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Neuroprogression and Cognitive Functioning in Bipolar Disorder: A Systematic Review

Abstract

Bipolar disorder (BD) has been associated with impairments in a range of cognitive domains including attention, verbal learning, and mental flexibility. These deficits are increased during the acute phases of the illness and worsen over the course of BD. This review will examine the literature in relation to potential mechanisms associated with cognitive decline in BD. Scopus (all databases), Pubmed, and Ovid Medline were systematically searched with no language or year restrictions, up to January 2015, for human studies that collected cross-sectional and longitudinal cognitive data in adults with BD and matched healthy controls (HC). Selected search terms were “bipolar,” “cognitive,” “aging,” “illness duration,” “onset,” and “progression.” Thirty-nine studies satisfied the criteria for consideration. There is evidence that cognitive function in BD is negatively associated with features of illness progression such as number of mood episodes, illness duration, and hospitalizations. Aging does not appear to affect cognitive functioning to a greater extent than in HC. Furthermore, the small number of longitudinal studies in this field does not allow to reaching firm conclusion in terms of which sub-populations would be more prone to cognitive decline in BD. The decline in cognitive abilities over the course of the BD seems to be associated with the number of episodes and number of hospitalizations. No meaningful interaction of age and bipolar disorder has been found in terms of cognitive decline. Future large-scale longitudinal studies are necessary to confirm these findings and assist in the development of preventive interventions in vulnerable individuals.

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Conflict of Interest

Taiane Cardoso, Isabelle E. Bauer, Thomas D. Meyer declare that they have no conflict of interest.

Flavio Kapczinski has received grants/research support from Astra-Zeneca, Eli Lilly, Janssen-Cilag, Servier, CNPq, CAPES, NARSAD and Stanley Medical Research Institute; has been a member of the board of speakers for Astra-Zeneca, Eli Lilly, Janssen and Servier; and has served as a consultant for Servier.

Jair C. Soares has received grants/research support from Forrest, BMS, Merck, Pfizer. This work was partly supported by the Dunn Foundation (Houston, TX), Stanley Medical Research Institute, NIH (1R01MH085667) and the Pat Rutherford Chair in Psychiatry (UTHealth).

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Jair C. Soares.

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Taiane Cardoso and Isabelle E. Bauer contributed equally to this work.

Taiane Cardoso and Isabelle E. Bauer should both be regarded as first authors.

This article is part of the Topical Collection on Bipolar Disorders

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Cardoso, T., Bauer, I.E., Meyer, T.D. et al. Neuroprogression and Cognitive Functioning in Bipolar Disorder: A Systematic Review. Curr Psychiatry Rep 17, 75 (2015). https://doi.org/10.1007/s11920-015-0605-x

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Keywords

  • Bipolar disorder
  • Cognition
  • Aging
  • Neuroprogression