DANIELLE SOARES BIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject The association between family functioning and childhood trauma and cognition in patients with bipolar disorder type I(2013) BIO, D. S.; MONTEIRO, R. O.; SOEIRO-DE-SOUZA, M.; MORENO, D.; MORENO, R. A.Objective: Bipolar disorder (BD) is characterized by high levels of childhood trauma as well as of cognitive dysfunction. Our aim is to investigate the association between these two factors in bipolar patients and in healthy controls. Methods: A total of 35 patients with BD in euthymia, aged between 18 and 40 years old, were recruited at Hospital das Clinicas in São Paulo, Brazil. Ninety four healthy volunteers (HC) (predominantly medical students) aged between 18 and 40 years old, with no current or past history of psychiatric disorder, were recruited from the University of São Paulo. Information about early life stress was obtained using the Childhood Trauma Questionnaire (CTQ). Cognitive function was assessed through a comprehensive and standardized neuropsychological test battery, including social cognition – Facial Emotional Recognized (FER). Results: In the BD group we observed: that physical abuse was significantly associated with reduced scores on verbal recall (p = 0.04) and with fewer recognized of “fear” faces (p = 0.02); sexual abuse and physical neglect were significantly associated with reduced scores on executive function scales (p = 0.02 to p = 0.04); emotional neglect was significantly associated only with reduced scores on recognized of “anger” faces; emotional abuse was significantly associated with reduced scores on attentional process (p = 0.02), verbal task from the Wechsler Abbreviated Scale of Intelligence (WASI) (p = 0.01), and recognized “anger” faces; pshysical neglect was yet significantly associated with reduced scores on verbal and performance tasks and IQ from the WASI (p = 0.02 to p < 0.001), and FER scores on the Emotion Hexagon (Hx) tests and e Ekman 60 Faces (EK60) total scores. In the control HC, Emotional Neglect and Physical Neglect was significantly associated with reduced scores on verbal and performance tasks and IQ from the WASI (p = 0.02 to p < 0.001), working memory (p = 0.01) and executive function (p = 0.01to p = 0.007); Emotional Neglect and Sexual Abuse was significantly associated with reduced scores on verbal fluency; and significantly reduced scores on FER was observed in emotional abuse (p = 0.03), Physical Neglect (p = 0.04 to p = 0.008) and Sexual Abuse (p = 0.04). Discussion: Our results indicate that childhood trauma is associated with a reduction in cognitive function across cognitive domains in patients with BD and HC, in particular social cognition, working memory and executive function as well as general cognition.conferenceObject Influence of childhood trauma on personality development in bipolar patients and healthy controls(2013) MONTEIRO, R.; BIO, D. Soares; SOEIRO-DE-SOUZA, M.; MISSIO, G.; MORENO, D.; MORENO, R. A.Objective: Bipolar disorder (BD) is characterized by high levels of childhood trauma and they can be detrimental in relation to the formation of personality. The aim of this study is to investigate the association between childhood trauma and BD personality compared to healthy controls (HC). Methods: A total of 27 euthimic BD patients, aged between 18 and 40 years old, were recruited at Hospital das Clinicas in São Paulo, Brazil. Twenty HC (predominantly medical students) aged between 18 and 35 years old, with no current or past history of psychiatric disorder, were recruited from the University of São Paulo. Information about early life stress was obtained using the Childhood Trauma Questionnaire (CTQ). Personality Formation was assessed through NEO-PI-R personality test – based on the Big Five personality traits: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Results: In the BD group the main significant associations were: physical abuse with concientiousness (p = 0.03); emotional neglect with agreeableness (p =0.03) and emotional abuse with conscientiousness (p = 0.04). There were no significant differences in HC group. Comparing BD and HC physical abuse was associated with concientiousness (p = 0.03) and emotion Neglecent was associated with agreeableness (p = 0.03). Discussion: Our results indicate that childhood trauma can be associated with personality traits in BD patients but not in HC, mainly regarding concientiousness and emotional neglect.- Neuropsychological testing of cognitive impairment in euthymic bipolar disorder: an individual patient data meta-analysis(2013) BOURNE, C.; AYDEMIR, O.; BALANZA-MARTINEZ, V.; BORA, E.; BRISSOS, S.; CAVANAGH, J. T. O.; CLARK, L.; CUBUKCUOGLU, Z.; DIAS, V. V.; DITTMANN, S.; FERRIER, I. N.; FLECK, D. E.; FRANGOU, S.; GALLAGHER, P.; JONES, L.; KIESEPPA, T.; MARTINEZ-ARAN, A.; MELLE, I.; MOORE, P. B.; MUR, M.; PFENNIG, A.; RAUST, A.; SENTURK, V.; SIMONSEN, C.; SMITH, D. J.; BIO, D. S.; SOEIRO-DE-SOUZA, M. G.; STODDART, S. D. R.; SUNDET, K.; SZOKE, A.; THOMPSON, J. M.; TORRENT, C.; ZALLA, T.; CRADDOCK, N.; ANDREASSEN, O. A.; LEBOYER, M.; VIETA, E.; BAUER, M.; WORHUNSKY, P. D.; TZAGARAKIS, C.; ROGERS, R. D.; GEDDES, J. R.; GOODWIN, G. M.Objective: An association between bipolar disorder and cognitive impairment has repeatedly been described, even for euthymic patients. Findings are inconsistent both across primary studies and previous meta-analyses. This study reanalysed 31 primary data sets as a single large sample (N = 2876) to provide a more definitive view. Method: Individual patient and control data were obtained from original authors for 11 measures from four common neuropsychological tests: California or Rey Verbal Learning Task (VLT), Trail Making Test (TMT), Digit Span and/or Wisconsin Card Sorting Task. Results: Impairments were found for all 11 test-measures in the bipolar group after controlling for age, IQ and gender (Ps <= 0.001, E.S. = 0.26-0.63). Residual mood symptoms confound this result but cannot account for the effect sizes found. Impairments also seem unrelated to drug treatment. Some test-measures were weakly correlated with illness severity measures suggesting that some impairments may track illness progression. Conclusion: This reanalysis supports VLT, Digit Span and TMT as robust measures of cognitive impairments in bipolar disorder patients. The heterogeneity of some test results explains previous differences in meta-analyses. Better controlling for confounds suggests deficits may be smaller than previously reported but should be tracked longitudinally across illness progression and treatment.
