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Yu SC, Hwang TJ, Liu CM, Chan HY, Kuo CJ, Yang TT, Wang JP, Liu CC, Hsieh MH, Lin YT, Chien YL, Kuo PH, Shih YW, Yu SL, Chen HY, Chen WJ. Patients with first-episode psychosis in northern Taiwan: neurocognitive performance and niacin response profile in comparison with schizophrenia patients of different familial loadings and relationship with clinical features. BMC Psychiatry 2024; 24:155. [PMID: 38389072 PMCID: PMC10885443 DOI: 10.1186/s12888-024-05598-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Examining patients with first-episode psychosis (FEP) provides opportunities to better understand the mechanism underlying these illnesses. By incorporating quantitative measures in FEP patients, we aimed to (1) determine the baseline distribution of clinical features; (2) examine the impairment magnitude of the quantitative measures by comparing with external controls and then the counterparts of schizophrenia patients of different familial loadings; and (3) evaluate whether these quantitative measures were associated with the baseline clinical features. METHODS Patients with FEP were recruited from one medical center, two regional psychiatric centers, and two private clinics in northern Taiwan with clinical features rated using the Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance (PSP) scale. Quantitative measurements included the Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), niacin response abnormality (NRA), and minor physical anomalies and craniofacial features (MPAs). To evaluate the relative performance of the quantitative measures in our FEP patients, four external comparison groups from previous studies were used, including three independent healthy controls for the CPT, WCST, and NRA, respectively, and one group of treatment-resistant schizophrenia patients for the MPAs. Additionally, patients from simplex families and patients from multiplex families were used to assess the magnitude of FEP patients' impairment on the CPT, WCST, and NRA. RESULTS Among the 80 patients with FEP recruited in this study (58% female, mean age = 25.6 years, mean duration of untreated psychosis = 132 days), the clinical severity was mild to moderate (mean PANSS score = 67.3; mean PSP score = 61.8). Patients exhibited both neurocognitive and niacin response impairments (mean Z-scores: -1.24 for NRA, - 1.06 for undegraded d', - 0.70 for degraded d', - 0.32 for categories achieved, and 0.44 for perseverative errors) but did not show MPAs indicative of treatment resistance. Among these quantitative measures, three of the four neurocognitive indices were correlated with the baseline clinical features, whereas NRA did not show such correlation. CONCLUSIONS This FEP study of Taiwanese patients revealed the presence of neurocognitive performance and niacin response and their different relationships with clinical features, rendering this sample useful for future follow-up and incorporation of multiomics investigation.
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Affiliation(s)
- Shun-Chun Yu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | | | - Chian-Jue Kuo
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tsung-Tsair Yang
- Department of Social Psychology, Shih Hsin University, Taipei, Taiwan
| | | | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Ya-Wen Shih
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sung-Liang Yu
- Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsuan-Yu Chen
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Centers for Genomic and Precision Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
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Türközer HB, Ivleva EI, Palka J, Clementz BA, Shafee R, Pearlson GD, Sweeney JA, Keshavan MS, Gershon ES, Tamminga CA. Biomarker Profiles in Psychosis Risk Groups Within Unaffected Relatives Based on Familiality and Age. Schizophr Bull 2021; 47:1058-1067. [PMID: 33693883 PMCID: PMC8266584 DOI: 10.1093/schbul/sbab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Investigating biomarkers in unaffected relatives (UR) of individuals with psychotic disorders has already proven productive in research on psychosis neurobiology. However, there is considerable heterogeneity among UR based on features linked to psychosis vulnerability. Here, using the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) dataset, we examined cognitive and neurophysiologic biomarkers in first-degree UR of psychosis probands, stratified by 2 widely used risk factors: familiality status of the respective proband (the presence or absence of a first- or second-degree relative with a history of psychotic disorder) and age (within or older than the common age range for developing psychosis). We investigated biomarkers that best differentiate the above specific risk subgroups. Additionally, we examined the relationship of biomarkers with Polygenic Risk Scores for Schizophrenia (PRSSCZ) in a subsample of Caucasian probands and healthy controls (HC). Our results demonstrate that the Brief Assessment of Cognition in Schizophrenia (BACS) score, antisaccade error (ASE) factor, and stop-signal task (SST) factor best differentiate UR (n = 169) from HC (n = 137) (P = .013). Biomarker profiles of UR of familial (n = 82) and non-familial (n = 83) probands were not significantly different. Furthermore, ASE and SST factors best differentiated younger UR (age ≤ 30) (n = 59) from older UR (n = 110) and HC from both age groups (age ≤ 30 years, n=49; age > 30 years, n = 88) (P < .001). In addition, BACS (r = -0.175, P = .006) and ASE factor (r = 0.188, P = .006) showed associations with PRSSCZ. Taken together, our findings indicate that cognitive biomarkers-"top-down inhibition" impairments in particular-may be of critical importance as indicators of psychosis vulnerability.
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Affiliation(s)
- Halide Bilge Türközer
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Elena I Ivleva
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Jayme Palka
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
| | - Brett A Clementz
- Department of Psychology and Neuroscience, Bio-Imaging Research Center, University of Georgia, Athens, GA
| | - Rebecca Shafee
- Department of Genetics, Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT
- Departments of Psychiatry and Neuroscience, Yale University, New Haven, CT
| | - John A Sweeney
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH
| | - Matcheri S Keshavan
- Department of Psychiatry and Cognitive Neurology, Beth Israel Deaconess Medical Center, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Carol A Tamminga
- Department of Psychiatry, the University of Texas Southwestern Medical Center, Dallas, TX
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Kataoka Y, Shimada T, Koide Y, Okubo H, Uehara T, Shioiri T, Kawasaki Y, Ohi K. Differences in executive function among patients with schizophrenia, their unaffected first-degree relatives and healthy participants. Int J Neuropsychopharmacol 2020; 23:pyaa052. [PMID: 32692837 PMCID: PMC7745249 DOI: 10.1093/ijnp/pyaa052] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/26/2020] [Accepted: 07/15/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Patients with schizophrenia (SCZ) display impaired executive functions compared with healthy controls (HCs). Furthermore, unaffected first-degree relatives (FRs) of patients with SCZ independently perform worse executive functions than do HCs. However, few studies have investigated the differences in executive functions assessed among patients with SCZ, FRs, and HCs, and the findings are inconsistent. METHODS We investigated diagnostic differences in executive functions, namely, (i) numbers of categories achieved (CA), (ii) total errors (TE) and (iii) %perseverative errors of Nelson types (%PEN), using the Wisconsin card sorting test (WCST) among patients with SCZ (n=116), unaffected FRs (n=62) and HCs (n=146) at a single institute. Correlations between these executive functions and clinical variables were investigated. RESULTS Significant differences existed in all executive functions among diagnostic groups (CA, F2,319=15.5, p=3.71×10-7; TE, F2,319=16.2, p=2.06×10-7; and %PEN, F2,319=21.3, p=2.15×10-9). Patients with SCZ had fewer CA and more TE and %PEN than those of HCs (CA, Cohen's d=-0.70, p=5.49×10-8; TE, d=0.70, p=5.62×10-8; and %PEN, d=0.82, p=2.85×10-10) and FRs (TE, d=0.46, p=3.73×10-3 and %PEN, d=0.38, p=0.017). Of the three executive functions, CA and %PEN of FRs were intermediately impaired between patients with SCZ and HCs (CA, d=-0.41, p=0.011 and %PEN, d=0.41, p=0.012). In contrast, no significant difference in TE existed between FRs and HCs (d=0.22, p=0.18). Although CA and TE were affected by the duration of illness (p<0.017), %PEN was not affected by any clinical variable in patients with SCZ (p>0.017). CONCLUSIONS Executive function, particularly %PEN, could be a useful intermediate phenotype for understanding the genetic mechanisms implicated in SCZ pathophysiology.
