Targeting Treatments to Improve Cognitive Function in Mood Disorder: Suggestions From Trials Using Erythropoietin.

dc.contributor.author

Miskowiak, Kamilla Woznica

dc.contributor.author

Rush, A John

dc.contributor.author

Gerds, Thomas A

dc.contributor.author

Vinberg, Maj

dc.contributor.author

Kessing, Lars V

dc.date.accessioned

2022-04-14T00:08:27Z

dc.date.available

2022-04-14T00:08:27Z

dc.date.issued

2016-12

dc.date.updated

2022-04-14T00:08:27Z

dc.description.abstract

Objective

There is no established efficacious treatment for cognitive dysfunction in unipolar and bipolar disorder. This may be partially due to lack of consensus regarding the need to screen for cognitive impairment in cognition trials or which screening criteria to use. We have demonstrated in 2 randomized placebo-controlled trials that 8 weeks of erythropoietin (EPO) treatment has beneficial effects on verbal memory across unipolar and bipolar disorder, with 58% of EPO-treated patients displaying a clinically relevant memory improvement as compared to 15% of those treated with placebo.

Methods

We reassessed the data from our 2 EPO trials conducted between September 2009 and October 2012 to determine whether objective performance-based memory impairment or subjective self-rated cognitive impairment at baseline was related to the effect of EPO on cognitive function as assessed by Rey Auditory Verbal Learning Test (RAVLT) total recall with multiple logistic regression adjusted for diagnosis, age, gender, symptom severity, and education levels.

Results

We included 79 patients with an ICD-10 diagnosis of unipolar or bipolar disorder, of whom 39 received EPO and 40 received placebo (saline). For EPO-treated patients with objective memory dysfunction at baseline (n = 16) (defined as RAVLT total recall ≤ 43), the odds of a clinically relevant memory improvement were increased by a factor of 290.6 (95% CI, 2.7-31,316.4; P = .02) compared to patients with no baseline impairment (n = 23). Subjective cognitive complaints (measured with the Cognitive and Physical Functioning Questionnaire) and longer illness duration were associated with small increases in patients' chances of treatment efficacy on memory (53% and 16% increase, respectively; P ≤ .04). Diagnosis, gender, age, baseline depression severity, and number of mood episodes did not significantly change the chances of EPO treatment success (P ≥ .06). In the placebo-treated group, the odds of memory improvement were not significantly different for patients with or without objectively defined memory dysfunction (P ≥ .59) or subjective complaints at baseline (P ≥ .06).

Conclusions

Baseline objectively assessed memory impairments and-to a lesser degree-subjective cognitive complaints increased the chances of treatment efficacy on cognition in unipolar and bipolar disorder.

Trial registration

ClinicalTrials.gov identifier: NCT00916552.
dc.identifier.issn

0160-6689

dc.identifier.issn

1555-2101

dc.identifier.uri

https://hdl.handle.net/10161/24818

dc.language

eng

dc.publisher

Physicians Postgraduate Press, Inc

dc.relation.ispartof

The Journal of clinical psychiatry

dc.relation.isversionof

10.4088/jcp.15m10480

dc.subject

Humans

dc.subject

Memory Disorders

dc.subject

Erythropoietin

dc.subject

Mood Disorders

dc.subject

Bipolar Disorder

dc.subject

Adult

dc.subject

Aged

dc.subject

Middle Aged

dc.subject

Female

dc.subject

Male

dc.subject

Young Adult

dc.subject

Cognitive Dysfunction

dc.subject

Outcome Assessment, Health Care

dc.title

Targeting Treatments to Improve Cognitive Function in Mood Disorder: Suggestions From Trials Using Erythropoietin.

dc.type

Journal article

duke.contributor.orcid

Rush, A John|0000-0003-2004-2382

pubs.begin-page

e1639

pubs.end-page

e1646

pubs.issue

12

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.publication-status

Published

pubs.volume

77

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Miskowiak_Kessing-2016_Targeting treatments to improve cognitive function in mood disorder- Suggestions from trials using erythropoietin.pdf
Size:
390.42 KB
Format:
Adobe Portable Document Format