Frontiers in Psychiatry (Jan 2024)

Study protocol – elucidating the neural correlates of functional remediation for older adults with bipolar disorder

  • Laura Montejo,
  • Laura Montejo,
  • Laura Montejo,
  • Laura Montejo,
  • Brisa Sole,
  • Brisa Sole,
  • Brisa Sole,
  • Brisa Sole,
  • Lydia Fortea,
  • Lydia Fortea,
  • Esther Jimenez,
  • Esther Jimenez,
  • Esther Jimenez,
  • Esther Jimenez,
  • Anabel Martinez-Aran,
  • Anabel Martinez-Aran,
  • Anabel Martinez-Aran,
  • Anabel Martinez-Aran,
  • Anabel Martinez-Aran,
  • Eloy Martinez-Heras,
  • Jose Sanchez-Moreno,
  • Jose Sanchez-Moreno,
  • Jose Sanchez-Moreno,
  • Jose Sanchez-Moreno,
  • Maria Ortuño,
  • Maria Ortuño,
  • Jose Pariente,
  • Aleix Solanes,
  • Carla Torrent,
  • Carla Torrent,
  • Carla Torrent,
  • Carla Torrent,
  • Enric Vilajosana,
  • Michele De Prisco,
  • Michele De Prisco,
  • Michele De Prisco,
  • Michele De Prisco,
  • Eduard Vieta,
  • Eduard Vieta,
  • Eduard Vieta,
  • Eduard Vieta,
  • Eduard Vieta,
  • Joaquim Radua,
  • Joaquim Radua,
  • Joaquim Radua

DOI
https://doi.org/10.3389/fpsyt.2023.1302255
Journal volume & issue
Vol. 14

Abstract

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IntroductionBeyond mood abnormalities, bipolar disorder (BD) includes cognitive impairments that worsen psychosocial functioning and quality of life. These deficits are especially severe in older adults with BD (OABD), a condition expected to represent most individuals with BD in the upcoming years. Restoring the psychosocial functioning of this population will thus soon represent a public health priority. To help tackle the problem, the Bipolar and Depressive Disorders Unit at the Hospital Clínic of Barcelona has recently adapted its Functional Remediation (FR) program to that population, calling it FROA-BD. However, while scarce previous studies localize the neural mechanisms of cognitive remediation interventions in the dorsal prefrontal cortex, the specific mechanisms are seldom unknown. In the present project, we will investigate the neural correlates of FR-OABD to understand its mechanisms better and inform for potential optimization. The aim is to investigate the brain features and changes associated with FROA-BD efficacy.MethodsThirty-two individuals with OABD in full or partial remission will undergo a magnetic resonance imaging (MRI) session before receiving FR-OABD. After completing the FR-OABD intervention, they will undergo another MRI session. The MRI sessions will include structural, diffusion-weighted imaging (DWI), functional MRI (fMRI) with working memory (n-back) and verbal learning tasks, and frontal spectroscopy. We will correlate the pre-post change in dorsolateral and dorsomedial prefrontal cortices activation during the n-back task with the change in psychosocial functioning [measured with the Functioning Assessment Short Test (FAST)]. We will also conduct exploratory whole-brain correlation analyses between baseline or pre-post changes in MRI data and other clinical and cognitive outcomes to provide more insights into the mechanisms and explore potential brain markers that may predict a better treatment response. We will also conduct separate analyses by sex.DiscussionThe results of this study may provide insights into how FROA-BD and other cognitive remediations modulate brain function and thus could optimize these interventions.

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