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Dai Y, Ding H, Lu X, Wu X, Xu C, Jiang T, Ming L, Xia Z, Song C, Shen H, Hao W, Huang S. CCRT and aerobic exercise: a randomised controlled study of processing speed, cognitive flexibility, and serum BDNF expression in schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:84. [PMID: 36261468 PMCID: PMC9581987 DOI: 10.1038/s41537-022-00297-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
Computerised cognitive remediation therapy (CCRT) and aerobic exercise are often used to rehabilitate social functioning in patients with schizophrenia. However, there is limited knowledge regarding the effects of CCRT combined with aerobic exercise on cognitive function and brain-derived neurotrophic factor (BDNF) levels in patients with schizophrenia and cognitive impairment. Ninety-six patients with schizophrenia and cognitive impairment were included in this study and randomly divided into control, aerobic exercise (AE), and CCRT combined with aerobic exercise (CAE) groups. Changes in processing speed and cognitive flexibility at week 8 were evaluated as primary and secondary cognitive outcomes using the Trail Making Test: Part A, the Brief Assessment of Cognition in Schizophrenia: Symbol Coding Test, and the Stroop Colour-Word Test. Positive and Negative Syndrome Scale (PANSS) scores and serum BDNF expression were determined as other secondary outcomes. The CAE group showed significantly better performance in terms of changes in processing speed and cognitive flexibility than the control and AE groups at week 8 (p < 0.05); however, no significant improvements in processing speed and cognitive flexibility were found between the control and AE groups. The CAE group showed significant improvements in the PANSS negative symptoms than the control group at week 8 (p < 0.05), but the AE group showed no significant difference in the changes of PANSS negative symptoms when compared with the other two groups. The CAE group and AE group showed a greater increase in serum BDNF levels than the control group (p < 0.01), but there was no significant difference in serum BDNF expression between the CAE group and AE group. In conclusion, 8-week CCRT combined with aerobic exercise may improve some cognitive performance and negative symptoms in patients with schizophrenia. Aerobic exercise may have an immediate effect on serum BDNF levels rather than cognitive function.
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Affiliation(s)
- Yuanyuan Dai
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Hongyan Ding
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Xiaozi Lu
- grid.452792.fQingdao Mental Health Center, Qingdao, 266034 China
| | - Xiumei Wu
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Chunhua Xu
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Tingting Jiang
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Liang Ming
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Zhong Xia
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Chuanfu Song
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
| | - Hongxian Shen
- grid.452708.c0000 0004 1803 0208National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 China
| | - Wei Hao
- grid.452708.c0000 0004 1803 0208National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011 China
| | - Shucai Huang
- The Fourth People’s Hospital of Wuhu, Wuhu, 241000 China
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2
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Belvederi Murri M, Folesani F, Costa S, Biancosino B, Colla C, Zerbinati L, Caruso R, Nanni MG, Purdon SE, Grassi L. Screening for cognitive impairment in non-affective psychoses: A comparison between the SCIP and the MoCA. Schizophr Res 2020; 218:188-194. [PMID: 31948897 DOI: 10.1016/j.schres.2020.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/03/2020] [Accepted: 01/07/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Neuropsychological performance has a strong impact on real-life functioning and clinical outcomes in psychosis. However, conducting lengthy cognitive assessments may not be feasible in routine clinical practice. Brief, reliable and cost-effective tools are highly needed, but few studies are available to guide clinician choice. METHODS The purpose of this study was to compare the performance of two widely used, short instruments: the Screen for Cognitive Impairment in Psychiatry (SCIP) and the Montreal Cognitive Assessment (MoCA). These instruments were validated in a sample of patients with psychotic disorders and healthy controls, using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and other instruments to assess executive functions, as comparators. RESULTS Patients fared worse than controls across almost all cognitive domains, with effect sizes ranging from 0 (MoCA naming) to 2.08 (SCIP total). Receiver Operator Curve analysis of patient and control performance suggested a better convergent validity for the SCIP (total score AUC: 0.85; 95%CI: 0.79-0.90; Se: 76%, Sp: 83%, PPV: 85%, NPV: 73%) than the MoCA (AUC: 0.78; 95%CI: 0.72-0.85; Se: 69%, Sp: 76%, PPV: 78.7%, NPV 66%). CONCLUSIONS The Screen for Cognitive Impairment in Psychiatry seems to be a more sensitive and specific screening tool than the MoCA to identify cognitive impairment among patients with psychotic disorders.
