Articles publicats en revistes (Psicologia Clínica i Psicobiologia)

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Do patients with bipolar disorder and subsyndromal symptoms benefit from funcional remediation? A 12-month follow-up study
(Elsevier B.V., 2017-04) Sánchez-Moreno, José; Bonnín Roig, Caterina del Mar; González-Pinto, Ana; Amann, Benedikt L.; Solé Cabezuelo, Brisa; Balanzá-Martínez, Vicent; Arango, Celso; Jiménez Martínez, Ester; Tabarés-Seisdedos, Rafael; García-Portilla González, María Paz, 1962-; Ibáñez, Ángela; Crespo, J. M. (José Manuel); Ayuso Mateos, José Luis; Vieta i Pascual, Eduard, 1963-; Martínez-Arán, Anabel, 1971-; Torrent Font, Carla; CIBERSAM Functional Remediation Group
We analyzed the efficacy of functional remediation, in a sample of patients with bipolar disorder who presented with subsyndromal symptoms. From a total sample of 239 patients with bipolar I and II disorder, according to DSM-IV-TR diagnostic criteria, entering a randomized clinical trial, those patients who presented with subsyndromal symptoms were selected based on a method already described by Berk and colleagues was applied. It consists of using the Clinical Global Impression-Bipolar version (CGI-BP) to establish the scores of the Hamilton Depression Rating Scale (HAM-D) and of the Young Mania Rating Scale (YMRS) that correspond with 1 in the CGI-BP. Functional outcome and mood symptoms were assessed at 6 and at 12-month follow-up. A total of 99 patients were selected for this post-hoc analysis, allocated as follows: functional remediation (n=33); psychoeducation (n=37) and treatment as usual (TAU,n=29). The repeated-measures analyses at 12-month follow-up revealed a significant group x time interaction in favour of the patients who received functional remediation when compared to psychoeducation and TAU (F=2.93; p=0.02) at improving psychosocial functioning. Finally, mood symptoms did not significantly change in any of the three groups at any time of follow-up, as shown by the non-significant group x time interaction effect in HAM-D scores (F=1.57; p=0.18) and YMRS scores (F=1.51; p=0.20). Bipolar patients with subsyndromal symptoms improve their functional outcome when exposed to functional remediation regardless of the persistence of mood symptomatology.
Functional remediation improves bipolar disorder functioning with no effects on brain-derived neurotrophic factor levels
(Elsevier B.V., 2019-06) Bonnín Roig, Caterina del Mar; Valls Roig, Èlia; Rosa, Adriane R.; Reinares, María; Jiménez Martínez, Ester; Solé Cabezuelo, Brisa; Montejo Egido, Laura; Meseguer, Ana; Pacchiarotti, Isabella; Colom, Francesc, 1971-; Martínez-Arán, Anabel, 1971-; Tomioka, Yoko; Vieta i Pascual, Eduard, 1963-; Torrent Font, Carla
The main aim of this study is to evaluate the impact of functional remediation (FR) in serum brain derived neurotrophic factor (BDNF) levels in euthymic adult patients with Bipolar Disorder (BD). A total of 128 participants were recruited at the Hospital Clinic of Barcelona. They were assessed at baseline and at the end of follow-up by the means of Hamilton Depression Scale (HAM-D), Young Mania Rating Scale (YMRS) and Functioning Assessment Short Test (FAST), as well as a clinical structured interview to collect clinical and demographic variables of interest. Blood samples were also collected to assess BDNF levels. After baseline assessment, patients received FR, Psychoeducation or treatment as usual (TAU). One hundred and two out of 126 participants finished the study distributed as follows: FR group (n = 39); Psychoeducation group (n = 47) and TAU group (n = 16). Longitudinal repeated-measures analyses addressing the treatment effect on BDNF levels showed non-significant differences between the three groups (Pillai's trace = 0.06; F(2,97)= 0.28; p = 0.75), suggesting no interaction between treatment allocation and time on BDNF levels. The results of this study suggest that FR has no effect on peripheral BDNF levels in euthymic patients with BD, despite the improvement in psychosocial functioning.
