The Relationship between Cognition and Asymmetric Dimethyl Arginine, Symmetric Dimethyl Arginine, Nitric Oxide Levels and Total Antioxidant Capacity in Euthymic Bipolar Disorder Patients

Tozoglu, Elif Ozcan; Ustundag, Mehmet Fatih; Gokceimam, Pinar Sen

doi:10.15761/0101-60830000000307

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Original Article • Arc. Clin. Psychiatr. 48 (4) • 2021 • https://doi.org/10.15761/0101-60830000000307 copy

The Relationship between Cognition and Asymmetric Dimethyl Arginine, Symmetric Dimethyl Arginine, Nitric Oxide Levels and Total Antioxidant Capacity in Euthymic Bipolar Disorder Patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

This study investigates the relationship between serum nitric oxide, asymmetrical dimethylarginine and symmetrical dimethylarginine levels and Total Antioxidant Capacity, and cognitive function in patients with bipolar disorder.

Method:

The study included 42 bipolar patients, diagnosed and assessed according to the DSM-V criteria, and 30 healthy controls. The Sociodemographic Questionnaire was used for the collection of data, and a bivariate Pearson correlation analysis was carried out.

Results:

The patient scores from a Rey Auditory Verbal Learning Test (RAVLT), Auditory Consonant Trigram (ACT), Digit Span Test (DST), Wisconsin Card Sorting Test (WCST), Trail Making-B (TMT-B) and Stroop Tests (ST) were found to be impaired in patients with BD when compared to the healthy controls. The SDMA level of the patient group was significantly higher in the control group, while the ADMA level was lower. The SDMA value was found to be positively correlated with ST-1,2,5 duration; and the NO value was positively correlated with ST-3 duration.

Conclusions:

The presence of neurobiological markers may serve to predict the severity of neurocognitive deficits, and can provide information about the progress of the disease.

Keywords:
Bipolar disorder; neurocognitive impairment; total antioxidant capacity; asymmetrical dimethylarginine; symmetrical dimethylarginine

	BD (n=42)	CONTROL (n=30)
VARIABLES
Gender
Male	50%	53%
Female	50%	47%
Age (Mean± SD)	36,1±9,6	34,38±8,4
Marital Status
Married	24 (57,1%)	16 (53,3%)
Single	18 (42,9%)	14 (46,7%)
Working Status
Employed /Student	21 (50%)	22 (73,3%)
Unemployed	1 (2,4%)	3 (10%)
Retired due to the disability	1 (2,4%)	–
Retired	2 (4,8%)	2 (6,7%)
Housewife	17 (40,4%)	3 (10%)
Education status		–
Literate	1 (2,4%)	–
Primary education	17 (40,5%)	6 (20%)
High school	9 (21,4%)	5 (16,7%)
University	14 (33,3%)	11 (36,7%)
Doctorate / Master	1 (2,4%)	8 (26,7%)
Financial level rate	2075,93±1257, 22 TL	3302,33±2433,35 TL

	GRUOP	N	MEAN	STD. DEVIATION	P	η2
	CONTROL	30	7,30	2,14
REY 1	BD	42	5,52	1,37	< 0,001	0,209
	CONTROL	30	9,43	2,45
REY 2	BD	42	7,10	1,92	< 0,001	0,227
	CONTROL	30	11,37	2,01
REY 3	BD	42	7,95	1,92	< 0,001	0,431
	CONTROL	30	12,70	2,04
REY 4	BD	42	8,71	2,48	< 0,001	0,427
	CONTROL	30	13,23	2,11
REY 5	BD	42	9,55	2,29	< 0,001	0,409
	CONTROL	30	54,03	9,28
REY TOTAL	BD	42	38,83	7,93	< 0,001	0,443
	CONTROL	30	11,93	2,36
REY 6	BD	42	7,26	2,18	< 0,001	0,518
	CONTROL	30	12,43	3,02
REY 7	BD	40	6,70	2,27	< 0,001	0,547
	CONTROL	30	13,93	2,02
CORRECT RECALL	BD	41	9,56	2,63	< 0,001	0,457
	CONTROL	30	1,50	2,84
FALSE POSITIVE	BD	41	3,07	3,87	0,018	0,049
RATIO OF REFUSING CORRECT	CONTROL	30	33,50	2,84
RATIO OF REFUSING CORRECT	BD	42	32,00	3,85	0,025	0,045
SEPERATION RATIO OF CORRECT	CONTROL	30	0,95	0,09
SEPERATION RATIO OF CORRECT	BD	42	0,83	0,08	< 0,001	0,334

