Ayşegül DEMİREL, Ömer Faruk DEMİREL, Muhammed Tayyib KADAK, Alaattin DURAN

Ötimik Bipolar Hastalarda Nörobilişsel Defisitler

Nörobilişsel defisitlerin bipolar bozukluğun seyri ve ciddiyeti üzerinde belirle-yici olduğu bilinmektedir. Bu derlemede ötimik bipolar hastalarda nörobilişsel defisit varlığını, bu defisitlerle bipolar hastalarda saptanan nöroanatomik lezyonların ilişkisi ve bu hastalarda saptanan bazı defisitlerin bir endofenotip olabileceği ile ilgili çalışmaları gözden geçirilmiştir. Çalışmalar ötimik hastalarda ve sağlıklı aile bireylerinde prefrontal korteks, temporo-limbik döngü ile ilişkili bulunan sözel bellek, öğrenme ve yürütücü fonksiyon alanlarında defisit gösterdiklerini teyit etmiştir. Ötimik hastalarda saptanan bilişsel defisitlerin genetik temellerini, bipolar hastalarda nöroanatomik tutu-lumla olan ilişkisini ve epigenetik mekanizmaların hastalık sürecine olası etkilerini araştırmaya yönelik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Bipolar bozukluk, nörobilişsel defisit, endofenotip

Neurocognitive Deficits in Euthymic Bipolar Patients

Neurocognitive deficits detected in bipolar patients have a negative influence on clinical course and severity. We reviewed studies on neurocognitive deficits in euthymic bipolar subjects and their possible neuroanatomical correlates. We also examined studies suggesting deficits seen in euthymic patients may be endophenotypes of the disorder. Results of the studies in euthymic patients and their healthy relatives indicate that have cognitive dysfunctions especially of verbal memory, learning and executive domains, which were found to be related to prefrontal cortex and temporo-limbic circuitry. Longitudinal studies investigating heritability of cognitive impairment in bipolar disorder and its relation with brain connectivity and epigenetic mechanisms are needed. Keywords: Bipolar disorder, neurocognitive deficit, endophenotype

Keywords:

Bipolar disorder, neurocognitive deficits, endophenotype,

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Ayşegül Demirel, Uzm.Dr., Üsküdar Devlet Hastanesi, İstanbul; Ömer Faruk Demirel, Dr., İ.Ü. Cerrahpaşa
Tıp Fakültesi Psikiyatri ABD, İstanbul; Muhammed Tayyip Kadak, Uzm. Dr., Yüzüncü Yıl Üniv. Tıp Fak. Çocuk
Psikiyatrisi ABD, Van; Alattin Duran, Prof. Dr., İ.Ü. Cerrahpaşa Tıp Fakültesi Psikiyatri ABD, İstanbul