El espectro del abuso sexual infantil: definición y tipología
(Fundació Orienta, 2010-11) Pereda Beltran, Noemí
La imposibilidad de establecer una definición unificada y reconocida de malos tratos y abuso sexual infantil dificulta enormemente la detección de estos casos y las estimaciones estadísticas de un problema, ya de por sí difícil de identificar. El trabajo recoge aquellas definiciones más utilizadas, especialmente las nacionalidades, y una propuesta de los criterios que permitan su correcta delimitación. A su vez, se propone el concepto “espectro del abuso sexual” para incluir todas aquellas tipologías, incluyendo las vinculadas con los últimos avances sociales y tecnológicos, pues se considera que los profesionales del ámbito clínico deberían conocerlas para su correcta detección, diagnóstico y posterior tratamiento.
Abuso sexual infantil y síndrome de alienación parental: criterios diferenciales
(Asociación de Médicos Forenses de Andalucía, 2009-10) Pereda Beltran, Noemí; Arch Marín, Mila
El abuso sexual infantil y los denominados casos de interferencias parental son situaciones de especial gravedad para los menores que las padecen, así como de evidente dificultad para su adecuado diagnóstico y abordaje profesional. Discernir cuando el profesional se encuentra ante uno u otro caso entraña una complejidad para la que son necesarios una formación adecuada y unos criterios fiables. El presente trabajo tiene como objetivo aportar algunos de los criterios recogidos de las publicaciones al respecto, que pretenden facilitar la diferenciación entre ambas situaciones. El análisis del relato del menor, así como diferentes indicadores clínicos presentes en una parte importante de las víctimas de abuso sexual pueden ayudar al profesional a tomar una decisión al respecto. Los efectos de un error diagnóstico en cualquiera de estos casos conllevaría un gran perjuicio para el menor, su familia y el sistema social, siendo fundamental que el profesional evite participar activamente en una evaluación de este tipo si no se dispone de la adecuada formación y experiencia.
Polivictimización, resiliencia y conductas suicidas en adolescentes atendidos por el sistema de protección y justicia juvenil en Cataluña
(Fundació Orienta, 2020-04) Suárez-Soto, Elizabeth; Pereda Beltran, Noemí; Codina, Marta
Polivictimización, resiliencia y conductas suicidas en adolescentes atendidos por el sistema de protección y justicia juvenil en Cataluña. Este estudio busca analizar la relación entre la polivictimización, los factores de resiliencia y las conductas suicidas (ideación suicida y/o comportamiento de autolesión) en un grupo de 227 (145 varones y 82 mujeres) adolescentes atendidos por el sistema de protección y justicia juvenil español. Con edades comprendidas entre los 12 y los 17 años (M = 15,26; DT = 1,54). Los resultados indicaron que un 39,6 % de los adolescentes informaron haber presentado conductas suicidas de algún tipo en los últimos seis meses. Se hallaron diferencias en cuanto al tipo de centro, a la edad y al género. La polivictimización fue un predictor significativo de las conductas suicidas, y los factores de resiliencia asociados al individuo contribuyen a reducir el riesgo de conductas suicidas. Palabras Clave: suicidabilidad, victimización, Polivictimización, JVQ, justicia juvenil, Sistema de protección juvenil.
Características del abuso sexual infantil por representantes de la Iglesia Católica en España
(Fundació Orienta, 2020) Pereda Beltran, Noemí; Segura, Anna; Sicilia, Laura
Características del Abuso Sexual Infantil por representantes de la Iglesia católica en España. Este es el primer estudio nacional en España en el que se evalúan las características diferenciales de la victimización sexual contra niños, niñas y adolescentes por parte de representantes de la Iglesia católica. Participaron 38 adultos (25 varones y 13 mujeres), a quienes se llegó mediante muestreo no probabilístico de conveniencia y bola de nieve. Se evaluaron las características de la victimización sexual y del victimario, la revelación y notificación y la vivencia de otras formas de victimización por parte de personas no pertenecientes al clero. Los resultados sugieren que las organizaciones religiosas deberían adquirir el compromiso de colaborar en el proceso de superación de las graves experiencias de victimización infantojuvenil acontecidas en su seno por parte de aquellos niños, niñas y adolescentes más vulnerables y victimizados
Victimización sexual infantil por representantes de la Iglesia Católica en España: descripción de sus características y daño espiritual en sus víctimas
(Universidad Miguel Hernández, 2021) Pereda Beltran, Noemí; Segura, Anna
Victimización sexual infantil por representantes de la Iglesia Católica en España: descripción de sus características y daño espiritual en sus víctimas.
