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Kim M, Lee J, Lee SY, Ha M, Park I, Jang J, Jang M, Park S, Kwon JS. Development of an eye-tracking system based on a deep learning model to assess executive function in patients with mental illnesses. Sci Rep 2024; 14:18186. [PMID: 39107349 PMCID: PMC11303748 DOI: 10.1038/s41598-024-68586-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 07/25/2024] [Indexed: 08/10/2024] Open
Abstract
Patients with mental illnesses, particularly psychosis and obsessive‒compulsive disorder (OCD), frequently exhibit deficits in executive function and visuospatial memory. Traditional assessments, such as the Rey‒Osterrieth Complex Figure Test (RCFT), performed in clinical settings require time and effort. This study aimed to develop a deep learning model using the RCFT and based on eye tracking to detect impaired executive function during visuospatial memory encoding in patients with mental illnesses. In 96 patients with first-episode psychosis, 49 with clinical high risk for psychosis, 104 with OCD, and 159 healthy controls, eye movements were recorded during a 3-min RCFT figure memorization task, and organization and immediate recall scores were obtained. These scores, along with the fixation points indicating eye-focused locations in the figure, were used to train a Long Short-Term Memory + Attention model for detecting impaired executive function and visuospatial memory. The model distinguished between normal and impaired executive function, with an F1 score of 83.5%, and identified visuospatial memory deficits, with an F1 score of 80.7%, regardless of psychiatric diagnosis. These findings suggest that this eye tracking-based deep learning model can directly and rapidly identify impaired executive function during visuospatial memory encoding, with potential applications in various psychiatric and neurological disorders.
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Affiliation(s)
- Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Jungha Lee
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Soo Yong Lee
- Kim Jaechul Graduate School of Artificial Intelligence, KAIST, Daejeon, Republic of Korea
| | - Minji Ha
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Inkyung Park
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Jiseon Jang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Moonyoung Jang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Sunghyun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea.
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea.
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Frigeni M, Petilli MA, Gobbo S, Di Giusto V, Zorzi CF, Rabuffetti M, Spinelli F, Gower V, Daini R, Cavallini A. Tablet-based Rey-Osterrieth Complex Figure copy task: a novel application to assess spatial, procedural, and kinematic aspects of drawing in children. Sci Rep 2024; 14:16787. [PMID: 39039095 PMCID: PMC11263365 DOI: 10.1038/s41598-024-67076-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024] Open
Abstract
The paper-and-pencil Rey-Osterrieth Complex Figure (ROCF) copy task has been extensively used to assess visuo-constructional skills in children and adults. The scoring systems utilized in clinical practice provide an integrated evaluation of the drawing process, without differentiating between its visuo-constructional, organizational, and motor components. Here, a tablet-based ROCF copy task capable of providing a quantitative assessment of the drawing process, differentiating between visuo-constructional, organizational, and motor skills, is trialed in 94 healthy children, between 7 and 11 years of age. Through previously validated algorithms, 12 indices of performance in the ROCF copy task were obtained for each child. Principal component analysis of the 12 indices identified spatial, procedural, and kinematic components as distinct dimensions of the drawing process. A composite score for each dimension was determined, and correlation analysis between composite scores and conventional paper-and-pencil measures of visuo-constructional, procedural, and motor skills performed. The results obtained confirmed that the constructional, organizational, and motor dimensions underlie complex figure drawing in children; and that each dimension can be measured by a unique composite score. In addition, the composite scores here obtained from children were compared with previsions results from adults, offering a novel insight into how the interplay between the three dimensions of drawing evolves with age.
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Affiliation(s)
- Marta Frigeni
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy.
- Division of Medical Genetics, Department of Pediatrics, Northwell Health, Great Neck, NY, USA.
| | - Marco A Petilli
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | - Silvia Gobbo
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | | | - Carla F Zorzi
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | - Marco Rabuffetti
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | | | - Valerio Gower
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
| | - Roberta Daini
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
- Department of Psychology, Università Degli Studi Di Milano-Bicocca, Milan, Italy
| | - Anna Cavallini
- Fondazione Don Carlo Gnocchi IRCCS S. Maria Nascente, Milan, Italy
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Segalàs C, Cernadas E, Puialto M, Fernández-Delgado M, Arrojo M, Bertolin S, Real E, Menchón JM, Carracedo A, Tubío-Fungueiriño M, Alonso P, Fernández-Prieto M. Cognitive and clinical predictors of a long-term course in obsessive compulsive disorder: A machine learning approach in a prospective cohort study. J Affect Disord 2024; 350:648-655. [PMID: 38246282 DOI: 10.1016/j.jad.2024.01.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/20/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a disabling illness with a chronic course, yet data on long-term outcomes are scarce. This study aimed to examine the long-term course of OCD in patients treated with different approaches (drugs, psychotherapy, and psychosurgery) and to identify predictors of clinical outcome by machine learning. METHOD We included outpatients with OCD treated at our referral unit. Demographic and neuropsychological data were collected at baseline using standardized instruments. Clinical data were collected at baseline, 12 weeks after starting pharmacological treatment prescribed at study inclusion, and after follow-up. RESULTS Of the 60 outpatients included, with follow-up data available for 5-17 years (mean = 10.6 years), 40 (67.7 %) were considered non-responders to adequate treatment at the end of the study. The best machine learning model achieved a correlation of 0.63 for predicting the long-term Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score by adding clinical response (to the first pharmacological treatment) to the baseline clinical and neuropsychological characteristics. LIMITATIONS Our main limitations were the sample size, modest in the context of traditional ML studies, and the sample composition, more representative of rather severe OCD cases than of patients from the general community. CONCLUSIONS Many patients with OCD showed persistent and disabling symptoms at the end of follow-up despite comprehensive treatment that could include medication, psychotherapy, and psychosurgery. Machine learning algorithms can predict the long-term course of OCD using clinical and cognitive information to optimize treatment options.
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Affiliation(s)
- C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - E Cernadas
- Centro Singular de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - M Puialto
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - M Fernández-Delgado
- Centro Singular de Investigación en Tecnoloxías Intelixentes da USC (CiTIUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - S Bertolin
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - E Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - A Carracedo
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Madrid, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, 32 Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
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4
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Ten Brink AF, Bultitude JH, Van der Stigchel S, Nijboer TCW. Zooming in on abnormal local and global processing biases after stroke: Frequency, lateralization, and associations with cognitive functions. J Int Neuropsychol Soc 2024; 30:67-76. [PMID: 37066832 DOI: 10.1017/s1355617723000231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
OBJECTIVES The 'attentional spotlight' can be adjusted depending on the task requirements, resulting in processing information at either the local or global level. Stroke can lead to local or global processing biases, or the inability to simultaneously attend both levels. In this study, we assessed the (1) prevalence of abnormal local and global biases following stroke, (2) differences between left- and right-sided brain damaged patients, and (3) relations between local and global interference, the ability to attend local and global levels simultaneously, and lateralized attention, search organization, search speed, visuo-construction, executive functioning, and verbal (working) memory. METHODS Stroke patients admitted for inpatient rehabilitation completed directed (N = 192 total; N = 46 left-sided/N = 48 right-sided lesion) and divided (N = 258 total; N = 67 left-sided/N = 66 right-sided lesion) local-global processing tasks, as well as a conventional neuropsychological assessment. Processing biases and interference effects were separately computed for directed and divided tasks. RESULTS On the local-global tasks, 7.8-10.9% of patients showed an abnormal local bias and 6.3-8.3% an abnormal global bias for directed attention, and 5.4-10.1% an abnormal local bias and 6.6-15.9% an abnormal global bias for divided attention. There was no significant difference between patients with left- and right-sided brain damage. There was a moderate positive relation between local interference and search speed, and a small positive relation between global interference and neglect. CONCLUSIONS Abnormal local and global biases can occur after stroke and might relate to a range of cognitive functions. A specific bias might require a different approach in assessment, psycho-education, and treatment.
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Affiliation(s)
- Antonia F Ten Brink
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Department of Psychology, University of Bath, Bath, UK
| | | | - Stefan Van der Stigchel
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
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Mock N, Balzer C, Gutbrod K, Jäncke L, Wandel J, Bonati L, Trost W. Nonverbal memory tests revisited: Neuroanatomical correlates and differential influence of biasing cognitive functions. Cortex 2023; 164:63-76. [PMID: 37201378 DOI: 10.1016/j.cortex.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/01/2023] [Accepted: 03/31/2023] [Indexed: 05/20/2023]
Abstract
The detection of right temporal lobe dysfunction with nonverbal memory tests has remained difficult in the past. Reasons for this might be the potential influence of other biasing cognitive functions such as executive functions or the verbalisability of nonverbal material. The aim of this study was to investigate three classic nonverbal memory tests by identifying their neuroanatomical correlates with lesion-symptom mapping (LSM) and by probing their independence from verbal encoding abilities and executive functions. In a cohort of 119 patients with first-time cerebrovascular accident, memory performance was assessed in the Nonverbal Learning and Memory Test for Routes (NLMTR), the Rey Complex Figure Test (RCFT), and the Visual Design Learning Test (VDLT). Calculating multivariate LSM, we identified crucial brain structures for these three nonverbal memory tests. Behavioural analyses were performed to assess the impact of executive functions and verbal encoding abilities with regression analyses and likelihood-ratio tests. LSM revealed for the RCFT mainly right-hemispheric frontal, insular, subcortical, and white matter structures and for the NLMTR right-hemispheric temporal (hippocampus), insular, subcortical, and white matter structures. The VDLT did not reach significance in LSM analyses. Behavioural results showed that amongst the three nonverbal memory tests the impact of executive functions was most pronounced for RCFT, and the impact of verbal encoding abilities was most important in VDLT. Likelihood-ratio tests confirmed that only for NLMTR did the goodness of fit not significantly improve by adding executive functions or verbal encoding abilities. These results suggest that amongst the three nonverbal memory tests the NLMTR, as a spatial navigation test, could serve as the most suitable marker of right-hemispheric temporal lobe functioning, with the right hippocampus being involved only in this test. In addition, the behavioural results propose that only NLMTR seems mostly unaffected by executive functions and verbal encoding abilities.
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Affiliation(s)
- Nadia Mock
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland; Department of Neurology, Zurich University Hospital, Zurich, Switzerland.
| | | | - Klemens Gutbrod
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Neurozentrum Bern, Switzerland
| | - Lutz Jäncke
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jasmin Wandel
- Institute for Optimisation and Data Analysis, Bern University of Applied Sciences, Switzerland
| | - Leo Bonati
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland; Department of Neurology, Department of Clinical Research, Basel University Hospital, Switzerland
| | - Wiebke Trost
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
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Alemany-Navarro M, Tubío-Fungueiriño M, Diz-de Almeida S, Cruz R, Lombroso A, Real E, Soria V, Bertolín S, Fernández-Prieto M, Alonso P, Menchón JM, Carracedo A, Segalàs C. The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS. J Affect Disord 2023; 333:365-376. [PMID: 37094658 DOI: 10.1016/j.jad.2023.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD. METHODS We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level. RESULTS No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits. LIMITATIONS Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum. CONCLUSIONS Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.
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Affiliation(s)
- M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; IBIS (Universidad de Sevilla, HUVR, Junta de Andalucia, CSIC) Sevilla, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain.
