Cognitive impairment in a Brazilian sample of patients with bipolar disorder

OBJECTIVE: Persistent neurocognitive deficits have been described in bipolar mood disorder. As far as we are aware, no study have examined whether the cognitive impairment is presented in the same way in a Brazilian sample. METHOD: Cognitive function of 66 patients with bipolar disorder (32 with depressive symptoms and 34 euthymic) and 28 healthy subjects was examined using a complete cognitive battery. RESULTS: Patients with bipolar disorder presented a significantly poorer performance in eight of the 12 subtests when compared to healthy subjects. There was no significant difference between the subgroups of patients. These patients showed impairment in both verbal and non-verbal cognitive function. CONCLUSION: Cognitive impairment was found in both groups of patients with bipolar disorder. The findings described here suggest an overall impairment of cognitive function, independent of mood symptoms. This is in line with data showing that cognitive deficits may be a persistent characteristic of bipolar disorder.

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Saffron for mild cognitive impairment and dementia: a systematic review and meta-analysis of randomised clinical trials

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03102-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Zahra Ayati ◽

Guoyan Yang ◽

Mohammad Hossein Ayati ◽

Seyed Ahmad Emami ◽

Dennis Chang

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Daily Living ◽

Randomised Clinical Trials ◽

Disease Assessment ◽

Significant Difference

Abstract Background Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety.

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Two-year course of cognitive function and instrumental activities of daily living in older adults with bipolar disorder: evidence for neuroprogression?

Psychological Medicine ◽

10.1017/s0033291712001614 ◽

2012 ◽

Vol 43 (4) ◽

pp. 801-811 ◽

Cited By ~ 47

Author(s):

A. G. Gildengers ◽

D. Chisholm ◽

M. A. Butters ◽

S. J. Anderson ◽

A. Begley ◽

...

Keyword(s):

Older Adults ◽

Bipolar Disorder ◽

Cognitive Impairment ◽

Cognitive Function ◽

Activities Of Daily Living ◽

Cognitive Aging ◽

Repeated Measures ◽

Daily Living ◽

Time Points ◽

Instrumental Activities

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.

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Nithsdale Schizophrenia Surveys 20

The British Journal of Psychiatry ◽

10.1192/bjp.177.4.348 ◽

2000 ◽

Vol 177 (4) ◽

pp. 348-353 ◽

Cited By ~ 26

Author(s):

C. Kelly ◽

V. Sharkey ◽

G. Morrison ◽

J. Allardyce ◽

R. G. McCreadie

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Deficits ◽

Verbal Fluency ◽

Mini Mental State Examination ◽

Community Based ◽

Adult Reading ◽

The Mean ◽

National Adult Reading Test ◽

State Examination

BackgroundCognitive deficits are a core aspect of schizophrenia but there has been no study of cognitive function in a catchment-area-based population of patients with schizophrenia.AimsTo assess cognitive function in a population of patients with schizophrenia, and relate it to community functioning.MethodAll patients with schizophrenia in Nithsdale, south-west Scotland, were identified (n=182). Measures of assessment were: National Adult Reading Test (NART), Mini-Mental State Examination (MMSE), Rivermead Behavioural Memory Test (RBMT), Executive Interview (EXIT), FAS Verbal Fluency and Health of the Nation Outcome Scales (HoNOS).ResultsWe assessed 138 patients, mean age 48 years (standard deviation (s.d.) 15). Only 14% were in-patients. The mean premorbid IQ as assessed by NART was 98 (s.d. 14); 15% of patients had significant global cognitive impairment (MMSE); 81% had impaired memory (RBMT); 25% had executive dyscontrol (EXIT); and 49% had impaired verbal fluency (FAS). Scores on the functional impairment sub-scale of HoNOS correlated with all measures of cognitive impairment.ConclusionsCognitive dysfunction is pervasive in a community-based population of patients with schizophrenia.