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Affiliation(s)
- Yuzuru Kataoka
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Takamitsu Shimada
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Yoko Koide
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Hiroaki Okubo
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Takashi Uehara
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Toshiki Shioiri
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasuhiro Kawasaki
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
| | - Kazutaka Ohi
- Department of Neuropsychiatry, Kanazawa Medical University, Ishikawa, Japan
- Department of Psychiatry and Psychotherapy, Gifu University Graduate School of Medicine, Gifu, Japan
- Department of General Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
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Zouraraki C, Karagiannopoulou L, Karamaouna P, Pallis EG, Giakoumaki SG. Schizotypal traits, neurocognition, and paternal age in unaffected first degree relatives of patients with familial or sporadic schizophrenia. Psychiatry Res 2019; 273:422-429. [PMID: 30684787 DOI: 10.1016/j.psychres.2018.12.142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022]
Abstract
Studies comparing cognitive processes between familial and sporadic schizophrenia have yielded inconsistent findings. In this study we examined differences in neurocognition and schizotypal traits in unaffected relatives of schizophrenia-spectrum patients with either the familial (multiplex) or the sporadic (simplex) subtype of the disorder, taking paternal age at birth into consideration. Simplex (n = 65; SR), multiplex (n = 35; MR) relatives and controls (n = 114) were compared on several cognitive functions and schizotypal traits; between-group differences were evaluated with and without including paternal age in the analyses. SR and MR had higher negative and paranoid traits compared with controls, but paternal age abolished the differences between the SR and control groups. When taking into account schizotypal traits and participants' age, controls outperformed MR in strategy formation and set-shifting and SR in psychomotor speed, set-shifting and executive working memory. After including paternal age in the analyses, controls outperformed MR in strategy formation, working memory and executive working memory and both groups in psychomotor speed and set-shifting. These findings suggest that multiplex relatives present with a "riskier" personality and cognitive profile when considering the effects of paternal age. Nevertheless, simplex relatives are impaired in fundamental cognitive processes, thus highlighting the detrimental effects of paternal age on neurocognition.
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Affiliation(s)
- Chrysoula Zouraraki
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece.
| | - Leda Karagiannopoulou
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Penny Karamaouna
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
| | - Eleftherios G Pallis
- Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Stella G Giakoumaki
- Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno 74100, Crete, Greece
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5
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Blakey R, Ranlund S, Zartaloudi E, Cahn W, Calafato S, Colizzi M, Crespo-Facorro B, Daniel C, Díez-Revuelta Á, Di Forti M, Iyegbe C, Jablensky A, Jones R, Hall MH, Kahn R, Kalaydjieva L, Kravariti E, Lin K, McDonald C, McIntosh AM, Picchioni M, Powell J, Presman A, Rujescu D, Schulze K, Shaikh M, Thygesen JH, Toulopoulou T, Van Haren N, Van Os J, Walshe M, Murray RM, Bramon E. Associations between psychosis endophenotypes across brain functional, structural, and cognitive domains. Psychol Med 2018; 48:1325-1340. [PMID: 29094675 PMCID: PMC6516747 DOI: 10.1017/s0033291717002860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND A range of endophenotypes characterise psychosis, however there has been limited work understanding if and how they are inter-related. METHODS This multi-centre study includes 8754 participants: 2212 people with a psychotic disorder, 1487 unaffected relatives of probands, and 5055 healthy controls. We investigated cognition [digit span (N = 3127), block design (N = 5491), and the Rey Auditory Verbal Learning Test (N = 3543)], electrophysiology [P300 amplitude and latency (N = 1102)], and neuroanatomy [lateral ventricular volume (N = 1721)]. We used linear regression to assess the interrelationships between endophenotypes. RESULTS The P300 amplitude and latency were not associated (regression coef. -0.06, 95% CI -0.12 to 0.01, p = 0.060), and P300 amplitude was positively associated with block design (coef. 0.19, 95% CI 0.10-0.28, p 0.38). All the cognitive endophenotypes were associated with each other in the expected directions (all p < 0.001). Lastly, the relationships between pairs of endophenotypes were consistent in all three participant groups, differing for some of the cognitive pairings only in the strengths of the relationships. CONCLUSIONS The P300 amplitude and latency are independent endophenotypes; the former indexing spatial visualisation and working memory, and the latter is hypothesised to index basic processing speed. Individuals with psychotic illnesses, their unaffected relatives, and healthy controls all show similar patterns of associations between endophenotypes, endorsing the theory of a continuum of psychosis liability across the population.
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Affiliation(s)
- R. Blakey
- Division of Psychiatry, University College London, London, UK
| | - S. Ranlund
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Zartaloudi
- Division of Psychiatry, University College London, London, UK
| | - W. Cahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S. Calafato
- Division of Psychiatry, University College London, London, UK
| | - M. Colizzi
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - B. Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of Medicine, University of Cantabria–IDIVAL, Santander, Spain
| | - C. Daniel
- Division of Psychiatry, University College London, London, UK
| | - Á. Díez-Revuelta
- Division of Psychiatry, University College London, London, UK
- Laboratory of Cognitive and Computational Neuroscience – Centre for Biomedical Technology (CTB), Complutense University and Technical University of Madrid, Madrid, Spain
| | - M. Di Forti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - C. Iyegbe
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Jablensky
- Centre for Clinical Research in Neuropsychiatry, The University of Western Australia, Perth, Western Australia, Australia
| | - R. Jones
- Division of Psychiatry, University College London, London, UK
| | - M.-H. Hall
- Psychology Research Laboratory, Harvard Medical School, McLean Hospital, Belmont, MA, USA
| | - R. Kahn
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L. Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical Research, The University of Western Australia, Perth, Australia
| | - E. Kravariti
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - K. Lin
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - C. McDonald
- Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Ireland
| | - A. M. McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | | | - M. Picchioni
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - J. Powell
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - A. Presman
- Division of Psychiatry, University College London, London, UK
| | - D. Rujescu
- Department of Psychiatry, Ludwig-Maximilians University of Munich, Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle Wittenberg, Halle, Germany
| | - K. Schulze
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - M. Shaikh
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- North East London Foundation Trust, London, UK
| | - J. H. Thygesen
- Division of Psychiatry, University College London, London, UK
| | - T. Toulopoulou
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychology, Bilkent University, Main Campus, Bilkent, Ankara, Turkey
- Department of Psychology, the University of Hong Kong, Pokfulam Rd, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, The Hong Kong Jockey Club Building for Interdisciplinary Research, Hong Kong SAR, China
| | - N. Van Haren
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J. Van Os
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, EURON, Maastricht, The Netherlands
| | - M. Walshe
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | | | - R. M. Murray
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Bramon
- Division of Psychiatry, University College London, London, UK
- Institute of Psychiatry Psychology and Neuroscience at King’s College London and South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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6
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Ranlund S, Calafato S, Thygesen JH, Lin K, Cahn W, Crespo‐Facorro B, de Zwarte SM, Díez Á, Di Forti M, Iyegbe C, Jablensky A, Jones R, Hall M, Kahn R, Kalaydjieva L, Kravariti E, McDonald C, McIntosh AM, McQuillin A, Picchioni M, Prata DP, Rujescu D, Schulze K, Shaikh M, Toulopoulou T, van Haren N, van Os J, Vassos E, Walshe M, Lewis C, Murray RM, Powell J, Bramon E. A polygenic risk score analysis of psychosis endophenotypes across brain functional, structural, and cognitive domains. Am J Med Genet B Neuropsychiatr Genet 2018; 177:21-34. [PMID: 28851104 PMCID: PMC5763362 DOI: 10.1002/ajmg.b.32581] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/24/2017] [Indexed: 12/26/2022]
Abstract
This large multi-center study investigates the relationships between genetic risk for schizophrenia and bipolar disorder, and multi-modal endophenotypes for psychosis. The sample included 4,242 individuals; 1,087 patients with psychosis, 822 unaffected first-degree relatives of patients, and 2,333 controls. Endophenotypes included the P300 event-related potential (N = 515), lateral ventricular volume (N = 798), and the cognitive measures block design (N = 3,089), digit span (N = 1,437), and the Ray Auditory Verbal Learning Task (N = 2,406). Data were collected across 11 sites in Europe and Australia; all genotyping and genetic analyses were done at the same laboratory in the United Kingdom. We calculated polygenic risk scores for schizophrenia and bipolar disorder separately, and used linear regression to test whether polygenic scores influenced the endophenotypes. Results showed that higher polygenic scores for schizophrenia were associated with poorer performance on the block design task and explained 0.2% (p = 0.009) of the variance. Associations in the same direction were found for bipolar disorder scores, but this was not statistically significant at the 1% level (p = 0.02). The schizophrenia score explained 0.4% of variance in lateral ventricular volumes, the largest across all phenotypes examined, although this was not significant (p = 0.063). None of the remaining associations reached significance after correction for multiple testing (with alpha at 1%). These results indicate that common genetic variants associated with schizophrenia predict performance in spatial visualization, providing additional evidence that this measure is an endophenotype for the disorder with shared genetic risk variants. The use of endophenotypes such as this will help to characterize the effects of common genetic variation in psychosis.