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - S Diz-de Almeida
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - R Cruz
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - A Lombroso
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - E Real
- Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - V Soria
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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7
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Greenberg JL, Phillips KA, Hoeppner SS, Jacobson NC, Fang A, Wilhelm S. Mechanisms of cognitive behavioral therapy vs. supportive psychotherapy in body dysmorphic disorder: An exploratory mediation analysis. Behav Res Ther 2023; 161:104251. [PMID: 36640457 PMCID: PMC9892287 DOI: 10.1016/j.brat.2022.104251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/12/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
Body dysmorphic disorder (BDD) is common, severe, and often chronic. Cognitive behavioral therapy (CBT) is the first-line psychosocial treatment for BDD, with well-established efficacy. However, some patients do not improve with CBT, and little is known about how CBT confers its effects. Neurocognitive processes have been implicated in the etiology and maintenance of BDD and are targeted by CBT-BDD treatment components. Yet, the malleability of these factors in BDD, and their potential role in mediating symptom improvement, are not well understood. Understanding how treatment works could help optimize treatment outcomes. In this secondary data analysis of a randomized clinical trial of CBT vs. supportive psychotherapy (SPT) in BDD (n = 120), we examined whether treatment-related changes in detail processing (Rey-Osterrieth Complex Figure test), maladaptive appearance beliefs (Appearance Schemas Inventory-Revised), and emotion recognition (Emotion Recognition Task) mediated treatment outcome. All constructs improved over time and were associated with symptom improvement. CBT was associated with greater improvements in maladaptive beliefs than SPT. None of the variables examined mediated symptom improvement. Findings suggest that with successful treatment, individuals with BDD demonstrate reduced neurocognitive deficits (detail processing, emotion recognition, maladaptive beliefs) and that CBT is more likely than SPT to improve maladaptive appearance beliefs. More work is needed to understand mechanisms of change and thus maximize treatment outcomes.
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Affiliation(s)
- Jennifer L Greenberg
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
| | - Katharine A Phillips
- Rhode Island Hospital and Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA; New York-Presbyterian Hospital and Weill Cornell Medical College, 315 East 62nd Street, New York, NY, 10065, USA.
| | - Susanne S Hoeppner
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
| | - Nicholas C Jacobson
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03766, USA.
| | - Angela Fang
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; University of Washington, 3751 West Stevens Way NE, Seattle, WA, 98195, USA.
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
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8
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Zainal NH, Camprodon JA, Greenberg JL, Hurtado AM, Curtiss JE, Berger-Gutierrez RM, Gillan CM, Wilhelm S. Goal-Directed Learning Deficits in Patients with OCD: A Bayesian Analysis. COGNITIVE THERAPY AND RESEARCH 2023. [DOI: 10.1007/s10608-022-10348-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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9
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Tubío-Fungueiriño M, Alemany-Navarro M, Alonso P, Arrojo M, Real E, Bertolin S, Menchón JM, Carracedo A, Fernández-Prieto M, Segalàs C. Neuropsychological performance and predictors of pharmacological treatment response in obsessive compulsive disorder. J Affect Disord 2022; 317:52-58. [PMID: 36029870 DOI: 10.1016/j.jad.2022.08.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/09/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Obsessive Compulsive Disorder (OCD) is characterized by the presence of executive dysfunctions. As organizational strategies may play an important role as a possible endophenotype of the disorder, we decided to investigate non-verbal memory and organizational abilities in OCD. We also investigated how organization and non-verbal memory differ between responder and non-responder patients to pharmacological treatment, to test whether cognitive functions can predict the response to pharmacological treatment. METHODS In Study 1, executive and clinical functioning measures were applied to 162 OCD and 95 controls. In Study 2, clinical, intelligence and executive functioning measures were applied to 72 OCD responders and 63 OCD non-responder patients. RESULTS OCD patients and controls from Study 1 differed in copy organization (p < 0.01) and delayed recall (p = 0.048). In Study 2, the OCD responders displayed better copy organization (p = 0.013) and lower depressive, anxious and OCD symptoms (p < 0.01 in the three cases). Scores in the following instruments were found to predict the response to pharmacological treatment: HDRS, Y-BOCS, Raven progressive matrices, and Direct digit subtest from the Wechsler's scale (p < 0.01 in all four cases). LIMITATIONS In Study 1, the imbalance of the sample can be considered a limitation, whilst in Study 2, some of the levels of pharmacological resistance were not represented. CONCLUSIONS In this study, non-verbal memory and organization was affected in OCD. Responder patients also displayed better executive functioning and fluid intelligence. Organizational ability is a predictor of pharmacological response to SSRI monotherapy in a predictive model controlling for anxious symptoms.
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Affiliation(s)
- M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - M Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - E Real
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolin
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Fundación Pública Galega de Medicina Xenómica- IDIS, SERGAS, Santiago de Compostela, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain.
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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10
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Zhang Y, Alwin Prem Anand A, Bode L, Ludwig H, Emrich HM, Dietrich DE. Word recognition memory and serum levels of Borna disease virus specific circulating immune complexes in obsessive-compulsive disorder. BMC Psychiatry 2022; 22:597. [PMID: 36076225 PMCID: PMC9454108 DOI: 10.1186/s12888-022-04208-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Borna disease virus 1 (BoDV-1) is a non-segmented, negative-strand RNA virus that persistently infects mammals including humans. BoDV-1 worldwide occurring strains display highly conserved genomes with overlapping genetic signatures between those of either human or animal origin. BoDV-1 infection may cause behavioral and cognitive disturbances in animals but has also been found in human major depression and obsessive-compulsive disorder (OCD). However, the impact of BoDV-1 on memory functions in OCD is unknown. METHOD To evaluate the cognitive impact of BoDV-1 in OCD, event-related brain potentials (ERPs) were recorded in a continuous word recognition paradigm in OCD patients (n = 16) and in healthy controls (n = 12). According to the presence of BoDV-1-specific circulating immune complexes (CIC), they were divided into two groups, namely group H (high) and L (low), n = 8 each. Typically, ERPs to repeated items are characterized by more positive waveforms beginning approximately 250 ms post-stimulus. This "old/new effect" has been shown to be relevant for memory processing. The early old/new effect (ca. 300-500 ms) with a frontal distribution is proposed to be a neural correlate of familiarity-based recognition. The late old/new effect (post-500 ms) is supposed to reflect memory recollection processes. RESULTS OCD patients were reported to show a normal early old/new effect and a reduced late old/new effect compared to normal controls. In our study, OCD patients with a high virus load (group H) displayed exactly these effects, while patients with a low virus load (group L) did not differ from healthy controls. CONCLUSION These results confirmed that OCD patients had impaired memory recollection processes compared to the normal controls which may to some extent be related to their BoDV-1 infection.
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Affiliation(s)
- Yuanyuan Zhang
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hanover, Germany. .,Present Address: Social Psychiatry Counseling Center, Region Hannover, Podbielskistr. 157, 30177, Hanover, Germany.
| | - A Alwin Prem Anand
- grid.10423.340000 0000 9529 9877Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hanover, Germany
| | - Liv Bode
- Freelance Bornavirus Workgroup, Beerenstr. 41, 14163 Berlin, Germany
| | - Hanns Ludwig
- Freelance Bornavirus Workgroup, Beerenstr. 41, 14163 Berlin, Germany
| | - Hinderk M. Emrich
- grid.10423.340000 0000 9529 9877Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hanover, Germany
| | - Detlef E. Dietrich
- grid.10423.340000 0000 9529 9877Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, 30625 Hanover, Germany ,AMEOS Klinikum Hildesheim, Goslarsche Landstr. 60, 31135 Hildesheim, Germany ,grid.412970.90000 0001 0126 6191Center for Systems Neuroscience Hannover, Hanover, Germany
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11
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Tommasini L, Bonaccorsi J, Del Prete E, Cintoli S, Pagni C, Mazzucchi S, Palermo G, Morganti R, Frosini D, Siciliano G, Tognoni G, Ceravolo R. Qualitative evaluation of the Rey-Osterrieth Complex Figure Test in patients with progressive supranuclear palsy. Clin Neuropsychol 2022:1-14. [PMID: 35997036 DOI: 10.1080/13854046.2022.2112296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: In early stages of disease, the differential diagnosis between Parkinson's Disease (PD) and atypical parkinsonism, such as Progressive Supranuclear Palsy (PSP), could be challenging. Growing attention has recently been dedicated to investigating neuropsychological markers of degenerative parkinsonism. The Rey-Osterrieth Complex Figure Test (ROCFT) copy score was hypothesized able to differentiate PSP from PD. However, ROCFT is a drawing test requiring multiple cognitive abilities and it is still unknown which of them assumes an important role in PSP performance. Using a qualitative scoring system, we investigated which cognitive abilities underpin the PSP performance at the ROCFT copy trial. Moreover, we evaluated usefulness of the BQSS scores in discriminating PSP from PD. Methods: Thirty PSP-Richardson's Syndrome (PSP-RS) patients, 30 PD patients, and 30 healthy control (HC) comparable for age, education, and gender were enrolled. All subjects underwent a neuropsychological evaluation; ROCFT copy were evaluated with the 36-Point Score and with the Boston Qualitative Scoring System (BQSS). Results: PSP-RS patients performed worse in ROCFT 36-Point Score and in several BQSS scores compared to other groups. Most suitable scores discriminating PSP-RS from PD were "Perseveration" and "Vertical Expansion" of BQSS. A logistic regression model considering "Perseveration" and "Vertical Expansion" showed a diagnostic accuracy of 83,3% for PSP-RS condition. Conclusion: our findings showed that "Perseveration" and "Vertical Expansion" BQSS scores were useful in discriminating PSP-RS from PD. "Perseveration" and "Vertical Expansion" BQSS scores might be included in the cognitive evaluation along with quantitative scores when PSP diagnosis is considered.
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Affiliation(s)
- L Tommasini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - J Bonaccorsi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - E Del Prete
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - S Cintoli
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - C Pagni
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - S Mazzucchi
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Palermo
- Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - R Morganti
- Section of Statistics, AOUP, Pisa, Italy
| | - D Frosini
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - G Siciliano
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
| | - G Tognoni
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy
| | - R Ceravolo
- Department of Medical Specialties - Neurology Unit, AOUP, Pisa, Italy.,Clinical and Experimental Medicine Department - Neurology Unit, University of Pisa, Pisa, Italy
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12
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Kang JG, Kim MS. Neuropsychological Profile of College Students Who Engage in Binge Drinking. Front Psychol 2022; 13:873654. [PMID: 35496236 PMCID: PMC9051325 DOI: 10.3389/fpsyg.2022.873654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/24/2022] [Indexed: 11/19/2022] Open
Abstract
This study investigated the neuropsychological profile of college students who engage in binge drinking (BD) using comprehensive neuropsychological tests evaluating verbal/non-verbal memory, executive functions, and attention. Groups were determined based on scores on the Korean version of the Alcohol Use Disorder Identification Test (AUDIT-K) and Alcohol Use Questionnaire (AUQ). There were 79 and 81 participants in the BD and non-BD groups, respectively. We administered the Korean version of the California Verbal Learning Test (K-CVLT) and Rey-Osterrieth Complex Figure Test (RCFT) to evaluate verbal and non-verbal memory, respectively, and measured executive functions using the Wisconsin Card Sorting Test (WCST), Trail-Making Test, Controlled Oral Word Association Test and Stroop Color-Word Test. We administered the d2 test to evaluate attention. Neuropsychological performance was analyzed by multivariate analysis of variance. The BD group showed significantly poorer performance in the long-term free recall condition of the K-CVLT and delayed recall condition of the RCFT and completed significantly fewer categories on the WCST than the non-BD group. In addition, there were significant negative associations among the AUDIT-K total score, AUQ binge score, and long-term free recall score of the K-CVLT. There were significant negative associations between the total AUDIT-K score and delayed recall RCFT score, and between the total AUDIT-K total score and numbers of completed categories on the WCST. These results indicate that college students who participate in BD have difficulties with verbal/non-verbal memory and executive functions, and further suggest that excessive alcohol use could have detrimental effects on the hippocampal-prefrontal circuit even with a relatively short period of alcohol use.
