Neurocognitive function in unmedicated manic and medicated euthymic pediatric bipolar patients
Mani N Pavuluri1, Lindsay S Schenkel, Subhash Aryal
1Center for Cognitive Medicine, Department of Psychiatry, University of Illinois at Chicago, 912 South Wood St. (M/C 913), Chicago, IL 60612, USA. mpavuluri@psych.uic.edu
The American Journal of Psychiatry
|February 2, 2006
Summary
Pediatric bipolar disorder is associated with lasting cognitive deficits in attention, executive function, working memory, and verbal learning, independent of medication or illness phase. These impairments appear to be trait-like characteristics of the disorder.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Pediatric bipolar disorder (PBD) presents complex challenges in understanding cognitive functioning.
- Systematic evaluation is needed to differentiate cognitive deficits across illness phases and medication effects in PBD.
Purpose of the Study:
- To systematically evaluate neuropsychological functioning in pediatric bipolar disorder.
- To clarify cognitive deficits in acutely ill vs. euthymic phases.
- To assess the impact of medication on cognitive deficits in PBD.
Main Methods:
- Compared unmedicated PBD (N=28), medicated PBD (N=28), and healthy controls (N=28) matched on key demographics and intelligence.
- Utilized a computerized neurocognitive battery and standardized tests.
- Assessed attention, executive function, working memory, verbal/visual memory, visuospatial perception, and motor skills.
Main Results:
- PBD patients, irrespective of medication or illness status, exhibited impairments in attention, executive functioning, working memory, and verbal learning compared to controls.
- Comorbid attention deficit hyperactivity disorder (ADHD) in PBD patients correlated with poorer performance on attention and executive function tasks.
Conclusions:
- Cognitive impairments in PBD appear to be trait-like, persisting across illness states and medication use.
- Deficits suggest frontal lobe involvement (working memory) and mesial temporal lobe involvement (verbal memory).
- These cognitive characteristics are present regardless of ADHD comorbidity.
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