Neural basis of memory impairments and relation to functional disability in fully or partially remitted patients with affective disorders

Prog Neuropsychopharmacol Biol Psychiatry. 2023 Jul 13;125:110767. doi: 10.1016/j.pnpbp.2023.110767. Epub 2023 Apr 15.


Bipolar disorder (BD) and major depressive disorder (MDD) are associated with cognitive and functional impairment. Cognitive impairment is often associated with dorsal prefrontal cortex (dPFC) hypo-activity, but the neuronal correlates of functional disability is largely unknown. In this study, 91 patients with affective disorders in full or partial remission (BD, n = 67; MDD, n = 24) with objectively verified cognitive impairment and substantial functional disability underwent neuropsychological assessment and functional magnetic resonance imaging (fMRI) scan during which they completed a strategic picture-encoding task. For comparison, 36 matched healthy controls underwent an identical test protocol. Patients showed encoding-related hypo-activity in the dPFC compared to controls. In patients, lower right dlPFC activity was associated with poorer overall functioning and more antipsychotic drug use. In conclusion, memory impairments were underpinned by failure to recruit the dPFC during task performance which was associated with impaired functioning in fully or partially remitted patients with affective disorders. This aberrant neurocircuitry activity has implications for the design of future pro-cognitive interventions that aim to improve not only cognition but also real-world functioning.

Keywords: Affective disorders; Cognitive impairment; Functional impairment; fMRI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bipolar Disorder* / complications
  • Bipolar Disorder* / diagnostic imaging
  • Cognition / physiology
  • Depressive Disorder, Major* / complications
  • Depressive Disorder, Major* / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Memory Disorders / complications
  • Memory Disorders / etiology
  • Mood Disorders / complications
  • Mood Disorders / etiology
  • Neuropsychological Tests
  • Prefrontal Cortex / diagnostic imaging