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Managing Cognitive Dysfunction in Bipolar Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.100 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S15-S16

Author(s):

K. Miskowiak

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Cognitive Dysfunction ◽

Functional Recovery ◽

Cognitive Deficits ◽

Clinical Treatment ◽

Screening Tools ◽

Treatment Target ◽

Concentration Difficulty

Cognitive dysfunction, including memory and concentration difficulty, is an emerging treatment target in bipolar disorder. However, a key challenge in the management of these cognitive deficits is the lack of treatments with robust effects on cognition. Further, it is unclear how cognitive dysfunction should be assessed and addressed in the clinical treatment of the disorder. This talk will review the evidence for cognitive impairment in bipolar disorder, including its severity, persistence and impact on patients’ functional recovery. It will then discuss when and how to assess cognition and present some new feasible screening tools for cognitive dysfunction. Finally, it will highlight some novel candidate cognition treatments.Disclosure of interestI have acted as a consultant and received honoraria from Lundbeck and Allergan.

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Sex differences between serum total bilirubin levels and cognition in patients with schizophrenia

BMC Psychiatry ◽

10.1186/s12888-021-03407-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shen He ◽

Yange Li ◽

Tian Li ◽

Feikang Xu ◽

Duan Zeng ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Deficits ◽

Total Bilirubin ◽

Stepwise Multiple Regression ◽

Serum Total Bilirubin ◽

Female Patients ◽

Neuropsychiatric Diseases ◽

Male Patients ◽

Cognition Impairment

Abstract Background Cognitive deficits are common in patients with schizophrenia (SCZ). Abnormal serum total bilirubin (TBIL) levels have been involved in cognitive deficits associated with neuropsychiatric diseases such as mild cognitive impairment and subcortical ischemic vascular disease. However, this relationship has not yet been fully investigated in patients with SCZ. Therefore, the aim of this study was to investigate the association between the serum TBIL concentration and cognitive deficits in SCZ patients and to determine whether a sex difference exists in the association. Methods A total of 455 participants were eligible and included in this cross-sectional study. Cognition was evaluated using the Montreal Cognitive Assessment. Serum TBIL concentration was measured with an automatic biochemistry analyzer according to the routine protocol in the hospital medical laboratory. Results Serum TBIL levels were lower in the cognition impairment group than in the cognition normal group in male patients. In contrast, serum TBIL levels tended to be increased in the cognition impairment group in female patients, although the difference was not significant. Further stepwise multiple regression analysis stratified by sex showed that serum TBIL was independently and positively associated with cognitive function in male patients but not in female patients. Moreover, the association between serum TBIL level and cognitive function was also identified by the propensity score matching (PSM) method in male patients, but not in female patients. Conclusion These findings suggest that lower serum TBIL levels may be associated with cognitive impairment in male SCZ patients.

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Effect of hemorrhagic cerebrospinal fluid drainage on cognitive function after intracranial aneurysm clipping

Brain Science Advances ◽

10.1177/2096595819896201 ◽

2019 ◽

Vol 5 (1) ◽

pp. 65-72 ◽

Cited By ~ 1

Author(s):

Chaoqun Lin ◽

Lukui Chen

Keyword(s):

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Subarachnoid Hemorrhage ◽

Cognitive Function ◽

Lumbar Puncture ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Cerebrospinal Fluid Drainage ◽

Aneurysm Clipping ◽

Significant Difference ◽

Drainage Group

Objective: The effects of repeated lumbar puncture and continuous lumbar cistern drainage on the cognitive function of patients with aneurysmal subarachnoid hemorrhage were compared and analyzed. Methods: Retrospective analysis was performed on 59 patients with aneurysmal subarachnoid hemorrhage treated at our Neurosurgery Department between October 2017 and October 2018. According to the hemorrhagic cerebrospinal fluid drainage mode after aneurysm clipping, the patients were divided into the following two groups: the repeated lumbar puncture drainage (Group A, n = 28) and continuous lumbar cistern drainage (Group B, n = 31). Before and 1 month after surgery, the cognitive function of the patients was scored using the Montreal Cognitive Assessment Scale. Scores of 27~30 were defined as normal, and scores of < 27 as cognitive impairment. Results: The incidences of cognitive impairment were 46% (13/28) and 32% (10/31) for Groups A and B, respectively, before surgery, but the difference was not significant ( P > 0.05). The incidences of cognitive impairment were 35% (10/28) and 12% (4/31) for Groups A and B, respectively, at 1 month after surgery, with significant difference ( P < 0.05). Conclusion: Compared with repeated lumbar puncture, continuous lumbar cistern drainage for aneurysmal subarachnoid hemorrhage significantly reduced the incidence of cognitive impairment after aneurysm clipping.