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Affiliation(s)
| | - Myung-Sun Kim
- Department of Psychology, Sungshin Women’s University, Seoul, South Korea
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13
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Berthoz S, Maria AS, Ringuenet D, Bourdier L, Nicolas I, Blanchet C, Foulon C, Lavoisy G, Godart N, Barry C. Cognitive flexibility and attention to detail in adolescents and adults with severe forms of anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2022; 30:289-297. [PMID: 35229408 DOI: 10.1002/erv.2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/14/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To determine if adolescents and adults diagnosed with anorexia nervosa differ in their levels of cognitive flexibility and attention to detail independently of potential confounds. METHOD Sixty-two adolescents and 54 adults were assessed while receiving inpatient treatment and completed the following self-reports: Eating Disorders Examination Questionnaire, Maudsley Obsessive Compulsive Inventory and Hospital Anxiety and Depression scale. Performance-based evaluations included the Wisconsin Card Sorting Test Computerised Version, the Comprehensive Trail Making Test, the Brixton Spatial Anticipation Test, the Rey Complex Figure and the Group Embedded Figures Test. RESULTS Comparisons of the adolescents and adults with anorexia nervosa revealed no significant differences for any of the neuropsychological test scores even after adjusting for potential confounding factors. Neither cognitive flexibility nor attention to detail were associated with level of eating disorder symptomatology, depression, anxiety or obsessive-compulsive symptomatology. Unlike age, illness duration was found weakly associated with perseverative errors Wisconsin Card Sorting Test and with the central coherence index of the Rey Complex Figure recall condition. CONCLUSIONS Set-shifting and central coherence performance were independent of age, clinical symptoms severity and emotional status. Additional studies on the relationship between the duration of anorexia nervosa and neuropsychological difficulties are needed.
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Affiliation(s)
- Sylvie Berthoz
- Université Bordeaux, CNRS, EPHE, INCIA, UMR 5287, Bordeaux, France.,Department of Psychiatry for Adolescents and Young Adults, Institut Mutualiste Montsouris, Paris, France
| | | | - Damien Ringuenet
- APHP, Hôpital Paul Brousse, Département de Psychiatrie, Unité Troubles du Comportement Alimentaires, Villejuif, France
| | - Léna Bourdier
- Addictology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Isabelle Nicolas
- Department of Psychiatry for Adolescents and Young Adults, Institut Mutualiste Montsouris, Paris, France
| | - Corinne Blanchet
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,APHP, Hôpital Cochin, Maison des Adolescents-Maison de Solenn, Paris, France
| | | | | | - Nathalie Godart
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.,UFR Simone Veil, UVSQ, Univ. Paris-Saclay, Montigny-le-Bretonneux, France.,Fondation Santé des Etudiants de France, Paris, France
| | - Caroline Barry
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France
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14
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Yacou MA, Chowdury A, Easter P, Hanna GL, Rosenberg DR, Diwadkar VA. Sustained attention induces altered effective connectivity of the ascending thalamo-cortical relay in obsessive-compulsive disorder. Front Psychiatry 2022; 13:869106. [PMID: 36032258 PMCID: PMC9402224 DOI: 10.3389/fpsyt.2022.869106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Abnormal function of the thalamo-cortical relay is considered a hallmark of obsessive-compulsive disorder (OCD) and aberrant network interactions may underpin many of the clinical and cognitive symptoms that characterize the disorder. Several statistical approaches have been applied to in vivo fMRI data to support the general loss of thalamo-cortical connectivity in OCD. However, (a) few studies have assessed the contextual constraints under which abnormal network interactions arise or (b) have used methods of effective connectivity to understand abnormal network interactions. Effective connectivity is a particularly valuable method as it describes the putative causal influences that brain regions exert over each other, as opposed to the largely statistical consistencies captured in functional connectivity techniques. Here, using dynamic causal modeling (DCM), we evaluated how attention demand induced inter-group differences (HC ≠ OCD) in effective connectivity within a motivated thalamo-cortical network. Of interest was whether these effects were observed on the ascending thalamo-cortical relay, essential for the sensory innervation of the cortex. fMRI time series data from sixty-two participants (OCD, 30; HC, 32) collected using an established sustained attention task were submitted to a space of 162 competing models. Across the space, models distinguished between competing hypotheses of thalamo-cortical interactions. Bayesian model selection (BMS) identified marginally differing likely generative model architectures in OCD and HC groups. Bayesian model averaging (BMA), was used to weight connectivity parameter estimates across all models, with each parameter weighted by each model's posterior probability, thus providing more stable estimates of effective connectivity. Inferential statistical analyses of estimated parameters revealed two principal results: (1) Significantly reduced intrinsic connectivity of the V1 → SPC pathway in OCD, suggested connective weakness in the early constituents of the dorsal visual pathway; (2) More pertinent with the discovery possibilities afforded by DCM, sustained attention in OCD patients induced significantly reduced contextual modulation of the ascending relay from the thalamus to the prefrontal cortex. These results form an important complement to our understanding of the contextual bases of thalamo-cortical network deficits in OCD, emphasizing vulnerability of the ascending relay.
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Affiliation(s)
- Mario A Yacou
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Asadur Chowdury
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Philip Easter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - David R Rosenberg
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Vaibhav A Diwadkar
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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Abstract
INTRODUCTION Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. DESIGN This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). RESULTS Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. CONCLUSION One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.
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16
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Zhang X, Lv L, Min G, Wang Q, Zhao Y, Li Y. Overview of the Complex Figure Test and Its Clinical Application in Neuropsychiatric Disorders, Including Copying and Recall. Front Neurol 2021; 12:680474. [PMID: 34531812 PMCID: PMC8438146 DOI: 10.3389/fneur.2021.680474] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
The Rey–Osterrieth Complex Figure (ROCF) test is a commonly used neuropsychological assessment tool. It is widely used to assess the visuo-constructional ability and visual memory of neuropsychiatric disorders, including copying and recall tests. By drawing the complex figure, the functional decline of a patient in multiple cognitive dimensions can be assessed, including attention and concentration, fine-motor coordination, visuospatial perception, non-verbal memory, planning and organization, and spatial orientation. This review first describes the different versions and scoring methods of ROCF. It then reviews the application of ROCF in the assessment of visuo-constructional ability in patients with dementia, other brain diseases, and psychiatric disorders. Finally, based on the scoring method of the digital system, future research hopes to develop a new digital ROCF scoring method combined with machine learning algorithms to standardize clinical practice and explore the characteristic neuropsychological structure information of different disorders.
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Affiliation(s)
- Xiaonan Zhang
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Liangliang Lv
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Guowen Min
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Qiuyan Wang
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yarong Zhao
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yang Li
- Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China
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17
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Kim M, Shin W, Lee TH, Kim T, Hwang WJ, Kwon JS. Eye movement as a biomarker of impaired organizational strategies during visual memory encoding in obsessive-compulsive disorder. Sci Rep 2021; 11:18402. [PMID: 34526587 PMCID: PMC8443551 DOI: 10.1038/s41598-021-97885-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/31/2021] [Indexed: 12/01/2022] Open
Abstract
The symptoms of obsessive–compulsive disorder (OCD) are largely related to impaired executive functioning due to frontostriatal dysfunction. To better treat OCD, the development of biomarkers to bridge the gap between the symptomatic-cognitive phenotype and brain abnormalities is warranted. Therefore, we aimed to identify biomarkers of impaired organizational strategies during visual encoding processes in OCD patients by developing an eye tracking-based Rey–Osterrieth complex figure test (RCFT). In 104 OCD patients and 114 healthy controls (HCs), eye movements were recorded during memorization of the RCFT figure, and organizational scores were evaluated. Kullback–Leibler divergence (KLD) scores were calculated to evaluate the distance between a participant’s eye gaze distribution and a hypothetical uniform distribution within the RCFT figure. Narrower gaze distributions within the RCFT figure, which yielded higher KLD scores, indicated that the participant was more obsessed with detail and had less organizational strategy. The OCD patients showed lower organizational scores than the HCs. Although no group differences in KLD scores were noted, KLD scores were significantly associated with organization T scores in the OCD group. The current study findings suggest that eye tracking biomarkers of visual memory encoding provide a rapidly determined index of executive functioning, such as organizational strategies, in OCD patients.
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Affiliation(s)
- Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Woncheol Shin
- Graduate School of Artificial Intelligence, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Tak Hyung Lee
- Healthcare Sensor Laboratory, Device Research Center, Samsung Advanced Institute of Technology, Samsung Electronics Co., Ltd., Suwon, Republic of Korea
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea. .,Department of Psychiatry, Seoul National University College of Medicine, 101 Daehak-no, Chongno-gu, Seoul, 03080, Republic of Korea. .,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
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18
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Mangum RW, Tolle-Fu KA, Hale AC, Gradwohl BD, Spencer RJ. The Savage Organizational Scoring System for the Rey-Osterrieth Complex Figure Test: Norms and New Data From Veterans in a Traumatic Brain Injury Clinic. Percept Mot Skills 2021; 128:2561-2581. [PMID: 34396818 DOI: 10.1177/00315125211039380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Rey-Osterrieth Complex Figure Test (RCFT) permits quantifying diverse cognitive abilities, including executive function (EF). We evaluated the psychometric properties of a scoring procedure for the RCFT, the Savage Organizational Scoring System (SOSS), that awards points for drawing the largest structural elements of the figures as continuous wholes. This was a two-phase study: first, we conducted a systematic literature search for studies using the SOSS, and aggregated previously published data for healthy controls to create a normative database; second, we observed performances from veterans evaluated for traumatic brain injury (TBI), examining the reliability of their SOSS scores, the SOSS correlations with two EF measures and the participants' self-reported cognitive functioning, and then compared their mean scores to normative expectations. Across our literature-derived normative database, the aggregated mean SOSS score was 4.12 (SD = 1.72), which was marginally higher than that of our veteran participants evaluated for TBI, 3.72 (SD = 1.79). The SOSS had modest internal consistency (α = .59). Unlike the criterion EF measures, the SOSS was not significantly related to self-reported cognitive functioning. The SOSS shared a small, significant correlation with Trails B and Shipley Abstraction; but RCFT Copy scores were more strongly related to these tests, and the SOSS added no significant incremental predictive value beyond the RCFT Copy score. However, SOSS scores did predict RCFT Recall beyond RCFT Copy scores. We conclude that the SOSS has modest reliability and is predictive of RCFT Recall scores, but it is not strongly correlated with other EF measures, and it is only minimally affected by mild TBI.