Estudi sobre l'experiència d'abús sexual en joves catalans
(Associació de Mestres Rosa Sensat, 2008-01) Pereda Beltran, Noemí
Aquest estudi pretén aprofundir en la prevalença i les característiques de l'abús sexual infantil en joves universitaris catalans matriculats a la Universitat de Barcelona i actualitzar-ne les dades. S'ha realitzat sobre una mostra de 1033 estudiants matriculats a la Universitat de Barcelona. L'abús sexual es defineix com el contacte sexual no desitjat entre: a) un menor de 13 anys i algú almenys cinc anys major, b) un menor de 13 anys i algú d’edat similar mitjançant coerció, i c) un menor de 18 anys i un altre individu contra la seva voluntat.
Reseña: Echeburúa, E. y Guerricaechevarría, C. (2000). Abuso sexual en la infancia: víctimas y agresores. Un enfoque clínico. Barcelona: Ed. Ariel
(Universitat de Barcelona, 2001) Pereda Beltran, Noemí
La perspectiva tomada en el libro de Echeburúa y Guerricaechevarría, tal y como viene indicado ya en su título, es una perspectiva integradora, básicamente clínica y centrada en la práctica, pero sin olvidar por ello la teoría de un tema tan complejo y universal como es el abuso sexual en la infancia.
Brain structure and function related to cognitive reserve variables in normal aging, mild cognitive impairment and Alzheimer's disease
(Elsevier B.V., 2009-07) Solé Padullés, Cristina; Bartrés Faz, David; Junqué i Plaja, Carme, 1955-; Vendrell i Gómez, Pere; Rami González, Lorena; Clemente, Immaculada; Bosch Capdevila, Beatriz; Villar, Amparo; Bargalló Alabart, Núria; Jurado, Ma. Ángeles (María Ángeles); Barrios Cerrejón, M. Teresa; Molinuevo, José Luis
Cognitive reserve (CR) is the brain's capacity to cope with cerebral damage to minimize clinical manifestations. The 'passive model' considers head or brain measures as anatomical substrates of CR, whereas the 'active model' emphasizes the use of brain networks effectively. Sixteen healthy subjects, 12 amnestic mild cognitive impairment (MCI) and 16 cases with mild Alzheimer's disease (AD) were included to investigate the relationships between proxies of CR and cerebral measures considered in the 'passive' and 'active' models. CR proxies were inferred premorbid IQ (WAIS Vocabulary test), 'education-occupation', a questionnaire of intellectual and social activities and a composite CR measure. MRI-derived whole-brain volumes and brain activity by functional MRI during a visual encoding task were obtained. Among healthy elders, higher CR was related to larger brains and reduced activity during cognitive processing, suggesting more effective use of cerebral networks. In contrast, higher CR was associated with reduced brain volumes in MCI and AD and increased brain function in the latter, indicating more advanced neuropathology but that active compensatory mechanisms are still at work in higher CR patients. The right superior temporal gyrus (BA 22) and the left superior parietal lobe (BA 7) showed greatest significant differences in direction of slope with CR and activation between controls and AD cases. Finally, a regression analysis revealed that fMRI patterns were more closely related to CR proxies than brain volumes. Overall, inverse relationships for healthy and pathological aging groups emerged between brain structure and function and CR variables.