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Affiliation(s)
- Siri Ranlund
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | | | - Kuang Lin
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Wiepke Cahn
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Benedicto Crespo‐Facorro
- CIBERSAMCentro Investigación Biomédica en Red Salud MentalMadridSpain
- Department of Psychiatry, University Hospital Marqués de Valdecilla, School of MedicineUniversity of Cantabria–IDIVALSantanderSpain
| | - Sonja M.C. de Zwarte
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Álvaro Díez
- Division of PsychiatryUniversity College LondonLondonUK
- Laboratory of Cognitive and Computational Neuroscience—Centre for Biomedical Technology (CTB)Complutense University and Technical University of MadridMadridSpain
| | - Marta Di Forti
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | - Conrad Iyegbe
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Assen Jablensky
- Centre for Clinical Research in NeuropsychiatryThe University of Western AustraliaPerth, Western AustraliaAustralia
| | - Rebecca Jones
- Division of PsychiatryUniversity College LondonLondonUK
| | - Mei‐Hua Hall
- Psychosis Neurobiology Laboratory, Harvard Medical SchoolMcLean HospitalBelmontMassachusetts
| | - Rene Kahn
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Luba Kalaydjieva
- Harry Perkins Institute of Medical Research and Centre for Medical ResearchThe University of Western AustraliaPerthAustralia
| | - Eugenia Kravariti
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Colm McDonald
- The Centre for Neuroimaging & Cognitive Genomics (NICOG) and NCBES Galway Neuroscience CentreNational University of Ireland GalwayGalwayIreland
| | - Andrew M. McIntosh
- Division of Psychiatry, University of EdinburghRoyal Edinburgh HospitalEdinburghUK
- Centre for Cognitive Ageing and Cognitive EpidemiologyUniversity of EdinburghEdinburghUK
| | | | | | - Marco Picchioni
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Diana P. Prata
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Faculdade de Medicina, Instituto de Medicina MolecularUniversidade de LisboaPortugal
| | - Dan Rujescu
- Department of PsychiatryLudwig‐Maximilians University of MunichMunichGermany
- Department of Psychiatry, Psychotherapy and PsychosomaticsUniversity of Halle WittenbergHalleGermany
| | - Katja Schulze
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Madiha Shaikh
- North East London Foundation TrustLondonUK
- Research Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
| | - Timothea Toulopoulou
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Department of Psychology, Bilkent UniversityMain CampusBilkent, AnkaraTurkey
- Department of PsychologyThe University of Hong Kong, Pokfulam RdHong Kong SARChina
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong KongThe Hong Kong Jockey Club Building for Interdisciplinary ResearchHong Kong SARChina
| | - Neeltje van Haren
- Department of Psychiatry, Brain Centre Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jim van Os
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Department of Psychiatry and Psychology, Maastricht University Medical CentreEURONMaastrichtThe Netherlands
| | - Evangelos Vassos
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Muriel Walshe
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | | | - Cathryn Lewis
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Robin M. Murray
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - John Powell
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
| | - Elvira Bramon
- Division of PsychiatryUniversity College LondonLondonUK
- Institute of Psychiatry Psychology and Neuroscience at King's College London and South LondonMaudsley NHS Foundation TrustLondonUK
- Institute of Cognitive NeuroscienceUniversity College LondonLondonUK
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7
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Zhang Z, Zhang R, Qin P, Tan L. Cognitive dysfunction and negative symptoms in patients with schizophrenia and their first-degree relatives from simplex and multiplex families. Neuropsychiatr Dis Treat 2018; 14:3339-3348. [PMID: 30584307 PMCID: PMC6287416 DOI: 10.2147/ndt.s179534] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to investigate cognitive functioning, negative symptoms, and the relationships in schizophrenia (SP) pedigrees and to explore the effect of genetic loading on those endophenotypes. PATIENTS AND METHODS Forty-four patients with SP, 81 first-degree non-psychotic relatives of patients from simplex and multiplex families, 14 matched control probands, and 29 first-degree relatives of the patients from communities were assessed by the vocabulary subtest (VS) of Wechsler Adult Intelligence Scale, memory span subtests of the Multiple Memory Assessment Scale (MMAS), Wisconsin Card Sorting Test (WCST), Continuous Performance Test (CPT), and Negative Scale of Positive and Negative Syndrome Scale. RESULTS Compared with controls, patients with SP and their relatives had worse performances in WCST and CPT, and more serious negative symptoms. Patients from multiple families performed poorly on most tests while patients from simplex families had impairments only on the parameters of CPT and WSCT as compared to control probands. Patients from multiple families differed significantly from the patients from simplex families in the digit span and word span of MMAS. After controlling for education, in comparison with relatives of control probands, relatives from multiple families showed impairments in VS, multiple domains of CPT, whereas relatives from simplex families had lower scores on the VS and more total cards and random errors in WSCT. The performances of most tests were linked to negative symptoms in patients with SP. For patients with SP, VS, correct numbers and categories in the WCST, and visual and acoustic errors in the CPT predicted 68.8% of the variability in negative symptoms. CONCLUSION Our findings support that cognitive deficits and negative symptoms may be markers of hereditary susceptibility of SP and aggravate as the degree of genetic load increases. There are certain relationships between cognitive deficits and negative symptoms in patients with SP.
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Affiliation(s)
- Zhikun Zhang
- Mental Health Center, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Rong Zhang
- Department of Psychiatry, Staff Hospital of Zhongyuan Oil Field Company, Puyang, Henan, China
| | - Peng Qin
- Department of Psychiatry, Changde Rehabilitation Hospital, Changde, Hunan, China
| | - Liwen Tan
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China,
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8
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Martin DM, McClintock SM, Forster JJ, Lo TY, Loo CK. Cognitive enhancing effects of rTMS administered to the prefrontal cortex in patients with depression: A systematic review and meta-analysis of individual task effects. Depress Anxiety 2017; 34:1029-1039. [PMID: 28543994 DOI: 10.1002/da.22658] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 03/31/2017] [Accepted: 04/23/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is an approved therapeutic treatment of major depressive disorder and has increasing clinical use throughout the world. However, it remains unclear whether an rTMS course for depression may also produce cognitive enhancement. In a recent meta-analysis of sham-controlled randomized controlled studies (RCTs) conducted in patients with neuropsychiatric conditions, no evidence was found for generalized cognitive enhancing effects across cognitive domains with active compared to sham rTMS. Notwithstanding, there remains the possibility of cognitive effects following an rTMS course that are more highly specific, for example, in specific clinical conditions, or at the individual task level. This study aimed to determine whether a therapeutic rTMS course in patients with depression is associated with cognitive enhancing effects at the task level. METHODS A systematic review and meta-analysis of outcomes on individual neuropsychological tasks from sham-controlled RCTs where an rTMS course was administered to the dorsolateral prefrontal cortex (DLPFC) in patients with depression. RESULTS Eighteen studies met the inclusion criteria. Active rTMS treatment showed no specific enhancing effects on the majority of cognitive tasks. Modest effect size improvements with active compared to sham rTMS treatment were found for performance on the Trail Making Test Parts A (g = 0.28, 95% CI = 0.06-0.50) and B (g = 0.26, 95% CI = 0.06-0.47). CONCLUSION A therapeutic rTMS course administered to the prefrontal cortex for depression may produce modest cognitive enhancing effects specific to psychomotor speed, visual scanning, and set-shifting ability.
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Affiliation(s)
- Donel M Martin
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Shawn M McClintock
- Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jane J Forster
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Tin Yan Lo
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Colleen K Loo
- School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia
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9
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Abstract
OBJECTIVES Social cognitive deficits have been discussed to be endophenotypes for schizophrenia and other serious mental illnesses. The current study aimed to assess emotional intelligence (EI) in unaffected siblings of schizophrenia patients to investigate its potential role as endophenotype for schizophrenia. METHODS EI was measured in 56 schizophrenia patients, 57 unaffected siblings, and 127 healthy control subjects by using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). In addition, non-social cognition was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS). Linear mixed models with compound symmetric correlation structure were used for of the three groups with respect to EI and non-social cognition. RESULTS Schizophrenia patients showed significantly lower overall EI and performed significantly worse in three out of four MSCEIT branches compared to unaffected siblings and control subjects, whereas the two latter groups had comparable EI levels. Similar performance patterns (patients<unaffected siblings=control subjects) were found with respect to non-social cognition. Solely in the "Tower of London" test, siblings achieved significantly lower task scores compared to control subjects. CONCLUSIONS Based on our results, EI as measured with the MSCEIT does not seem to represent a marker of risk for schizophrenia. Further investigations should concentrate on other EI measures to reassess this finding. (JINS, 2017, 23, 577-583).
