{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:44:11Z","timestamp":1782899051882,"version":"3.54.5"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Bipolar disorder is associated with an increased risk of dementia with aging. Little is known regarding this association, limiting appropriate diagnosis and management. We aimed to describe the characteristics of bipolar patients with late cognitive impairment for whom the hypothesis of an underlying neurodegenerative disease had been raised. We performed a retrospective multicenter study, recruiting bipolar patients over 50 years old from five French tertiary memory centers who had undergone cerebrospinal fluid (CSF) biomarker assessment for Alzheimer\u2019s disease (AD). Clinical, neuropsychological, and paraclinical characteristics were analyzed and 78 patients were included. The mean age at the onset of cognitive impairment was 62.4 years (\u00b19.2). The mean MMSE score was 22.8 (\u00b14.5), the mean FAB was 11.7 (\u00b13.9), and the mean FCRST was 15.8 (\u00b17.4)\/36.8 (\u00b19.7) (free\/total recall). A total of 48.6% of the patients displayed cognitive fluctuations, and 38.2% showed cognitive improvement during follow-ups; and 56.3% of the patients showed Parkinsonism, of which 12.7% had never received antipsychotics. Among patients who underwent DAT-scans, 35.3% displayed dopaminergic denervation; 10.3% of patients had CSF AD biological signature (\u201cA+ T+\u201d profile), while 56.4% had other abnormal CSF profiles. Thus, clinical presentation was dominated by executive dysfunction, episodic memory impairment, fluctuating cognition, and a high frequency of Parkinsonism. Specifically, high frequency of delusional episodes suggests limited tolerance of psychotropic drugs. Most patients had abnormal CSF biomarker profiles, but only a minority displayed AD\u2019s specific biomarker signature. Therefore, while our results unveil shared common neurocognitive features in bipolar patients with cognitive impairment of suspected neurodegenerative origin they suggest a participation of various underlying pathologies rather than a common degenerative mechanism in the pathophysiology of this condition.<\/jats:p>","DOI":"10.3390\/jpm11111183","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T23:04:46Z","timestamp":1636671886000},"page":"1183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Characteristics of Bipolar Patients with Cognitive Impairment of Suspected Neurodegenerative Origin: A Multicenter Cohort"],"prefix":"10.3390","volume":"11","author":[{"given":"Esteban Munoz","family":"Musat","sequence":"first","affiliation":[{"name":"Cognitive Neurology Center, Assistance Publique\u2014H\u00f4pitaux de Paris Nord, Site Lariboisi\u00e8re Fernand-Widal, F-75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeline","family":"Marlinge","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictive Medicine, Assistance Publique\u2014H\u00f4pitaux de Paris Nord, Site Lariboisi\u00e8re Fernand-Widal, F-75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-394X","authenticated-orcid":false,"given":"M\u00e9lanie","family":"Leroy","sequence":"additional","affiliation":[{"name":"Lille Neuroscience & Cognition, Centre Hospitalier R\u00e9gional Universitaire de Lille, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Univ. Lille, F-59000 Lille, France"},{"name":"Centre National de R\u00e9f\u00e9rence Maladie d\u2019Alzheimer Jeune, Institut National de la Sant\u00e9 et de la Recherche M\u00e9-dicale, Univ. Lille, F-59000 Lille, France"},{"name":"Lille Centre of Excellence for Neurodegenerative Disorders (LiCEND), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Univ. Lille, F-59000 Lille, France"},{"name":"Laboratoire Excellence Development of Innovative Strategies for a Transdisciplinary Approach to ALZ-heimer\u2019s Disease (DISTAlz), Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Univ. Lille, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Oli\u00e9","sequence":"additional","affiliation":[{"name":"Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, Centre Hospitalier R\u00e9gional Universitaire de Montpellier, F-34000 Montpellier, France"},{"name":"Pathologies du Systeme Nerveux: Recherch\u00e9 \u00c9pid\u00e9miologique et Clinique (PSNREC), Universit\u00e9 de Montpellier, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, Centre Hospitalier R\u00e9gional Universitaire de Montpellier, F-34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloi","family":"Magnin","sequence":"additional","affiliation":[{"name":"Centre M\u00e9moire Ressources et Recherche (CMRR), Service de Neurologie, Centre Hospitalier R\u00e9gional Universitaire de Besan\u00e7on, F-25000 Besan\u00e7on, France"},{"name":"Neurosciences Int\u00e9gratives et Cliniques EA481, Universit\u00e9 de Bourgogne Franche-Comt\u00e9, F-25000 Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Lebert","sequence":"additional","affiliation":[{"name":"Unit\u00e9 Cognitivo-Comportementale of Bailleul, Centre M\u00e9moire Ressource et Recherche, University Lille Nord de France, F-59270 Bailleul, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Gabelle","sequence":"additional","affiliation":[{"name":"Clinical and Research Memory Center of Montpellier, Department of Neurology, Gui de Chauliac Hospital, University of Montpellier, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicaleU1061, F-34000 Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djamila","family":"Bennabi","sequence":"additional","affiliation":[{"name":"Neurosciences Int\u00e9gratives et Cliniques EA481, Universit\u00e9 de Bourgogne Franche-Comt\u00e9, F-25000 Besan\u00e7on, France"},{"name":"Psychiatry Center, Expert Center FondaMental Fondation, Clinical Research Center 1431, F-25030 Besan\u00e7on, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9deric","family":"Blanc","sequence":"additional","affiliation":[{"name":"Day Hospital of Geriatrics, Memory Resource and Research Centre (CMRR) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, F-67000 Strasbourg, France"},{"name":"University of Strasbourg and French National Centre for Scientific Research (CNRS), ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), Team Imagerie Multimodale Integrative en Sante (IMIS)\/ICONE, F-67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Paquet","sequence":"additional","affiliation":[{"name":"Cognitive Neurology Center, Assistance Publique\u2014H\u00f4pitaux de Paris Nord, Site Lariboisi\u00e8re Fernand-Widal, F-75010 Paris, France"},{"name":"Universit\u00e9 de Paris, Unit\u00e9 Mixte de Recherche 1144 Optimisation Th\u00e9rapeutique en Neuropsychopharmacologie, Equipe Biomarqueurs de la R\u00e9ponse Th\u00e9rapeutique et de la Rechute en Neuropsychiatrie, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, F-75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3521-5832","authenticated-orcid":false,"given":"Emmanuel","family":"Cognat","sequence":"additional","affiliation":[{"name":"Cognitive Neurology Center, Assistance Publique\u2014H\u00f4pitaux de Paris Nord, Site Lariboisi\u00e8re Fernand-Widal, F-75010 Paris, France"},{"name":"Universit\u00e9 de Paris, Unit\u00e9 Mixte de Recherche 1144 Optimisation Th\u00e9rapeutique en Neuropsychopharmacologie, Equipe Biomarqueurs de la R\u00e9ponse Th\u00e9rapeutique et de la Rechute en Neuropsychiatrie, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, F-75010 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/acps.12133","article-title":"Neuropsychological Testing of Cognitive Impairment in Euthymic Bipolar Disorder: An Individual Patient Data Meta-Analysis","volume":"128","author":"Bourne","year":"2013","journal-title":"Acta Psychiatr. 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