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Affiliation(s)
- Ryan W Mangum
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Kathryn A Tolle-Fu
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Andrew C Hale
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Brian D Gradwohl
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Robert J Spencer
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
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19
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Petilli MA, Daini R, Saibene FL, Rabuffetti M. Automated scoring for a Tablet-based Rey Figure copy task differentiates constructional, organisational, and motor abilities. Sci Rep 2021; 11:14895. [PMID: 34290339 PMCID: PMC8295394 DOI: 10.1038/s41598-021-94247-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
Accuracy in copying a figure is one of the most sensitive measures of visuo-constructional ability. However, drawing tasks also involve other cognitive and motor abilities, which may influence the final graphic produced. Nevertheless, these aspects are not taken into account in conventional scoring methodologies. In this study, we have implemented a novel Tablet-based assessment, acquiring data and information for the entire execution of the Rey Complex Figure copy task (T-RCF). This system extracts 12 indices capturing various dimensions of drawing abilities. We have also analysed the structure of relationships between these indices and provided insights into the constructs that they capture. 102 healthy adults completed the T-RCF. A subgroup of 35 participants also completed a paper-and-pencil drawing battery from which constructional, procedural, and motor measures were obtained. Principal component analysis of the T-RCF indices was performed, identifying spatial, procedural and kinematic components as distinct dimensions of drawing execution. Accordingly, a composite score for each dimension was determined. Correlational analyses provided indications of their validity by showing that spatial, procedural, and kinematic scores were associated with constructional, organisational and motor measures of drawing, respectively. Importantly, final copy accuracy was found to be associated with all of these aspects of drawing. In conclusion, copying complex figures entails an interplay of multiple functions. T-RCF provides a unique opportunity to analyse the entire drawing process and to extract scores for three critical dimensions of drawing execution.
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Affiliation(s)
- Marco A Petilli
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.
| | - Roberta Daini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy
- NeuroMI-Milan Center for Neuroscience, Milan, Italy
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20
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Carlesimo GA, Taglieri S, Zabberoni S, Scalici F, Peppe A, Caltagirone C, Costa A. Subjective organization in the episodic memory of individuals with Parkinson's disease associated with mild cognitive impairment. J Neuropsychol 2021; 16:161-182. [PMID: 34089629 DOI: 10.1111/jnp.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Word clustering (i.e., the ability to reproduce the same word pairs in consecutive recall trials of an unrelated word list) has been extensively investigated as a proxy of subjective organization (SO) of memorandum. In healthy subjects and in groups of brain-damaged patients, the rate of SO generally predicts accuracy of word list recall. This study aimed at evaluating SO in the performance of patients with Parkinson's disease (PD) on a word list recall task in order to investigate the basic mechanisms of episodic memory impairment that are frequently observed in these patients. For this purpose, 56 PD patients, who were stratified according to the presence and quality of mild cognitive impairment (MCI), and a group of healthy controls (HCs) were administered a word list task and an extensive battery of neuropsychological tests. Results showed that recall accuracy on the word list task progressively decreased passing from HC to PD patients without cognitive impairment, to patients with single-domain dysexecutive MCI and to patients with multiple-domain dysexecutive and amnesic MCI. Conversely, only the latter PD group showed a lower SO score than that achieved by the other groups. In the overall PD group, correlational and regression analyses demonstrated that SO scores and a composite score of executive functions were not reciprocally related, but both provided an independent and significant contribution to the prediction of word list recall accuracy. These data are discussed in terms of the contribution of executive functions and hippocampal storage processes to the onset of memory impairment in PD.
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Affiliation(s)
- Giovanni Augusto Carlesimo
- Department of Systems Medicine, Tor Vergata University, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Sara Taglieri
- IRCCS Santa Lucia Foundation, Rome, Italy.,Niccolò Cusano University, Rome, Italy
| | | | | | | | - Carlo Caltagirone
- Department of Systems Medicine, Tor Vergata University, Rome, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
| | - Alberto Costa
- IRCCS Santa Lucia Foundation, Rome, Italy.,Niccolò Cusano University, Rome, Italy
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21
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Deepthi K, Roopesh BN, Balachander S, Vijay Sagar JK, Kandavel T, Reddy YCJ. Neuropsychological performance in youth with obsessive-compulsive disorder. J Psychiatr Res 2021; 138:301-310. [PMID: 33892268 DOI: 10.1016/j.jpsychires.2021.03.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/03/2021] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
There is a paucity of literature on neuropsychological functions in youth with obsessive-compulsive disorder (OCD). Most studies have small sample sizes and have yielded inconsistent results. A recent meta-analysis failed to identify any significant impairments. We studied neuropsychological functions (attention, verbal fluency, working memory, set-shifting, response inhibition, planning and visuospatial abilities) in a large sample of youth with OCD (n = 97) in comparison with controls who did not have OCD (n = 50). After controlling for the confounding effects (age, sex, severity of depression and anxiety, presence of comorbid attention-deficit hyperactivity disorder, any tic disorder, number of comorbidities, and non-verbal intelligence measured by the standard progressive matrices), the youth with OCD significantly underperformed with large effect sizes compared to controls, only on the test of 'behavioral reversal', measured by the Object Alternation Test (trials to reach criterion p < 0.001, Cohen's d = 1.49; perseverative errors p < 0.001, Cohen's d = 1.31). Patients also underperformed on a task of planning, but it was statistically insignificant. Certain comorbid disorders, antipsychotic use and age of onset did not influence neuropsychological performance significantly. Our study demonstrates that youth with OCD may have impaired 'set-shifting' in the form of 'behavioral reversal' and possibly planning, findings broadly consistent with the literature in adults and with the fronto-striatal model of OCD. It is possible that youth may accumulate more neuropsychological impairments over a period, as the illness continues into adulthood.
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Affiliation(s)
- K Deepthi
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Bangalore N Roopesh
- Department of Clinical Psychology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Srinivas Balachander
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - John K Vijay Sagar
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Thennarasau Kandavel
- Department of Biostatistics, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Y C Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India.
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22
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Jalal B. "Men Fear Most What They Cannot See." sleep paralysis "Ghost Intruders" and faceless "Shadow-People"-The role of the right hemisphere and economizing nature of vision. Med Hypotheses 2021; 148:110521. [PMID: 33573871 DOI: 10.1016/j.mehy.2021.110521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/17/2021] [Accepted: 01/25/2021] [Indexed: 11/26/2022]
Abstract
Sleep paralysis is a curious condition where the paralyzed person may hallucinate terrifying ghosts. These hypnogogic and hypnopompic visions are common worldwide. They often entail seeing and sensing shadow beings; although hallucinating full-fledged figures (e.g., cat-like creatures and witches) are not uncommon. In this paper, I propose a neuroscientific account (building on previous work) for why people see ghosts during sleep paralysis and why these tend to manifest as faceless shadows. This novel venture considers the distinct computational styles of the right and left hemisphere and their functional specializations vis-à-vis florid intruder hallucinations and out-of-body experiences (OBEs) during these dream-like states. Additionally, I provide a brain-based explanation for dissociative phenomena common during sleep paralysis. Specifically, I posit that these ghost hallucinations and OBEs are chiefly mediated by activity in key regions in the right hemisphere; and outline how the functional organization of the visual system (evoking concepts like surface interpolation) and its economizing nature (i.e., proclivity to minimize computational load and take short-cuts) can explain faceless humanoid-shadows and sensed presence hallucinations during sleep paralysis; and how the hypothalamus and anterior cingulate may be implicated during related dissociative states. Ultimately empirical research must shed light on the validity of this account. If this hypothesis is correct, patients with right hemisphere damage (i.e., in implicated areas) should be less likely to hallucinate ghosts during sleep paralysis; i.e., compared to those with intact hemispheres or damage to the left only. It may also be possible to temporarily disable right hemisphere functions during sleep paralysis using transcranial magnetic stimulation. Accordingly, this procedure should eradicate sleep paralysis ghost hallucinations.
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Affiliation(s)
- Baland Jalal
- Harvard University, USA; University of Cambridge, UK.
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23
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Abstract
In this chapter, I address the concept of endophenotypes for obsessive-compulsive disorder (OCD). Endophenotypes are objective and heritable quantitative traits hypothesized to be more biologically tractable than distal clinical phenotypes. This approach has been adopted to gain a better understanding of psychiatric conditions in general. It is theorized that endophenotypes will particularly assist in clarifying both the diagnostic status and aetiological origins of complex neuropsychiatric conditions such as OCD. At the cognitive level, separable constructs of relevance for OCD have been identified. The prevailing model for OCD assumes the development of abnormalities within fronto-striatal neural circuits leading to impairment of executive functions and their neuropsychological subcomponents. Here, I address whether this model can guide towards the identification of endophenotypes for this condition and discuss possible implications.
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Affiliation(s)
- Matilde M Vaghi
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London, UK.
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24
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Oh S, Jung WH, Kim T, Shim G, Kwon JS. Brain Activation of Patients With Obsessive-Compulsive Disorder During a Mental Rotation Task: A Functional MRI Study. Front Psychiatry 2021; 12:659121. [PMID: 34025482 PMCID: PMC8138312 DOI: 10.3389/fpsyt.2021.659121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/06/2021] [Indexed: 01/01/2023] Open
Abstract
Functional neuroimaging studies have implicated alterations in frontostriatal and frontoparietal circuits in obsessive-compulsive disorder (OCD) during various tasks. To date, however, brain activation for visuospatial function in conjunction with symptoms in OCD has not been comprehensively evaluated. To elucidate the relationship between neural activity, cognitive function, and obsessive-compulsive symptoms, we investigated regional brain activation during the performance of a visuospatial task in patients with OCD using functional magnetic resonance imaging (fMRI). Seventeen medication-free patients with OCD and 21 age-, sex-, and IQ-matched healthy controls participated in this study. Functional magnetic resonance imaging data were obtained while the subjects performed a mental rotation (MR) task. Brain activation during the task was compared between the two groups using a two-sample t-test. Voxel-wise whole-brain multiple regression analyses were also performed to examine the relationship between obsessive-compulsive symptom severity and neural activity during the task. The two groups did not differ in MR task performance. Both groups also showed similar task-related activation patterns in frontoparietal regions with no significant differences. Activation in the right dorsolateral prefrontal cortex in patients with OCD during the MR task was positively associated with their total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores. This study identified the specific brain areas associated with the interaction between symptom severity and visuospatial cognitive function during an MR task in medication-free patients with OCD. These findings may serve as potential neuromodulation targets for OCD treatment.
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Affiliation(s)
- Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Gyeonggi-do, South Korea
| | - Wi Hoon Jung
- Department of Psychology, Daegu University, Gyeongsan, South Korea
| | - Taekwan Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - Geumsook Shim
- KAIST Clinic Pappalardo Center, KAIST, Daejeon, South Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea.,Institute of Human Behavioral Medicine, SNU-MRC, Seoul, South Korea
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25
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Dikmeer N, Besiroglu L, Di Biase MA, Zalesky A, Kasal MI, Bilge A, Durmaz E, Polat S, Gelal F, Zorlu N. White matter microstructure and connectivity in patients with obsessive-compulsive disorder and their unaffected siblings. Acta Psychiatr Scand 2021; 143:72-81. [PMID: 33029781 DOI: 10.1111/acps.13241] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to examine white matter microstructure and connectivity in individuals with obsessive-compulsive disorder (OCD) and their unaffected siblings, relative to healthy controls. METHODS Diffusion-weighted magnetic resonance imaging (dMRI) scans were acquired in 30 patients with OCD, 21 unaffected siblings, and 31 controls. We examined white matter microstructure using measures of fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD). Structural networks were examined using network-based statistic (NBS). RESULTS Compared to controls, OCD patients showed significantly reduced FA and increased RD in clusters traversing the left forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and cingulum. Furthermore, the OCD group displayed significantly weaker connectivity (quantified by the streamline count) compared to controls in the right hemisphere, most notably in edges connecting subcortical structures to temporo-occipital cortical regions. The sibling group showed intermediate streamline counts, FA and RD values between OCD and healthy control groups in connections found to be abnormal in patients with OCD. However, these reductions did not significantly differ compared to controls. CONCLUSION Therefore, siblings of OCD patients display intermediate levels in dMRI measures of microstructure and connectivity, suggesting white matter abnormalities might be related to the familial predisposition for OCD.
