Brain Age and Cognitive Functioning in First-episode Bipolar Disorder

Overview

Journal Psychol Med

Publisher Cambridge University Press

Specialty Psychology

Date 2022 Jul 25

PMID 35875930

Authors

Trisha Chakrabarty

Sophia Frangou

Ivan J Torres

Ruiyang Ge

Lakshmi N Yatham

Affiliations

Soon will be listed here.

Abstract

Background: There is significant heterogeneity in cognitive function in patients with bipolar I disorder (BDI); however, there is a dearth of research into biological mechanisms that might underlie cognitive heterogeneity, especially at disease onset. To this end, this study investigated the association between accelerated or delayed age-related brain structural changes and cognition in early-stage BDI.

Methods: First episode patients with BDI ( = 80) underwent cognitive assessment to yield demographically normed composite global and domain-specific scores in verbal memory, non-verbal memory, working memory, processing speed, attention, and executive functioning. Structural magnetic resonance imaging data were also collected from all participants and subjected to machine learning to compute the brain-predicted age difference (brainPAD), calculated by subtracting chronological age from age predicted by neuroimaging data (positive brainPAD values indicating age-related acceleration in brain structural changes and negative values indicating delay). Patients were divided into tertiles based on brainPAD values, and cognitive performance compared amongst tertiles with ANCOVA.

Results: Patients in the lowest (delayed) tertile of brainPAD values (brainPAD range -17.9 to -6.5 years) had significantly lower global cognitive scores ( = 0.025) compared to patients in the age-congruent tertile (brainPAD range -5.3 to 2.4 yrs), and significantly lower verbal memory scores ( = 0.001) compared to the age-congruent and accelerated (brainPAD range 2.8 to 16.1 yrs) tertiles.

Conclusion: These results provide evidence linking cognitive dysfunction in the early stage of BDI to apparent delay in typical age-related brain changes. Further studies are required to assess how age-related brain changes and cognitive functioning evolve over time.

Citing Articles

BrainAGE, brain health, and mental disorders: A systematic review.

Seitz-Holland J, Haas S, Penzel N, Reichenberg A, Pasternak O Neurosci Biobehav Rev. 2024; 159:105581.

PMID: 38354871 PMC: 11119273. DOI: 10.1016/j.neubiorev.2024.105581.

Functional Alterations in Patients with Bipolar Disorder and Their Unaffected First-Degree Relatives: Insight from Genetic, Epidemiological, and Neuroimaging Data.

Zhang H, Chen J, Fang Y Neuropsychiatr Dis Treat. 2023; 19:2797-2806.

PMID: 38111594 PMC: 10726715. DOI: 10.2147/NDT.S427617.

References

Kendler K, Ohlsson H, Mezuk B, Sundquist K, Sundquist J . A Swedish National Prospective and Co-relative Study of School Achievement at Age 16, and Risk for Schizophrenia, Other Nonaffective Psychosis, and Bipolar Illness. Schizophr Bull. 2015; 42(1):77-86. PMC: 4681557. DOI: 10.1093/schbul/sbv103. View

Yatham L, Kauer-SantAnna M, Bond D, Lam R, Torres I . Course and outcome after the first manic episode in patients with bipolar disorder: prospective 12-month data from the Systematic Treatment Optimization Program For Early Mania project. Can J Psychiatry. 2009; 54(2):105-12. DOI: 10.1177/070674370905400208. View

Tamnes C, Herting M, Goddings A, Meuwese R, Blakemore S, Dahl R . Development of the Cerebral Cortex across Adolescence: A Multisample Study of Inter-Related Longitudinal Changes in Cortical Volume, Surface Area, and Thickness. J Neurosci. 2017; 37(12):3402-3412. PMC: 5373125. DOI: 10.1523/JNEUROSCI.3302-16.2017. View

Nuechterlein K, Green M, Kern R, Baade L, Barch D, Cohen J . The MATRICS Consensus Cognitive Battery, part 1: test selection, reliability, and validity. Am J Psychiatry. 2008; 165(2):203-13. DOI: 10.1176/appi.ajp.2007.07010042. View

Fischl B, van der Kouwe A, Destrieux C, Halgren E, Segonne F, Salat D . Automatically parcellating the human cerebral cortex. Cereb Cortex. 2003; 14(1):11-22. DOI: 10.1093/cercor/bhg087. View