Assessment criteria in relocation cases: An exploratory study of Spanish family court Judges
(Routledge, Taylor & Francis, 2020) Fabregas, Mar; Arch Marín, Mila; García-Arch, Josué; Segura Bernal, Jordi; Pereda Beltran, Noemí
This descriptive study determined whether Spanish family law judges (N = 30) use the criteria proposed in the scientific literature and jurisprudence to assess cases of the relocation of minors after the breakdown of their parents’ relationship. Our results showed that the judges consider the criteria to be relevant in guiding their decision-making process, the most valued criteria being the psychological ones (parents’ psychological adjustment; relationship between the minor and each parent; the right of the child to maintain personal relationships with both parents). However, we observed trends in the judicial resolutions, with a third of the judges tending to authorize relocation requests and another third tending to deny them, indicating the presence of biases or presumptions.
Sentimiento de culpa en víctimas de abuso sexual infantil: modelos teóricos e intervención
(Universidade de Vigo, 2007) Pereda Beltran, Noemí; Arch Marín, Mila
La influencia de determinadas variables para atenuar o acentuar el riesgo de desarrollar problemas psicológicos ante situaciones adversas o estresantes ha sido sugerida en las orientaciones más clásicas del estrés. Dentro de esta perspectiva, la presencia o ausencia de ciertas variables no únicamente relacionadas con las características objetivas del estresor si no también con factores individuales y psicosociales, de manera consistente, facilitaría la aparición de trastornos psicopatológicos en situaciones de estrés, mientras que la presencia o ausencia de otras variables minimizaría o anularía los posibles efectos psicológicos relacionados con esa situación y proporcionaría al individuo la capacidad de resistencia frente a ese estresor. El presente artículo tiene como objetivo realizar una revisión teórica del efecto del sentimiento de culpa como variable mediadora entre la experiencia de abuso sexual infantil y el desarrollo de sintomatología psicopatológica, dada su generalizada presencia en estas víctimas y la importancia de su tratamiento en el pronóstico de este colectivo.
Víctimas de abuso sexual en la infancia. Estudio descriptivo
(Institut Català d'Estudis de la Violència, 2007) Pereda Beltran, Noemí; Polo, Pilar; Grau, Núria; Navales, Núria; Martínez, Mireia
La asociación FADA se creó en 1997 con la finalidad de ofrecer un servicio profesional de asesoramiento, atención y formación especializado en el tema del abuso sexual acontecido durante la infancia. El estudio describe las características de la población (n = 593) atendida durante el año 2005. Se constata que gran parte de los casos pertenecen a mujeres adultas (44,86%). Los servicios requeridos con mayor frecuencia son los relacionados con la atención psicológica (90,48%). En menores de 18 años, la mayoría de personas que se ponen en contacto con la asociación son figuras maternas (50,93%) o profesionales relacionados con la víctima de algún modo (32,20%). Las víctimas actualmente adultas se ponen en contacto directamente con la asociación (67,91%). A nivel general, la mayoría de agresores son figuras paternas (38,04%), miembros de la familia extensa (29,19%) o conocidos de la víctima (17,70%). Los denominados tocamientos, ya sea por encima o debajo de la ropa, son la categoría de abuso sexual más frecuente en la muestra analizada (64,39%). Los resultados obtenidos muestran la elevada frecuencia de abuso sexual en nuestro país y la necesidad de atención especializada que requieren no sólo las víctimas, sino también sus familias y entorno social.