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Affiliation(s)
- Nur Dikmeer
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Lutfullah Besiroglu
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Maria A Di Biase
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Andrew Zalesky
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Department of Biomedical Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - Meltem I Kasal
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Aslıhan Bilge
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Ercan Durmaz
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Serap Polat
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
| | - Fazil Gelal
- Department of Radiodiagnostics, Katip Celebi University, Ataturk Education and Research Hospital, Ankara, Turkey
| | - Nabi Zorlu
- Department of Psychiatry, Katip Celebi University, Ataturk Education and Research Hospital, Izmir, Turkey
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26
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Maria AS, Barry C, Ringuenet D, Falissard B, Group T, Berthoz S. Subjective cognitive rigidity and attention to detail: A cross-cultural validation of the Detail and Flexibility Questionnaire (DFlex) in a French clinical sample. J Clin Exp Neuropsychol 2020; 42:1059-1071. [PMID: 33274668 DOI: 10.1080/13803395.2020.1842333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: People diagnosed with Anorexia Nervosa (AN) are at risk for poor cognitive flexibility and excessive attention to detail. These difficulties are traditionally quantified using neuropsychological tests. These tests do not capture the subjective repercussions of these cognitive styles. The Detail and Flexibility Questionnaire (DFlex) has been specifically developed to measure these repercussions. The aim of this study was to evaluate the psychometric properties of the French version of this scale (F-DFlex) and to adapt it if needed. Methods: The instrument factor structure, internal consistency, convergent, and discriminant validity were assessed in a sample of 107 French women AN inpatients. For convergent validity, associations between F-DFlex scores, perceived levels of autistic traits (Autism Quotient questionnaire - AQ) and eating disorders symptomatology (Eating Disorder Examination Questionnaire - EDE-Q), as well as neuropsychological evaluations (Wisconsin Card Sorting Test - WCST, Rey Complex Figure - RCF) were tested. Discriminant validity was assessed by comparing F-DFlex scores of the patients with a chronic versus non-chronic illness. Results: The results of the exploratory factorial analysis led to the removal of four items. Internal consistency indices of this shortened version were good. Correlation coefficients directions and values between F-DFlex factors and relevant AQ Switching and Detail subscores were satisfactory, indicating good convergent validity. F-DFlex Rigidity scores were associated with the WCST percentage of perseverative errors, but the F-DFlex Attention to Detail scores were not associated with the RCF central coherence index. F-DFlex scores were associated with the severity of eating disorders symptomatology independently of BMI, illness duration, or anxiety, and depression. Conclusion: This study indicates good psychometric properties of this new version of the DFlex. The F-DFlex appears as a promising self-report screening tool of important cognitive dimensions for use in clinical management of people diagnosed with AN.
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Affiliation(s)
- Anne-Solène Maria
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM , Villejuif, France
| | - Caroline Barry
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM , Villejuif, France
| | - Damien Ringuenet
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM , Villejuif, France.,Unité de Traitement des Troubles des Conduites Alimentaires, Département de Psychiatrie et d'Addictologie, Hôpital Paul Brousse , Villejuif, France
| | - Bruno Falissard
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM , Villejuif, France
| | | | - Sylvie Berthoz
- Département de Psychiatrie de l'Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris , Paris, France.,Univ. Bordeaux, CNRS, EPHE, INCIA, UMR 5287 , Bordeaux, France
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27
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The effects of selective serotonin reuptake inhibitors on brain functional networks during goal-directed planning in obsessive-compulsive disorder. Sci Rep 2020; 10:20619. [PMID: 33244182 PMCID: PMC7691328 DOI: 10.1038/s41598-020-77814-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/10/2020] [Indexed: 02/04/2023] Open
Abstract
Whether brain network connectivity during goal-directed planning in patients with obsessive–compulsive disorder (OCD) is abnormal and restored by treatment with selective serotonin reuptake inhibitors (SSRIs) remains unknown. This study investigated whether the disrupted network connectivity during the Tower of London (ToL) planning task in medication-free OCD patients could be restored by SSRI treatment. Seventeen medication-free OCD patients and 21 matched healthy controls (HCs) underwent functional magnetic resonance imaging (fMRI) while performing the ToL task at baseline and again after 16 weeks of SSRI treatment. Internetwork connectivity was compared across the groups and treatment statuses (pretreatment versus posttreatment). At baseline, compared with the HCs, the OCD patients showed lower internetwork connectivity between the dorsal attention network and the default-mode network during the ToL planning task. After 16 weeks of SSRI treatment, the OCD patients showed improved clinical symptoms accompanied by normalized network connectivity, although their improved behavioral performance in the ToL task did not reach that of the HCs. Our findings support the conceptualization of OCD as a network disease characterized by an imbalance between brain networks during goal-directed planning and suggest that internetwork connectivity may serve as an early biomarker of the effects of SSRIs on goal-directed planning.
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28
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Examining memory performance in body dysmorphic disorder (BDD): A comparison study with obsessive compulsive disorder (OCD). Asian J Psychiatr 2020; 53:102110. [PMID: 32505114 DOI: 10.1016/j.ajp.2020.102110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/31/2020] [Accepted: 04/14/2020] [Indexed: 11/24/2022]
Abstract
The aim of this study is comparing directly the BDD and OCD disorders in terms of similarities and differences in memory function for the first time. 19 BDD patients, 15 OCD patients and 26 individuals in a healthy control group were recruited from three hospitals in Tehran. They were administered the following subtests of the Wechsler Memory Scale: logical memory (immediate and delayed), verbal paired association (immediate and delayed), digit span and spatial span as well as the Rey-Osterrieth complex figure test (RCFT). The results showed that BDD and OCD groups had lower performance in comparison to the control group across all measures, except for the immediate memory of the verbal paired associate task, which was similar across the three groups. Both the BDD and OCD groups showed poor performance on the auditory-verbal memory tasks. However, only the BDD group showed poor performance in the visual domain (i.e. spatial span and RCFT). This suggest that memory deficits are similar between BDD and OCD patients in the verbal domain. Furthermore, BDD patients demonstrated poorer visual working memory. The findings of this study reveal that BDD and OCD patients have more similarities than differences regarding neuropsychological features, in other words, the idea of the incorporation of BDD within the obsessive-compulsive and related disorders (OCRDs) spectrum in DSM-5 is supported, at least through the viewpoint of neuropsychology.
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29
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Neural primacy of the dorsolateral prefrontal cortex in patients with obsessive-compulsive disorder. NEUROIMAGE-CLINICAL 2020; 28:102432. [PMID: 32987298 PMCID: PMC7522851 DOI: 10.1016/j.nicl.2020.102432] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/08/2023]
Abstract
The dorsolateral prefrontal cortex (DLPFC), a key structure in the executive system, has consistently emerged as a crucial element in the pathophysiology of obsessive-compulsive disorder (OCD). However, the neural primacy of the DLPFC remains elusive in this disorder. We investigated the causal interaction (measured by effective connectivity) between the DLPFC and the remaining brain areas using bivariate Granger causality analysis of resting-state fMRI collected from 88 medication-free OCD patients and 88 matched healthy controls. Additionally, we conducted seed-based functional connectivity (FC) analyses to identify network-level neural functional alterations using the bilateral DLPFC as seeds. OCD patients demonstrated reduced FC between the right DLPFC and right orbitofrontal cortex (OFC), and activity in the right OFC had an inhibitory effect on the right DLPFC. Additionally, we observed alterations in both feedforward and reciprocal influences between the inferior temporal gyrus (ITG) and the DLPFC in patients. Furthermore, activity in the cerebellum had an excitatory influence on the right DLPFC in OCD patients. These findings may help to elucidate the psychopathology of OCD by detailing the directional connectivity between the DLPFC and the rest of the brain, ultimately helping to identify regions that could serve as treatment targets in OCD.
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30
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Neuropsychological profile of children and adolescents with psychosis risk syndrome: the CAPRIS study. Eur Child Adolesc Psychiatry 2020; 29:1311-1324. [PMID: 31897849 DOI: 10.1007/s00787-019-01459-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 12/11/2019] [Indexed: 12/27/2022]
Abstract
Neuropsychological underperformance is well described in young adults at clinical high risk for psychosis, but the literature is scarce on the cognitive profile of at-risk children and adolescents. The aim of this study is to describe the neuropsychological profile of a child and adolescent sample of patients with psychosis risk syndrome (PRS) compared to healthy controls and to analyze associations between attenuated psychotic symptoms and cognitive impairment. Cross-sectional baseline data analysis from a longitudinal, naturalistic, case-control, two-site study is presented. Eighty-one help-seeking subjects with PRS and 39 healthy controls (HC) aged between 10 and 17 years of age were recruited. PRS was defined by: positive or negative attenuated symptoms, Brief Limited Intermittent Psychotic Symptoms (BLIPS), genetic risk (first- or second-degree relative), or schizotypal personality disorder plus impairment in functioning. A neuropsychological battery was administered to assess general intelligence, verbal and visual memory, visuospatial abilities, speed processing, attention, and executive functions. The PRS group showed lower general neuropsychological performance scores at a multivariate level and lower scores than controls in general intelligence and executive functions. Lower scores on executive function and poorer attention were associated with high scores of positive attenuated psychotic symptoms. No association with attenuated negative symptoms was found. This study provides evidence of cognitive impairment in PRS children and adolescents and shows a relationship between greater cognitive impairment in executive functions and attention tasks and severe attenuated positive symptoms. However, longitudinal studies are needed to clarify the nature of cognitive impairment as a possible vulnerability marker.
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Bernardes ET, Manitto AM, Miguel EC, Pan PM, Batistuzzo MC, Rohde LA, Polanczyk GV. Relationships between childhood maltreatment, impairment in executive functions and disruptive behavior disorders in a community sample of children. Eur Child Adolesc Psychiatry 2020; 29:969-978. [PMID: 31559500 DOI: 10.1007/s00787-019-01408-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 09/13/2019] [Indexed: 11/27/2022]
Abstract
Evidence points to an independent relationship among childhood maltreatment, impairments in executive functions (EF) and disruptive behavior disorders (DBD). However, it is still not fully understood how these three factors are interrelated. This study evaluated the association between childhood maltreatment and DBD testing the role of EF performance as a mediator or moderator. We studied a probabilistic school-based sample of 2016 children from 6 to 12 years. Mental disorders were assessed using the Development and Well-Being Assessment with parents and children. Children answered questions about exposure to child maltreatment and were evaluated with a set of cognitive tasks addressing inhibitory control, working memory, cognitive flexibility and planning. Childhood maltreatment was strongly associated with DBD (OR = 7.7, CI 95% 4.5-12.9). No association was found between childhood maltreatment and EF performance. Children with DBD showed worse performance in cognitive flexibility, which was not identified as a mediator or moderator of the association between childhood maltreatment and DBD. Results indicate that the association between maltreatment and disruptive behavior occurs regardless of performance in executive function in a community sample. Future studies are essential to confirm these findings and elucidate the cognitive mechanisms involved in this association.
