The impact of general intellectual ability and white matter volume on the functional outcome of patients with Bipolar Disorder and their relatives

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• 作者：Irene Forcada^a ; ^b ; Efstathios Papachristou^a ; Maria Mur^b ; Tessa Christodoulou^a ; Jigar Jogia^a ; Abraham Reichenberg^a ; Eduard Vieta^c ; Sophia Frangou^a ; ^{sophia.frangou@kcl.ac.uk"" rel=""nofollow}
• 关键词：White matter volume ; Cognition ; Functional outcome ; Relatives ; Bipolar Disorder
• 刊名：Journal of Affective Disorders
• 出版年：2011
• 出版时间：May 2011
• 年：2011
• 卷：130
• 期：3
• 页码：413-420
• 全文大小：356 K

文摘

Background

There is substantial evidence that cognitive deficits and brain structural abnormalities are present in patients with Bipolar Disorder (BD) and in their first-degree relatives. Previous studies have demonstrated associations between cognition and functional outcome in BD patients but have not examined the role of brain morphological changes. Similarly, the functional impact of either cognition or brain morphology in relatives remains unknown. Therefore we focused on delineating the relationship between psychosocial functioning, cognition and brain structure, in relation to disease expression and genetic risk for BD.

Methods

Clinical, cognitive and brain structural measures were obtained from 41 euthymic BD patients and 50 of their unaffected first-degree relatives. Psychosocial function was evaluated using the General Assessment of Functioning (GAF) scale. We examined the relationship between level of functioning and general intellectual ability (IQ), memory, attention, executive functioning, symptomatology, illness course and total gray matter, white matter and cerebrospinal fluid volumes.

Limitations

Cross-sectional design.

Results

Multiple regression analyses revealed that IQ, total white matter volume and a predominantly depressive illness course were independently associated with functional outcome in BD patients, but not in their relatives, and accounted for a substantial proportion (53 % ) of the variance in patients' GAF scores. There were no significant domain-specific associations between cognition and outcome after consideration of IQ.

Conclusions

Our results emphasise the role of IQ and white matter integrity in relation to outcome in BD and carry significant implications for treatment interventions.