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Zhou Y, Zhu H, Hu W, Song Y, Zhang S, Peng Y, Yang G, Shi H, Yang Y, Li W, Lv L, Zhang Y. Abnormal regional homogeneity as a potential imaging indicator for identifying adolescent-onset schizophrenia: Insights from resting-state functional magnetic resonance imaging. Asian J Psychiatr 2024; 98:104106. [PMID: 38865883 DOI: 10.1016/j.ajp.2024.104106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND In patients with schizophrenia, there is abnormal regional functional synchrony. However, whether it also in patients with adolescent-onset schizophrenia (AOS) remains unclear. The goal of this study was to analyze the regional homogeneity (ReHo) of resting functional magnetic resonance imaging to explore the functional abnormalities of the brain in patients with AOS. METHODS The study included 107 drug-naive first-episode AOS patients and 67 healthy, age, sex, and education-matched controls using resting-state functional magnetic resonance imaging scans. The ReHo method was used to analyze the imaging dataset. RESULTS Compared with the control group, the ReHo values of the right inferior frontal gyrus orbital part, right middle frontal gyrus (MFG.R), left inferior parietal, but supramarginal and angular gyri, and left precentral gyrus (PreCG.L) were significantly increased and the ReHo value of the left posterior cingulate cortex/anterior cuneiform lobe was significantly decreased in schizophrenia patients. ROC analysis showed that the ReHo values of the MFG.R and PreCG.L might be regarded as potential markers in helping to identify patients. Furthermore, the PANSS scores in the patient group and the ReHo values showed a positive correlation between MFG.R ReHo values and general scores. CONCLUSIONS Our results suggested that AOS patients had ReHo abnormalities. The ReHo values of these abnormal regions may serve as potential imaging biomarkers for the identification of AOS patients.
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Affiliation(s)
- Youqi Zhou
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Hanyu Zhu
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Wenyan Hu
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Yichen Song
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Sen Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Yue Peng
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ge Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
| | - Han Shi
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Wenqiang Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China
| | - Yan Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China; Henan Key Lab of Biological Psychiatry, Xinxiang Medical University, Xinxiang 453002, China; International Joint Research Laboratory for Psychiatry and Neuroscience of Henan of Xinxiang Medical University, Xinxiang 453002, China; Henan Collaborative Innovation Center of Prevention and treatment of mental disorder, Xinxiang 453002, China.
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Serrano-Sponton L, Lange F, Dauth A, Krenzlin H, Perez A, Januschek E, Schumann S, Jussen D, Czabanka M, Ringel F, Keric N, Gonzalez-Escamilla G. Harnessing the frontal aslant tract's structure to assess its involvement in cognitive functions: new insights from 7-T diffusion imaging. Sci Rep 2024; 14:17455. [PMID: 39075100 PMCID: PMC11286763 DOI: 10.1038/s41598-024-67013-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024] Open
Abstract
The first therapeutical goal followed by neurooncological surgeons dealing with prefrontal gliomas is attempting supramarginal tumor resection preserving relevant neurological function. Therefore, advanced knowledge of the frontal aslant tract (FAT) functional neuroanatomy in high-order cognitive domains beyond language and speech processing would help refine neurosurgeries, predicting possible relevant cognitive adverse events and maximizing the surgical efficacy. To this aim we performed the recently developed correlational tractography analyses to evaluate the possible relationship between FAT's microstructural properties and cognitive functions in 27 healthy subjects having ultra-high-field (7-Tesla) diffusion MRI. We independently assessed FAT segments innervating the dorsolateral prefrontal cortices (dlPFC-FAT) and the supplementary motor area (SMA-FAT). FAT microstructural robustness, measured by the tract's quantitative anisotropy (QA), was associated with a better performance in episodic memory, visuospatial orientation, cognitive processing speed and fluid intelligence but not sustained selective attention tests. Overall, the percentual tract volume showing an association between QA-index and improved cognitive scores (pQACV) was higher in the SMA-FAT compared to the dlPFC-FAT segment. This effect was right-lateralized for verbal episodic memory and fluid intelligence and bilateralized for visuospatial orientation and cognitive processing speed. Our results provide novel evidence for a functional specialization of the FAT beyond the known in language and speech processing, particularly its involvement in several higher-order cognitive domains. In light of these findings, further research should be encouraged to focus on neurocognitive deficits and their impact on patient outcomes after FAT damage, especially in the context of glioma surgery.