GRUOP		N	MEAN	STD. DEVIATION	p	η2
	CONTROL	30	16,03	5,67
LETTER “K”	BD	42	10,67	4,03	< 0,001	0,240
	CONTROL	30	10,27	4,88
LETTER “A”	BD	42	7,40	3,93	0,009	0,098
	CONTROL	30	11,03	5,34
LETTER “S”	BD	42	8,26	3,53	0,044	0,091
	CONTROL	30	37,33	14,40
TOTAL	BD	42	26,26	10,37	0,001^* * denotes statistical significance (p<0,05)	0,171
	CONTROL	30	6,57	1,68
DST FORWARD	BD	42	5,33	1,32	0,003^* * denotes statistical significance (p<0,05)	0,148
DST BACKWARD	CONTROL	30	5,23	1,72
DST BACKWARD	BD	42	3,29	0,97	< 0,001	0,349
	CONTROL	30	11,80	3,19
DST TOTAL	BD	42	8,62	1,85	< 0,001	0,289
TRAIL MAKING	CONTROL	30	85,60	33,87
TEST	CONTROL	30	85,60	33,87	< 0,001	0,327
TEST	BD	42	193,52	97,06

	GRUOP	N	MEAN	STD. DEVIATION	p	η2
	CONTROL	30	9,67	2,77		0,129
STROOP 1 DURATION	BD	42	14,76	8,32	0,002^* * denotes statistical significance (p<0,05)	0,129
STROOP 1 NUMBER OF ERROR	CONTROL	30	0,00	–		–
STROOP 1 NUMBER OF ERROR	BD	42	0,00	–	1	–
STROOP 1 NUMBER OF CORRECTION	CONTROL	30	0,00	–		–
STROOP 1 NUMBER OF CORRECTION	BD	42	0,00	–	1	–
	CONTROL	30	10,73	5,29		0,071
STROOP 2 DURATION	BD	42	14,60	7,94	0,023^* * denotes statistical significance (p<0,05)	0,071
STROOP 2 NUMBER OF ERROR	CONTROL	30	0,03	0,18		0,014
STROOP 2 NUMBER OF ERROR	BD	42	0,21	0,98	0,320	0,014
STROOP 2 NUMBER OF CORRECTION	CONTROL	30	0,03	0,18		0,007
STROOP 2 NUMBER OF CORRECTION	BD	42	0,07	0,26	0,494	0,007
	CONTROL	30	12,37	3,31		0,306
STROOP 3 DURATION	BD	42	21,67	8,73	< 0,001	0,306
STROOP 3 NUMBER OF ERROR	CONTROL	30	0,00	0,00		0,037
STROOP 3 NUMBER OF ERROR	BD	42	0,12	0,40	0,104	0,037
STROOP 3 NUMBER OF CORRECTION	CONTROL	30	0,23	0,50		0,029
STROOP 3 NUMBER OF CORRECTION	BD	42	0,45	0,71	0,150	0,029
	CONTROL	30	17,17	7,36		0,300
STROOP 4 DURATION	BD	42	29,76	10,94	< 0,001	0,300
STROOP 4 NUMBER OF ERROR	CONTROL	30	0,00	0,00		0,044
STROOP 4 NUMBER OF ERROR	BD	42	0,24	0,73	0,077	0,044
STROOP 4 NUMBER OF CORRECTION	CONTROL	30	0,53	1,85		0,001
STROOP 4 NUMBER OF CORRECTION	BD	42	0,67	1,63	0,748	0,001
	CONTROL	30	27,80	9,97		0,333
STROOP 5 DURATION	BD	42	51,59	20,47	< 0,001	0,333
STROOP 5 NUMBER OF ERROR	CONTROL	30	0,37	1,07		0,161
STROOP 5 NUMBER OF ERROR	BD	42	2,54	3,13	< 0,001	0,161
STROOP 5 NUMBER OF CORRECTION	CONTROL	30	1,10	1,54		0,066
STROOP 5 NUMBER OF CORRECTION	BD	42	1,90	2,02	0,03^* * denotes statistical significance (p<0,05)	0,066

