Data support the notion that 40–60% of patients with bipolar disorder (BD) have neurocognitive deficits. It is increasingly accepted that functioning in BD is negatively impacted by these deficits, yet they have not been a successful target for treatment. The biomarkers that predict cognitive deficits in BD are largely unknown, however recent evidence suggests that inflammation may be associated with poorer cognitive outcomes in BD. We measured C-reactive protein (CRP), a marker of systemic inflammation and risk of inflammatory disease, in 222 euthymic BD patients and 52 healthy controls. Within the patient sample, using multivariate analyses of covariance (MANCOVA) we compared cognitive performance of those with high CRP (≥5 mg/L) versus the remaining subjects (<5 mg/L) on a battery of cognitive tests. We evaluated relationships with several other relevant clinical features. We also examined the role of CRP in cognitive decline using a proxy cognitive decline metric, defined as the difference between premorbid and current IQ estimates, in a logistic regression analysis. Approximately 80% of our sample were BD-I, and the remainder were BD-II and 42.6% of our sample had a history of psychosis. We found a statistically significant effect of CRP on cognitive performance on a broad range of tests; participants with CRP ≥ 5 mg/L had worse performance on several measures of executive functioning, MATRICS processing speed and MATRICS reasoning and problem solving relative to those with lower CRP. We also identified CRP as a significant positive predictor of proxy cognitive decline. Our results indicate that elevated CRP is associated with a broad cognitive dysfunction in affectively remitted BD patients. These results may point to a subgroup of patients who might benefit from treatments to reduce inflammation.

数据支持这样的观点，即 40-60% 的双相情感障碍 (BD) 患者存在神经认知缺陷。人们越来越多地认为，BD 的功能受到这些缺陷的负面影响，但它们并不是成功的治疗目标。预测 BD 认知缺陷的生物标志物在很大程度上是未知的，但最近的证据表明炎症可能与 BD 较差的认知结果有关。我们测量了 222 名心境正常的 BD 患者和 52 名健康对照者的 C 反应蛋白 (CRP)，这是全身炎症和炎症性疾病风险的标志物。在患者样本中，我们使用多变量协方差分析 (MANCOVA) 在一系列认知测试中比较了高 CRP (≥5 mg/L) 与其余受试者 (<5 mg/L) 的认知表现。我们评估了与其他几个相关临床特征的关系。我们还在逻辑回归分析中使用代理认知下降指标（定义为病前和当前 IQ 估计值之间的差异）检查了 CRP 在认知下降中的作用。我们的样本中大约 80% 是 BD-I，其余是 BD-II，并且我们样本中的 42.6% 有精神病史。我们发现 CRP 在广泛的测试中对认知表现具有统计学显着影响；与 CRP 较低的参与者相比，CRP ≥ 5 mg/L 的参与者在执行功能、MATRICS 处理速度以及 MATRICS 推理和问题解决等多项指标上的表现较差。我们还将 CRP 确定为代理认知能力下降的显着正预测因子。我们的结果表明，升高的 CRP 与情感缓解的 BD 患者的广泛认知功能障碍有关。这些结果可能指向可能受益于减少炎症治疗的患者亚组。