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Affiliation(s)
- Elisa Teixeira Bernardes
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil.
| | - Alicia Matijasevich Manitto
- Departamento de Medicina Preventiva, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Arnaldo, 455, Sao Paulo, SP, Brazil
- Programa de pos-graduacao em Epidemiologia, Universidade Federal de Pelotas, R. Mal. Deodoro, 1160, Pelotas, RS, Brazil
| | - Eurípedes Constantino Miguel
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
| | - Pedro Mario Pan
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
- Labortatorio Interdisciplinar de Neuroimagem e Cognicao (LiNC), Universidade Federal de Sao Paulo (UNIFESP), R. Pedro de Toledo, 669, Sao Paulo, SP, Brazil
| | - Marcelo Camargo Batistuzzo
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
| | - Luis Augusto Rohde
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
- Departmento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
| | - Guilherme V Polanczyk
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, R. Dr Ovidio Pires de Campos, 875, Sao Paulo, SP, Brazil
- Instituto Nacional de Psiquiatria do Desenvolvimento para Crianças e Adolescentes (INCT-INPD), R. Dr Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil
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Kim T, Kwak S, Hur JW, Lee J, Shin WG, Lee TY, Kim M, Kwon JS. Neural bases of the clinical and neurocognitive differences between earlyand late-onset obsessive–compulsive disorder. J Psychiatry Neurosci 2020; 45:234-242. [PMID: 31765115 PMCID: PMC7828929 DOI: 10.1503/jpn.190028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Using biological evidence to define subtypes within the heterogeneous population with obsessive–compulsive disorder (OCD) is important for improving treatment response. Based on age at onset, OCD can be clustered into 2 groups, each of which is more homogeneous with respect to clinical and cognitive phenotype. However, the neural bases for these phenotypic differences need to be established to construct evidence-based homogeneous groups. METHODS We compared brain volumes, clinical symptoms, and neurocognitive function for 49 people with early-onset OCD and 52 with late-onset OCD (participants in both groups were unmedicated or drug-naïve), and 103 healthy controls. We performed regression analyses to examine group × volume interaction effects on clinical outcomes or neurocognitive function in people with OCD. RESULTS We observed larger volumes in the precentral, orbitofrontal, middle frontal, and middle temporal gyri in people with early-onset OCD compared to those with late-onset OCD. Poorer visuospatial construction in early-onset OCD was correlated with a larger left middle frontal gyrus volume. Impaired visuospatial memory in people with early-onset OCD and cognitive inflexibility in people with late-onset OCD were correlated with increased and decreased volume in the left middle frontal gyrus, respectively. We found group × volume interactions for obsessive–compulsive symptom scores in the left middle temporal gyrus of people with OCD. LIMITATIONS Although we divided the subtypes using the commonly adopted criterion of age at onset, this criterion is still somewhat controversial. CONCLUSION We provided the neural bases for clinical and neurocognitive differences to demonstrate that biological evidence underlies the distinctions between early- and late-onset OCD. This study suggests that different treatment options should be considered for the OCD subtypes, because their neurobiology differs and is related to distinct phenotypic profiles.
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Affiliation(s)
- Taekwan Kim
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Seoyeon Kwak
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Ji-Won Hur
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Junhee Lee
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Won-Gyo Shin
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Tae Young Lee
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Minah Kim
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
| | - Jun Soo Kwon
- From the Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea (T. Kim, Kwak, Kwon); Department of Psychology, Korea University, Seoul, Republic of Korea (Hur); Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea (J. Lee, T.Y. Lee, M. Kim, Kwon); Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea (Shin, T.Y. Lee, Kwon); and Department of Neuropsychiatry, Seoul National University Hospital, Republic of Korea (M. Kim)
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Weight and age do not account for a worse executive functioning among BED-obese patients. Eat Weight Disord 2020; 25:373-377. [PMID: 30382543 DOI: 10.1007/s40519-018-0608-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/25/2018] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Research has demonstrated impaired executive functioning among Binge Eating Disorder (BED) patients that could be influenced by age and weight. We aim to compare decision-making, set-shifting and central coherence between BED-obese patients (BED-Ob), non-BED-obese patients (non-BED-Ob), and normal-weight healthy controls (NW-HC) without the influence of these variables. METHODS Overall, 35 BED-Ob, 32 non-BED-Ob and 26 NW-HC participants completed the Iowa Gambling Task, the Trail Making Test and the Rey-Osterrieth Complex Figure Test. RESULTS BED-Ob patients showed higher cognitive impairment compared to NW-HC on decision-making, set-shifting, visual attention and memory. CONCLUSIONS BED-Ob patients have an impaired cognitive profile on decision-making, set-shifting, visual attention and memory but not impaired central coherence. As all groups were aged-matched and no significant differences between BED-Ob and non-BED-Ob participants were evident, our results demonstrate that this impairment is independent from weight/age, pointing out that it is BED itself to account for inefficiencies in cognitive functioning. LEVEL OF EVIDENCE Level III, case-control study.
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Poreh A, Levin JB, Teaford M. Geriatric Complex Figure Test: A test for the assessment of planning, visual spatial ability, and memory in older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2020; 27:101-107. [PMID: 30183429 DOI: 10.1080/23279095.2018.1490288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/13/2018] [Accepted: 06/14/2018] [Indexed: 06/08/2023]
Abstract
The present study describes the development of a simplified complex figure for older adults. This new figure is based on theoretical organizational strategy models developed for the Rey Complex Figure Test and combines several new technologies for the enhancement of the data capture. The study shows that the accuracy and memory scores for the new measure correlate significantly with Trail Making Test, Five Point Test, and RBANS Complex Figure scores. The new figure's strategy scores correlate with predominantly nonverbal and to a lesser extent with verbal executive functions, supporting the construct validity of these scores and illustrating that computer-based data recording methodologies can reliably discern the multiple cognitive operations that impact performance on this and similar graphomotor measures.
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Affiliation(s)
- Amir Poreh
- Psychology, Cleveland State University, Cleveland, Ohio, USA
- Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Jennifer B Levin
- Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Max Teaford
- Psychology, Miami University, Oxford, Ohio, USA
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Jalal B, McNally RJ, Elias JA, Potluri S, Ramachandran VS. "Fake it till You Make it"! Contaminating Rubber Hands ("Multisensory Stimulation Therapy") to Treat Obsessive-Compulsive Disorder. Front Hum Neurosci 2020; 13:414. [PMID: 31998095 PMCID: PMC6962184 DOI: 10.3389/fnhum.2019.00414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/07/2019] [Indexed: 12/22/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a deeply enigmatic psychiatric condition associated with immense suffering worldwide. Efficacious therapies for OCD, like exposure and response prevention (ERP), are sometimes poorly tolerated by patients. As many as 25% of patients refuse to initiate ERP mainly because they are too anxious to follow exposure procedures. Accordingly, we proposed a simple and tolerable (immersive yet indirect) low-cost technique for treating OCD that we call “multisensory stimulation therapy.” This method involves contaminating a rubber hand during the so-called “rubber hand illusion” (RHI) in which tactile sensations may be perceived as arising from a fake hand. Notably, Jalal et al. (2015) showed that such fake hand contamination during the RHI provokes powerful disgust reactions in healthy volunteers. In the current study, we explored the therapeutic potential of this novel approach. OCD patients (n = 29) watched as their hidden real hand was being stroked together with a visible fake hand; either synchronously (inducing the RHI; i.e., the experimental condition; n = 16) or asynchronously (i.e., the control condition; n = 13). After 5 min of tactile stimulation, the rubber hand was contaminated with fake feces, simulating conventional exposure therapy. Intriguingly, results suggested sensory assimilation of contamination sensations into the body image via the RHI: patients undergoing synchronous stimulation did not report greater contamination sensations when the fake hand was initially contaminated relative to asynchronous stroking. But contrary to expectations, they did so after the rubber hand had been contaminated for 5 min, as assessed via disgust facial expressions (a secondary outcome) and in vivo exposure (upon discontinuing the illusion). Further, to our surprise, synchronous and asynchronous stroking induced an equally vivid and fast-emerging illusion, which helps explain why both conditions initially (5 min after initiating tactile stimulation) provoked contamination reactions of equal magnitude. This study is the first to suggest heightened malleability of body image in OCD. Importantly, it may pave the way for a tolerable technique for the treatment of OCD—highly suitable for poorly resourced and emergency settings, including low-income and developing countries with minimal access to high-tech solutions like virtual reality.
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Affiliation(s)
- Baland Jalal
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.,Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Richard J McNally
- Department of Psychology, Harvard University, Cambridge, MA, United States
| | - Jason A Elias
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Sriramya Potluri
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Vilayanur S Ramachandran
- Center for Brain and Cognition, University of California, San Diego, San Diego, CA, United States
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Conradi N, Behrens M, Kannemann T, Merkel N, Strzelczyk A, Reif PS, Rosenow F, Hermsen A. Factorial validity of a neuropsychological test battery and its ability to discern temporal lobe epilepsy from frontal lobe epilepsy - A retrospective study. Seizure 2019; 74:81-88. [PMID: 31855714 DOI: 10.1016/j.seizure.2019.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Firstly, to evaluate the validity of a neuropsychological test battery in epilepsy patients, i.e. whether its tests sufficiently allow the assessment of the required cognitive domains in this specific group. Secondly, to examine its ability to differentiate between cognitive profiles of different subgroups of focal epilepsy. METHODS The test battery suggested by the German ILAE Chapter was performed on 207 epilepsy patients, and its factor structure was investigated by principal component analysis (PCA). To further examine its accuracy in two matched subgroups of patients with temporal lobe epilepsy (TLE, n = 35) and frontal lobe epilepsy (FLE, n = 35), a discriminant function analysis (DFA) was used. RESULTS PCA revealed eleven interpretable factors, accounting for 69.1% of total variance: Divided Attention, Reaction Time, Verbal Learning, Verbal Memory, Contextual Memory, Short-term- and Working Memory, Visuospatial Functioning, Space Perception, Verbal Fluency, Response Monitoring and Cognitive Flexibility. DFA identified six test to be most appropriate to discern TLE from FLE: WMS-IV Logical Memory, recognition; WMS-R Digit Span, backwards; VLMT, repetitions; VOSP Silhouettes; VLMT, delayed recall; and RWT Phonemic verbal fluency. Group membership was correctly predicted for 78.6% of patients using cross-validation. CONCLUSIONS As neuropsychological assessments are central in clinical decision-making in presurgical work-up of epilepsy patients, the appropriateness of the test battery in use is essential. The majority of cognitive domains are sufficiently measurable by the test battery and it is highly sensitive to differentiate between the cognitive profiles of TLE and FLE. However, the selection of tests assessing nonverbal memory functions requires further improvement.
