Neuropsychological disturbances and cerebral blood flow in bipolar disorder.
OBJECTIVE
To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients.


METHODS
Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO. Forty-three outpatients out of 85 fulfilling RDC diagnostic criteria for bipolar disorder and six healthy subjects were included in the study. SPECT and neuropsychological assessments were performed in 30 patients in manic (n = 7), hypomanic (n = 8), depressed (n = 12) or euthymic (n = 3) states. All assessments were carried out before starting treatment.


RESULTS
Several corrected correlations between neuropsychological function and cerebral blood flow (CBF) were identified: executive function (WCST) and striatal, frontal, temporal, cerebellum, parietal and cingulate CBF; memory (WMS, WAIS-Digits) and striatal, frontal, temporal and parietal CBF; attentional tasks (Stroop) and striatal, temporo-medial and parietal CBF; verbal learning (CVLT) and frontal, posterior temporal, cingulate and occipital CBF; psychomotor disturbances (TMT) and anterior temporal CBF; poorer intelligence performance scores (WAIS-Vocabulary) and cerebellum and parietal CBF.


CONCLUSIONS
This study confirms the presence of functional disturbances in fronto-subcortical structures, the cerebellum and limbic system in bipolar patients.
Benabarre
Antoni
A
Clinical Institute of Neuroscience, Hospital Clinic, C/Villaroel 170, 08036 Barcelona, Spain.
Vieta
Eduard
E
Martínez-Arán
Anabel
A
Garcia-Garcia
Margarida
M
Martín
Francisco
F
Lomeña
Francisco
F
Torrent
Carla
C
Sánchez-Moreno
José
J
Colom
Francesc
F
Reinares
María
M
Brugue
Esteve
E
Valdés
Manuel
M
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000209:etiology; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014888:Wechsler Scales
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime