Barcelona snapshots

Prof. Kamilla Miskowiak

Kamilla Miskowiak psychiatrist Controversies Psiquiatry Barcelona
University of Copenhagen, Denmark
Talk Interventions for preventing cognitive impairment in affective disorders
Date Friday, September 17th, 2021
Time 11:15 - 12:00
Round Table 3. Affective disorders


Kamilla Miskowiak is Professor of Cognitive Neuropsychiatry at Department of Psychology, University of Copenhagen, and head of the Neurocognition and Emotion in Affective Disorders (NEAD) Group based at the Psychiatric Centre Copenhagen, Copenhagen University Hospital. She conducts clinical and experimental studies in patients with mood disorders using neurocognitive testing, clinical ratings and neuroimaging. Her research aims to identify new treatments targeting cognitive impairments and to delineate the mechanisms of established and novel candidate treatments. She also uses the Danish twin registers to study the effects of genetic risk of mood disorder on neurocognition. Dr Miskowiak has a degree in Psychology (2006) from University of Copenhagen with a dissertation on multidisciplinary research on depression, which received the university gold medal, and an MSc (with distinction) (2004) and a DPhil (2008) from University of Oxford, and a DMSc (2018) from University of Copenhagen. She has authored >160 peer-reviewed articles in leading international journals in the field.


Cognitive impairment in attention, memory, and executive functions occur across several neuropsychiatric disorders, including bipolar disorder (BD) and major depressive disorder (MDD). Cognitive impairment often prevails during remission and contributes to socio-occupational disability and poor treatment response. Given this, targeting residual cognitive impairment during remission in these affective disorders is a pressing treatment priority.

Accordingly, the field has undertaken a large number of treatment trials over the last two decades that aimed to improve cognition in these patient groups. Notwithstanding these efforts, there are still no clinically available pro-cognitive treatments with replicated efficacy in remitted patients. This is partially due to several broad methodological challenges in cognition trials in affective disorders. The International Society for Bipolar Disorders (ISBD) therefore convened an expert task force under the lead of Dr Miskowiak, which recently developed a consensus-based guidance paper for the methodology and design of cognition trials in affective disorders.

This talk will provide a review of the evidence for novel candidate pro-cognitive treatments in partially or fully remitted patients with affective disorders. It will then summarize the consensus-based recommendations by the ISBD Targeting Cognition Task Force for the design and methodology of intervention trials, which include pre-screening for cognitive impairment, inclusion of remitted patients, pre-selection of one primary cognition outcome and inclusion of neuroimaging assessments. Specifically, neuroimaging provides a powerful new way of assessing the potential of new treatments through their neurocircuitry target engagement. The potential of neuroimaging for treatment development will be illustrated through a review and discussion of the recent findings from neuroimaging assessments in pro-cognitive treatment trials in affective disorders. Based on the findings, a novel putative functional magnetic resonance imaging (fMRI) biomarker model of pro-cognitive effects will be presented and its potential value for decision making in treatment development strategies will be discussed.

Overall, the talk will provide the audience with a comprehensive update of the evidence from pro-cognitive intervention trials in affective disorders, the methodological recommendations by the ISBD Targeting Cognition Task Force and the potential of neuroimaging to support treatment development targeting cognitive impairments in affective disorders.


Petersen CS, Miskowiak KW. (2021). Toward a transdiagnostic neurocircuitry-based biomarker model for pro-cognitive effects: challenges, opportunities, and next steps . CNS Spectr. 2021 Aug;26(4):333-337. doi: 10.1017/S1092852920000061.

Ott, C.V., et al. (2021). Change in prefrontal activity and executive functions after action-based cognitive remediation in bipolar disorder: a randomized controlled trial. Neuropsychopharmacol. 46, 1113–1121 (2021).

Miskowiak KW, et al. (2017). Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force. Bipolar Disord. 2017 Dec;19(8):614-626. doi: 10.1111/bdi.12534. Epub 2017 Sep 12. PMID: 28895274; PMCID: PMC6282834.