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Neurocognitive subtypes in patients with bipolar disorder and their unaffected siblings

Published online by Cambridge University Press:  07 June 2017

M. Russo ,
T. E. Van Rheenen ,
M. Shanahan ,
K. Mahon ,
M. M. Perez-Rodriguez ,
A. Cuesta-Diaz ,
E. Larsen ,
A. K. Malhotra  and
K. E Burdick
M. Russo
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
T. E. Van Rheenen
Affiliation:
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Australia Brain and Psychological Sciences Research Centre, School of Health Sciences, Swinburne University, Melbourne, Australia Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Central Clinical School, Monash University, Melbourne, Australia
M. Shanahan
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
K. Mahon
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
M. M. Perez-Rodriguez
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
A. Cuesta-Diaz
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
E. Larsen
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA
A. K. Malhotra
Affiliation:
Zucker Hillside Hospital – Northwell Health System, Glen Oaks, NY, USA
K. E Burdick*
Affiliation:
Department of Psychiatry, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA Department of Neuroscience, Icahn School of Medicine at Mount Sinai School of Medicine, New York, NY, USA James J Peters Veteran Administration (VA) Hospital, Bronx, NY, USA Brigham and Women's Hospital, Boston, MA, USA
*
*Address for correspondence: K. E. Burdick, Ph.D., Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, Box 1230, New York, NY 10029, USA. (Email: katherine.burdick@mssm.edu; kburdick1@bwh.harvard.edu)
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Abstract

Background

Our previous work revealed substantial heterogeneity in the cognitive profile of bipolar disorder (BD) due to the presence of three underlying cognitive subgroups characterized as: globally impaired, selectively impaired, or cognitively intact. In an effort to determine whether these subgroups are differentially related to genetic risk for the illness, we investigated whether cognitive deficits were more pronounced in unaffected siblings (UAS) of BD probands within identified clusters.

Methods

Cluster analysis was used to identify cognitive clusters in BD (N = 60). UAS (N = 49) were classified into groups according to their proband sibling's cluster assignment; comparisons were made across all clusters and healthy controls (HCs; N = 71).

Results

Three cognitive clusters in BD emerged: a globally impaired (36.7%), a selectively impaired (30%), and a cognitively intact cluster (33.3%). UAS showed a qualitatively similar pattern to their BD siblings; UAS of the globally impaired BD cluster showed verbal memory and general cognitive impairments relative to HCs. In contrast, UAS of the other two clusters did not differ from HCs.

Conclusions

This study corroborates findings from prior work regarding the presence of cognitive heterogeneity in BD. UAS of subjects in the globally impaired BD cluster presented with a qualitatively similar cognitive profile to their siblings and performed worse than all other BD clusters and UAS groups. This suggests that inherited risk factors may be contributing to cognitive deficits more notably in one subgroup of patients with BD, pointing toward differential causes of cognitive deficits in discrete subgroups of patients with the disorder.

Keywords

Bipolar disordercognitionheterogeneityunaffected siblingverbal memory
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 16 , December 2017 , pp. 2892 - 2905
Copyright
Copyright © Cambridge University Press 2017 

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