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Cognitive function and fatigue in cancer patients after chemotherapy: A longitudinal cohort study in patients with colorectal cancer (CRC)

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.9099 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 9099-9099

Author(s):

J. L. Vardy ◽

S. Rourke ◽

G. R. Pond ◽

J. Galica ◽

A. Park ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Healthy Volunteers ◽

Clotting Factors ◽

Related Factors ◽

Post Surgery ◽

Significant Difference ◽

Cytokine Levels ◽

Group A ◽

Group B

9099 Background: There is growing evidence that fatigue and cognitive dysfunction can affect cancer survivors. Here we evaluated these symptoms in patients with CRC in a longitudinal prospective study. Methods: Patients with localized CRC were evaluated for cognitive function and fatigue at baseline (mean 8 weeks post-surgery or before neoadjuvant therapy), 6 & 12 months. Group A (Stage III/high risk II) received chemotherapy (CT) and group B (Stage I/II) received no CT. Pts had neuropsychological (NP) assessment with traditional tests and CANTAB, a computerized NP battery. They completed concurrent questionnaires for fatigue & QOL (FACT-F), anxiety/depression (GHQ), and perception of cognitive function (FACT-COG). Blood tests evaluated cytokine levels, blood clotting factors, sex hormones and apolipoprotein genotyping as potential causal factors. Primary endpoints were cognitive function (traditional NP tests) and fatigue. Associations between test results, demographic and disease-related factors were sought. Results: Baseline data are available for 182 pts: 127 group A, and 55 group B, with follow-up at 6 and 12 months for 71 and 39 pts. Mean age was 57 years and 62% were male. At baseline (pre CT): 30% had cognitive impairment on traditional NP tests & 20% on CANTAB; 25% reported moderate fatigue and 10% extreme fatigue. At 6 months there was no significant difference on objective NP testing between the groups or in perceived cognitive impairment (median FACT- COG 82 vs 88, p=0.34). CT pts had more fatigue (median FACT-F 75 vs 91, p<0.001). At 12 months CT pts tend to have more cognitive impairment on traditional NP tests (26% vs 0%, p=.09), more perceived cognitive impairment (13.5% vs 0%, p=.57) & greater fatigue (16% vs 0%). Cytokine levels were elevated in all groups at all time points compared to healthy volunteers. There was a trend to higher cytokine levels with greater fatigue and worse cognitive impairment. Fatigue, QOL and anxiety and depression were highly correlated. Conclusions: Cognitive impairment is present in some pts prior to CT and there is a trend for CT pts to have worse cognitive impairment at 12 but not at 6 months. Fatigue is associated with CT. Cytokine levels remained elevated in all groups compared to healthy volunteers. No significant financial relationships to disclose.

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Meta-analysis of cognitive function in Chinese first-episode schizophrenia: MATRICS Consensus Cognitive Battery (MCCB) profile of impairment

General Psychiatry ◽

10.1136/gpsych-2018-100043 ◽

2019 ◽

Vol 32 (3) ◽

pp. e100043 ◽

Cited By ~ 4

Author(s):

Huijuan Zhang ◽

Yao Wang ◽

Yuliang Hu ◽

Yikang Zhu ◽

Tianhong Zhang ◽

...

Keyword(s):

Cognitive Function ◽

Effect Size ◽

Meta Analysis ◽

Verbal Learning ◽

Chinese Patients ◽

First Episode ◽

Neurocognitive Deficits ◽

Cognitive Domains ◽

Significant Difference ◽

First Episode Schizophrenia

BackgroundCompromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population.AimTo provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES.MethodsAn independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size.Results56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as ‘high quality’ according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=−1.60, 95% CI −1.82 to −1.38, I2=67%) and all seven cognitive domains, with the SMD ranging from −0.87 to −1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=−1.90), Trail Making Test (TMT) (SMD=−1.36), Continuous Performance Test-Identical Pairs (SMD=−1.33), Hopkins Verbal Learning Test (SMD=−1.24), Brief Visuospatial Memory Test (SMD=−1.18), Mazes (SMD=−1.16), Category Fluency (SMD=−1.01), Spatial Span (SMD=−0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=−0.38).ConclusionsOur meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.