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Affiliation(s)
- Nadine Conradi
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany.
| | - Marion Behrens
- Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany
| | - Tabitha Kannemann
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany
| | - Nina Merkel
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany
| | - Philipp S Reif
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany
| | - Anke Hermsen
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt and Goethe University, Frankfurt Am Main, Germany; LOEWE Center for Personalized Translational Epilepsy Research (CePTER), Goethe University, Frankfurt Am Main, Germany
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Slapik M, Kronemer SI, Morgan O, Bloes R, Lieberman S, Mandel J, Rosenthal L, Marvel C. Visuospatial Organization and Recall in Cerebellar Ataxia. THE CEREBELLUM 2019; 18:33-46. [PMID: 29949096 DOI: 10.1007/s12311-018-0948-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Poor visuospatial skills can disrupt activities of daily living. The cerebellum has been implicated in visuospatial processing, and patients with cerebellar injury often exhibit poor visuospatial skills, as measured by impaired memory for the figure within the Rey-Osterrieth complex figure task (ROCF). Visuospatial skills are an inherent aspect of the ROCF; however, figure organization (i.e., the order in which the figure is reconstructed by the participant) can influence recall ability. The objective of this study was to examine and compare visuospatial and organization skills in people with cerebellar ataxia. We administered the ROCF to patients diagnosed with cerebellar ataxia and healthy controls. The cerebellar ataxia group included patients that carried a diagnosis of spinocerebellar ataxia (any subtype), autosomal dominant cerebellar ataxia, or cerebellar ataxia with unknown etiology. Primary outcome measures were organization and recall performance on the ROCF, with supplemental information derived from cognitive tests of visuospatial perception, working memory, processing speed, and motor function. Cerebellar ataxia patients revealed impaired figure organization relative to that of controls. Figure copy was impaired in the patients, but their subsequent recall performance was normal, suggesting compensation from initial organization and copying strategies. In controls, figure organization predicted recall performance, but this relationship was not observed in the patients. Instead, processing speed predicted patients' recall accuracy. Supplemental tasks indicated that visual perception was intact in the cerebellar ataxia group and that performance deficits were more closely tied to organization strategies than with visuospatial skills.
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Affiliation(s)
- Mitchell Slapik
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | | | - Owen Morgan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Ryan Bloes
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Seth Lieberman
- College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Jordan Mandel
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Liana Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA
| | - Cherie Marvel
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall W102A, Baltimore, MD, 21205, USA.
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Ouimet AJ, Ashbaugh AR, Radomsky AS. Hoping for more: How cognitive science has and hasn't been helpful to the OCD clinician. Clin Psychol Rev 2019; 69:14-29. [DOI: 10.1016/j.cpr.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 12/19/2022]
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Hale AC, Tolle KA, Kitchen Andren KA, Spencer RJ. Cross-validation of incidental learning tasks from the WAIS-IV as a measure of memory. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 27:517-524. [PMID: 30793966 DOI: 10.1080/23279095.2019.1570930] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although incidental learning (IL) routinely occurs in everyday life, it is infrequently assessed during neuropsychological evaluations. This study aimed to further examine the concurrent validity of IL measures based on the Vocabulary and Similarities subtests from the Wechsler Adult Intelligence Test-Fourth Edition (WAIS-IV). Participants included 43 Veterans referred for outpatient neuropsychological testing. Performances on the IL procedures correlated strongly with performances on the Repeatable Battery for the Assessment of Neuropsychological Status Immediate and Delayed Recall Indices (r = .48 to r = .78). These results indicate that the IL procedures from selected WAIS-IV subtests provided an efficient and valid measure of memory. In particular, the task based on the Similarities subtest provided exceptionally high value as a screen for memory problems. These IL procedures, which require minimal additional administration time, capitalize on the semantic encoding that is inherent in completing the Vocabulary and Similarities subtests, and offer a complementary approach to standard memory assessment.
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Affiliation(s)
- Andrew C Hale
- VA Center for Clinical Management Research, Ann Arbor, Michigan, USA.,VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Kathryn A Tolle
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Katherine A Kitchen Andren
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA.,Saint Joseph Mercy Health System, Rehabilitation Service, Ypsilanti, Michigan, USA
| | - Robert J Spencer
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan, USA
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Salvadori E, Dieci F, Caffarra P, Pantoni L. Qualitative Evaluation of the Immediate Copy of the Rey-Osterrieth Complex Figure: Comparison Between Vascular and Degenerative MCI Patients. Arch Clin Neuropsychol 2019; 34:14-23. [PMID: 29420698 DOI: 10.1093/arclin/acy010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/22/2018] [Indexed: 01/05/2023] Open
Abstract
Objective The immediate copy of the Rey-Osterrieth Complex Figure (ROCF) is considered a visuo-spatial test. However, reproducing this complex structure possibly involves also executive functions, such as planning and organizational strategies. In a previous study, we found a high rate of impaired performances in this test in a sample of subcortical vascular mild cognitive impairment patients. Executive functions contribution in the immediate copy of the ROCF can be assessed with the Boston Qualitative Scoring System (BQSS). We aimed at examining whether BQSS executive scores of ROCF immediate copy: (1) differ between vascular (v-MCI) and degenerative MCI (d-MCI) patients; (2) can at least partly explain the high rate of abnormal ROCF immediate copy performances in v-MCI patients. Method Thirty d-MCI patients (age 75.2 ± 4.4) and 27 v-MCI (age 73.2 ± 6.9) were enrolled. The performances of patients were scored using the BQSS executive scores (Fragmentation, Planning, Organization, Perseveration) during the accomplishment of ROCF immediate copy. Results Comparing d-MCI and v-MCI performances, d-MCI patients scored worse on ROCF delayed recall (9.9 ± 4.7 vs. 13.4 ± 5.9, p = .020) and MMSE (23.9 ± 2.6 vs. 27.8 ± 2.3, p = .001) while v-MCI patients had more frequently impaired performances in ROCF immediate copy (40% vs. 81%, p = .001) and showed worse scores on Fragmentation (2.4 ± 0.9 vs. 1.8 ± 1.3, p = .035), Planning (2.4 ± 0.8 vs. 1.8 ± 1, p = .039), Organization (4.8 ± 1.3 vs. 3.6 ± 2.1, p = .017), and Perseveration (3.5 ± 0.8 vs. 2.9 ± 1.2, p = .048). Conclusions The performance of v-MCI patients in ROCF immediate copy seemed to be more affected by executive dysfunction than the performance obtained by d-MCI. When analyzing ROCF performances, a qualitative approach allows to evaluate patients' strategies during the reproduction, and thus to discriminate between executive and visuo-constructional abilities.
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Affiliation(s)
- Emilia Salvadori
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Francesca Dieci
- Outpatients Center for Cognitive Disorders and Dementia, AUSL of Parma, Parma, Italy
| | - Paolo Caffarra
- Unit of Neuroscience, Department of Medicine and Surgery, Parma, Italy
| | - Leonardo Pantoni
- L. Sacco' Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Tezcan D, Tümkaya S. Situation Awareness in Obsessive Compulsive Disorder and Their Relatives: an Endophenotype Study. ACTA ACUST UNITED AC 2019; 55:370-375. [PMID: 30622396 DOI: 10.5152/npa.2017.20571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 08/09/2017] [Indexed: 11/22/2022]
Abstract
Introduction It has been theorized that endophenotype models will help to understand the etiology of heterogeneous brain disorders such as obsessive-compulsive disorder (OCD). In this study, it was aimed to determine whether "situational awareness" impairments which can be defined as partially naturalistic working memory deficits, are an endofenotype for OCD. Methods In this study, situational awareness (SA) task performances of 67 OCD patients, 50 their unaffected first-degree relatives, and 41 healthy controls who matched with regard to sex, age and years of education were measured to investigate endophenotypes in OCD. For this purpose, a visuospatial working memory test was used. Results As a result, the relatives showed a task performance between patients with OCD and control group in both SA1 and SA2 tasks. Patients with OCD performed significantly worse than control group on SA1 single and dual task. On the other hand, there were no significant differences between relatives and patients of any SA assessment. Conclusion These results indicated that poor situational awareness may be a candidate endophenotype for OCD. Early perceptual dysfunctions such as poor performance on SA1 task can mediate the genetic risk for OCD.
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Affiliation(s)
- Didem Tezcan
- İzzet Baysal Research and Training Hospital, Department of Psychiatry, Bolu, Turkey
| | - Selim Tümkaya
- Pamukkale University Medicine Faculty, Department of Psychiatry, Denizli, Turkey
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Abstract
Obsessive-compulsive disorder (OCD) is a debilitating mental illness characterized by an early onset and chronic course. Evidence from several lines of research suggests significant neuropsychological deficits in patients with OCD; executive dysfunction and nonverbal memory deficits have been reported consistently in OCD. These deficits persist despite controlling potential confounders such as comorbidity, severity of illness, and medications. Neuropsychological impairments are independent of illness severity, thus suggesting that the neuropsychological deficits are trait markers of the disease. In addition, these deficits are seen in first-degree relatives of individuals with OCD. These reports suggest that neuropsychological deficits are potential endophenotype markers in OCD. Neuropsychological studies in pediatric OCD are limited; they show impairments of small effect size across multiple domains but with doubtful clinical significance. Preliminary evidence shows that different symptom dimensions of OCD may have unique neuropsychological deficits suggestive of discrete but overlapping neuroanatomical regions for individual symptom dimensions. Overall, neuropsychological deficits further support the role of frontostriatal circuits in the neurobiology of OCD. In addition, emerging literature also suggests the important role of other areas, in particular parietal cortex. Preliminary evidence suggests the possible role of neuropsychological deficits to be markers of treatment response but needs to be examined in future. Longitudinal studies with examination of patients at different time points and examination of their potential utility as predictors of treatment response are needed in future.
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Affiliation(s)
- Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Naren P Rao
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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43
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Chou CY, Mackin RS, Delucchi KL, Mathews CA. Detail-oriented visual processing style: Its role in the relationships between early life adversity and hoarding-related dysfunctions. Psychiatry Res 2018; 267:30-36. [PMID: 29883858 PMCID: PMC6131021 DOI: 10.1016/j.psychres.2018.05.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/20/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
Abstract
Early life adversity, ranging from material deprivation and parental dysfunction to abusive and life-threatening events, has been associated with hoarding symptom severity. Moreover, both victims of early life adversity and individuals with hoarding disorder have been found to have a higher tendency toward detail-oriented visual processing. This study aimed to investigate the role of detail-oriented visual processing in the relationship between early life adversity and hoarding-related dysfunction. Childhood exposure to life adversity, hoarding symptom severity, and emotional attachment to possessions, a hoarding-related dysfunction thought to be most closely related to adversity exposure, were assessed. Detail-oriented visual processing was evaluated using the Central Coherence Index, which was calculated based on the drawing process during the Rey-Osterrieth Complex Figure Test. It was found that detail-oriented visual processing was not significantly associated with hoarding symptom severity, emotional attachment to possessions, or the relationship between early life adversity and hoarding symptom severity. It did, however, act as a significant moderator in the relationship between early life adversity and emotional attachment to possessions. These findings add to the literature by identifying the role of a specific neurocognitive processing style in the mechanism through which early life adversity affects the development of a key hoarding-related dysfunction, elevated emotional attachment to possessions.
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Affiliation(s)
- Chia-Ying Chou
- Department of Psychiatry, University of California, San Francisco, USA
| | - R Scott Mackin
- Department of Psychiatry, University of California, San Francisco, USA
| | - Kevin L Delucchi
- Department of Psychiatry, University of California, San Francisco, USA
| | - Carol A Mathews
- Department of Psychiatry, University of California, San Francisco, USA; Department of Psychiatry, University of Florida, Gainesville, USA.
