Apathy-related Neurobehavioral Markers of Cognitive Decline in Old-age Bipolar Disorders: Proof-of-concept

Hospital Center Guillaume Régnier30 enrolled

Overview

The goal of this clinical trial is to identify reliable markers of apathy in elderly subjects with bipolar disorder, age between 70 and 85 years, in order to accurately identify subjects at high risk of progressing to dementia by measuring motor activity (actimetrics), recorded language and analysing brain changes (MRI). Actimetry is the measurement and recording of body movements using an actimeter. This device is worn on the wrist and contains sensors capable of measuring and recording all movements, including those of very low intensity. An automated speech analysis using artificial intelligence is used to detect low-intensity anomalies, and we want to test whether individual differences correspond to individual differences in brain anatomy and function. Researchers will compare elderly subjects with bipolar disorder and healthy volunteer, age between 70 and 85 years. Participants will be asked to: * Perform an MRI * Complete 3 cognitive tests: verbal memory, verbal fluency and an emotional storytelling task, in which you will be asked to describe a memory orally using positive, negative and neutral emotions. * wear an actimeter on your wrist for 4 days.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Apathy Bipolar Disorder

Interventions

All participants will wear a wGT3X-BT actigraph (wGT3x-BT) for 4 days. Actigraphs are collected back at Day 4, after full 96 hours, when coming to the MRI platform. There, they will undergo 45 minutes MRI that acquire MRI signals to quantify degenerative, inflammatory, vascular and functional cerebral features.

Eligibility

Sex: ALLMin age: 70 YearsMax age: 85 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: 1. Population: Age between 70 and 85 years-old, living at home (Participants living in nursing homes are not included). 2. Condition: OABD type 1, type 2 and type 3 assessed by the DSM5 criteria 3. Stable: no MDE or hypomanic state within the last 6 months 4. Ambulatory setting only 5. General condition: Successful Gait speed test from the Short Physical Performance Battery (SPPB): beingable to walk 4 meters in 4 seconds (SPPB NIH Toolbox)44 6. Person affiliated to a social security regime 7. Patients who have given their free, informed and written consent to take part in the study Exclusion Criteria: 1. Psychiatric conditions and or co-morbidities 1. Unipolar depression 2. Recurrent unipolar depression 3. Substance use disorder according to DSM5 criteria. Benzodiaepine and/or z-drugs dependence are accepted. 2. Neurological and cerebral co-morbidities 1. Major Cognitive Disorder: significant cognitive decline characterized by extensive cognitive tests or at least a standardized clinical evaluation AND at least loss of autonomy in complex instrumental daily living function, not related to delirium (DSM5 criteria) 2. Medical history of known degenerative disorders: Alzheimer's disease, Lobar Degenerative Fronto-temporal disorders, Lewy Body disease, corticobasal degenerative disorder, Supranuclear Palsy, epilepsy. 3. Medical history of known Parkinson's disease (according to the Movement Disorder Society (MDS)45 criteria) 4. Medical history of known stroke 5. Severe Parkinsonism (defined by MDS-Unified Parkinson's Disease Rating Scale46 \> 20) 3. MRI contra-indications: metallic implants, severe claustrophobia 4. Adults under legal protection (safeguard of justice, curatorship, guardianship), persons deprived of their liberty. 5. Hospitalized at inclusion

Outcomes

Primary Outcomes

Compare Actigraphic measures acquired by OABD participants and with those of Healthy controls (HC)

These very complex and highly dimensional signals are reduced to a sum, for a given period of time, of the variations in acceleration (in g/sec) after pre-processing (band-pass filtering) for each participants (OABD and healthy controls

Time frame: during 4 days

Secondary Outcomes

speech biomarkers :Temporal, Source, Prosodic and Spectral speech features automatically derived from the audio recordings of 3 cognitive tasks.

To identify a set of speech biomarkers, specific to OABD (compared to HC), 3 cognitive tasks , verbal learning (with the Rey Auditory Verbal Learning Task), semantic verbal fluency task and narrative storytelling are implemented on the Milli® platform. Each of these tasks enable to derive temporal, source, prosodic and spectral features from remote recordings.

Time frame: baseline and only for OABD participants at 12 month and 36 month

MRI derived cerebral features, specific to OABD participants compared to Healthy control

measure cortical thickness and sub-cortical volumes to identify degenerative alterations measure water diffusion in several cellular compartments and appropriate multi compartment modeling (MCM) such as Neurite Orientation Diffusion and Dispersion Index (NODDI) to identify Inflammation Measure tissue blood flow Using arterial spin labeling (ASL) to identify Vascular health

Time frame: at Day 4