conferenceObject COMT allele (Met(158)) modulates facial emotion recognition in bipolar disorder I mood episodes and in healthy controls(2012) BIO, D. S.; SOEIRO-DE-SOUZA, M. G.; MORENO, D. H.; MORENO, R. A.Background: One of the many cognitive deficits reported in Bipolar Disorder (BD) patients is facial emotion recognition (FER), which has recently been associated with dopaminergic catabolism. Catechol-O-methyltransferase (COMT) is one of the main enzymes involved in the metabolic degradation of dopamine (DA) in the prefrontal cortex (PFC). The COMT gene polymorphism rs4680 (Val 158 Met) Met allele is associated with decreased activity of this enzyme in healthy controls. The objective of this study was to evaluate the influence of Val158 Met on FER during manic and depressive episodes in BDI patients and in healthy controls. Materials & Methods: 64 BD type I patients (39 in manic and 25 in depressive episodes) and 75 healthy controls were genotyped for COMT rs4680 and assessed for FER using the Ekman 60 Faces (EK60) and Emotion Hexagon (Hx) tests. Results: Bipolar manic patients carrying the Met allele recognized fewer surprised faces, while depressed patients with the Met allele recognized fewer angry and happy faces. Healthy homozygous subjects with the COMT Met allele had higher FER scores on the Hx total score, as well as on disgust and angry faces than other genotypes. Conclusion: This is the first study suggesting that COMT rs4680 modulates FER differently during BD episodes and in healthy controls. This provides evidence that PFC DA is part of the neurobiological mechanisms of social cognition. DA receptor stimulation alterations during BD mood episodes might explain the contrasting results found in BD compared to controls. Further studies on other COMT polymorphisms that include euthymic BD patients are warranted.- The impact of limbic system morphology on facial emotion recognition in bipolar I disorder and healthy controls(2013) BIO, Danielle Soares; SOEIRO-DE-SOUZA, Marcio Gerhardt; OTADUY, Maria Concepcion Garcia; MACHADO-VIEIRA, Rodrigo; MORENO, Ricardo AlbertoIntroduction: Impairments in facial emotion recognition (FER) have been reported in bipolar disorder (BD) subjects during all mood states. This study aims to investigate the impact of limbic system morphology on FER scores in BD subjects and healthy controls. Material and methods: Thirty-nine euthymic BD I (type I) subjects and 40 healthy controls were subjected to a battery of FER tests and examined with 3D structural imaging of the amygdala and hippocampus. Results: The volume of these structures demonstrated a differential pattern of influence on FER scores in BD subjects and controls. In our control sample, larger left and right amygdala demonstrated to be associated to less recognition of sadness faces. In BD group, there was no impact of amygdala volume on FER but we observed a negative impact of the left hippocampus volume in the recognition of happiness while the right hippocampus volume positively impacted on the scores of happiness. Conclusion: Our results indicate that amygdala and hippocampus volumes have distinct effects on FER in BD subjects compared to controls. Knowledge of the neurobiological basis of the illness may help to provide further insights on the role of treatments and psychosocial interventions for BD. Further studies should explore how these effects of amygdala and hippocampus volumes on FER are associated with social networks and social network functioning.
