Neurocognitive and Neurobiological Features of Early-Stage Unmedicated Patients with Bipolar Disorder.

Abstract

Objective: The aim of this project was to determine young adults who met the criteria of bipolar disorder (BD) but have not yet received diagnosis or treatment; and evaluate the neurocognitive and neurobiological changes by comparing with healthy controls.

Methods: The high-risk group for BD was determined by using HCL-32R. After that, participants were interviewed with SCID-I to determine the previously undiagnosed and drug-naive patients (DNP) (n=27). Healthy control (HC) group (n=27) was included to compared with the DNP group. All participants completed a cognitive battery which evaluated executive functioning, attention, working memory and verbal learning. Magnetic Resonance Imaging data in all participants were obtained to compare cortical thickness. TBARS, NO and the antioxidant enzymes SOD and catalase activities were measured to determine the oxidative stress status.

Results: The DNP group underperformed in all the tests administered but group differences were significant in the WCST and RVALT. Only catalase levels of oxidative stress markers were significantly higher in patients. DNP group showed significant cortical thinning in various regions of brain.

Conclusion: Neurobiological changes and neurocognitive dysfunction are present in the early stage and unmedicated of BD. However longitudinal studies are needed to understand the progression.