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Affiliation(s)
- Martino Belvederi Murri
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy.
| | - Federica Folesani
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Silvia Costa
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Bruno Biancosino
- Department of Mental Health and Addictive Disorders Addiction, Health Trust, Ferrara, Italy
| | - Cristina Colla
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosangela Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Scot E Purdon
- Alberta Hospital Edmonton, and the Department of Psychiatry, University ofAlberta, Edmonton, Alberta, Canada
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
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Valenza G, Passamonti L, Duggento A, Toschi N, Barbieri R. Uncovering complex central autonomic networks at rest: a functional magnetic resonance imaging study on complex cardiovascular oscillations. J R Soc Interface 2020; 17:20190878. [PMID: 32183642 DOI: 10.1098/rsif.2019.0878] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study aims to uncover brain areas that are functionally linked to complex cardiovascular oscillations in resting-state conditions. Multi-session functional magnetic resonance imaging (fMRI) and cardiovascular data were gathered from 34 healthy volunteers recruited within the human connectome project (the '100-unrelated subjects' release). Group-wise multi-level fMRI analyses in conjunction with complex instantaneous heartbeat correlates (entropy and Lyapunov exponent) revealed the existence of a specialized brain network, i.e. a complex central autonomic network (CCAN), reflecting what we refer to as complex autonomic control of the heart. Our results reveal CCAN areas comprised the paracingulate and cingulate gyri, temporal gyrus, frontal orbital cortex, planum temporale, temporal fusiform, superior and middle frontal gyri, lateral occipital cortex, angular gyrus, precuneous cortex, frontal pole, intracalcarine and supracalcarine cortices, parahippocampal gyrus and left hippocampus. The CCAN visible at rest does not include the insular cortex, thalamus, putamen, amygdala and right caudate, which are classical CAN regions peculiar to sympatho-vagal control. Our results also suggest that the CCAN is mainly involved in complex vagal control mechanisms, with possible links with emotional processing networks.
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Affiliation(s)
- Gaetano Valenza
- Bioengineering and Robotics Research Centre 'E. Piaggio', University of Pisa, Pisa, Italy.,Deparment of Information Engineering, University of Pisa, Pisa, Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy.,Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Andrea Duggento
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy
| | - Riccardo Barbieri
- Department of Electronics, Informatics and Bioengineering, Politecnico di Milano, Milano, Italy
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Kumar V, Shivakumar V, Chhabra H, Bose A, Venkatasubramanian G, Gangadhar BN. Functional near infra-red spectroscopy (fNIRS) in schizophrenia: A review. Asian J Psychiatr 2017; 27:18-31. [PMID: 28558892 DOI: 10.1016/j.ajp.2017.02.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/02/2017] [Accepted: 02/12/2017] [Indexed: 01/14/2023]
Abstract
The research on the alterations in functional connectivity in schizophrenia has been facilitated by development of an array of functional neuroimaging techniques. Functional Near Infra Red Spectroscopy (fNIRS) is a novel diffuse optical neuromonitring method with its own advantages and limitations. The advantages of fNIRS have made it to be frequently used as a research tool by medical community in different settings. In fNIRS the property of haemoglobin to absorb near infrared light is used to measure brain activity. It provides the indirect measurement of the neuronal activity in the areas of interest. The advantage of fNIRS being less restrictive has made it to be used more commonly in the research of psychiatric disorders in general, schizophrenia in particular. The fNIRS studies on patients with schizophrenia have shown haemodynamic hypo activation primarily in the prefrontal cortex during various cognitive tasks. In this review, initially we have briefly explained the basic principles of fNIRS followed by detailed review of fNIRS findings in patients with schizophrenia.
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Affiliation(s)
- Vijay Kumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Venkataram Shivakumar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harleen Chhabra
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anushree Bose
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bangalore N Gangadhar
- The Schizophrenia Clinic, Department of Psychiatry & Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
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5
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Kumari V, Hamid A, Brand A, Antonova E. Acoustic prepulse inhibition: one ear is better than two, but why and when? Psychophysiology 2014; 52:714-21. [PMID: 25476733 PMCID: PMC4407923 DOI: 10.1111/psyp.12391] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/05/2014] [Indexed: 11/26/2022]
Abstract
We examined whether monaural prepulses produce more prepulse inhibition (PPI) because they might be more attention capturing (unambiguous to locate) than binaural prepulses. Monaural and binaural PPI was tested under normal and verbal and visuospatial attention manipulation conditions in 55 healthy men, including 29 meditators. Attention manipulations abolished monaural PPI superiority, similarly in meditators and meditation-naïve individuals, and this was most strongly evident for right ear PPI under visuospatial attention manipulation. Meditators performed better than meditation-naïve individuals on attention tasks (verbal: more targets detected; visuospatial: faster reaction time). Spatial attention processes contribute to monaural PPI, particularly with the right ear. Better attentional performance, with similar attentional modulation of PPI, may indicate a stronger attentional capacity in meditators, relative to meditation-naïve individuals.
