Jeff Zarp

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Psychologist with a PhD in cognitive neuropsychiatry (University of Copenhagen). As a PhD student, I worked in the NEAD Group, CADIC, Psychiatric Centre Copenhagen, Rigshospitalet and Department of Psychology under the supervision of Prof. Kamilla Miskowiak. I successfully defended my PhD thesis in February 2021.

My scientific work includes investigation of neurocircuitry markers for cognitive impairment in bipolar disorder as well as the discrepancy between objectively-assessed and subjectively-reported cognitive functioning across neuropsychiatric disorders. During my PhD studies, I was also involved in clinical trials investigating the effects of pro-cognitive treatments on cognition and neural activity in remitted, cognitively impaired patients with mood disorders and ECT-treated patients, respectively.
Supervisors: Kamilla Miskowiak and Lars Kessing

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Andrej Dujella

University of Zagreb

Hemin Koyi

Uppsala University

Jana Javornik

University of East London

Graham Martin

University of Leicester

Gwen Robbins Schug

University of North Carolina at Greensboro

Gabriel Gutierrez-Alonso

University of Salamanca

John Sutton

Macquarie University

Eros Carvalho

Universidade Federal do Rio Grande do Sul

Kevin Arbuckle

Swansea University

Jesper Hoffmeyer

University of Copenhagen

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Papers by Jeff Zarp

[Cognitive side effects of electroconvulsive therapy]

Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but is asso... more Electroconvulsive therapy (ECT) is the most effective treatment for severe depression but is associated with cognitive side effects. Side effects on executive function and memory may persist for months. Patients with a low cognitive reserve and/or poor cognition before ECT seem to be at greater risk of cognitive side effects than patients with a high cognitive reserve. However, better understanding of the nature and predictors of these side effects is needed. We recommend implementing a cognition assessment tool to monitor cognition during ECT. This may improve patient information and provide a basis for more personalised treatments.

Longitudinal investigation of subjective and objective cognitive side effects of electroconvulsive therapy - a pilot study

The method of teaching arabic as a second language has much progress following the development of... more The method of teaching arabic as a second language has much progress following the development of language teaching mathod. In its history, direct method is the oldest method applied in teaching language after qawa'id-tarjamah. This writing explored the history of direct method as counter to previous methods. This method assumes that language teaching-learning process is like teachinglearning mother languag that is by using language directly. Thus, language become active and dinamic.

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Erythropoietin as an add-on treatment for cognitive side effects of electroconvulsive therapy: a study protocol for a randomized controlled trial

Trials, 2018

Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe depression... more Background: Electroconvulsive therapy (ECT) is the most effective treatment for severe depression, but its use is impeded by its cognitive side effects. Novel treatments that can counteract these side effects may therefore improve current treatment strategies for depression. The present randomized trial investigates (1) whether short-term add-on treatment with erythropoietin (EPO) can reduce the cognitive side-effects of ECT and (2) whether such effects are long-lasting. Further, structural and functional magnetic resonance imaging (MRI) will be used to explore the neural underpinnings of such beneficial effects of EPO. Finally, the trial examines whether potential protective effects of EPO on cognition are accompanied by changes in markers of oxidative stress, inflammation, and neuroplasticity. Methods/design: The trial has a double-blind, randomized, placebo-controlled, parallel group design. Patients with unipolar or bipolar disorder with current moderate to severe depression referred to ECT (N = 52) are randomized to receive four high-dose infusions of EPO (40,000 IU/ml) or placebo (saline). The first EPO/saline infusion is administered within 24 h before the first ECT. The following three infusions are administered at weekly intervals immediately after ECT sessions 1, 4, and 7. Cognition assessments are conducted at baseline, after the final EPO/saline infusion (3 days after eight ECT sessions), and at a 3 months follow-up after ECT treatment completion. The neuronal substrates for potential cognitive benefits of EPO are investigated with structural and functional MRI after the final EPO/saline infusion. The primary outcome is change from baseline to after EPO treatment (3 days after eight ECT sessions) in a cognitive composite score spanning attention, psychomotor speed, and executive functions. With a sample size of N = 52 (n = 26 per group), we have ≥ 80% power to detect a clinically relevant between-group difference in the primary outcome measure at an alpha level of 5% (two-sided test). Behavioral, mood, and blood-biomarker data will be analyzed using repeated measures analysis of covariance. Functional MRI data will be preprocessed and analyzed using the FMRIB Software Library.