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Affiliation(s)
- Lucas Serrano-Sponton
- Department of Neurosurgery, Sana Clinic Offenbach, Johann Wolfgang Goethe University Frankfurt am Main Academic Hospitals, Starkenburgring 66, 63069, Offenbach am Main, Germany
| | - Felipa Lange
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany
| | - Alice Dauth
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany
| | - Harald Krenzlin
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany
| | - Ana Perez
- Department of Neurology, Oslo University Hospital HF, Sognsvannsveien 20, 0372, Oslo, Norway
| | - Elke Januschek
- Department of Neurosurgery, Sana Clinic Offenbach, Johann Wolfgang Goethe University Frankfurt am Main Academic Hospitals, Starkenburgring 66, 63069, Offenbach am Main, Germany
| | - Sven Schumann
- Institute of Anatomy, University Medical Center of the Johannes Gutenberg-University Mainz, Johann-Joachim-Becher-Weg 13, 55128, Mainz, Germany
| | - Daniel Jussen
- Department of Neurosurgery, University Medical Center of the Johann Wolfgang Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Marcus Czabanka
- Department of Neurosurgery, University Medical Center of the Johann Wolfgang Goethe University Frankfurt am Main, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany
| | - Naureen Keric
- Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany
| | - Gabriel Gonzalez-Escamilla
- Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience, Rhine Main Neuroscience Network, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeck Str. 1, 55131, Mainz, Germany.
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Yorca-Ruiz Á, Magdaleno Herrero R, Ortiz García de la Foz V, Murillo-García N, Ayesa-Arriola R. Breaking down processing speed: Motor and cognitive insights in first-episode psychosis and unaffected first-degree relatives. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00036-X. [PMID: 38908403 DOI: 10.1016/j.sjpmh.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/17/2024] [Accepted: 06/16/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION Processing speed (PS) deficits represent a fundamental aspect of cognitive impairment, evident not only in schizophrenia but also in individuals undergoing their first episode of psychosis (FEP) and their unaffected first-degree relatives. Heterogeneity in tests assessing PS reflects the participation of motor and cognitive subcomponents to varying degrees. We aim to explore differences in performance of the subcomponents of PS in FEP patients, parents, siblings, and controls. MATERIALS AND METHODS Results from tests, including Trail Making Test part A and part B, Digit Symbol Coding Test, Grooved Pegboard Test, and Stroop Word and Stroop Color subtests, were obtained from 133 FEP patients, 146 parents, and 202 controls. Exploratory factor analysis (EFA) was employed in controls to establish the structure, followed by confirmatory factor analysis (CFA) to verify if the other groups share this structure. RESULTS EFA revealed a two-factor model: Factor 1 for the motor subcomponent and Factor 2 for the cognitive subcomponent. Subsequently, CFA indicated a good fit for the remaining groups with differences in the relationship between the factors. CONCLUSIONS Differences in the relationships of factors within a common structure suggest the involvement of different compensatory strategies among groups, providing insights into the underlying mechanisms of PS deficits in patients and relatives.
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Affiliation(s)
- Ángel Yorca-Ruiz
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rebeca Magdaleno Herrero
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Víctor Ortiz García de la Foz
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain; Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Nancy Murillo-García
- Department of Molecular Biology, Faculty of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Valdecilla Biomedical Research Institute, Santander, Spain; Faculty of Psychology, National University of Distance Education (UNED), Madrid, Spain; Biomedical Research Networking Center for Mental Health (CIBERSAM), Madrid, Spain.