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Affiliation(s)
- Veena Kumari
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
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6
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Amaresha AC, Danivas V, Shivakumar V, Agarwal SM, Kalmady SV, Narayanaswamy JC, Venkatasubramanian G. Clinical correlates of parametric digit-symbol substitution test in schizophrenia. Asian J Psychiatr 2014; 10:45-50. [PMID: 25042951 PMCID: PMC4156309 DOI: 10.1016/j.ajp.2014.03.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/07/2014] [Indexed: 11/23/2022]
Abstract
Processing speed deficit, ascertained by digit-symbol substitution test (DSST), is considered as a fundamental impairment in schizophrenia. Clinical correlates of processing speed abnormalities, especially using the parametric version of DSST is yet to be evaluated comprehensively. In this study, we examined schizophrenia patients (N=66) and demographically matched healthy controls (N=72) using computer-administered parametric DSST (pDSST) with fixed (pDSSTF) as well as random (pDSSTR) conditions and analysed the relationship between pDSST performance and clinical symptoms. Psychopathology was assessed using Scale for Assessment of Positive Symptoms (SAPS)/Negative Symptoms (SANS) with good inter-rater reliability. In comparison with healthy controls, patients demonstrated significantly lesser number of correct responses (CN) in pDSSTF (t=8.0; p<0.001) and pDSSTR (t=7.8; p<0.001) as well as significantly prolonged reaction time in pDSSTF (t=7.1; p<0.001) and pDSSTR (t=7.0; p<0.001). The difference in CN between pDSSTF and pDSSTR [ΔCN] was significantly lesser in patients than healthy controls (t=2.61; p=0.01). The pDSST reaction time had significant positive correlation with negative syndrome scores as well as bizarre behaviour score. Significantly greater processing speed deficits in pDSST suggest potential relational memory/visual scanning abnormalities in schizophrenia. Furthermore, pDSST deficits demonstrated a significant association with the psychopathology, especially with the various negative symptoms and bizarre behaviour.
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Affiliation(s)
- Anekal C Amaresha
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Vijay Danivas
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Venkataram Shivakumar
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Sri Mahavir Agarwal
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Sunil V Kalmady
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Janardhanan C Narayanaswamy
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India; Translational Psychiatry Laboratory, Cognitive Neurobiology Division, Neurobiology Research Centre, National Institute of Mental Health & Neurosciences, Bangalore, India.
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7
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Richetto J, Riva MA. Prenatal maternal factors in the development of cognitive impairments in the offspring. J Reprod Immunol 2014; 104-105:20-5. [PMID: 24794049 DOI: 10.1016/j.jri.2014.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/11/2014] [Accepted: 03/17/2014] [Indexed: 01/16/2023]
Abstract
Different environmental factors acting during sensitive prenatal periods can have a negative impact on neurodevelopment and predispose the individual to the development of various psychiatric conditions that often share cognitive impairments as a common component. As cognitive symptoms remain one of the most challenging and resistant aspects of mental illness to be treated pharmacologically, it is important to investigate the mechanisms underlying such cognitive deficits, with particular focus on the impact of early life adverse events that predispose the individual to mental disorders. Multiple clinical studies have, in fact, repeatedly confirmed that prenatal maternal factors, such as infection, stress or malnutrition, are pivotal in shaping behavioral and cognitive functions of the offspring, and in the past decade many preclinical studies have investigated this hypothesis. The purpose of this review is to describe recent preclinical studies aimed at dissecting the relative impact of various prenatal maternal factors on the development of cognitive impairments in offspring, focusing on animal models of prenatal stress and prenatal infection. These recent studies point to the pivotal role of prenatal stressful experiences in shaping memory and learning functions associated with specific brain structures, such as the hippocampus and the prefrontal cortex. More importantly, such experimental evidence suggests that different insults converge on similar downstream functional targets, such as cognition, which may therefore represent an endophenotype for several pathological conditions. Future studies should thus focus on investigating the mechanisms contributing to the convergent action of different prenatal insults in order to identify targets for novel therapeutic intervention.
