Objectives: Impaired verbal declarative memory has been proposed as a trait marker for adult bipolar disorder. However, similar impairments in juvenile‐onset bipolar disorder have not been yet documented. Here, we assessed declarative memory in a large sample of clinically well‐characterized children with bipolar disorder. Methods: Forty‐one children and adolescents with bipolar disorder [21 bipolar I disorder (BP‐I), 10 bipolar II disorder (BP‐II), and 10 bipolar disorder, not otherwise specified (BP‐NOS)] and 17 demographically matched healthy participants completed a standardized learning and memory test. Results: BP‐I children recalled and recognized significantly fewer words than healthy subjects, whereas children with BP‐II and BP‐NOS did not differ from controls. However, individuals with BP‐NOS made more perseverative errors and intrusions than the other groups. Severity of mood symptomatology was not associated with memory performance in any bipolar subtype. Conclusions: Findings suggest that declarative memory impairments in juvenile BP‐I are similar to those seen in the adult form of the illness. These impairments do not appear to be secondary to clinical state; rather, they may reflect trait‐related impairments. Distinct performance patterns in BP‐I, BP‐II, and BP‐NOS suggest that the broadly defined phenotype is significantly heterogeneous, and may not be informative for pathogenetic investigations of bipolar disorder.

Memory Impairment

10.1111/j.1399-5618.2005.00267.x

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Estudo sobre as condições sociais e de saúde mental de moradores de rua adultos de Porto Alegre - resultados parciais

Alexandre Annes Henriques Manoela Fonseca Eduardo S. Ghisolfi Betina Kruter Simone Hauck

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Evidence for disruption in prefrontal cortical functions in juvenile bipolar disorder

Bipolar Disorders (2007)

Carrie E. Bearden David C. Glahn Sheila C. Caetano Rene L. Olvera Manoela Fonseca

Objectives: Systematic parsing of executive function processes is critical for the development of more specific models of neurobiological processes mediating disturbed cognition in youth with bipolar disorder (BPD). Methods: A sample of 33 children and adolescents with bipolar I disorder (BPD I) (mean age 12.1 ± 3.0 years, 39% female) and 44 demographically matched healthy participants (mean age 12.9 ± 2.8 years, 50% female) completed a neurocognitive battery including measures aimed at detection of disruption in prefrontal cortical circuitry (i.e., working memory, set shifting, and rule attainment). Results: Compared to healthy controls, BPD I children exhibited significant deficits in spatial working memory, visual sequencing and scanning, verbal fluency and abstract problem solving, particularly when a memory component was involved. In our spatial delayed response task, memory set size was parametrically varied; the performance pattern in BPD I children suggested deficits in short‐term memory encoding and/or storage, rather than capacity limitations in spatial working memory. Earlier age at onset of illness and antipsychotic medication usage were associated with poorer performance on speeded information‐processing tasks; however, severity of mood symptomatology and comorbidity with disruptive behavior disorders were not associated with task performance. Conclusions: These results suggest impairment in measures of prefrontal cortical function in juvenile BPD I that are similar to those seen in the adult form of the illness, and implicate both the ventral and dorsolateral prefrontal cortex as loci of pathology in juvenile BPD. As these deficits were not associated with clinical state or comorbidity with other disorders, they may reflect trait‐related impairments, a hypothesis that will be pursued further in longitudinal studies.

Neurocognitive

Verbal fluency test

10.1111/j.1399-5618.2007.00453.x

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Fronto-Limbic Brain Abnormalities in Juvenile Onset Bipolar Disorder

Biological Psychiatry (2005)

Sheila C. Caetano Rene L. Olvera David C. Glahn Manoela Fonseca Steven R. Pliszka

10.1016/j.biopsych.2005.04.027

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Anormalidades neuropatológicas e neuroquímicas no transtorno afetivo bipolar

Brazilian Journal of Psychiatry (2004)

Benício N. Frey Manoela Fonseca Rodrigo Machado‐Vieira Jair C. Soares Flávio Kapczinski

OBJETIVOS: Estudos pós-mortem, farmacológicos, de neuroimagem e em modelos animais têm demonstrado uma possível associação de mecanismos de sinalização intracelular na fisiopatologia do transtorno afetivo bipolar (TAB). Esse trabalho tem como objetivo revisar os achados em neuropatologia e bioquímica celular. MÉTODOS: Foi realizada uma pesquisa ao MEDLINE, entre 1980 e 2003, tendo sido utilizados os unitermos: bipolar disorder, signaling, second messengers e postmortem, além de referências cruzadas dos artigos selecionados. RESULTADOS: uropatológicos demonstraram uma diminuição do número de células neuronais e gliais, principalmente no córtex pré-frontal de pacientes bipolares. Estudos neuroquímicos demonstraram alterações nas vias do AMPc, fosfatidilinositol, Wnt/GSK-3beta e Ca++ intracelular nesses pacientes. CONCLUSÃO: Os achados de alterações neuropatológicas e neuroquímicas no TAB podem estar relacionados com a fisiopatologia deste transtorno e com os efeitos dos estabilizadores de humor. No entanto, mais estudos são necessários para esclarecer o papel das cascatas de sinalização intracelular na patogênese deste transtorno.

Neurochemical

Neuropathology

Pathophysiology

Postmortem studies

10.1590/s1516-44462004000300008

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Citations (20)