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Gao T, Wang X, Cen H, Li X, Zhai Z, Lu C, Dong Y, Zhang S, Zhuo K, Xiang Q, Wang Y, Liu D. Cross-modal associative memory impairment in schizophrenia. Neuropsychologia 2023; 191:108721. [PMID: 37918479 DOI: 10.1016/j.neuropsychologia.2023.108721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 11/04/2023]
Abstract
Impaired associative memory function in patients with schizophrenia has received considerable attention. However, previous studies have primarily concentrated on unisensory materials, which limits our understanding of the broader implications of this impairment. In this study, we sought to expand on this knowledge by examining two types of associative memory domains in individuals with schizophrenia, leveraging both visual (Vis) and auditory (Aud) materials. A total of 32 patients with schizophrenia and 29 healthy controls were recruited to participate in the study. Each participant participated in an experiment composed of three paradigms in which different abstract materials (Aud-Aud, Aud-Vis, and Vis-Vis) were presented. Subsequently, the discriminability scores of the two groups were calculated and compared in different modal tasks. Results from the study indicated that individuals with schizophrenia demonstrated varying degrees of associative memory dysfunction in both the same and cross-modalities, with the latter having a significantly lower score than healthy controls (t = 4.120, p < 0.001). Additionally, the cross-modal associative memory function was significantly and negatively correlated with the severity of negative symptoms among individuals diagnosed with schizophrenia (r = -0.362, p = 0.042). This study provides evidence of abnormalities in the processing and memorization of information that integrates multiple sensory modalities in individuals with schizophrenia. This is of great significance for further understanding the cognitive symptoms and pathological mechanisms of schizophrenia, potentially guiding the development of relevant interventions and treatment methods.
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Affiliation(s)
- Tianhao Gao
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Xiaoliang Wang
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Haixin Cen
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Xuan Li
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Zhaolin Zhai
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Chang Lu
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Yuke Dong
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Suzhen Zhang
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Kaiming Zhuo
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Qiong Xiang
- Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China
| | - Yan Wang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, 200062, China.
| | - Dengtang Liu
- Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, 200040, China; Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Clinical Center for Psychotic Disorders, National Center for Mental Disorders, Shanghai, 200030, China; Institute of Mental Health, Fudan University, Shanghai, 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
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Abplanalp SJ, Lee J, Horan WP, Kern RS, Penn DL, Green MF. A Bayesian Network Approach to Social and Nonsocial Cognition in Schizophrenia: Are Some Domains More Fundamental than Others? Schizophr Bull 2023; 49:997-1006. [PMID: 36869810 PMCID: PMC10318874 DOI: 10.1093/schbul/sbad012] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVES Social and nonsocial cognition are defined as distinct yet related constructs. However, the relative independence of individual variables-and whether specific tasks directly depend on performance in other tasks-is still unclear. The current study aimed to answer this question by using a Bayesian network approach to explore directional dependencies among social and nonsocial cognitive domains. STUDY DESIGN The study sample comprised 173 participants with schizophrenia (71.7% male; 28.3% female). Participants completed 5 social cognitive tasks and the MATRICS Consensus Cognitive Battery. We estimated Bayesian networks using directed acyclic graph structures to examine directional dependencies among the variables. STUDY RESULTS After accounting for negative symptoms and demographic variables, including age and sex, all nonsocial cognitive variables depended on processing speed. More specifically, attention, verbal memory, and reasoning and problem solving solely depended on processing speed, while a causal chain emerged between processing speed and visual memory (processing speed → attention → working memory → visual memory). Social processing variables within social cognition, including emotion in biological motion and empathic accuracy, depended on facial affect identification. CONCLUSIONS These results suggest that processing speed and facial affect identification are fundamental domains of nonsocial and social cognition, respectively. We outline how these findings could potentially help guide specific interventions that aim to improve social and nonsocial cognition in people with schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham AL, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- WCG VeraSci, Durham, NC, USA
| | - Robert S Kern
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Penn
- Departement of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chappel Hill, NC, USA
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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Everaert E, Vorstman JAS, Selten IS, Slieker MG, Wijnen F, Boerma TD, Houben ML. Executive functioning in preschoolers with 22q11.2 deletion syndrome and the impact of congenital heart defects. J Neurodev Disord 2023; 15:15. [PMID: 37173621 PMCID: PMC10181926 DOI: 10.1186/s11689-023-09484-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Executive functioning (EF) is an umbrella term for various cognitive functions that play a role in monitoring and planning to effectuate goal-directed behavior. The 22q11.2 deletion syndrome (22q11DS), the most common microdeletion syndrome, is associated with a multitude of both somatic and cognitive symptoms, including EF impairments in school-age and adolescence. However, results vary across different EF domains and studies with preschool children are scarce. As EF is critically associated with later psychopathology and adaptive functioning, our first aim was to study EF in preschool children with 22q11DS. Our second aim was to explore the effect of a congenital heart defects (CHD) on EF abilities, as CHD are common in 22q11DS and have been implicated in EF impairment in individuals with CHD without a syndromic origin. METHODS All children with 22q11DS (n = 44) and typically developing (TD) children (n = 81) were 3.0 to 6.5 years old and participated in a larger prospective study. We administered tasks measuring visual selective attention, visual working memory, and a task gauging broad EF abilities. The presence of CHD was determined by a pediatric cardiologist based on medical records. RESULTS Analyses showed that children with 22q11DS were outperformed by TD peers on the selective attention task and the working memory task. As many children were unable to complete the broad EF task, we did not run statistical analyses, but provide a qualitative description of the results. There were no differences in EF abilities between children with 22q11DS with and without CHDs. CONCLUSION To our knowledge, this is the first study measuring EF in a relatively large sample of young children with 22q11DS. Our results show that EF impairments are already present in early childhood in children with 22q11DS. In line with previous studies with older children with 22q11DS, CHDs do not appear to have an effect on EF performance. These findings might have important implications for early intervention and support the improvement of prognostic accuracy.
