Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders
Background Immune dysregulation appears involved in affective disorder pathophysiology. Inflammatory biomarkers have been linked with the cognitive impairment observed in people with bipolar disorders and as such are candidate markers that may improve with, and/or predict outcomes to, cognitive rem...
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Cambridge University Press
2024-11-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424008184/type/journal_article |
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| author | Rebecca Strawbridge Dimosthenis Tsapekos Allan H. Young |
| author_facet | Rebecca Strawbridge Dimosthenis Tsapekos Allan H. Young |
| author_sort | Rebecca Strawbridge |
| collection | DOAJ |
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Background
Immune dysregulation appears involved in affective disorder pathophysiology. Inflammatory biomarkers have been linked with the cognitive impairment observed in people with bipolar disorders and as such are candidate markers that may improve with, and/or predict outcomes to, cognitive remediation therapies (CRT).
Aims
Nine candidate biomarkers were examined as putative mediators and/or moderators to improvements following CRT compared with treatment as usual (TAU) from a randomised controlled trial.
Method
Euthymic adults with bipolar disorders who had been randomised to CRT (n = 23) or TAU (n = 21) underwent blood testing before and after a 12 week intervention period. Five cytokines and four growth factor proteins, selected a priori, were examined in association with global cognition and psychosocial functioning outcomes.
Results
CRT attenuated a reduction in the brain-derived neurotrophic factor (BDNF), basic fibroblast growth factor and vascular endothelial growth factor-C compared to TAU. For the BDNF, lower baseline levels predicted better functional outcomes across the sample but was more pronounced in TAU versus CRT participants and indicated larger CRT effects in those with a higher BDNF. A moderation effect was also apparent for tumour necrosis factor-β and interleukin-16, with greater CRT versus TAU effects on functioning for participants with lower baseline levels.
Conclusions
Although preliminary, results suggest that CRT may exert some protective biological effects, and that people with lower levels of neurotrophins or cytokines may benefit more from CRT. We note an absence of associations with cognitive (versus functional) outcomes. These findings require further examination in large well-controlled studies.
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| format | Article |
| id | doaj-art-c88bb33cd52f4745b72e4c08aa37b191 |
| institution | OA Journals |
| issn | 2056-4724 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-c88bb33cd52f4745b72e4c08aa37b1912025-08-20T02:19:11ZengCambridge University PressBJPsych Open2056-47242024-11-011010.1192/bjo.2024.818Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disordersRebecca Strawbridge0https://orcid.org/0000-0002-2984-1124Dimosthenis Tsapekos1https://orcid.org/0000-0002-1972-4813Allan H. Young2https://orcid.org/0000-0003-2291-6952Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK Background Immune dysregulation appears involved in affective disorder pathophysiology. Inflammatory biomarkers have been linked with the cognitive impairment observed in people with bipolar disorders and as such are candidate markers that may improve with, and/or predict outcomes to, cognitive remediation therapies (CRT). Aims Nine candidate biomarkers were examined as putative mediators and/or moderators to improvements following CRT compared with treatment as usual (TAU) from a randomised controlled trial. Method Euthymic adults with bipolar disorders who had been randomised to CRT (n = 23) or TAU (n = 21) underwent blood testing before and after a 12 week intervention period. Five cytokines and four growth factor proteins, selected a priori, were examined in association with global cognition and psychosocial functioning outcomes. Results CRT attenuated a reduction in the brain-derived neurotrophic factor (BDNF), basic fibroblast growth factor and vascular endothelial growth factor-C compared to TAU. For the BDNF, lower baseline levels predicted better functional outcomes across the sample but was more pronounced in TAU versus CRT participants and indicated larger CRT effects in those with a higher BDNF. A moderation effect was also apparent for tumour necrosis factor-β and interleukin-16, with greater CRT versus TAU effects on functioning for participants with lower baseline levels. Conclusions Although preliminary, results suggest that CRT may exert some protective biological effects, and that people with lower levels of neurotrophins or cytokines may benefit more from CRT. We note an absence of associations with cognitive (versus functional) outcomes. These findings require further examination in large well-controlled studies. https://www.cambridge.org/core/product/identifier/S2056472424008184/type/journal_articleBipolarcognitioncognitive remediationinflammationbiomarker |
| spellingShingle | Rebecca Strawbridge Dimosthenis Tsapekos Allan H. Young Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders BJPsych Open Bipolar cognition cognitive remediation inflammation biomarker |
| title | Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders |
| title_full | Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders |
| title_fullStr | Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders |
| title_full_unstemmed | Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders |
| title_short | Circulating inflammatory and neurotrophic markers as moderators and/or mediators of cognitive remediation outcome in people with bipolar disorders |
| title_sort | circulating inflammatory and neurotrophic markers as moderators and or mediators of cognitive remediation outcome in people with bipolar disorders |
| topic | Bipolar cognition cognitive remediation inflammation biomarker |
| url | https://www.cambridge.org/core/product/identifier/S2056472424008184/type/journal_article |
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