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10
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Dynamic brain network reconfiguration as a potential schizophrenia genetic risk mechanism modulated by NMDA receptor function. Proc Natl Acad Sci U S A 2016; 113:12568-12573. [PMID: 27791105 DOI: 10.1073/pnas.1608819113] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Schizophrenia is increasingly recognized as a disorder of distributed neural dynamics, but the molecular and genetic contributions are poorly understood. Recent work highlights a role for altered N-methyl-d-aspartate (NMDA) receptor signaling and related impairments in the excitation-inhibitory balance and synchrony of large-scale neural networks. Here, we combined a pharmacological intervention with novel techniques from dynamic network neuroscience applied to functional magnetic resonance imaging (fMRI) to identify alterations in the dynamic reconfiguration of brain networks related to schizophrenia genetic risk and NMDA receptor hypofunction. We quantified "network flexibility," a measure of the dynamic reconfiguration of the community structure of time-variant brain networks during working memory performance. Comparing 28 patients with schizophrenia, 37 unaffected first-degree relatives, and 139 healthy controls, we detected significant differences in network flexibility [F(2,196) = 6.541, P = 0.002] in a pattern consistent with the assumed genetic risk load of the groups (highest for patients, intermediate for relatives, and lowest for controls). In an observer-blinded, placebo-controlled, randomized, cross-over pharmacological challenge study in 37 healthy controls, we further detected a significant increase in network flexibility as a result of NMDA receptor antagonism with 120 mg dextromethorphan [F(1,34) = 5.291, P = 0.028]. Our results identify a potential dynamic network intermediate phenotype related to the genetic liability for schizophrenia that manifests as altered reconfiguration of brain networks during working memory. The phenotype appears to be influenced by NMDA receptor antagonism, consistent with a critical role for glutamate in the temporal coordination of neural networks and the pathophysiology of schizophrenia.
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11
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Liang S, Deng W, Wang Q, Ma X, Li M, Brown MRG, Hu X, Li X, Greenshaw AJ, Li T. Performance of Verbal Fluency as an Endophenotype in Patients with Familial versus Sporadic Schizophrenia and Their Parents. Sci Rep 2016; 6:32597. [PMID: 27581658 PMCID: PMC5007652 DOI: 10.1038/srep32597] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
What’s the neurocognitive deficit as an endophenotype to familial schizophrenia? Here, we investigate the neurocognitive endophenotype in first-episode patients with familial schizophrenia (FS) and sporadic schizophrenia (SS), and their parents. 98 FS patients and their 105 parents; 190 SS patients and their 207 parents; 195 controls matched with patients, and 190 controls matched with the patients’ parents, were assessed with the short version of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), the immediate and delayed logical memory tests from the Wechsler Memory Scale-Revised in China (WMS-RC), the Verbal Fluency Test (VFT), the Trail Making Test Parts A and B-Modified (TMA, TMB-M), and the Modified Wisconsin Card Sorting Test (WCST-M). The results showed that with age, gender, and education as covariates, after controlling for false discovery rates, the FS group and their parent group performed worse than the SS group and their parent group on VFT. No significant differences were found for other neurocognitive tests between the FS and SS patient groups, and their respective parent groups. Our findings suggest the patients with familial and sporadic schizophrenia and their respective parent groups may have a different genetic predisposition in relation to a cognitive endophenotype.
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Affiliation(s)
- Sugai Liang
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Deng
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaohong Ma
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Mingli Li
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Matthew R G Brown
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Xun Hu
- Huaxi Biobank, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xinmin Li
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Tao Li
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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12
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Tamminga CA, Pearlson GD, Stan AD, Gibbons RD, Padmanabhan J, Keshavan M, Clementz BA. Strategies for Advancing Disease Definition Using Biomarkers and Genetics: The Bipolar and Schizophrenia Network for Intermediate Phenotypes. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2016; 2:20-27. [PMID: 29560884 DOI: 10.1016/j.bpsc.2016.07.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/22/2016] [Accepted: 07/01/2016] [Indexed: 10/21/2022]
Abstract
It is critical for psychiatry as a field to develop approaches to define the molecular, cellular, and circuit basis of its brain diseases, especially for serious mental illnesses, and then to use these definitions to generate biologically based disease categories, as well as to explore disease mechanisms and illness etiologies. Our current reliance on phenomenology is inadequate to support exploration of molecular treatment targets and disease formulations, and the leap directly from phenomenology to disease biology has been limiting because of broad heterogeneity within conventional diagnoses. The questions addressed in this review are formulated around how we can use brain biomarkers to achieve disease categories that are biologically based. We have grouped together a series of vignettes as examples of early approaches, all using the Bipolar and Schizophrenia Network on Intermediate Phenotypes (BSNIP) biomarker database and collaborators, starting off with describing the foundational statistical methods for these goals. We use primarily criterion-free statistics to identify pertinent groups of involved genes related to psychosis as well as symptoms, and finally, to create new biologically based disease cohorts within the psychopathological dimension of psychosis. Although we do not put these results forward as final formulations, they represent a novel effort to rely minimally on phenomenology as a diagnostic tool and to fully embrace brain characteristics of structure, as well as molecular and cellular characteristics and function, to support disease definition in psychosis.
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Affiliation(s)
- Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical School, Dallas, Texas.
| | | | - Ana D Stan
- Department of Psychiatry, UT Southwestern Medical School, Dallas, Texas
| | - Robert D Gibbons
- Center for Health Statistics, University of Chicago School of Medicine, Chicago, Illinois
| | - Jaya Padmanabhan
- Department of Psychiatry, Beth Israel and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Brett A Clementz
- Department of Psychology, University of Georgia, Athens, Georgia
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13
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Tsang J, Fullard JF, Giakoumaki SG, Katsel P, Katsel P, Karagiorga VE, Greenwood TA, Braff DL, Siever LJ, Bitsios P, Haroutunian V, Roussos P. The relationship between dopamine receptor D1 and cognitive performance. NPJ SCHIZOPHRENIA 2015; 1:14002. [PMID: 27336024 PMCID: PMC4849437 DOI: 10.1038/npjschz.2014.2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cognitive impairment cuts across traditional diagnostic boundaries and is one of the most typical symptoms in various psychiatric and neurobiological disorders. AIMS The objective of this study was to examine the genetic association between 94 candidate genes, including receptors and enzymes that participate in neurotransmission, with measures of cognition. METHODS The Clinical Dementia Rating (CDR), a global measure of cognition, and genotypes derived from a custom array of 1,536 single-nucleotide polymorphisms (SNPs) in 94 genes were available for a large postmortem cohort of Caucasian cases with Alzheimer's disease (AD), schizophrenia and controls (n=727). A cohort of healthy young males (n=1,493) originating from the LOGOS project (Learning On Genetics Of Schizophrenia Spectrum) profiled across multiple cognitive domains was available for targeted SNP genotyping. Gene expression was quantified in the superior temporal gyrus of control samples (n=109). The regulatory effect on transcriptional activity was assessed using the luciferase reporter system. RESULTS The rs5326-A allele at the promoter region of dopamine receptor D1 (DRD1) locus was associated with: (i) poorer cognition (higher CDR) in the postmortem cohort (P=9.325×10(-4)); (ii) worse cognitive performance relevant to strategic planning in the LOGOS cohort (P=0.008); (iii) lower DRD1 gene expression in the superior temporal gyrus of controls (P=0.038); and (iv) decreased transcriptional activity in human neuroblastoma (SH-SY5Y) cells (P=0.026). CONCLUSIONS An interdisciplinary approach combining genetics with cognitive and molecular neuroscience provided a possible mechanistic link among DRD1 and alterations in cognitive performance.