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Affiliation(s)
- Emma Everaert
- Institute for Language Sciences, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands.
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
| | - Jacob A S Vorstman
- Program in Genetics and Genome Biology, Research Institute, and Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Iris S Selten
- Institute for Language Sciences, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - Martijn G Slieker
- Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center Utrecht, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Frank Wijnen
- Institute for Language Sciences, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands
| | - Tessel D Boerma
- Institute for Language Sciences, Utrecht University, Trans 10, 3512 JK, Utrecht, The Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
| | - Michiel L Houben
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands
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McCutcheon RA, Keefe RSE, McGuire PK. Cognitive impairment in schizophrenia: aetiology, pathophysiology, and treatment. Mol Psychiatry 2023; 28:1902-1918. [PMID: 36690793 PMCID: PMC10575791 DOI: 10.1038/s41380-023-01949-9] [Citation(s) in RCA: 91] [Impact Index Per Article: 91.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
Cognitive deficits are a core feature of schizophrenia, account for much of the impaired functioning associated with the disorder and are not responsive to existing treatments. In this review, we first describe the clinical presentation and natural history of these deficits. We then consider aetiological factors, highlighting how a range of similar genetic and environmental factors are associated with both cognitive function and schizophrenia. We then review the pathophysiological mechanisms thought to underlie cognitive symptoms, including the role of dopamine, cholinergic signalling and the balance between GABAergic interneurons and glutamatergic pyramidal cells. Finally, we review the clinical management of cognitive impairments and candidate novel treatments.
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Affiliation(s)
- Robert A McCutcheon
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
- Oxford health NHS Foundation Trust, Oxford health NHS Foundation Trust, Oxford, UK.
| | - Richard S E Keefe
- Departments of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Philip K McGuire
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford health NHS Foundation Trust, Oxford health NHS Foundation Trust, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
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8
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Cognitive reserve profiles are associated with outcome in schizophrenia. J Neurol Sci 2022; 443:120496. [PMID: 36410188 DOI: 10.1016/j.jns.2022.120496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/17/2022] [Accepted: 11/12/2022] [Indexed: 11/17/2022]
Abstract
Cognitive reserve (CR), the brain's ability to cope with brain pathology to minimize symptoms, could explain the heterogeneity of outcomes in neuropsychiatric disorders, however it is still rarely investigated in schizophrenia. Indeed, this study aims to classify CR in this disorder and evaluate its impact on neurocognitive and socio-cognitive performance and daily functioning. A group of 106 patients diagnosed with schizophrenia was enrolled and assessed in these aereas: neurocognition, Theory of Mind (ToM) and daily functioning. A composite CR score was determined through an integration of the intelligence quotient and education and leisure activities. CR profiles were classified with a two-step cluster analysis and differences among clusters were determined with an analysis of variance (ANOVA). The cluster analysis was identified with three CR profiles characterized, respectively, by high, medium and low CR. ANOVA analysis showed significant differences on neurocognition, ToM and daily functioning between the clusters: people with higher CR reached significantly superior scores. This study suggests that greater general cognitive resources could act as a buffer against the effect of brain pathology, allowing patients to have a better cognitive performance, social outcome and quality of life.
