‘emotional categorization and memory’ task. Weekly self-reported symptoms of depression and mania were collected prospectively. In linear regression analyses, associations between cognitive bias and mood variability were explored together with the influence of demographic and clinical factors, including current medication.ResultsGreater accuracy in the classification of negative words relative to positive words was associated with greater instability in depressive symptoms. Furthermore, greater negative bias in free recall was associated with higher instability in manic symptoms. Participants diagnosed with BDII, compared with BDI, showed overall better word recognition and recall. Current antipsychotic use was associated with reduced instability in manic symptoms but this did not impact on emotional processing performance.ConclusionsEmotional processing biases in bipolar disorder are related to instability in mood. These findings prompt further investigation into the underpinnings as well as clinical significance of mood instability.

Interepisode Functioning of Bipolar Disorder

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
O. Aydemir
Keyword(s):  
Bipolar Disorder ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Subjective Assessment ◽  
Substantial Effect ◽  
Cognitive Domain ◽  
Residual Symptoms ◽  
Psychosocial Impairment ◽  
Objective Tests ◽  
Bipolar Patients

Even though bipolar disorder is suggested to have a benign course with episodes and remissions, it has been shown that interepisode functioning of bipolar disorder is not so good. Subclinical residual mood symptoms are found to be in 24% of bipolar patients during remission. Furthermore, it appears that 30-60% of individuals with bipolar disorder fail to regain full functioning in occupational and social domains. In cognitive domain, euthymic bipolar patients demonstrate relatively marked impairment in aspects of executive function such as processing speed and verbal fluency, sustained attention, and verbal memory.It is estimated that 30-50% of largely remitted patients fail to attain premorbid levels of psychosocial functioning due to their cognitive impairment. It is also suggested that the subsyndromal residual depressive symptoms have substantial effect on the persistence of cognitive and psychosocial impairment after remission. Thus, residual symptoms play an important role in the inter-episode functioning of the bipolar patients.In the assessment of interepisode functioning, subjective QOL in bipolar patients may not accurately reflect objective functional outcome status. Especially, in the subjective assessment of cognitive functions, bipolar patients tend to over-estimate themselves. There is only weak to moderate correlation between subjective cognitive complains and objective cognitive tests. Therefore, it would be more accurate to assess the inter-episode functioning of the bipolar patients via objective tests and ratings.

Using a highly abbreviated California Verbal Learning Test-II to detect verbal memory deficits

2012 ◽  
Vol 19 (4) ◽  
pp. 498-501 ◽  
Author(s):  
Elizabeth S Gromisch ◽  
Vance Zemon ◽  
Ralph HB Benedict ◽  
Nancy D Chiaravalloti ◽  
John DeLuca ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Operating Characteristic ◽  
Screening Tool ◽  
Verbal Learning ◽  
Memory Deficits ◽  
California Verbal Learning Test ◽  
Memory Impairments ◽  
Memory Problems ◽  
The Mean ◽  
Learning Test

Multiple sclerosis (MS) is frequently accompanied by changes in verbal memory. We hypothesized that administering an abbreviated California Verbal Learning Test-II (CVLT-II) would detect verbal memory problems in MS accurately, thus serving as a potential screening tool. We performed receiver-operating-characteristic (ROC) analyses of three trials (trial 1, trial 2, and trial 1+2 combined) for raw data against standardized total scores. The results showed that at 1.5 standard deviations (SD) from the mean, the first two trials were 96.3% accurate, while at 2 SD from the mean, the first two trials combined were 97.5% accurate. We conclude that this study demonstrates than an abbreviated CVLT-II is a valid screening tool for verbal memory impairments.

Mechanisms underlying memory impairment in schizophrenia

1997 ◽  
Vol 27 (2) ◽  
pp. 383-393 ◽  
Author(s):  
G. BRÉBION ◽  
X. AMADOR ◽  
M. J. SMITH ◽  
J. M. GORMAN
Keyword(s):  
Analysis Of Variance ◽  
Verbal Memory ◽  
Early Phase ◽  
Memory Performance ◽  
Memory Task ◽  
Long Term Memory ◽  
Free Recall Task ◽  
Semantic Cues ◽  
Memory Impairments

Background. The purpose of this experiment was to investigate mechanisms underlying commonly-observed verbal memory impairments in schizophrenia, and especially the hypothesized encoding deficit.Methods. A verbal memory task was administered to 38 patients with schizophrenia and 38 normal controls. Three functions involved in long-term memory – encoding, early phase of storage, retrieval – were investigated. First, non-organizable lists were compared to semantically-organizable lists in a free recall task, in order to vary encoding conditions. Superficial encoding (measured by a ‘sequence’ index) and deep encoding (measured by a categorization index) were assessed. Secondly, early storage was investigated by varying the delay between learning and recall. Lastly, cues were provided for organizable lists (semantic cues) and non-organizable lists (recognition sheet), in order to vary retrieval conditions.Results. An analysis of variance revealed an interaction between type of list (organizable, non-organizable) and group, showing that patients used organization less than controls. A further analysis showed that deep encoding was impaired. Also, although the propensity to use superficial encoding was unimpaired, its efficiency was less. The analysis of variance revealed no interaction with delay or with either type of cue. A correlation was found between deep processing and memory performance in both groups.Conclusions. A major deficit in encoding appeared in the patient group, with a lesser use of deep encoding and a lesser efficiency of superficial encoding. On the other hand, the early phase of storage and the retrieval function seemed unaffected. Overall memory performance appeared to be related to the depth of encoding.

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