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Neurocognitive impairment in unaffected siblings of youth with bipolar disorder

Published online by Cambridge University Press:  11 December 2008

A. E. Doyle ,
J. Wozniak ,
T. E. Wilens ,
A. Henin ,
L. J. Seidman ,
C. Petty ,
R. Fried ,
L. M. Gross ,
S. V. Faraone  and
J. Biederman
A. E. Doyle*
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
J. Wozniak
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
T. E. Wilens
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
A. Henin
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
L. J. Seidman
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
C. Petty
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
R. Fried
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
L. M. Gross
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
S. V. Faraone
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
J. Biederman
Affiliation:
Pediatric Psychopharmacology Unit, Massachusetts General Hospital and Department of Psychiatry, Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: A. E. Doyle, Ph.D., Massachusetts General Hospital, Child Psychiatry Service, YAW 6-6A, 55 Fruit Street, Boston, MA02114, USA. (Email: doylea@helix.mgh.harvard.edu)
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Abstract

Background

There is growing evidence for the familiality of pediatric bipolar disorder (BPD) and its association with impairments on measures of processing speed, verbal learning and ‘executive’ functions. The current study investigated whether these neurocognitive impairments index the familial risk underlying the diagnosis.

Method

Subjects were 170 youth with BPD (mean age 12.3 years), their 118 non-mood-disordered siblings and 79 non-mood-disordered controls. Groups were compared on a battery of neuropsychological tests from the Wechsler Intelligence Scales, the Stroop Color Word Test, the Wisconsin Card Sorting Test (WCST), the Rey–Osterrieth Complex Figure (ROCF), an auditory working memory Continuous Performance Test (CPT) and the California Verbal Learning Test – Children's Version (CVLT-C). Measures were factor analyzed for data reduction purposes. All analyses controlled for age, sex and attention-deficit/hyperactivity disorder (ADHD).

Results

Principal components analyses with a promax rotation yielded three factors reflecting: (1) processing speed/verbal learning, (2) working memory/interference control and (3) abstract problem solving. The CPT working memory measure with interference filtering demands (WM INT) was only administered to subjects aged ⩾12 years and was therefore analyzed separately. BPD youth showed impairments versus controls and unaffected relatives on all three factors and on the WM INT. Unaffected relatives exhibited impairments versus controls on the abstract problem-solving factor and the WM INT. They also showed a statistical trend (p=0.07) towards worse performance on the working memory/interference control factor.

Conclusions

Neurocognitive impairments in executive functions may reflect the familial neurobiological risk mechanisms underlying pediatric BPD and may have utility as endophenotypes in molecular genetic studies of the condition.

Keywords

Endophenotypeexecutive functionspediatric bipolar disorder
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 8 , August 2009 , pp. 1253 - 1263
Copyright
Copyright © 2008 Cambridge University Press

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Footnotes

Aspects of this work were presented as a poster at the 2005 National Institute of Mental Health (NIMH) Pediatric Bipolar Conference in Chicago, IL, USA.

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