Evidence map›Paper›PMID 40698869›Full record

SynthesisActa psychiatrica Scandinavica2026

Association Between Inflammatory Markers and Cognitive Function in Adults With Bipolar Disorder: A Systematic Review.

David R A Coelho, Jennifer Nicoloro Santabarbara, Marzieh Majd, Willians Fernando Vieira, Maura De Laney, Melis Lydston, Olindo Assis Martins-Filho, Lilian Maria Garcia Bahia-Oliveira, Joshua D Salvi, Paolo Cassano and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Acta psychiatrica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

David R A CoelhoDivision of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4217-2399
Jennifer Nicoloro SantabarbaraDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-6423-3554
Marzieh MajdDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-7367-663X
Willians Fernando VieiraDivision of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-3022-7997
Maura De LaneyDepartment of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Melis LydstonTreadwell Library, Massachusetts General Hospital, Boston, Massachusetts, USA.
Olindo Assis Martins-FilhoRené Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.ORCID https://orcid.org/0000-0002-5494-4889
Lilian Maria Garcia Bahia-OliveiraDepartment of Medicine, Institute of Medical Science, Federal University of Rio de Janeiro, Macaé, Rio de Janeiro, Brazil.ORCID https://orcid.org/0000-0003-3001-8079
Joshua D SalviDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-5140-7746
Paolo CassanoDivision of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-0225-199X
Katherine E BurdickDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-4417-4988

Funding

Brain-based Mechanisms of Emotion Regulation in Aging and Mood DisordersR01MH124381 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI BURDICK, KATHERINE ELIZABETH, GUNNING, FAITH M · 2021 to 2025
$4.1M
Using allopregnanolone to probe behavioral and neurobiological mechanisms that underlie depression in women across perimenopausal stageR01MH128617 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI Katherine Elizabeth Burdick, HADINE JOFFE · 2022 to 2026
$3.7M
NIMH NIH HHS R01 MH124381NIMH NIH HHS R01 MH128617
6 · The paper itself

Abstract

introductionBipolar disorder (BD) is frequently associated with cognitive dysfunction, which can significantly impact the quality of life and functional recovery of affected individuals. Growing evidence suggests that inflammation may contribute to the cognitive dysfunction observed in BD.

methodsWe conducted a systematic review following PRISMA guidelines, searching six databases on March 23, 2023 (PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, and ClinicalTrials.gov), with the aim of identifying studies that examined the relationship between peripheral or central inflammatory markers and cognitive function in adults with BD. Studies involving animals, abstracts, protocols, reviews, and non-English publications were excluded. The quality of included studies was assessed using the Risk of Bias in Non-Randomized Studies-of Exposure (ROBINS-E). A narrative synthesis was completed, stratifying results based on the associations between inflammatory markers and cognitive domains in BD. The review protocol was pre-registered in PROSPERO (CRD42023415437).

resultsOut of 2680 identified records, 25 studies involving 3567 adults with BD (mean age: 43.6 years; 1839 females and 1728 males) met the inclusion criteria. Seventeen studies were classified as low risk of bias, seven as having some concerns, and one as high risk. Elevated levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1Ra) were most commonly associated with cognitive dysfunction in domains such as executive function, processing speed, and memory. Findings for other inflammatory markers were less consistent. Most studies relied on cross-sectional designs, which limit causal interpretations.

conclusionThis review found a consistent association between inflammation and cognitive dysfunction in BD, particularly involving CRP, TNF-α, IL-6, and IL-1RA in areas such as executive function, processing speed, and memory. Targeting inflammation may offer a promising approach to mitigating these cognitive challenges. Future studies should prioritize longitudinal designs, standardized cognitive assessments, and the exploration of central inflammatory markers to better understand the neurobiological processes underlying cognitive dysfunction in BD. These findings may help inform the development of adjunctive anti-inflammatory strategies to support cognitive health in individuals with BD.

Indexed as

Bipolar DisorderCognitive DysfunctionInflammationAdultBiomarkersFemaleHumansMaleBiomarkersbipolar disordercognitioncognitive dysfunctioninflammationinflammatory markers

Identifiers

PMID40698869
PMCPMC13065248

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.