Inferior frontal and insular cortical thinning is related to dysfunctional brain activation/deactivation during working memory task in schizophrenic patients
(Elsevier B.V., 2013-11-30) Pujol, Núria; Penadés Rubio, Rafael; Rametti, Giuseppina; Catalán Campos, Rosa; Vidal Piñeiro, Dídac; Palacios, Eva M.; Bargalló Alabart, Núria; Bernardo Arroyo, Miquel; Junqué i Plaja, Carme, 1955-
Although working memory is known to be impaired in schizophrenia the anatomical and functional relationships underlying this deficit remain to be elucidated. A combined imaging approach involving functional and structural magnetic resonance techniques was used, applying independent component analysis and surface-based morphometry to 14 patients with schizophrenia and 14 healthy controls. Neurocognitive functioning was assessed by a neuropsychological test battery that measured executive function. It was hypothesized that working memory dysfunctional connectivity in schizophrenia is related to underlying anatomical abnormalities. Patients with schizophrenia showed cortical thinning in the left inferior frontal gyrus and insula, which explained 57% of blood oxygenation level-dependent signal magnitude in functional magnetic resonance imaging in the central executive network (lateral prefrontal and parietal cortex) over-activation and default mode network (anterior and posterior cingulate) deactivation. No structure-function relationship emerged in the healthy control group. The study provides evidence to suggest that dysfunctional activation/deactivation patterns in schizophrenia may be explained in terms of underlying gray matter deficits.
Editorial: Conversaciones sobre psicoterapia
(Revista de Psicoterapia, 2020-07-01) Soldevilla Alberti, Joan Miquel; Saúl, Luis Ángel; Caro Garcia, Ciro
Los días 1 y 2 de febrero de 2019 la Asociación Española de Psicoterapias Cognitivas organizó las I Jornadas Nacionales de psicoterapia constructivista, con la intención de generar un espacio de encuentro en el que reivindicar la importancia de la formación y acreditación para el ejercicio profesional de la psicoterapia. El leitmotiv elegido para las jornadas fue “Tejiendo el futuro”, para poner de relieve el elemento de crear un espacio conversacional en el que perfilar y desarrollar tramas sobre psicoterapia y psicoterapia constructivista. Durante los dos días en los que se desarrollaron las jornadas, hubo ponencias sobre temas centrales, espacios de reflexión y discusión, talleres y una mesa de análisis de un caso clínico desde diferentes vertientes teóricas. Varios miembros de ASEPCO y profesionales ajenos a dicha asociación contribuyeron desinteresadamente para que estas jornadas pudieran ser un éxito.
Hippocampal abnormalities and age in chronic schizophrenia: morphometric study across the adult lifespan
(The Royal College of Psychiatrists, 2014-09-11) Pujol, Núria; Penadés Rubio, Rafael; Junqué i Plaja, Carme, 1955-; Dinov, Ivo; Fu, Cynthia H. Y.; Catalán Campos, Rosa; Ibarretxe Bilbao, Naroa ; Bargalló Alabart, Núria; Bernardo Arroyo, Miquel; Toga, Arthur; Howard, Robert J.; Costafreda, Sergi G.
Background: Hippocampal abnormalities have been demonstrated in schizophrenia. It is unclear whether these abnormalities worsen with age, and whether they affect cognition and function. Aims: To determine whether hippocampal abnormalities in chronic schizophrenia are associated with age, cognition and socio-occupational function. Method: Using 3 T magnetic resonance imaging we scanned 100 persons aged 19-82 years: 51 were out-patients with stable schizophrenia at least 2 years after diagnosis and 49 were healthy volunteers matched for age and gender. Automated analysis was used to determine hippocampal volume and shape. Results: There were differential effects of age in the schizophrenia and control samples on total hippocampal volume (group × age interaction: F(1,95) = 6.57, P = 0.012), with steeper age-related reduction in the schizophrenia group. Three-dimensional shape analysis located the age-related deformations predominantly in the mid-body of the hippocampus. In the schizophrenia group similar patterns of morphometric abnormalities were correlated with impaired cognition and poorer socio-occupational function. Conclusions: Hippocampal abnormalities are associated with age in people with chronic schizophrenia, with a steeper decline than in healthy individuals. These abnormalities are associated with cognitive and functional deficits, suggesting that hippocampal morphometry may be a biomarker for cognitive decline in older patients with schizophrenia.
