Review article
Cognitive and neurological impairment in mood disorders

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Cognitive deficits

Cognitive deficits within mood disorders have been studied extensively. Although results have not always been consistent, an overall pattern of specific impairments has become evident. In general, unipolar and bipolar patients have shown impaired performance in tests of attention, executive function, and memory. Increased cognitive dysfunction often is associated with greater symptom severity. Nevertheless, cognitive deficits persist during the euthymic/remitted states, indicating that some

Structural and functional abnormalities of the brain in mood disorders

Combined with cognitive assessment, more recent advances in neuropathological and neuroimaging studies have begun to delineate the neural substrates of mood disorders. Neuroanatomical findings help to not only gain insight into the underlying neural systems of mood regulation, but also to provide a basis for understanding the cognitive features associated with mood disorders. Neuroanatomical abnormalities have been found in limbic regions associated with identification of emotion, social

Neurological deficits

There has been a renewed interest in the motor component of neurological deficits that often accompany mood disorders. Some neurological signs are evident in nonmedicated patients, while other signs have been associated primarily with medication treatment. Neurological symptoms add to the global burden of mood disorders and often constitute a major therapeutic challenge. This section, summarized in Table 4, provides a general description of motor deficits that have been observed in unipolar

Relationships among mood, cognition, and movement

This article characterizes the relations of mood state to cognition, brain structure/function, and abnormal movements. An intriguing question is whether there is a predictable association among various domain deficits, including mood disturbance, cognitive deficit, and movement abnormality. Few studies have addressed this question directly. Gilleard and Vaddadi [80] compared TD and mood symptoms to memory function in patients with bipolar disorder. They found that increased TD was correlated to

Summary

Disorders of mood are accompanied by a range of cognitive and neurological impairments. Similar types of cognitive deficits are shared by patients with unipolar depression and bipolar disorder. Given the disparate clinical nature of these two disorders, it is interesting and informative to understand that they share common impairments in cognition. Neuroimaging studies indicate that these impairments in both patient populations may be subserved by disruptions of the dorsal lateral and ventral

Acknowledgements

The authors would like to thank Natalie Robinson for assisting in the preparation of this manuscript, and John Bayless for his helpful comments on the text.

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    Supported in part by NIMH 5T32 MH19113. Sergio Paradiso is supported by the Edward Mallinckrodt, Jr. Foundation.

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