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Residual Negative Symptoms Differentiate Cognitive Performance in Clinically Stable Patients with Schizophrenia and Bipolar Disorder

Schizophrenia Research and Treatment ◽

10.1155/2014/785310 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Rajeev Krishnadas ◽

Seethalakshmi Ramanathan ◽

Eugene Wong ◽

Ajita Nayak ◽

Brian Moore

Keyword(s):

Bipolar Disorder ◽

Cognitive Function ◽

Cognitive Deficits ◽

Verbal Memory ◽

Negative Symptoms ◽

Psychotic Symptoms ◽

Cognitive Tests ◽

Healthy Controls ◽

Patient Groups ◽

The Difference

Cognitive deficits in various domains have been shown in patients with bipolar disorder and schizophrenia. The purpose of the present study was to examine if residual psychopathology explained the difference in cognitive function between clinically stable patients with schizophrenia and bipolar disorder. We compared the performance on tests of attention, visual and verbal memory, and executive function of 25 patients with schizophrenia in remission and 25 euthymic bipolar disorder patients with that of 25 healthy controls. Mediation analysis was used to see if residual psychopathology could explain the difference in cognitive function between the patient groups. Both patient groups performed significantly worse than healthy controls on most cognitive tests. Patients with bipolar disorder displayed cognitive deficits that were milder but qualitatively similar to those of patients with schizophrenia. Residual negative symptoms mediated the difference in performance on cognitive tests between the two groups. Neither residual general psychotic symptoms nor greater antipsychotic doses explained this relationship. The shared variance explained by the residual negative and cognitive deficits that the difference between patient groups may be explained by greater frontal cortical neurophysiological deficits in patients with schizophrenia, compared to bipolar disorder. Further longitudinal work may provide insight into pathophysiological mechanisms that underlie these deficits.

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Bipolar Disorder, Obesity and Cognitive Impairment

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2167 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S207-S207 ◽

Cited By ~ 2

Author(s):

M. La Montagna ◽

E. Stella ◽

F. Ricci ◽

L. Borraccino ◽

A.I. Triggiani ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Problem Solving ◽

Cognitive Deficits ◽

Cognitive Functions ◽

Visual Learning ◽

Verbal Learning ◽

Speed Of Processing ◽

Anthropometric Measures ◽

Cognitive Domains

IntroductionAccording to scientific literature, cognitive impairment is a disabling feature of the bipolar disorder (BD), present in all the phases of the disease. Obesity and metabolic disorders represent another risk factor for cognitive dysfunctions in BD, since the excess of weight could adversely influence several cognitive domains.ObjectiveTo highlight the presence of impairment of cognitive functions in a sample of subjects suffering from BD and obesity.AimsEvaluation of the cognitive performance in a sample of BD patients, considering their anthropometric measures (height and weight) and body mass index (BMI).MethodsThe neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained physicians for the evaluation of seven different cognitive domains in 46 patients (mean age: 43.17 years old; 39.13% male), affected by BD enrolled in the psychiatric unit of Azienda Sanitaria Locale and University of Foggia. In particular, cognitive functions assessed were speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. BMI was calculated, and patients were divided into a group of normal weight and another one of overweight or obese, on the base of BMI value (BMI cut-off = 25).ResultsThe obese patients amounted at 56.52%. We have found the presence of cognitive deficits in two of the seven domains assessed, that are speed of processing (P < 0.01) and reasoning and problem solving (P < 0.05) in the sample of overweight patients.ConclusionsCognitive deficits are clearly revealed in BD patients during the euthymic phase of the disorder. The obesity in BD could contribute to increase dysfunctions in cognitive domains.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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