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Affiliation(s)
- Juliet Richetto
- Center of Neuropharmacology, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Marco A Riva
- Center of Neuropharmacology, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy.
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Shim SS, Nadeem R. Are NMDA receptor antagonists beneficial in the treatment of schizophrenia? J Psychiatr Res 2014; 51:19-20. [PMID: 24423483 DOI: 10.1016/j.jpsychires.2013.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 12/16/2013] [Indexed: 12/21/2022]
Affiliation(s)
- Seong S Shim
- Rosalind Franklin University of Medicine and Science (RFUMS), The Chicago Medical School, United States.
| | - Rashid Nadeem
- Rosalind Franklin University of Medicine and Science (RFUMS), The Chicago Medical School, United States
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Harciarek M, Malaspina D, Sun T, Goldberg E. Schizophrenia and frontotemporal dementia: shared causation? Int Rev Psychiatry 2013; 25:168-77. [PMID: 23611347 DOI: 10.3109/09540261.2013.765389] [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] [Indexed: 12/13/2022]
Abstract
The relationship between specific genes and particular diseases in neuropsychiatry is unclear, and newer studies focus on shared domains of neurobiological and cognitive pathology across different disorders. This paper reviews the evidence for an association between schizophrenia and frontotemporal dementia, including symptom similarity, familial co-morbidity, and neuroanatomical changes. Genetic as well as epigenetic findings from both schizophrenia and frontotemporal dementia are also discussed. As a result, we introduce the hypothesis of a shared susceptibility for certain subgroups of schizophrenia and frontotemporal dementia. This common causation may involve the same gene(s) at different stages of life: early in schizophrenia and late in frontotemporal dementia. Additionally, we provide a rationale for future research that should emphasize both genetic and cognitive parallels between certain forms of schizophrenia and frontotemporal dementia in a synergistic, coordinated way, placing both in the context of aberrant lateralization patterns.
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Affiliation(s)
- Michał Harciarek
- Division of Clinical Psychology and Neuropsychology, Institute of Psychology, University of Gdansk, Poland
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10
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Wylie MA, Shnall A, Onyike CU, Huey ED. Management of frontotemporal dementia in mental health and multidisciplinary settings. Int Rev Psychiatry 2013; 25:230-6. [PMID: 23611352 PMCID: PMC3929950 DOI: 10.3109/09540261.2013.776949] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Diagnosis of frontotemporal dementia (FTD) in the mental health setting and issues pertaining to longitudinal care of this population in a specialist clinic are reviewed. FTD is often misdiagnosed as a psychiatric disorder, most commonly as a mood disorder. FTD has features that overlap with those of major depression, mania, obsessive-compulsive disorder and schizophrenia. We describe these features and how to differentiate FTD from these psychiatric disorders. This paper also describes practical issues in the management of FTD, specifically the issues that clinicians, patients and their families face in managing this disease. Areas of clinical care along the continuum are explored; FTD care involves collaborative management of symptoms and disability, and assisting patients and families in adapting to the disease.
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Affiliation(s)
- Mary Anne Wylie
- Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Adriana Shnall
- Ross Memory Clinic, Baycrest Health Science Centre, Ontario, Canada,University of Toronto, Faculty of Social Work, Toronto, Canada
| | - Chiadi U. Onyike
- Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain,Departments of Psychiatry and Neurology, College of Physicians and Surgeons, Columbia University, New York, USA
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McClure MM, Harvey PD, Bowie CR, Iacoviello B, Siever LJ. Functional outcomes, functional capacity, and cognitive impairment in schizotypal personality disorder. Schizophr Res 2013; 144:146-50. [PMID: 23375943 PMCID: PMC3572293 DOI: 10.1016/j.schres.2012.12.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/18/2012] [Accepted: 12/20/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals with schizotypal personality disorder (SPD) exhibit impaired cognitive functioning in a pattern similar to that found in schizophrenia; less clear is the extent to which these individuals also share schizophrenia patients' impairments in functional capacity and real-world functioning. METHOD We evaluated 46 SPD patients, as well as 38 individuals with avoidant personality disorder (AvPD) and 55 healthy controls (HC) on: cognitive functioning, real-world functioning (employment and residential status), and functional capacity (indexed by the UPSA, a performance-based skills assessment). RESULTS We found that individuals with SPD exhibited worse performance on both the cognitive battery and the UPSA than the other groups; they were also less likely to be employed and to be living independently. Additionally, cognitive and UPSA performance in the SPD group was intercorrelated to a degree comparable to what has been found in schizophrenia, and this relationship was not present in the AvPD group. Finally, real-world functioning was related to UPSA performance for both patient groups. CONCLUSIONS SPD patients exhibit impaired real-world functioning suggesting that these deficits extend across the schizophrenia spectrum. In addition, there is supportive evidence for the validity and importance of performance-based measures such as the UPSA to predict everyday outcomes across the schizophrenia spectrum.