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Effects of recombinant human erythropoietin on cognition and neural activity in remitted patients with mood disorders and first-degree relatives of patients with psychiatric disorders: a study protocol for a randomized controlled trial

Trials, 2018

Background: Bipolar disorder (BD) and unipolar disorder (UD) are associated with cognitive defici... more Background: Bipolar disorder (BD) and unipolar disorder (UD) are associated with cognitive deficits and abnormal neural activity in a "cognitive control network." There is an increased prevalence of cognitive dysfunction in psychiatric patients' first-degree relatives, which constitutes a risk factor for psychiatric illness onset. However, there is no treatment with enduring pro-cognitive efficacy. We found preliminary evidence for beneficial effects of eight weekly doses of recombinant human erythropoietin (EPO) on cognition in BD in a recent randomized controlled trial (RCT). The present RCT consists of two sub-studies that extend our previous work by investigating important novel aspects: (1) the effects of 12 weekly doses of EPO on cognition in first-degree relatives of patients with BD, UD, or schizophrenia; and (2) the effects of extending the treatment schedule from 8 to 12 weeks in remitted patients with BD or UD; and (3) assessment of early treatment-associated neural activity changes that may predict cognitive improvement.

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Predictors of the discrepancy between objective and subjective cognition in bipolar disorder: a novel methodology

Acta Psychiatrica Scandinavica, 2016

This article may be used for non-commercial purposes in accordance with Wiley Terms and Condition... more

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The search for neuroimaging and cognitive endophenotypes: A critical systematic review of studies involving unaffected first-degree relatives of individuals with bipolar disorder

Neuroscience and biobehavioral reviews, Feb 12, 2016

The phenomenology and underlying pathophysiology of bipolar disorder (BD) are heterogeneous. The ... more The phenomenology and underlying pathophysiology of bipolar disorder (BD) are heterogeneous. The identification of putative endophenotypes for BD can aid in the investigation of unique patho-etiological pathways, which may lead to the development of personalised preventative and therapeutic approaches for this multi-faceted disorder. We included original studies involving unaffected first-degree relatives of BD patients (URs) and a healthy control (HC) comparison group with no first-degree family history of mental disorders, investigating: 'cold' and 'hot' cognition and functional and structural neuroimaging. Seventy-seven cross-sectional studies met the inclusion criteria. The present review revealed that URs in comparison with HCs showed: (i) widespread deficits in verbal memory, sustained attention, and executive function; (ii) abnormalities in the reactivity to and regulation of emotional information along with aberrant reward processing, and heightened attention...

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Effects of recombinant human erythropoietin on antiplatelet action of aspirin and clopidogrel in healthy subjects: Results of a double-blind, placebo-controlled randomized trial

American Heart Journal, 2007

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Neuronal underpinnings of cognitive impairment in bipolar disorder: A large data‐driven functional magnetic resonance imaging study

Bipolar Disorders, 2021

OBJECTIVES Cognitive impairment occurs in approximately 50% of remitted patients with bipolar dis... more OBJECTIVES Cognitive impairment occurs in approximately 50% of remitted patients with bipolar disorder (BD). However, there exists no treatment with replicated and robust efficacy on cognition in BD. This is partially due to limited insight into the neuronal underpinnings of cognitive impairment in these patients. This is the first study to investigate neuronal underpinnings of cognitive impairment in a large functional magnetic resonance imaging (fMRI) dataset comparing neural activity patterns between distinct neurocognitive subgroups of partially or fully remitted patients with BD. METHODS Patients (n=153) and healthy controls (HC) (n=52) underwent neuropsychological assessment and fMRI, during which they performed a verbal N-back working memory (WM) task. Based on hierarchical cluster analysis of neuropsychological test performance, patients were grouped into one of two neurocognitive subgroups (cognitively impaired, n=91; cognitively normal compared to HC, n=62) that were compared on WM-related neural activity. RESULTS Cognitively impaired patients displayed WM-related hypo-activity in left dorsolateral prefrontal cortex and frontal and parietal regions within a cognitive control network (CCN) as well as hyper-activity in the default mode network (DMN) compared to cognitively normal patients. In contrast, cognitively normal patients only exhibited hypo-activity within a small cluster in the superior frontal gyrus relative to HC. CONCLUSIONS Cognitive impairment in BD seems to originate from a failure to recruit key regions in the CCN and to suppress task-irrelevant DMN activity during cognitive performance. These results highlight modulation of aberrant dorsal prefrontal and DMN activity as a putative target for pro-cognitive treatment in BD.

[Cognitive side effects of electroconvulsive therapy]