Frontal cortical thinning and subcortical volume reductions in early adulthood obesity
(Elsevier B.V., 2013-11-30) Marqués Iturria, Idoia; Pueyo Benito, Roser; Garolera i Freixa, Maite; Segura i Fàbregas, Bàrbara; Junqué i Plaja, Carme, 1955-; García-García, Isabel; Sender-Palacios, Maria José; Vernet-Vernet, Maria; Narberhaus, Ana; Ariza González, Mar; Jurado, Ma. Ángeles (María Ángeles)
Obesity depends on homeostatic and hedonic food intake behavior, mediated by brain plasticity changes in cortical and subcortical structures. The aim of this study was to investigate cortical thickness and subcortical volumes of regions related to food intake behavior in a healthy young adult sample with obesity. Thirty-seven volunteers, 19 with obesity (age=33.7±5.7 (20-39) years body-mass index (BMI)=36.08±5.92 (30.10-49.69)kg/m(2)) and 18 controls (age=32.3±5.9 (21-40) years; BMI=22.54±1.94 (19.53-24.97)kg/m(2)) participated in the study. Patients with neuropsychiatric or biomedical disorders were excluded. We used FreeSurfer software to analyze structural magnetic resonance images (MRI) and obtain global brain measures, cortical thickness and subcortical volume estimations. Finally, correlation analyses were performed for brain structure data and obesity measures. There were no between-group differences in age, gender, intelligence or education. Results showed cortical thickness reductions in obesity in the left superior frontal and right medial orbitofrontal cortex. In addition, the obesity group had lower ventral diencephalon and brainstem volumes than controls, while there were no differences in any other subcortical structure. There were no statistically significant correlations between brain structure and obesity measures. Overall, our work provides evidence of the structural brain characteristics associated with metabolically normal obesity. We found reductions in cortical thickness, ventral diencephalon and brainstem volumes in areas that have been implicated in food intake behavior.
High cognitive reserve in bipolar disorders as a moderator of neurocognitive impairment
(Elsevier B.V., 2017-01-15) Grande i Fullana, Iria; Sánchez-Moreno, José; Solé Cabezuelo, Brisa; Jiménez Martínez, Ester; Torrent Font, Carla; Bonnín Roig, Caterina del Mar; Varo, Cristina; Tabarés-Seisdedos, Rafael; Balanzá-Martínez, Vicent; Valls, Elia; Morilla, Ivette; Carvalho, André F.; Ayuso-Mateos ,J.L.; Vieta i Pascual, Eduard, 1963-; Martínez-Arán, Anabel, 1971-
Background: Cognitive reserve (CR) reflects the capacity of the brain to endure neuropathology, minimize clinical manifestations and successfully complete cognitive tasks. The present study aims to determine whether high CR may constitute a moderator of cognitive functioning in bipolar disorder (BD). Methods: 102 patients with BD and 32 healthy controls were enrolled. All patients met DSM-IV criteria for I or II BD and were euthymic (YMRS≤6 and HDRS≤8) during a 6-month period. All participants were tested with a comprehensive neuropsychological battery, and a Cerebral Reserve Score (CRS) was estimated. Subjects with a CRS below the group median were classified as having low CR, whereas participants with a CRS above the median value were considered to have high CR. Results: Participants with BD with high CR displayed a better performance in measures of attention (digits forward: F=4.554, p=0.039); phonemic and semantic verbal fluency (FAS: F=9.328, p=0.004; and Animal Naming: F=8.532, p=0.006); and verbal memory (short cued recall of California Verbal Learning Test: F=4.236, p=0.046), after multivariable adjustment for potential confounders, including number of admissions and prior psychotic symptoms. Limitations: The cross-sectional design of the study does not allow the establishment of causal inferences. Additionally, the small size of the sample may have limited some results. Conclusions: High cognitive reserve may therefore be a valuable construct to explore for predicting neurocognitive performance in patients with BD regarding premorbid status.