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Affiliation(s)
- Margaret M. McClure
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,VA VISN3 Mental Illness Research, Education, and Clinical Center, Bronx, NY,Department of Psychology, Fairfield University, Fairfield, CT,Corresponding Author: Margaret McNamara McClure, PhD, VA VISN 3 MIRECC, James J. Peters VAMC, 130 West Kingsbridge Road, Bronx, NY 10468, (718) 584-9000, x3844 (phone), (718) 364-3576 (fax),
| | - Philip D. Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL,Research Service, Miami VA Medical Center, Miami, FL
| | | | - Brian Iacoviello
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY
| | - Larry J. Siever
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY,VA VISN3 Mental Illness Research, Education, and Clinical Center, Bronx, NY
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Bodatsch M, Klosterkötter J, Müller R, Ruhrmann S. Basic disturbances of information processing in psychosis prediction. Front Psychiatry 2013; 4:93. [PMID: 23986723 PMCID: PMC3750943 DOI: 10.3389/fpsyt.2013.00093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/09/2013] [Indexed: 11/13/2022] Open
Abstract
The basic symptoms (BS) approach provides a valid instrument in predicting psychosis onset and represents moreover a significant heuristic framework for research. The term "basic symptoms" denotes subtle changes of cognition and perception in the earliest and prodromal stages of psychosis development. BS are thought to correspond to disturbances of neural information processing. Following the heuristic implications of the BS approach, the present paper aims at exploring disturbances of information processing, revealed by functional magnetic resonance imaging (fMRI) and electro-encephalographic as characteristics of the at-risk state of psychosis. Furthermore, since high-risk studies employing ultra-high-risk criteria revealed non-conversion rates commonly exceeding 50%, thus warranting approaches that increase specificity, the potential contribution of neural information processing disturbances to psychosis prediction is reviewed. In summary, the at-risk state seems to be associated with information processing disturbances. Moreover, fMRI investigations suggested that disturbances of language processing domains might be a characteristic of the prodromal state. Neurophysiological studies revealed that disturbances of sensory processing may assist psychosis prediction in allowing for a quantification of risk in terms of magnitude and time. The latter finding represents a significant advancement since an estimation of the time to event has not yet been achieved by clinical approaches. Some evidence suggests a close relationship between self-experienced BS and neural information processing. With regard to future research, the relationship between neural information processing disturbances and different clinical risk concepts warrants further investigations. Thereby, a possible time sequence in the prodromal phase might be of particular interest.
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Affiliation(s)
- Mitja Bodatsch
- Department of Psychiatry and Psychotherapy, University of Cologne , Cologne , Germany
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Abstract
AbstractDespite 50 years of pharmacological and psychosocial interventions schizophrenia remains one of the leading causes of disability. The inability to function in everyday settings includes deficits in performance of social, occupational, and independent living activities. Schizophrenia is also a life-shortening illness, caused mainly by poor physical health and its complications. Dysfunctional lifestyles including sedentary behavior and lack of physical activity prevail, while treatment with adipogenic antipsychotic medication interacts with poor performance in screening, monitoring, and intervention that result in shortening of life expectancies by 25–30 years. Disability interferes with self-care and medical care, further worsening physical health to produce a vicious cycle of disability. Further, the neurobiological impact of obesity on brain functioning is substantial and relevant to schizophrenia. Decision making deficits that lead to choices resulting in obesity themselves have neurobiological determinants. Simultaneous treatment of cognitive deficits and related deficits in functional skills, ubiquitous determinants of everyday functioning in schizophrenia, and targeted interventions aimed at poor physical health, especially obesity and associated comorbidities, may lead to additive or even interactive gains in everyday functioning in patients with schizophrenia not previously realized with other interventions.
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