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.

Public Health Relevance

Converging evidence suggests that patients with bipolar disorder (BPD) have persistent neurocognitive impairment, despite remission of acute affective symptoms that contribute directly to functional disability in social, occupational, and residential status. The current study aims to identify subgroups of BPD patients based on their cognitive performance and to identify clinical features and biomarkers that are associated with cognitive dysfunction and functional disability. Ultimately, data derived from this project could serve to 1) identify groups of BPD patients who are at increased risk for developing cognitive problems~ and 2) guide future efforts toward developing novel and effective treatments for these disabling symptoms.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH100125-01A1
Application #
8596131
Study Section
Adult Psychopathology and Disorders of Aging Study Section (APDA)
Program Officer
Rumsey, Judith M
Project Start
2013-08-05
Project End
2018-04-30
Budget Start
2013-08-05
Budget End
2014-04-30
Support Year
1
Fiscal Year
2013
Total Cost
$423,750
Indirect Cost
$173,750
Name
Icahn School of Medicine at Mount Sinai
Department
Psychiatry
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Mercedes Perez-Rodriguez, M; Mahon, Katie; Russo, Manuela et al. (2015) Oxytocin and social cognition in affective and psychotic disorders. Eur Neuropsychopharmacol 25:265-82
Burdick, K E; Russo, M; Frangou, S et al. (2014) Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: clinical implications. Psychol Med 44:3083-96
Russo, Manuela; Mahon, Katie; Shanahan, Megan et al. (2014) Affective temperaments and neurocognitive functioning in bipolar disorder. J Affect Disord 169:51-6