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Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions

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Abstract

The progression of bipolar disorder (BD) is characterized by recurrent episodes of depression, mania, and hypomania, thus affecting the daily functionality of individuals. Previous studies have shown that a large proportion of patients diagnosed with BD who are in clinical remission experience significant functional disorders. The present study aimed to investigate the relationships between cognitive impairment and serum progesterone, allopregnanolone and BDNF levels in male bipolar disorder patients who are in the euthymic period. Our study included 41 euthymic male patients with bipolar disorder and 40 age, sex, body mass index (BMI) and smoking-matched male healthy control subjects. Neuropsychiatric tests such as the Stroop Test TBAG Form, Auditory Verbal Digit Span Test- Form B (VADS-B) and Cancellation Test were administered to all participants, and 5–7 ml of peripheral venous blood sample was taken from all participants. Serum allopregnanolone, progesterone and BDNF levels were also measured in all participants. Serum allopregnanolone and progesterone levels were found to be lower in bipolar patients, and it was observed that the serum level of allopregnanolone decreased as the disease duration increased. The serum BDNF levels were similar between groups. The cognitive functions assessed using the Stroop, VADS-B and cancellation tests were found to be better in healthy subjects. The neurocognitive test performances of all participants were strongly positively correlated with allopregnanolone levels. The present study supports the hypothesis that allopregnanolone acts as an endogenous mood stabilizer.

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Data availability

The data that support the findings of this study are available on request from the corresponding author (YA).

Abbreviations

BAI:

Beck anxiety inventory

BD:

Bipolar disorder

BDNF:

Brain-derived neurotrophic factor

BMI:

Body mass index

CT:

Cancellation test

DSM-5:

Diagnostic and statistical manual of mental disorders, fifth edition

ECLIA:

Electrochemiluminescence immunoassay

ELISA:

Enzyme-linked immunosorbent assay

GABA:

Gamma-aminobutyric acid

HC:

Healthy control

HDRS:

Hamilton depression rating scale

HPA:

Hypothalamic–pituitary–adrenal

MDD:

Major depressive disorder

NS:

Neurosteroid

PFC:

Prefrontal cortex

VADS-B:

Visual aural digit span test form B

PPD:

Postpartum depression

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Authors and Affiliations

  1. Faculty of Medicine, Department of Psychiatry, Tekirdağ Namık Kemal University, Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi 59100, Süleymanpaşa, Tekirdağ, Turkey

    Mihrali Karademir, Elmas Beyazyüz, Murat Beyazyüz & Yakup Albayrak

  2. Faculty of Medicine, Department of Biochemistry, Tekirdağ Namık Kemal University, Tekirdağ, Turkey

    Ahsen Yılmaz

Authors
  1. Mihrali Karademir
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  2. Elmas Beyazyüz
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  3. Murat Beyazyüz
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  4. Ahsen Yılmaz
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  5. Yakup Albayrak
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Correspondence to Yakup Albayrak.

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The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the local Ethics Committee of Tekirdağ Namık Kemal University according to the Declaration of Helsinki.

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Informed written consent was obtained from all parents and/or care providers of the patients; participation in the study was voluntary, and the data were processed anonymously.

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Karademir, M., Beyazyüz, E., Beyazyüz, M. et al. Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions. Eur Arch Psychiatry Clin Neurosci 274, 515–524 (2024). https://doi.org/10.1007/s00406-023-01607-9

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  • DOI: https://doi.org/10.1007/s00406-023-01607-9

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