***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To determine if the repeated occurrence of manic episodes in bipolar I disorder ( BD-I ) patients is associated with reduced cognitive performance , which could in turn imply a worsening in the disorder 's evolution . METHOD Cognitive performance in euthymic patients was assessed using  attention , memory , and executive function tests  on 24 BD-I patients who had experienced only 1 manic episode , on 27 BD-I patients with 2 manic episodes , on 47 BD-I patients with 3 or more manic episodes , and on 66 healthy control subjects . RESULTS In BD-I patients , number of manic episodes was positively associated with poorer performance on neurocognitive tests , an association that was not accounted for by depression , disease chronicity , onset , or medication . Significant differences in attention and executive function were found between patients and controls and in those patients who had had just 1 manic episode compared to those who had 3 or more . CONCLUSION The number of manic episodes predicted poor cognitive performance , suggesting that the recurrence of mania may have a long-term neuropsychological impact . Prospect i ve follow-up studies need to be completed to explore this effect further as better treatment adherence may have a protective effect on neurocognitive function OBJECTIVES Individuals with bipolar disorder have high rates of other medical comorbidity , which is associated with higher mortality rates and worse course of illness . The present study examined common predictors of medical comorbidity . METHODS The Clinical and Health Outcomes Initiative in Comparative Effectiveness for Bipolar Disorder study ( Bipolar CHOICE ) enrolled 482 participants with bipolar I or bipolar II disorder in a six-month , r and omized comparative effectiveness trial . Baseline assessment s included current and lifetime DSM-IV-TR diagnoses , demographic information , psychiatric and medical history , severity of psychiatric symptoms , level of functioning , and a fasting blood draw . Medical comorbidities were categorized into two groups : cardiometabolic ( e.g. , diabetes , hyperlipidemia , and metabolic syndrome ) and non-cardiovascular ( e.g. , seizures , asthma , and cancer ) . Additionally , we looked at comorbid substance use ( e.g. , smoking and drug dependence ) . RESULTS We found that 96.3 % of participants had at least one other medical comorbidity . Older age predicted a greater likelihood of having a cardiometabolic condition . Early age of onset of bipolar symptoms was associated with a lower chance of having a cardiometabolic condition , but a greater chance of having other types of medical comorbidity . Additional predictors of other medical comorbidities in bipolar disorder included more time spent depressed , less time spent manic/hypomanic , and longer duration of illness . Medications associated with weight gain were associated with low high-density lipoprotein and abnormal triglycerides . CONCLUSIONS There appears to be a substantial medical burden associated with bipolar disorder , highlighting the need for collaborative care among psychiatric and general medical providers to address both psychiatric and other medical needs concomitantly in this group of patients Neuropsychological assessment of older individuals with dementing illnesses has suffered from a lack of appropriately design ed test instruments . The Repeatable Battery for the Assessment of Neuropsychological Status ( RBANS ) was developed for the dual purpose s of identifying and characterizing abnormal cognitive decline in the older adult and as a neuropsychological screening battery for younger patients . The entire battery takes less than 30 minutes to administer , and yields scaled scores for five cognitive domains . The current study reports preliminary clinical validity results with the RBANS , comparing very mildly demented patients with a diagnosis of probable Alzheimer 's disease ( n = 20 ) to patients with Huntington 's disease ( n = 20 ) and normal controls ( n = 40 ) . Although the patient groups had essentially identical total scores on the RBANS , they exhibited opposite profiles , differing significantly on four of the five subsections . The AD patients performed most poorly on Language , and Delayed Memory subsections , while the HD patients obtained their lowest scaled scores on the Attention and the Visuospatial/Constructional subsections . These results are consistent with the neuropsychological profiles of these dementing disorders derived from lengthier st and ardized tests and experimental investigations . In addition , even those patients who performed above the suggested cut-off points on the MMSE and the Dementia Rating Scale scored significantly below their controls on the RBANS . These data suggest that the RBANS is effective at both detecting and characterizing dementia of different etiologies 
    Output:
    
The TNF superfamily and inflammatory cytokines may have a relationship with the neuroprogression of the disease .
This study suggests that TNF and ILs could play a role in neuroprogression .
However , longitudinal studies are needed to clarify the relationship between factors associated with neuroprogression