Chakrabarty T, Kozicky J, Torres I, Lam R, Yatham L . Verbal memory impairment in new onset bipolar disorder: Relationship with frontal and medial temporal morphology. World J Biol Psychiatry. 2015; 16(4):249-60. DOI: 10.3109/15622975.2014.1000373. View

Ronan L, Alexander-Bloch A, Wagstyl K, Farooqi S, Brayne C, Tyler L . Obesity associated with increased brain age from midlife. Neurobiol Aging. 2016; 47:63-70. PMC: 5082766. DOI: 10.1016/j.neurobiolaging.2016.07.010. View

Han L, Dinga R, Hahn T, Ching C, Eyler L, Aftanas L . Brain aging in major depressive disorder: results from the ENIGMA major depressive disorder working group. Mol Psychiatry. 2020; 26(9):5124-5139. PMC: 8589647. DOI: 10.1038/s41380-020-0754-0. View

Zanelli J, Reichenberg A, Morgan K, Fearon P, Kravariti E, Dazzan P . Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations. Am J Psychiatry. 2009; 167(1):78-85. DOI: 10.1176/appi.ajp.2009.09010118. View

10.

Bonnin C, Gonzalez-Pinto A, Sole B, Reinares M, Gonzalez-Ortega I, Alberich S . Verbal memory as a mediator in the relationship between subthreshold depressive symptoms and functional outcome in bipolar disorder. J Affect Disord. 2014; 160:50-4. DOI: 10.1016/j.jad.2014.02.034. View

11.

Sheehan D, Lecrubier Y, Sheehan K, Amorim P, Janavs J, Weiller E . The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1999; 59 Suppl 20:22-33;quiz 34-57. View

12.

MacCabe J, Lambe M, Cnattingius S, Sham P, David A, Reichenberg A . Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study. Br J Psychiatry. 2010; 196(2):109-15. DOI: 10.1192/bjp.bp.108.060368. View

13.

Abe C, Ekman C, Sellgren C, Petrovic P, Ingvar M, Landen M . Manic episodes are related to changes in frontal cortex: a longitudinal neuroimaging study of bipolar disorder 1. Brain. 2015; 138(Pt 11):3440-8. DOI: 10.1093/brain/awv266. View

14.

Glahn D, Almasy L, Barguil M, Hare E, Peralta J, Kent Jr J . Neurocognitive endophenotypes for bipolar disorder identified in multiplex multigenerational families. Arch Gen Psychiatry. 2010; 67(2):168-77. PMC: 3401550. DOI: 10.1001/archgenpsychiatry.2009.184. View

15.

Wierenga L, Doucet G, Dima D, Agartz I, Aghajani M, Akudjedu T . Greater male than female variability in regional brain structure across the lifespan. Hum Brain Mapp. 2020; 43(1):470-499. PMC: 8675415. DOI: 10.1002/hbm.25204. View

16.

Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea J, Salamero M . Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord. 2007; 9(1-2):103-13. DOI: 10.1111/j.1399-5618.2007.00327.x. View

17.

Torres I, Qian H, Basivireddy J, Chakrabarty T, Wong H, Lam R . Three-year longitudinal cognitive functioning in patients recently diagnosed with bipolar disorder. Acta Psychiatr Scand. 2019; 141(2):98-109. DOI: 10.1111/acps.13141. View

18.

Jimenez-Lopez E, Sanchez-Morla E, Lopez-Villarreal A, Aparicio A, Martinez-Vizcaino V, Vieta E . Neurocognition and functional outcome in patients with psychotic, non-psychotic bipolar I disorder, and schizophrenia. A five-year follow-up. Eur Psychiatry. 2018; 56:60-68. DOI: 10.1016/j.eurpsy.2018.11.008. View

19.

Sparding T, Joas E, Clements C, Sellgren C, Palsson E, Landen M . Long-term trajectory of cognitive performance in people with bipolar disorder and controls: 6-year longitudinal study. BJPsych Open. 2021; 7(4):e115. PMC: 8240122. DOI: 10.1192/bjo.2021.66. View

20.

Klapwijk E, van de Kamp F, van der Meulen M, Peters S, Wierenga L . Qoala-T: A supervised-learning tool for quality control of FreeSurfer segmented MRI data. Neuroimage. 2019; 189:116-129. DOI: 10.1016/j.neuroimage.2019.01.014. View