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Affiliation(s)
- Jonathan Tsang
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John F Fullard
- Department of Psychiatry, New York, NY, USA
- Friedman Brain Institute, New York, NY, USA
| | | | | | | | | | | | - David L Braff
- Department of Psychiatry, University of California, San Diego, CA, USA
- VISN-22 Mental Illness Research, Education, and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
| | - Larry J Siever
- Department of Psychiatry, New York, NY, USA
- James J. Peters VA Medical Center, Mental Illness Research Education and Clinical Center (MIRECC), 130 West Kingsbridge Road, Bronx, NY, USA
| | - Panos Bitsios
- Department of Psychiatry, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
- Computational Medicine Laboratory, Institute of Computer Science at FORTH, Heraklion, Greece
| | - Vahram Haroutunian
- Department of Psychiatry, New York, NY, USA
- Friedman Brain Institute, New York, NY, USA
- James J. Peters VA Medical Center, Mental Illness Research Education and Clinical Center (MIRECC), 130 West Kingsbridge Road, Bronx, NY, USA
| | - Panos Roussos
- Department of Psychiatry, New York, NY, USA
- Friedman Brain Institute, New York, NY, USA
- James J. Peters VA Medical Center, Mental Illness Research Education and Clinical Center (MIRECC), 130 West Kingsbridge Road, Bronx, NY, USA
- Department of Genetics and Genomic Sciences, New York, NY, USA
- Institute for Genomics and Multiscale Biology, New York, NY, USA
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14
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Lam M, Collinson SL, Eng GK, Rapisarda A, Kraus M, Lee J, Chong SA, Keefe RSE. Refining the latent structure of neuropsychological performance in schizophrenia. Psychol Med 2014; 44:3557-3570. [PMID: 25066336 DOI: 10.1017/s0033291714001020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Elucidating the cognitive architecture of schizophrenia promises to advance understanding of the clinical and biological substrates of the illness. Traditional cross-sectional neuropsychological approaches differentiate impaired from normal cognitive abilities but are limited in their ability to determine latent substructure. The current study examined the latent architecture of abnormal cognition in schizophrenia via a systematic approach. METHOD Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were carried out on a large neuropsychological dataset including the Brief Assessment of Cognition in Schizophrenia, Continuous Performance Test, Wisconsin Card Sorting Test, Benton Judgment of Line Orientation Test, and Wechsler Abbreviated Scale of Intelligence matrix reasoning derived from 1012 English-speaking ethnic Chinese healthy controls and 707 schizophrenia cases recruited from in- and out-patient clinics. RESULTS An initial six-factor model fit cognitive data in healthy and schizophrenia subjects. Further modeling, which accounted for methodological variance between tests, resulted in a three-factor model of executive functioning, vigilance/speed of processing and memory that appeared to best discriminate schizophrenia cases from controls. Factor analytic-derived g estimands and conventionally calculated g showed similar case-control discrimination. However, agreement analysis suggested systematic differences between both g indices. CONCLUSIONS Factor structures derived in the current study were broadly similar to those reported previously. However, factor structures between schizophrenia subjects and healthy controls were different. Roles of factor analytic-derived g estimands and conventional composite score g were further discussed. Cognitive structures underlying cognitive deficits in schizophrenia may prove useful for interrogating biological substrates and enriching effect sizes for subsequent work.
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Affiliation(s)
- M Lam
- Research Division,Institute of Mental Health,Singapore
| | - S L Collinson
- Department of Psychology,National University of Singapore,Singapore
| | - G K Eng
- Research Division,Institute of Mental Health,Singapore
| | - A Rapisarda
- Research Division,Institute of Mental Health,Singapore
| | - M Kraus
- Department of Psychiatry and Behavioral Sciences,Duke University Medical Center,Durham, NC,USA
| | - J Lee
- Research Division,Institute of Mental Health,Singapore
| | - S A Chong
- Research Division,Institute of Mental Health,Singapore
| | - R S E Keefe
- Department of Psychiatry and Behavioral Sciences,Duke University Medical Center,Durham, NC,USA
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15
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Koiliari E, Roussos P, Pasparakis E, Lencz T, Malhotra A, Siever LJ, Giakoumaki SG, Bitsios P. The CSMD1 genome-wide associated schizophrenia risk variant rs10503253 affects general cognitive ability and executive function in healthy males. Schizophr Res 2014; 154:42-7. [PMID: 24630139 DOI: 10.1016/j.schres.2014.02.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 01/24/2014] [Accepted: 02/17/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND The single-nucleotide polymorphism (SNP) rs10503253, located within the CUB and Sushi multiple domains-1 (CSMD1) gene on 8p23.2, has reached genome-wide support as a risk factor for schizophrenia. There is initial but inconclusive evidence for a role of this variant in aspects of cognition. METHODS We investigated the neurocognitive effects of the CSMD1 rs10503253 (C/A) polymorphism in a large, demographically homogeneous sample of young, healthy Greek Caucasian males (n=1149) phenotyped for a wide range of neuropsychological measures, most of which have been shown to be reliable endophenotypes for schizophrenia. RESULTS The risk 'A' allele was associated with poorer performance on measures of general cognitive ability, strategy formation, spatial and visual working memory, set shifting, target detection and planning for problem solving but not for emotional decision making. Most of these effects were dependent on risk "A" allele dose, with AA and CC homozygotes being the worse and the best respectively, while CA individuals were intermediate. Potential genotype effects in Stroop and verbal memory performance were also suggested by our dataset. DISCUSSION These results underline the relevance of the risk "A" allele to neurocognitive functioning and suggest that its detrimental effects on cognition, may be part of the mechanism by which the CSMD1 mediates risk for schizophrenia.
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Affiliation(s)
- Erasmia Koiliari
- Department of Psychiatry, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Panos Roussos
- Department of Psychiatry, Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Science, Institute for Multiscale Biology, Mount Sinai, New York, NY, USA; Mental Illness Research, Education, and Clinical Center (VISN 3), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Emmanouil Pasparakis
- Department of Psychiatry, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Todd Lencz
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA; Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Anil Malhotra
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA; Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Larry J Siever
- Department of Psychiatry, Mount Sinai, New York, NY, USA; Mental Illness Research, Education, and Clinical Center (VISN 3), James J. Peters VA Medical Center, Bronx, NY, USA
| | | | - Panos Bitsios
- Department of Psychiatry, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
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16
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Velligan D, Mintz J, Maples N, Xueying L, Gajewski S, Carr H, Sierra C. A randomized trial comparing in person and electronic interventions for improving adherence to oral medications in schizophrenia. Schizophr Bull 2013; 39:999-1007. [PMID: 23086987 PMCID: PMC3756784 DOI: 10.1093/schbul/sbs116] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed.
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17
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Lin SH, Liu CM, Hwang TJ, Hsieh MH, Hsiao PC, Faraone SV, Tsuang MT, Hwu HG, Chen WJ. Performance on the Wisconsin Card Sorting Test in families of schizophrenia patients with different familial loadings. Schizophr Bull 2013; 39:537-46. [PMID: 23196712 PMCID: PMC3627779 DOI: 10.1093/schbul/sbs141] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite the consistent presence of performance deficits on the Wisconsin Card Sorting Test (WCST) in schizophrenia patients, whether poorer performance is also present in their nonpsychotic relatives is not certain. This study aimed to estimate both the recurrence risk ratio (λs) and the heritability of WCST scores in simplex and multiplex families, respectively, and to examine the influence of familial loading on these estimates. Participants were patients with schizophrenia and their nonpsychotic first-degree relatives from 168 simplex families and 653 multiplex families as well as 440 normal comparisons. On the basis of adjusted z scores, both the λs at a series of cutoff points and heritability estimates based on variance component modeling in the nonpsychotic relatives of schizophrenia patients were estimated. The WCST deficits in schizophrenia patients were more prominent in multiplex families than in simplex ones. Among relatives, WCST deficits were limited to parents of multiplex families for most WCST scores and siblings from multiplex families for total errors, perseverative responses, and perseverative errors. Pertaining to λs, the estimates for multiplex families (highest estimates ranging from 7.9 to 11.0) were greater than those for simplex ones (<2.5). Nevertheless, the heritability estimates were very similar between simplex (ranging from 0% to 17%) and multiplex (ranging from 0% to 21%) families, with the latter having slightly greater values than the former. There is only a small-to-modest familial aggregation on part of WCST scores in families of schizophrenia patients, and this may limit its use as endophenotypic markers to schizophrenia susceptibility.