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Huang Y, Wang W, Hei G, Yang Y, Long Y, Wang X, Xiao J, Xu X, Song X, Gao S, Shao T, Huang J, Wang Y, Zhao J, Wu R. Altered regional homogeneity and cognitive impairments in first-episode schizophrenia: A resting-state fMRI study. Asian J Psychiatr 2022; 71:103055. [PMID: 35303593 DOI: 10.1016/j.ajp.2022.103055] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/11/2022] [Accepted: 02/27/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with schizophrenia consistently present pervasive cognitive deficits, but the neurobiological mechanism of cognitive impairments remains unclear. By analyzing regional homogeneity (ReHo) of resting-state functional Magnetic Resonance Imaging, this study aimed to explore the association between brain functional alterations and cognitive deficits in first-episode schizophrenia (FES) with a relatively large sample. METHODS A total of 187 patients with FES and 100 healthy controls from 3 independent cohorts underwent resting-state functional magnetic resonance scans. The MATRICS Consensus Cognitive Battery (MCCB) was used to assess cognitive function. Partial correlation analysis was performed between abnormal ReHo values and the severity of symptoms and cognitive deficits. RESULTS Compared with healthy controls, ReHo values increased in right superior frontal cortex and decreased in right anterior cingulate cortex (ACC), left middle occipital gyrus (MOG), left cuneus, right posterior cingulate cortex (PCC), and right superior occipital gyrus in schizophrenia patients. ReHo values in ACC, PCC and superior occipital gyrus were correlated with PANSS scores. In addition, ReHo values in ACC and MOG were negatively correlated with working memory; left cuneus was positively correlated with multiple cognitive domains (speed of processing, attention/vigilance and social cognition); PCC was positively correlated with verbal learning; right superior occipital gyrus was positively correlated with speed of processing and social cognition. CONCLUSION In conclusion, we found widespread ReHo alterations and cognitive dysfunction in FES. And the pathophysiology mechanism of a wide range of cognitive deficits may be related to abnormal spontaneous brain activity.
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Affiliation(s)
- Yuyan Huang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Weiyan Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Gangrui Hei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Ye Yang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yujun Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoyi Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jingmei Xiao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xijia Xu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Xueqin Song
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Shuzhan Gao
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210000, Jiangsu, China
| | - Tiannan Shao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jing Huang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Ying Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Jingping Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Renrong Wu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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10
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Thuaire F, Rondepierre F, Vallet GT, Jalenques I, Izaute M. Executive deficits in schizophrenia: mediation by processing speed and its relationships with aging. Psychol Med 2022; 52:1126-1134. [PMID: 32840193 DOI: 10.1017/s0033291720002871] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Executive deficits are a core characteristic of schizophrenia. Yet, the origin of these impairments remains unclear as they may be caused by processing slowing. This issue is of particular interest for aging insofar as cognitive aging is also associated with a decline in executive functioning and a slowing of processing speed. As schizophrenia patients' life expectancy increases, a better understanding of the origin of older patients' cognitive deficits becomes essential so that healthcare can be adapted to suit them. This study aims to determine whether processing speed mediates how schizophrenia affects executive functions and whether these relationships are moderated by age. METHODS Sixty-two schizophrenia patients (27 women) and 62 healthy comparison subjects matched for age (range: 18-76 years), gender and education performed neurocognitive tests to evaluate their executive functions (shifting, updating, inhibition and access) and processing speed. RESULTS Processing speed mediated the effect of schizophrenia on the four specific executive functions, and age moderated this mediation for shifting, updating and access, but in different ways. Age moderated the effect of processing speed on shifting, the direct effect of schizophrenia on access, and both the effect of processing speed and the direct effect of schizophrenia on updating. CONCLUSIONS This research highlights the need to evaluate processing speed routinely during therapeutic follow-up, as it is easy and simple to assess and appears to be at the heart of the cognitive deficits in schizophrenia. Finally, processing speed abilities yield information about the evolution of cognition with aging in schizophrenia.
