Relationship Between the Levels of Nitric Oxide, Asymmetric Dimethylarginine and Neurocognitive Functions in Patients with Bipolar Disorder

Abstract

Aim: The current study aimed to explore the association between cognitive functions and serum nitric oxide (NO), asymmetric dimethylarginine (ADMA) levels in patients with bipolar disorder.

Material and Methods: The study sample was consisted of patients followed by Afyon Kocatepe University Psychiatry Department outpatient clinic. 45 patients diagnosed with bipolar disorder according to DSM-5 criteria and 45 volunteers adjusted for gender, age, and education were included. Sociodemographic Data Form, Hamilton Depression Rating Scale and Young Mania Rating Scale were applied to all participants. Neurocognitive functions were assessed with Test of Verbal Memory Processes, Wisconsin Card Sorting Test (WCST), Stroop Test and Trail-Making Test. Serum NO and ADMA levels were measured using ELISA kit.

Results: It was determined that there was a significant difference (p=0.002) in the family psychiatric family questionnaire between the two matched groups in terms of age, gender and educational status and bipolar disorder in the family of 31% of the patient group. Neuropsychological test scores of patients was statistically lower than control group. Serum ADMA levels of patient group was statistically lower than control group (p=0.001). Statistically significant correlation was found between ADMA levels and spontaneous recall scores (p=0.037), the percent of conceptual level responses (p=0.029), including Stroop Test time scores (p=0.043) and Trail Making Test A time score (p=0.002).

Conclusion: According to the results of present study, in patients with bipolar mood disorder, there is deterioration in areas of cognitive such as memory, learning, attention, processing speed, changing strategy and solving problem. It was determined that the impairment is not associated with serum NO level but the scores of spontaneous recall, the percent of conceptual level responses, time to complete the Stroop Test, Trail Making Test A time were determined that the relationship with serum ADMA level.

Keywords

• Bipolar disorder,cognition,nitric oxide,asymmetric dimethylarginine

Bipolar Bozukluk Tanılı Hastalarda Nörokognitif İşlevler ile Nitrik Oksit ve Asimetrik Dimetilarjinin Düzeyleri Arasındaki İlişki

Abstract

Amaç: Bu çalışmada bipolar bozukluk tanısı olan hastalarda bilişsel işlevlerin, serum nitrik oksit (NO) ve asimetrik dimetilarjinin (ADMA) düzeyleri ile ilişkisinin belirlenmesi planlanmıştır.

Gereç ve Yöntemler: Çalışmanın örneklemi Afyon Kocatepe Üniversitesi Tıp Fakültesi Psikiyatri Polikliniği tarafından ayaktan takip edilen, DSM-5’e göre bipolar bozukluk tanısı konulmuş ötimik dönemdeki 45 hasta ile yaş, cinsiyet ve eğitim süresi yönünden eşleştirilmiş 45 sağlıklı gönüllüden oluşturuldu. Çalışmaya katılanlara sosyodemografik veri formu, Hamilton Depresyon Derecelendirme Ölçeği ve Young Mani Derecelendirme Ölçeği uygulandı. Nörokognitif fonksiyonlar Sözel Bellek Süreçleri Testi, Wisconsin Kart Eşleştirme Testi, Stroop Testi ve İz Sürme Testi ile incelendi. Serum NO ve ADMA düzeyleri ELİSA kiti kullanılarak ölçüldü.

Bulgular: Yaş, cinsiyet ve eğitim durumu açısından eşleştirilmiş iki grup arasında ailevi psikiyatrik soygeçmiş sorgulamasında anlamlı farklılık (p=0,002) olduğu ve hasta grubunun %31’inin ailesinde bipolar bozukluk olduğu tesbit edildi. Hasta grubunun nöropsikolojik test sonuçlarının kontrol grubundan istatistiksel olarak anlamlı derecede düşük olduğu bulundu. Serum ADMA düzeyinin ise hasta grubunda kontrol grubuna göre daha düşük düzeyde olduğu gözlendi (p=0,001). ADMA düzeyi ile kendiliğinden hatırlama puanı (p=0,037), kavramsal düzey tepki yüzdesi (p=0,029), Stroop Test puanları (p=0,043) ve İz Sürme A testi süresi (p=0,002) arasında istatistiki olarak anlamlı ilişki olduğu saptandı.

Sonuç: Bu çalışmanın sonuçlarına göre bipolar bozukluk hastalarında bellek, öğrenme, dikkat, işlem hızı, strateji değiştirme, problem çözme gibi bilişsel alanlarda bozulma olduğu fakat bu bozulmanın serum NO düzeyi ile ilişkisi olmadığı fakat kendiliğinden hatırlama, kavramsal tepki yüzdesi, Stroop Testi tamamlama süresi, İz Sürme A testi süresi puanlarının ADMA ile ilişkisi olduğu belirlenmiştir.

Keywords

• Bipolar bozukluk,biliş,nitrik oksit,asimetrik dimetilarjinin

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