Structural brain changes and cognition in relation to markers of vascular dysfunction
(Elsevier B.V., 2012-05) Miralbell Blanch, Júlia; Soriano Raya, Juan José; Spulber, Gabriela; López Cancio, Elena; Arenillas, Juan Francisco; Bargalló Alabart, Núria; Galán, Amparo; Barrios Cerrejón, M. Teresa; Cáceres, Cynthia; Alzamora, María Teresa; Pera, Guillem; Kivipelto, Miia; Wahlund, Lars-Olof; Dávalos, Antoni; Mataró Serrat, Maria
The aim was to investigate the relationship between blood markers of vascular dysfunction with brain microstructural changes and cognition. Eighty-six participants from the Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) neuropsychology study were included. Subjects were 50–65 years old, free from dementia and without history of vascular disease. We assessed correlations of blood levels of inflammatory biomarkers (C-reactive protein [CRP] and resistin) and fibrinolysis inhibitors (plasminogen activator inhibitor-1 [PAI-1] and A-lipoprotein (Lp (a)) with fractional anisotropy (FA) measurements of diffusion tensor images (DTI), regional gray matter (GM) volumes and performance in several cognitive domains. Increasing levels of C-reactive protein and PAI-1 levels were associated with white matter (WM) integrity loss in corticosubcortical pathways and association fibers of frontal and temporal lobes, independently of age, sex and vascular risk factors. PAI-1 was also related to lower speed and visuomotor/coordination. None of the biomarkers were related to gray matter volume changes. Our findings suggest that inflammation and dysregulation of the fibrynolitic system may be involved in the pathological mechanisms underlying the WM damage seen in cerebrovascular disease and subsequent cognitive impairment.
Cognitive patterns in relation to biomarkers of cerebrovascular disease and vascular risk factors
(Karger, 2013-10) Miralbell Blanch, Júlia; López Cancio, Elena; López-Olóriz, Jorge; Arenillas, Juan Francisco; Barrios Cerrejón, M. Teresa; Soriano Raya, Juan José; Galán, Amparo; Cáceres, Cynthia; Alzamora, María Teresa; Pera, Guillem; Toran, Pere; Dávalos, Antoni; Mataró Serrat, Maria
Background: Risk factors for vascular cognitive impairment (VCI) are the same as traditional risk factors for cerebrovascular disease (CVD). Early identification of subjects at higher risk of VCI is important for the development of effective preventive strategies. In addition to traditional vascular risk factors (VRF), circulating biomarkers have emerged as potential tools for early diagnoses, as they could provide in vivo measures of the underlying pathophysiology. While VRF have been consistently linked to a VCI profile (i.e., deficits in executive functions and processing speed), the cognitive correlates of CVD biomarkers remain unclear. In this population-based study, the aim was to study and compare cognitive patterns in relation to VRF and circulating biomarkers of CVD. Methods: The Barcelona-AsIA Neuropsychology Study included 747 subjects older than 50, without a prior history of stroke or coronary disease and with a moderate to high vascular risk (mean age, 66 years; 34.1% women). Three cognitive domains were derived from factoral analysis: visuospatial skills/speed, verbal memory and verbal fluency. Multiple linear regression was used to assess relationships between cognitive performance (multiple domains) and a panel of circulating biomarkers, including indicators of inflammation, C-reactive protein (CRP) and resistin, endothelial dysfunction, asymmetric dimethylarginine (ADMA), thrombosis, plasminogen activator inhibitor 1 (PAI-1), as well as traditional VRF, metabolic syndrome and insulin resistance (homeostatic model assessment for insulin resistance index). Analyses were adjusted for age, gender, years of education and depressive symptoms. Results: Traditional VRF were related to lower performance in verbal fluency, insulin resistance accounted for lower performance in visuospatial skills/speed and the metabolic syndrome predicted lower performance in both cognitive domains. From the biomarkers of CVD, CRP was negatively related to verbal fluency performance and increasing ADMA levels were associated with lower performance in verbal memory. Resistin and PAI-1 did not relate to cognitive function performance. Conclusion: Vascular risk factors, and markers of inflammation and endothelial dysfunction predicted lower performance in several cognitive domains. Specifically, cognitive functions associated with CRP are typically affected in VCI and overlap those related to VRF. ADMA indicated a dissociation in the cognitive profile involving verbal memory. These findings suggest that inflammation and endothelial dysfunction might play a role in the predementia cognitive impairment stages.

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