- COMT polymorphisms as predictors of cognitive dysfunction during manic and mixed episodes in bipolar I disorder(2012) SOEIRO-DE-SOUZA, Marcio Gerhardt; MACHADO-VIEIRA, Rodrigo; BIO, Danielle Soares; PRADO, Carolina Martins Do; MORENO, Ricardo AlbertoObjective: The dopaminergic system plays an important role in the prefrontal cortex (PFC) and is believed to mediate cognitive dysfunction (CD) in bipolar disorder (BD). The enzyme catechol-O-methyltransferase (COMT) is involved in the catabolism of dopamine in the PFC, and an association between COMT single nucleotide polymorphisms (SNPs) and BD has been reported. COMT SNPs have also been associated with executive and working memory performance in healthy subjects, patients with schizophrenia, and euthymic BD patients. The objective of this study was to investigate the association between COMT SNPs and acute CD during BD mood episodes. Methods: Seventy-two symptomatic, medication-free subjects with bipolar I disorder (BD-I) and 76 healthy controls were evaluated using neuropsychological tests, and genotyped for COMT SNPs rs4680 and rs165599. Results: Patients undergoing mania and mixed episodes carrying the COMT allele G had better performance on executive function, memory, verbal fluency, and intelligence tests. Moreover, an interaction was detected between the COMT allele G and the Young Mania Rating Scale in BD CD. Conclusions: Allele G from COMT SNPs rs4680 and rs165599 may represent reliable state-dependent predictors of global CD during manic and mixed episodes in BD. Further studies in larger samples are necessary to confirm these findings.
conferenceObject Facial emotion recognitions and its correlation to executive functions in young bipolar I patients(2013) DAVID, D. P.; BIO, D. S.; SOEIRO-DE-SOUZA, M.; MORENO, R. A.Background: The ability to recognize facial emotions is considered a fundamental skill for a successful social interaction. Bipolar Disorders (BD) symptomatic treatments itself do not guarantee improvements in social functioning and quality of life of patients. Social functioning is one of the factors that determine the evolution of BD because it reflects patients’ ability to manage the environ- ment and their social reintegration. Impairments in social function- ing may increase relapse rates of BD, worsening morbidity. The ability to recognize facial emotions is altered in patients with BD, as well as cognitive functioning in mood swings and even in euthy- mia. However, it is unclear whether the ability to recognize facial emotions has some correlation with the cognitive deficits in BD. The objective was evaluated Facial Emotion Recognitions (FER) and its correlation to executive functions (EF) in young bipolar I patients during mania, depression or euthymia compared to healthy controls. Methods: A total of 110 patients with BD-I (75 females), age 18 – 40 years old were included (41 in manic episode; 31 in depressive episode and 38 euthymic), and assessed for FER and EF. Ninety-six healthy volunteers (18 to 40 y/o) were recruited from the University of Sao Paulo. Results: The findings from our study suggest that BD patients process FER differently as compared to healthy controls and the measures of EF impact on measures of FER in both bipolar patients and in controls. BD-I patients have an inferior FER performance compared to controls and manic patients has underperformed the control group in HEX total test score (p = 0.0001), in fear subtests (p = 0.0001), happiness (p = 0.039) and surprise test HEX (p = 0.001), total score on the test EK60 (p = 0.0001) and the subtest EK60 fear test (p = 0.0001). In the same direction, the group of euthymic patients showed significantly lower performance compared to the control group in HEX total test score (p = 0.0001), in HEX subtest fear test (p = 0.0001) and total score test EK60 (p = 0.0001). BD-I manic patients showed inferior performance on EF compared to controls. Comparing EF between the groups we found that the manic group provides lower performance than control group nearly in all measures WCST, with the mania group having a higher number of preservatives responses (p = 0.008), error (p = 0.001), preservative errors (p = 0.0001) and non-preservative (p = 0.017), fewer completed categories (p = 0.003) and conceptual level responses (p = 0.001). Discussion: Our findings suggest that BD-1 patients, even during remission, have psychosocial problems caused not only by residual symptoms, but also by cognitive deficits and difficulties to recognize emotions in human faces. Both BD-1 groups showed a significant impairment in FER compared with a similar sample of healthy volunteers and we suggest that FER is influenced by EF.- The CACNA1C risk allele selectively impacts on executive function in bipolar type I disorder(2013) SOEIRO-DE-SOUZA, M. G.; BIO, D. S.; DIAS, V. V.; VIETA, E.; MACHADO-VIEIRA, R.; MORENO, R. A.ObjectiveCalcium channels are important for converting electrical activity into biochemical events. A single nucleotide polymorphism (SNP) (rs1006737) in the CACNA1C gene has been strongly associated with increased risk for Bipolar disorder (BD) in genome-wide association studies. Recently, this same SNP has been reported to influence executive function in schizophrenia and controls, but it remains unclear whether this SNP affects behaviour, especially cognition in subjects with BD. MethodA total of 109 BD type I subjects and 96 controls were genotyped for CACNA1C rs1006737 and assessed with an executive function tests battery [Wechsler Adult Intelligence Scale III (WAIS-III) Letter-Number Sequence subtest (WAIS-LNS), digit span (WAISDS), trail making test (TMT), and WCST (Wisconsin Card Sorting Test)]. ResultsIn patients with BD, the CACNA1C genotype Met/Met was associated with worse performance on all four executive function tests compared to Val/Val. No influence of CACNA1C was observed in the cognitive performance of healthy controls. ConclusionOur data indicate for the first time that the CACNA1C risk allele is likely associated with executive dysfunction as a trait in BD, as this association was found regardless the presence of mood symptoms. Larger studies should evaluate the potential influence of CACNA1C on other cognitive domains in BD.