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Martoni RM, de Filippis R, Cammino S, Giuliani M, Risso G, Cavallini MC, Bellodi L. Planning functioning and impulsiveness in obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci 2018; 268:471-481. [PMID: 28466133 DOI: 10.1007/s00406-017-0803-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
Abstract
Planning ability (PA) is a key aspect of cognitive functioning and requires subjects to identify and organise the necessary steps to achieve a goal. Despite the central role of executive dysfunction in patients with obsessive-compulsive disorder (OCD), deficits in PA have been investigated leading to contrasting results. Given these inconsistencies, the main aim of our work is to give a deeper and clearer understanding of PA in OCD patients. Moreover, we are interested in investigating the relationship between PAs and impulsivity traits and other clinical variables. Sixty-eight OCD patients and 68 healthy controls (HCs) matched for sex and age were assessed through the Stocking of Cambridge (SoC), a computerised version of the Tower of London. We examined planning sub-components for each difficulty levels (from 2 to 5 minimum moves). Our results showed that OCD patients needed longer initial thinking time than HCs during the execution of low demanding tasks (i.e. 2 and 3 moves), while the accuracy level between the two groups did not significantly differ. OCD patients required longer initial thinking time also during high demanding tasks (i.e., 4 and 5 moves), but in this case their accuracy was significantly worse than HCs' one. We did not find any association between impulsivity and PAs. Our results supported the hypothesis that OCD patients were not able to retain in memory the planned sequence and they had to reschedule their movements during the execution. Thus, future studies should deepen the interrelation between working memory and PA to better understand the influence between these two cognitive functions and their interaction with clinical variables in OCD patients.
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Affiliation(s)
- Riccardo Maria Martoni
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Roberta de Filippis
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy.
| | - Stefania Cammino
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Mattia Giuliani
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Gaia Risso
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Maria Cristina Cavallini
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
| | - Laura Bellodi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Via Stamira D'Ancona, 20, 20127, Milan, Italy
- Faculty of Psychology, University Vita-Salute San Raffaele, Milan, Italy
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de Filippis R, Aloi M, Bruni A, Gaetano R, Segura-Garcia C, De Fazio P. Bipolar disorder and obsessive compulsive disorder: The comorbidity does not further impair the neurocognitive profile. J Affect Disord 2018; 235:1-6. [PMID: 29627704 DOI: 10.1016/j.jad.2018.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/12/2018] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND The comorbidity of bipolar disorder (BD) and obsessive-compulsive disorder (OCD) has been widely described. Several studies have investigated the cognitive profiles of BD and OCD patients, but studies that compare BD, BD-OCD, and OCD patients in neuropsychological domains do not exist. The purpose of this study was to compare set-shifting, decision making, and central coherence among BD, BD-OCD, and OCD patients. METHODS A battery of neuropsychological tests was administered to 68 patients (22 BD, 26 BD-OCD, 20 OCD). The Young Mania Rating Scale and Hamilton Depression Rating Scale were used to evaluate manic and depressive symptoms, and OCD severity was assessed with the Yale Brown Obsessive Compulsive Scale. RESULTS No significant differences emerged in decision-making and cognitive flexibility, whereas BD patients had lower scores in the Accuracy Index on Rey-Osterrieth Complex Figure Test and poor response speed on Hayling Sentence Completion Test Part A than OCD patients. LIMITATIONS The small sample size with different BD patients, the cross-sectional design, and the study clinical nature. CONCLUSIONS The most striking result is that, contrary to our hypothesis, comorbidity does not further impair the neurocognitive profile. The clinical relevance of our work could be a shift from the current cognitive rehabilitation model focusing on individualized pathways towards a new overlapping model for all three patient groups. This could make the cognitive rehabilitation faster and less costly. Notwithstanding, these disorders do not only need cognitive training but also various psycho-educative approaches and treatment according to their different clinical profile.
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Affiliation(s)
- Renato de Filippis
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy
| | - Matteo Aloi
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy
| | - Antonella Bruni
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy
| | - Raffaele Gaetano
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy
| | - Cristina Segura-Garcia
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, Viale Europa, Catanzaro 88100, Italy.
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Tulacı RG, Cankurtaran EŞ, Özdel K, Öztürk N, Kuru E, Özdemir İ. The relationship between theory of mind and insight in obsessive-compulsive disorder. Nord J Psychiatry 2018; 72:273-280. [PMID: 29426262 DOI: 10.1080/08039488.2018.1436724] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). AIM To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. METHODS Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. RESULTS Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05). CONCLUSIONS The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.
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Affiliation(s)
- Rıza Gökçer Tulacı
- a Department of Psychiatry , Uşak University Teaching and Research Hospital , Uşak , Turkey
| | | | - Kadir Özdel
- c Department of Psychiatry , University of Health Science, Dşkapı YB Teaching and Research Hospital , Ankara , Turkey
| | - Nefise Öztürk
- d Department of Psychiatry , Elazığ Mental Health Hospital , Elazığ , Turkey
| | - Erkan Kuru
- e Private Practice, Psychiatry , Ankara , Turkey
| | - İlker Özdemir
- f Department of Psychiatry , Tavşanlı State Hospital , Tavşanlı, Kütahya , Turkey
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47
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Bhat NA, Sharma V, Kumar D. Prospective memory in obsessive compulsive disorder. Psychiatry Res 2018; 261:124-131. [PMID: 29294457 DOI: 10.1016/j.psychres.2017.12.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 12/05/2017] [Accepted: 12/12/2017] [Indexed: 01/01/2023]
Abstract
Studies on the nature and extent of prospective memory impairment in patients with obsessive-compulsive disorder are relatively scarce. The present study examined prospective memory in patients with obsessive-compulsive disorder in comparison to patients with schizophrenia and healthy controls. Prospective memory was assessed using Memory for Intentions Screening Test (MIST). Further, the participants were administered Delis-Kaplan Executive Function System Tower Test, Wisconsin Card Sorting Test, and Stroop Test for assessing their planning ability, mental flexibility and cognitive inhibition, respectively. Monitoring was assessed by frequency of clock checking. Results indicated that as compared to healthy controls, the patients with obsessive-compulsive disorder performed poorly on both time- and event-based prospective memory tasks, whereas, patients with schizophrenia performed poorly on time-based prospective memory task only. Further, both the patient groups had comparable performance across time- and event-based tasks. Results of error analysis indicated that patients with obsessive-compulsive disorder mainly committed no response and task substitution errors, whereas patients with schizophrenia committed no response errors. Except monitoring, none of the neurocognitive variables correlated with time or event-based prospective memory in any group. The findings are discussed in the light of their implications for retraining of prospective memory deficits in patients with obsessive-compulsive disorder and schizophrenia.
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Affiliation(s)
- Naseer Ahmad Bhat
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India.
| | - Vibha Sharma
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences, (IHBAS), Delhi 110095, India
| | - Devvarta Kumar
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore 560029, India
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Greenberg JL, Weingarden H, Reuman L, Abrams D, Mothi SS, Wilhelm S. Set shifting and visuospatial organization deficits in body dysmorphic disorder. Psychiatry Res 2018; 260:182-186. [PMID: 29202381 DOI: 10.1016/j.psychres.2017.11.062] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
Abstract
Individuals with body dysmorphic disorder (BDD) over-attend to perceived defect(s) in their physical appearance, often becoming "stuck" obsessing about perceived flaws and engaging in rituals to hide flaws. These symptoms suggest that individuals with BDD may experience deficits in underlying neurocognitive functions, such as set-shifting and visuospatial organization. These deficits have been implicated as risk and maintenance factors in disorders with similarities to BDD but have been minimally investigated in BDD. The present study examined differences in neurocognitive functions among BDD participants (n = 20) compared to healthy controls (HCs; n = 20). Participants completed neuropsychological assessments measuring set-shifting (Cambridge Neuropsychological Test Automated Battery Intra-Extra Dimensional Set Shift [IED] task) and visuospatial organization and memory (Rey-Osterrieth Complex Figure Test [ROCF]). Results revealed a set-shifting deficit among BDD participants compared to HCs on the IED. On the ROCF, BDD participants exhibited deficits in visuospatial organization compared to HCs, but they did not differ in visuospatial memory compared to HCs. Results did not change when accounting for depression severity. Findings highlight neurocognitive deficits as potential endophenotype markers of clinical features (i.e., delusionality). Understanding neuropsychological deficits may clarify similarities and differences between BDD and related disorders and may guide targets for BDD treatment.
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Affiliation(s)
- Jennifer L Greenberg
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Hilary Weingarden
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Lillian Reuman
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, Chapel Hill, 27599 NC, USA.
| | - Dylan Abrams
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Suraj S Mothi
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Sabine Wilhelm
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
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49
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Profiling Online Poker Players: Are Executive Functions Correlated with Poker Ability and Problem Gambling? J Gambl Stud 2018; 34:823-851. [PMID: 29330827 DOI: 10.1007/s10899-017-9741-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Poker playing and responsible gambling both entail the use of the executive functions (EF), which are higher-level cognitive abilities. This study investigated if online poker players of different ability showed different performances in their EF and if so, which functions were the most discriminating for their playing ability. Furthermore, it assessed if the EF performance was correlated to the quality of gambling, according to self-reported questionnaires (PGSI, SOGS, GRCS). Three poker experts evaluated anonymized poker hand history files and, then, a trained professional administered an extensive neuropsychological test battery. Data analysis determined which variables of the tests correlated with poker ability and gambling quality scores. The highest correlations between EF test results and poker ability and between EF test results and gambling quality assessment showed that mostly different clusters of executive functions characterize the profile of the strong(er) poker player and those ones of the problem gamblers (PGSI and SOGS) and the one of the cognitions related to gambling (GRCS). Taking into consideration only the variables overlapping between PGSI and SOGS, we found some key predictive factors for a more risky and harmful online poker playing: a lower performance in the emotional intelligence competences (Emotional Quotient inventory Short) and, in particular, those grouped in the Intrapersonal scale (emotional self-awareness, assertiveness, self-regard, independence and self-actualization).
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50
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Watanabe A, Nakamae T, Sakai Y, Nishida S, Abe Y, Yamada K, Yokota I, Narumoto J. The detection of white matter alterations in obsessive-compulsive disorder revealed by TRActs Constrained by UnderLying Anatomy (TRACULA). Neuropsychiatr Dis Treat 2018; 14:1635-1643. [PMID: 29950845 PMCID: PMC6016536 DOI: 10.2147/ndt.s164058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE In recent years, a large number of studies have investigated obsessive-compulsive disorder (OCD) using diffusion-weighted images (DWIs) and have reported microstructural abnormalities in various regions, mainly the corpus callosum and cingulum. In the present study, we aimed to detect microstructural changes in the white matter using whole-brain tractography. PATIENTS AND METHODS We obtained MRI data from 25 adult non-medicated OCD patients and 27 healthy controls. DWI data from MRI scans were analyzed by the automated probabilistic tractography method referred to as TRActs Constrained by UnderLying Anatomy (TRACULA). We investigated diffusivity parameters: fractional anisotropy, radial diffusivity (RD), axial diffusivity, and mean diffusivity in 18 major white matter tracts and examined indices to know which measurements in which fibers can predict the diagnosis of OCD. RESULTS Compared to healthy controls, OCD patients had significantly increased RD in the forceps major and a reduction of RD in the right cingulum angular (infracallosal) bundle. There was no correlation between these values and the clinical features. CONCLUSION We found RD alterations in the forceps major and the right cingulum angular (infracallosal) bundle, which might be associated with myelination changes in the temporal and occipital regions in OCD. Our results suggest that the pathogenesis of OCD may include abonormality of myelination status in not only the fronto-striato-thalamic circuit but also the posterior and temporal regions.
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Affiliation(s)
- Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Nakamae
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuki Sakai
- Department of Neural Computation for Decision-Making, Advanced Telecommunications Research Institute International Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - Seiji Nishida
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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