Cortisol to Dehydroepiandrosterone Sulphate Ratio and Executive Function in Bipolar Disorder

Neuropsychobiology. 2021;80(4):342-351. doi: 10.1159/000513512. Epub 2021 Jan 28.

Abstract

Introduction: Bipolar disorder (BD) is associated with impairment in cognitive domains such as verbal memory and executive functions. Very few studies have assessed dehydroepiandrosterone sulphate (DHEA-S) in BD and its relation to cognitive functioning despite evidence showing its regulatory effects on glucocorticoid action. The aim of our study was to explore the association of cortisol, DHEA-S, and cortisol to DHEA-S ratio with visuospatial memory and executive functioning in BD.

Methods: Cognitive performance of 60 bipolar I patients and 30 healthy subjects was evaluated by using Cambridge Neuropsychological Test Automated Battery tasks targeting visuospatial memory (spatial recognition memory) and executive functions (planning [Stockings of Cambridge; SOC] and attentional set shifting [ID/ED]). Morning serum cortisol and DHEA-S levels were measured in patients. Main effects of cortisol, DHEA-S, and cortisol/DHEA-S ratio for each neurocognitive task were explored in multiple regression analyses correcting for demographic and clinical parameters as well as treatment-related factors (current use of antipsychotic and mood stabilizer medication).

Results: Bipolar patients showed poorer performance than healthy subjects in planning and attentional set shifting but not in visuospatial memory. Cortisol to DHEA-S ratio predicted worse performance in planning (SOC).

Conclusions: This is the first study to assess memory and executive function in BD in relation to DHEA-S and cortisol to DHEA-S ratio. We report an association of cortisol to DHEA-S ratio with worse performance in planning in bipolar I patients, which warrants further investigation.

Keywords: Bipolar disorder; Cognition; Cortisol; Dehydroepiandrosterone sulphate; Executive function.

MeSH terms

  • Bipolar Disorder* / drug therapy
  • Dehydroepiandrosterone Sulfate
  • Executive Function
  • Humans
  • Hydrocortisone
  • Neuropsychological Tests

Substances

  • Dehydroepiandrosterone Sulfate
  • Hydrocortisone