	GRUOP	N	MEAN	STD. DEVIATION	P	η2
TOTAL NUMBER CORRECT	CONTROL	30	110,30	22,03
TOTAL NUMBER CORRECT	BD	42	119,45	28,16	0,003^* * denotes statistical significance (p<0,05)	0,122
TOTAL NUMBER OF ERRORS	CONTROL	30	43,23	28,54
TOTAL NUMBER OF ERRORS	BD	42	67,35	23,32	<0,001	0,182
TOTAL NUMBER OF RESPONSE	CONTROL	30	30,00	31,25
TOTAL NUMBER OF RESPONSE	BD	42	50,18	32,32	0,011^* * denotes statistical significance (p<0,05)	0,092
TOTAL NUMBER OF PERSEVERATIVE ERROR	CONTROL	30	36,17	20,22
TOTAL NUMBER OF PERSEVERATIVE ERROR	BD	42	50,48	20,51	0,004^* * denotes statistical significance (p<0,05)	0,110
PERCENT OF PERSEVERATIVE ERROR	CONTROL	30	21,17	17,18
PERCENT OF PERSEVERATIVE ERROR	BD	42	32,05	18,08	0,013^* * denotes statistical significance (p<0,05)	0,087
TOTAL NUMBER OF NON-PERSEVERATIVE ERROR	CONTROL	30	17,70	13,27
TOTAL NUMBER OF NON-PERSEVERATIVE ERROR	BD	42	26,65	17,88	0,107	0,051
CONCEPTUAL LEVEL RESPONSES	CONTROL	30	54,97	21,95
CONCEPTUAL LEVEL RESPONSES	BD	42	37,88	26,58	0,006^* * denotes statistical significance (p<0,05)	0,108
PERCENT CONCEPTUAL LEVEL RESPONSES	CONTROL	30	54,07	26,37
PERCENT CONCEPTUAL LEVEL RESPONSES	BD	42	31,13	23,23	< 0,001	0,180
NUMBER OF COMPLETE CATEGORY	CONTROL	30	4,20	2,23
NUMBER OF COMPLETE CATEGORY	BD	42	1,95	2,09	< 0,001	0,216
FAILURE OF CARRYING ON SETUP	CONTROL	30	0,73	1,05
FAILURE OF CARRYING ON SETUP	BD	42	1,35	1,51	0,098	0,081
	CONTROL	30	-102,87	546,00
LEARNING TO LEARN	BD	42	-877,00	–	0,179	0,031

		Pearson Correlation Coefficients	N	p
REY 4	ADMA	0,298	42	0,011^* * denotes statistical significance (p<0,05)
REY TOTAL		0,251	42	0,033^* * denotes statistical significance (p<0,05)
SEPERATION RATIO OF TRUE		0,301	42	0,011^* * denotes statistical significance (p<0,05)
STROOP 1 DURATION	SDMA	0,384	42	0,001^* * denotes statistical significance (p<0,05)
STROOP 2 DURATION		0,390	42	0,001^* * denotes statistical significance (p<0,05)
STROOP 5 DURATION		0,415	41	< 0,001
STROOP 3 DURATION	NO	0,324	42	0,038^* * denotes statistical significance (p<0,05)
WCST TOTAL NUMBER CORRECT	TAC	0,310	42	0,043^* * denotes statistical significance (p<0,05)

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[1] Address for correspondence: Mehmet Fatih Ustundag, Psychiatrist, Department of Psychiatry, Istanbul Erenkoy Psychiatric and Neurological Disorders Hospital, Istanbul, Turkey, Tel: 00 90 216 3025959; E-mail: mfustundag@gmail.com