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Affiliation(s)
- Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Chang Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
| | - Stephen V. Faraone
- Department of Psychiatry and Behavioral Sciences, Medical Genetics Research Center, SUNY Upstate Medical University Syracuse, NY
| | - Ming T. Tsuang
- Departments of Epidemiology and Psychiatry, Harvard Institute of Psychiatric Epidemiology and Genetics, Harvard University, Boston, MA
- Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego, CA
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Wei J. Chen
- Department of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Genetic Epidemiology Core Laboratory, Research Center for Medical Excellence, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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18
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Bagney A, Rodriguez-Jimenez R, Martinez-Gras I, Sanchez-Morla EM, Santos JL, Jimenez-Arriero MA, Lobo A, McGorry PD, Palomo T. Negative symptoms and executive function in schizophrenia: does their relationship change with illness duration? Psychopathology 2013; 46:241-8. [PMID: 23147471 DOI: 10.1159/000342345] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 07/26/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Negative symptoms and cognitive dysfunction are of crucial functional and prognostic importance in schizophrenia. However, the nature of the relationship between them and the factors that may influence it have not been well established. AIMS To investigate whether the relationship between negative symptoms and executive function changes according to the duration of illness in schizophrenia. METHODS The Positive and Negative Syndrome Scale was used to assess psychopathology and the Wisconsin Card Sorting Test (WCST) to evaluate executive function in a sample of 200 schizophrenic patients who were classified in 3 groups according to their duration of illness: up to 5 years (short duration group), 6-20 years (intermediate duration group) and over 20 years of illness (long duration group). RESULTS Medium-sized correlations were found between negative symptoms and WCST performance as assessed by the number of completed categories in all 3 groups. However, differences were found according to the duration of schizophrenia. For patients in the short duration group, negative symptoms correlated with WCST nonperseverative errors, but for those in the long duration group the correlation was with perseverative errors. CONCLUSION We found a differential relationship between negative and cognitive symptoms in different stages of schizophrenia. Illness duration should be considered when studying the relationship between negative symptoms and cognition.
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Affiliation(s)
- Alexandra Bagney
- Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain.
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19
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Scala S, Lasalvia A, Cristofalo D, Bonetto C, Ruggeri M. Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. a case-control study. Psychiatry Res 2012; 200:137-43. [PMID: 22652345 DOI: 10.1016/j.psychres.2012.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 04/30/2012] [Accepted: 05/05/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with schizophrenia show a broad range of neurocognitive deficits, which are considered as core features of the disorder and are thought to be partly heritable. Similar deficits, albeit at a lesser degree, have been also found in their healthy biological relatives. These deficits, if better characterized, might represent underlying vulnerable traits for psychosis. METHODS This case-control study compared neurocognitive functioning of adult first-degree relatives of patients with schizophrenia (SCZ-RELs) (n=55) with healthy control subjects (n=55) and explored its association with the negative symptoms. Subjects in both study and control group were assessed with an extensive neurocognitive test battery (Trail Making test, Phonemic Verbal fluency, Wisconsin Card Sorting Test, Bushke Fuld Test, Stroop Test, n-Back and Digit span) and a set of clinical measures (SANS, GAF and DAS). RESULTS SCZ-RELs were more significantly impaired on executive function tasks (i.e. Wisconsin Card Sorting Test and the Phonemic Verbal fluency) and displayed significantly more severe negative symptoms and poorer social functioning than control subjects. Significant correlations between neurocognitive measures and negative symptoms were found in the study group, whereas no significant correlations were detected among the controls. DISCUSSION Subtle executive impairments, associated with negative symptoms, are shown to be evident in healthy relatives of patients with schizophrenia. These deficits, which reflect subtle dysfunction in concept formation, flexibility and mental shifting, may be seen as potential phenotypic markers of vulnerability for schizophrenia. This raises the question of underlying prefrontal dysfunction as core feature of the disorder.
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Affiliation(s)
- Silvia Scala
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10 37134 Verona, Italy.
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20
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Derks EM, Boks MPM, Vermunt JK. The identification of family subtype based on the assessment of subclinical levels of psychosis in relatives. BMC Psychiatry 2012; 12:71. [PMID: 22759464 PMCID: PMC3504553 DOI: 10.1186/1471-244x-12-71] [Citation(s) in RCA: 4] [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: 12/12/2011] [Accepted: 06/08/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Schizophrenia is a complex psychiatric disorder characterized by high phenotypic heterogeneity. Previous studies have distinguished between familial and sporadic forms of schizophrenia and have suggested clinical differentiation between patients and relatives from sporadic and multiplex families. We will introduce a more refined method to distinguish between family subtypes based on psychosis dimension profiles in the relatives of schizophrenia patients. METHODS Positive, negative, disorganization, mania, and depression scores were assessed in 1,392 relatives. Mixed Model Latent Class Analysis was used to identify family subtypes. A family subtype is a relatively homogeneous group of families with similar symptom profiles in the relatives in these families. Next, we investigated in 616 schizophrenia patients whether family subtype was associated with symptom profiles, IQ, cannabis dependence/abuse, or age of onset of psychosis. RESULTS Based on the data of relatives, we identified two different family types: "healthy" and "at risk for psychiatric disorder". Patients from at risk families obtained higher positive scores compared to patients from healthy families (Wald(1) =6.6293, p=0.010). No significant differences were found in any of the remaining variables. CONCLUSIONS Our findings confirm the existence of high-risk families and although we did not establish an etiological basis for the distinction between family types, genetic studies might reveal whether family subtype is associated with genetic heterogeneity.
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Affiliation(s)
- Eske M Derks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands.
| | - Marco PM Boks
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, AMC-APC, room PA1-179 Meibergdreef, Amsterdam, AZ 51105, The Netherlands
| | - Jeroen K Vermunt
- Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands
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21
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Understanding the executive functioning heterogeneity in schizophrenia. Brain Cogn 2012; 79:60-9. [DOI: 10.1016/j.bandc.2012.01.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 01/09/2012] [Indexed: 11/21/2022]
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22
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Cognitive impairments in schizophrenia and schizoaffective disorder: relationship with clinical characteristics. J Nerv Ment Dis 2012; 200:316-22. [PMID: 22456585 DOI: 10.1097/nmd.0b013e31824cb359] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The present study aimed to compare population-based familial samples of patients with schizophrenia (n = 218) and schizoaffective disorder (n = 62) and a healthy control group (n = 123). Patients with schizoaffective disorder outperformed patients with schizophrenia in verbal ability, processing speed, visual working memory, and verbal memory. When compared with controls, patients with schizoaffective disorder also had a generalized cognitive impairment. Adjusting for clinical characteristics removed significant differences between the patient groups. Irrespective of the diagnosis, patients with the most severe negative symptoms and highest dose of antipsychotics had the most severe cognitive impairments, whereas mood symptoms were not related to cognitive performance. In conclusion, people with schizoaffective disorder have severe cognitive impairments, but the impairments are milder than in schizophrenia. Mood symptoms may not explain the difference between the diagnostic groups in cognitive functions, but the difference may be related to differences in the severity of negative symptoms.
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Holmén A, Juuhl-Langseth M, Thormodsen R, Sundet K, Melle I, Rund BR. Executive function tests in early-onset psychosis: which one to choose? Scand J Psychol 2012; 53:200-5. [PMID: 22416819 DOI: 10.1111/j.1467-9450.2012.00940.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
People with schizophrenia exhibit executive functioning deficits, an area well investigated in the adult onset schizophrenia (AOS) group, but far less so in early-onset schizophrenia (EOS). Since EOS in general seems to exhibit poorer cognitive functions and is clinically more compromised than AOS, choice of efficient and sensitive assessment measures is not necessarily the same within the two groups. The MATRICS Consensus Cognitive Battery was developed for adults when studying treatment effects and uses Mazes (Neuropsychological Assessment Battery [NAB]) to assess executive functioning. We tested 31 adolescents with schizophrenia spectrum disorders and 66 healthy controls in order to examine how Mazes compares to two other commonly used tests to measure executive functioning, D-KEFS Color Word Interference Test (Stroop) and the Wisconsin Card Sorting Test (WCST). Significant discriminating power was found for all three measures. Patients performed 0.8-1.5 SD below controls with Stroop as the most sensitive measure, followed by Mazes and WCST. Mazes was selected by the MATRICS to assess treatment effects in AOS and is shown to be able. We find the instrument also able to separate adolescent patients from controls and thus, it appears a sensible choice in clinical settings. If a more elaborated neuropsychological evaluation of the executive functioning domain is needed, Stroop should be considered a complementary test.
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Affiliation(s)
- Aina Holmén
- Akershus University Hospital, Mental Health Services, Norway Department of Psychology, University of Oslo, Norway.
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24
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Landgraf S, Steingen J, Eppert Y, Niedermeyer U, van der Meer E, Krueger F. Temporal information processing in short- and long-term memory of patients with schizophrenia. PLoS One 2011; 6:e26140. [PMID: 22053182 PMCID: PMC3203868 DOI: 10.1371/journal.pone.0026140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 09/20/2011] [Indexed: 11/19/2022] Open
Abstract
Cognitive deficits of patients with schizophrenia have been largely recognized as core symptoms of the disorder. One neglected factor that contributes to these deficits is the comprehension of time. In the present study, we assessed temporal information processing and manipulation from short- and long-term memory in 34 patients with chronic schizophrenia and 34 matched healthy controls. On the short-term memory temporal-order reconstruction task, an incidental or intentional learning strategy was deployed. Patients showed worse overall performance than healthy controls. The intentional learning strategy led to dissociable performance improvement in both groups. Whereas healthy controls improved on a performance measure (serial organization), patients improved on an error measure (inappropriate semantic clustering) when using the intentional instead of the incidental learning strategy. On the long-term memory script-generation task, routine and non-routine events of everyday activities (e.g., buying groceries) had to be generated in either chronological or inverted temporal order. Patients were slower than controls at generating events in the chronological routine condition only. They also committed more sequencing and boundary errors in the inverted conditions. The number of irrelevant events was higher in patients in the chronological, non-routine condition. These results suggest that patients with schizophrenia imprecisely access temporal information from short- and long-term memory. In short-term memory, processing of temporal information led to a reduction in errors rather than, as was the case in healthy controls, to an improvement in temporal-order recall. When accessing temporal information from long-term memory, patients were slower and committed more sequencing, boundary, and intrusion errors. Together, these results suggest that time information can be accessed and processed only imprecisely by patients who provide evidence for impaired time comprehension. This could contribute to symptomatic cognitive deficits and strategic inefficiency in schizophrenia.
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Affiliation(s)
- Steffen Landgraf
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Inserm-Laboratory of Psychopathology and Mental Diseases, Center for Psychiatry and Neuroscience, U984, Sainte Anne Hospital, Service-Hospitalo Universitaire, Paris, France
| | - Joerg Steingen
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Yvonne Eppert
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Elke van der Meer
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Frank Krueger
- Department of Molecular Neuroscience, Krasnow Institute for Advanced Study, George Mason University, Fairfax, Virginia, United States of America
- Department of Psychology, George Mason University, Fairfax, Virginia, United States of America
- * E-mail:
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25
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Giakoumaki SG, Roussos P, Pallis EG, Bitsios P. Sustained attention and working memory deficits follow a familial pattern in schizophrenia. Arch Clin Neuropsychol 2011; 26:687-95. [PMID: 21813556 DOI: 10.1093/arclin/acr060] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Cognitive deficits are core features of schizophrenia and considered putative endophenotypes. This study assessed the familial pattern of deficits in sustained attention, working memory and executive function in remitted-schizophrenia patients and their unaffected siblings. Sixteen patients, 16 unaffected siblings, and 17 healthy control subjects underwent a battery of neuropsychological tasks that have so far yielded mixed findings in performance differences. Both groups had prolonged reaction times compared with controls in sustained attention tasks; the siblings made more false alarms in the working memory task, but only the patients' performance was poorer in the executive function tasks. These findings further support sustained attention and working memory deficits as potential endophenotypes of schizophrenia. Reaction time and false alarm rates are suggested as additional useful endophenotypic measures that could potentially account for differences in performance in tasks that are not purported to examine the specific measures per se.
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26
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Torniainen M, Suvisaari J, Partonen T, Castaneda AE, Kuha A, Perälä J, Saarni S, Lönnqvist J, Tuulio-Henriksson A. Sex differences in cognition among persons with schizophrenia and healthy first-degree relatives. Psychiatry Res 2011; 188:7-12. [PMID: 21126773 DOI: 10.1016/j.psychres.2010.11.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 06/23/2010] [Accepted: 11/03/2010] [Indexed: 02/01/2023]
Abstract
Previous research suggests differences between women and men in the clinical features of schizophrenia, but studies examining sex differences in neuropsychological functioning have reached inconsistent results. In the present study, sex differences in cognition and clinical features were investigated in population-based samples of participants with schizophrenia (n=218), their healthy first-degree relatives (n=438) and controls (n=123). Sex differences in illness features were small; nevertheless, women with schizophrenia had less negative symptoms and lived independently more often than men. The schizophrenia group had impairments in all studied neuropsychological domains, and the relatives were impaired in processing speed and set-shifting. In all groups, women performed better than men in processing speed, set-shifting and verbal episodic memory, whereas men outperformed women in visual working memory. The group-by-sex interaction was significant in two variables: women outperformed men in the relatives group in immediate verbal reproduction and in the use of semantic clustering as a learning strategy, while there was no sex difference in the schizophrenia group. In conclusion, sex differences in cognition are mostly similar in schizophrenia to those among controls, despite sex differences in illness features. The preservation of sex differences also in first-degree relatives supports the conclusion.
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Affiliation(s)
- Minna Torniainen
- Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Mannerheimintie 166, 00271 Helsinki, Finland.
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27
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Chen CY, Lu RB, Yeh YW, Shih MC, Huang SY. Association study of catechol-O-methyltransferase gene polymorphisms with schizophrenia and psychopathological symptoms in Han Chinese. GENES BRAIN AND BEHAVIOR 2011; 10:316-24. [PMID: 21255265 DOI: 10.1111/j.1601-183x.2010.00670.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Although dysfunction of catechol-O-methyltransferase (COMT)-mediated dopamine transmission is implicated in the etiology of schizophrenia, the human COMT gene has not been associated consistently with schizophrenia. The purpose of this study was to investigate whether the COMT gene is associated with the development of schizophrenia and whether the polymorphisms of this gene influence the psychopathological symptoms in patients with schizophrenia. Fourteen polymorphisms of the COMT gene were analyzed in a case-control study of 876 Han Chinese individuals (434 patients and 442 controls). All participants were screened using a Chinese version of the modified Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L) and all patients met the criteria for schizophrenia. Furthermore, pretreatment of psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) in a subset of 224 hospitalized schizophrenia patients, who were drug-naÏve or drug-free, to examine the association between clinical symptomatology and COMT polymorphisms. No significant differences in allele or genotype frequencies were observed between schizophrenia patients and controls, for all variants investigated. Haplotype analysis showed that three haplotype blocks of the COMT gene were not associated with the development of schizophrenia. Moreover, these COMT polymorphisms did not influence the PANSS scores of schizophrenia patients. This study suggests that the COMT gene may not contribute to the risk of schizophrenia and to the psychopathological symptoms of schizophrenia among Han Chinese.
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Affiliation(s)
- C-Y Chen
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
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28
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Chkonia E, Roinishvili M, Makhatadze N, Tsverava L, Stroux A, Neumann K, Herzog MH, Brand A. The shine-through masking paradigm is a potential endophenotype of schizophrenia. PLoS One 2010; 5:e14268. [PMID: 21151559 PMCID: PMC3000331 DOI: 10.1371/journal.pone.0014268] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 11/19/2010] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To understand the genetics of schizophrenia, a hunt for so-called intermediate phenotypes or endophenotypes is ongoing. Visual masking has been proposed to be such an endophenotype. However, no systematic study has been conducted yet to prove this claim. Here, we present the first study showing that masking meets the most important criteria for an endophenotype. METHODOLOGY/PRINCIPAL FINDINGS We tested 62 schizophrenic patients, 39 non-affected first-degree relatives, and 38 healthy controls in the shine-through masking paradigm and, in addition, in the Continuous Performance Test (CPT) and the Wisconsin Card Sorting Test (WCST). Most importantly, masking performance of relatives was significantly in between the one of patients and controls in the shine-through paradigm. Moreover, deficits were stable throughout one year. Using receiver operating characteristics (ROC) methods, we show that the shine-through paradigm distinguishes with high sensitivity and specificity between schizophrenic patients, first-order relatives and healthy controls. CONCLUSIONS/SIGNIFICANCE The shine-through paradigm is a potential endophenotype.
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Affiliation(s)
- Eka Chkonia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia.
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29
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Magaud E, Kebir O, Gut A, Willard D, Chauchot F, Olie JP, Kazes M, Krebs MO. Altered semantic but not phonological verbal fluency in young help-seeking individuals with ultra high risk of psychosis. Schizophr Res 2010; 123:53-8. [PMID: 20605416 DOI: 10.1016/j.schres.2010.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 04/02/2010] [Accepted: 05/08/2010] [Indexed: 11/17/2022]
Abstract
Some of the cognitive impairments of schizophrenia are already detectable before the onset of the disease, and could help to identify individuals at higher risk of psychosis. In patients with schizophrenia, semantic verbal fluency (VF) is more impaired than phonological fluency. We investigated whether the same profile is present in young patients at Ultra High Risk of psychosis (UHR). One hundred and fifty six young patients (15-30y.o.) consecutively seeking help at our specialized youth mental health center with no definite psychiatric diagnoses were recruited and assessed with the CAARMS. Individuals meeting the criteria for UHR were compared to the remaining patients considered as Help Seeker Controls (HSCo). UHR individuals had a lower mean total semantic fluency score than HSCo. This effect was significant for each semantic category ('animals' and 'fruits'). By contrast, there were no differences in phonological fluency scores between UHR and HSCo either in the total score or when each letter ('P' and 'R') was considered separately. Semantic but not phonological VF differentiated UHR individuals from non-psychotic help-seeking young adults. These results suggest that semantic deficits are present during the prodromal phase, prior to clinical expression of full-blown psychosis, and suggest that prodromes could be associated with alteration in temporal brain areas.
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30
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Longitudinal alterations of executive function in non-psychotic adolescents at familial risk for schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:469-74. [PMID: 20117163 PMCID: PMC3163435 DOI: 10.1016/j.pnpbp.2010.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 01/21/2010] [Accepted: 01/22/2010] [Indexed: 11/22/2022]
Abstract
Genetic diathesis to schizophrenia may involve alterations of adolescent neurodevelopment manifesting as cognitive deficits. Brain regions mediating executive function (fronto-striatal circuits) develop during adolescence while those supporting elementary aspects of attention (e.g. sustained focused attention) have a more protracted maturation beginning in childhood. We hence predicted that adolescents at risk for schizophrenia would show a failure of normal maturation of executive function. We prospectively assessed 18 offspring and 6 siblings of schizophrenia patients (HR) and 28 healthy controls at baseline, year-1 and year-2 follow-up using the Continuous Performance Test [visual-d'] and Wisconsin Card Sort Test (WCST). Perseverative errors on the WCST in HR remained stable but decreased in controls over the follow-up (study-group by assessment-time interaction, p=0.01, controlling for IQ). No significant study-group by assessment-time interactions were seen for sustained attentional performance. HR may not improve while healthy subjects progressively improve on executive function during adolescence and early adulthood. Our results suggest an altered maturational trajectory of executive function during adolescence in individuals at familial risk for schizophrenia.
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Besnier N, Richard F, Zendjidjian X, Kaladjian A, Mazzola-Pomietto P, Adida M, Azorin JM. Stroop and emotional Stroop interference in unaffected relatives of patients with schizophrenic and bipolar disorders: distinct markers of vulnerability? World J Biol Psychiatry 2010; 10:809-18. [PMID: 19707957 DOI: 10.1080/15622970903131589] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Reduced inhibition has been demonstrated in both schizophrenic and bipolar patients through the findings of increased interference on the Stroop Colour-Word Task (SCWT) and increased emotional interference on specific versions of the Emotional Stroop Task (EST). Despite previous findings of enhanced interference in unaffected relatives of schizophrenic and bipolar patients, it remains unclear whether interference might be a candidate endophenotype to both disorders. Moreover, data regarding emotional interference in unaffected relatives are critically lacking. In the present study, we aimed to compare unaffected relatives of patients with schizophrenia (SZ-rel, N = 30) and bipolar disorder (BD-rel, N= 30) with normal controls (N = 60) when performing the SCWT and an EST designed with neutral, depressive, paranoid and manic words. SZ-rel exhibited greater interference effect on both the SCWT and the EST as compared to either BD-rel or normal controls. BD-rel, and by contrast to SZ-rel and controls, showed increased emotional interference effect on the EST that was specifically associated to the disease-related words. The findings support the hypothesis of different markers of vulnerability to schizophrenic and bipolar disorders; impairment in cognitive inhibition could characterize high-risk individuals for schizophrenia whereas an emotional bias towards mood-related information could be a trait marker of bipolar disease.
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Affiliation(s)
- Nathalie Besnier
- Pôle de Psychiatrie, Hôpital Sainte Marguerite, Marseille, France.
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Keshavan MS, Kulkarni S, Bhojraj T, Francis A, Diwadkar V, Montrose DM, Seidman LJ, Sweeney J. Premorbid cognitive deficits in young relatives of schizophrenia patients. Front Hum Neurosci 2010; 3:62. [PMID: 20300465 PMCID: PMC2839849 DOI: 10.3389/neuro.09.062.2009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Accepted: 11/20/2009] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune "window" to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed.
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Affiliation(s)
- Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School Boston, MA, USA
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Association of promoter variants of human dopamine transporter gene with schizophrenia in Han Chinese. Schizophr Res 2010; 116:68-74. [PMID: 19879111 DOI: 10.1016/j.schres.2009.10.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 09/28/2009] [Accepted: 10/04/2009] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Although dopamine was implicated in the etiology of schizophrenia, the human dopamine transporter gene (DAT1; SLC6A3) has not consistently been associated with schizophrenia. The purpose of this study was to examine whether six polymorphisms within the DAT1 gene are associated with schizophrenia. METHODS Six polymorphisms of the DAT1 gene (3 SNPs [rs6413429, rs2652511, and rs2975226] in the promoter region, one SNP [rs6347] in exon 9, and one SNP [rs27072]/one variable number tandem repeat [VNTR] in exon 15) were analyzed in 352 Chinese patients with schizophrenia and in 311 healthy controls. Pretreatment psychopathology was assessed using the Positive and Negative Syndrome Scale in a subset of 160 hospitalized schizophrenia patients who were drug-free or drug-naïve. RESULTS A statistically significant difference in two polymorphisms (rs2652511 and rs2975226) and a promoter region haplotype (rs2652511, rs2975226, and rs6413429) was found between patients and healthy controls. No association with schizophrenia was found for other polymorphisms and another haplotype (3' region). Symptoms severity (PANSS global, positive, negative and general symptoms scores) was similar regardless of DAT1 polymorphism. CONCLUSION The promoter region of the DAT1 gene may play a role in increasing susceptibility to schizophrenia, but does not affect the severity of psychotic symptoms in Han Chinese.
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Chou LN, Kuo PH, Lin CCH, Chen WJ. Genetic and Environmental Influences on the Wisconsin Card Sorting Test Performance in Healthy Adolescents: A Twin/Sibling Study. Behav Genet 2009; 40:22-30. [DOI: 10.1007/s10519-009-9299-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Accepted: 09/15/2009] [Indexed: 11/30/2022]
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HTR1B as a risk profile maker in psychiatric disorders: a review through motivation and memory. Eur J Clin Pharmacol 2009; 66:5-27. [DOI: 10.1007/s00228-009-0724-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 08/18/2009] [Indexed: 12/21/2022]
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Hill SK, Harris MSH, Herbener ES, Pavuluri M, Sweeney JA. Neurocognitive allied phenotypes for schizophrenia and bipolar disorder. Schizophr Bull 2008; 34:743-59. [PMID: 18448479 PMCID: PMC2632447 DOI: 10.1093/schbul/sbn027] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Psychiatric disorders are genetically complex and represent the end product of multiple biological and social factors. Links between genes and disorder-related abnormalities can be effectively captured via assessment of phenotypes that are both associated with genetic effects and potentially contributory to behavioral abnormalities. Identifying intermediate or allied phenotypes as a strategy for clarifying genetic contributions to disorders has been successful in other areas of medicine and is a promising strategy for identifying susceptibility genes in complex psychiatric disorders. There is growing evidence that schizophrenia and bipolar disorder, rather than being wholly distinct disorders, share genetic risk at several loci. Further, there is growing evidence of similarity in the pattern of cognitive and neurobiological deficits in these groups, which may be the result of the effects of these common genetic factors. This review was undertaken to identify patterns of performance on neurocognitive and affective tasks across probands with schizophrenia and bipolar disorder as well as unaffected family members, which warrant further investigation as potential intermediate trait markers. Available evidence indicates that measures of attention regulation, working memory, episodic memory, and emotion processing offer potential for identifying shared and illness-specific allied neurocognitive phenotypes for schizophrenia and bipolar disorder. However, very few studies have evaluated neurocognitive dimensions in bipolar probands or their unaffected relatives, and much work in this area is needed.
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Affiliation(s)
- S. Kristian Hill
- To whom correspondence should be addressed; tel: 312 996-2107, fax: 312 413-8837, e-mail:
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