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Affiliation(s)
- Flavien Thuaire
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401-63001 Clermont-Ferrand Cedex 1, Clermont-Ferrand, France
| | - Fabien Rondepierre
- Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Guillaume T Vallet
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401-63001 Clermont-Ferrand Cedex 1, Clermont-Ferrand, France
| | - Isabelle Jalenques
- Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Institut de Psychiatrie-GDR 3557, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Marie Izaute
- Université Clermont Auvergne, CNRS, LAPSCO, 34 avenue Carnot - TSA 60401-63001 Clermont-Ferrand Cedex 1, Clermont-Ferrand, France
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11
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A neuropsychological study on Leonhard's nosological system. Eur Arch Psychiatry Clin Neurosci 2022; 272:427-436. [PMID: 34269880 DOI: 10.1007/s00406-021-01298-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 07/04/2021] [Indexed: 12/17/2022]
Abstract
Phenotype validation of endogenous psychosis is a problem that remains to be solved. This study investigated the neuropsychological performance of endogenous psychosis subtypes according to Wernicke-Kleist-Leonhard's classification system (WKL). The participants included consecutive admissions of patients with schizophrenia spectrum disorder or mood disorder with psychotic symptoms (N = 98) and healthy comparison subjects (N = 50). The patients were assessed by means of semi-structured interviews and diagnosed through the WKL system into three groups: a manic-depressive illness and cycloid psychosis group (MDC), unsystematic schizophrenia (USch) and systematic schizophrenia (SSch). All the participants completed a comprehensive neuropsychological battery. The three Leonhard's psychosis subtypes showed a common neuropsychological profile with differences in the severity of impairment relative to healthy controls. MDC patients showed better performance on premorbid intelligence, verbal memory and global cognitive index than USch and SSch patients, and they showed better performance on processing speed, and working memory than SSch patients. USch patients outperformed SSch patients in verbal memory, working memory and global cognitive index. Neuropsychological performance showed a modest accuracy for classification into the WKL nosology. Our results suggest the existence of a common profile of cognitive impairment cutting across WKL subtypes of endogenous psychosis but with significant differences on a severity continuum. In addition, classification accuracy in the three WKL subtypes by means of neuropsychological performance was modest, ranging between 40 and 64% of correctly classified patients.
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12
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Orna T, Efrat B. Sleep Loss, Daytime Sleepiness, and Neurobehavioral Performance among Adolescents: A Field Study. Clocks Sleep 2022; 4:160-171. [PMID: 35323169 PMCID: PMC8947444 DOI: 10.3390/clockssleep4010015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
The current study investigates the impact of sleep loss on neurobehavioral functioning and sleepiness in a natural setting among healthy adolescents. Fifty-nine adolescents (32 females) from grades 7 to 12 (mean age of 16.29 ± 1.86 years) participated in the study. All participants wore the actigraph for a continuous five to seven days, including school and nonschool days. Subjective sleepiness and neurobehavioral performance (using the psychomotor vigilance test and the digit symbol substitution test) were measured three times a day on two school days and one nonschool day. The results presented that sleep loss influenced subjective sleepiness reports, showing higher sleepiness scores following sleep loss than following sufficient night sleep. Neurobehavioral functioning across all measurements was also significantly worse following sleep loss. Furthermore, participants performed worse on weekday morning assessments than on assessments at other times of the day following sleep loss. These findings suggest that sleep loss in natural settings has a significant impact on neurobehavioral performance and subjective sleepiness. Our findings have essential implications for public policy on school schedules.
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13
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Khalil M, Hollander P, Raucher-Chéné D, Lepage M, Lavigne KM. Structural brain correlates of cognitive function in schizophrenia: A meta-analysis. Neurosci Biobehav Rev 2021; 132:37-49. [PMID: 34822878 DOI: 10.1016/j.neubiorev.2021.11.034] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
Schizophrenia is characterized by cognitive impairments and widespread structural brain abnormalities. Brain structure-cognition associations have been extensively studied in schizophrenia, typically involving individual cognitive domains or brain regions of interest. Findings in overlapping and diffuse brain regions may point to structural alterations in large-scale brain networks. We performed a systematic review and meta-analysis examining whether brain structure-cognition associations can be explained in terms of biologically meaningful brain networks. Of 7,261 screened articles, 88 were included in a series of meta-analyses assessing publication bias, heterogeneity, and study quality. Significant associations were found between overall brain structure and eight MATRICS-inspired cognitive domains. Brain structure mapped onto the seven Yeo functionally defined networks and extraneous structures (amygdala, hippocampus, and cerebellum) typically showed associations with conceptually related cognitive domains, with higher-level domains (e.g., executive function, social cognition) associated with more networks. These findings synthesize the extensive literature on brain structure and cognition in schizophrenia from a contemporary network neuroscience perspective and suggest that brain structure-cognition associations in schizophrenia may follow functional network architecture.
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Affiliation(s)
- Marianne Khalil
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Philippine Hollander
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Delphine Raucher-Chéné
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France; Cognition, Health, and Society Laboratory (EA 6291), University of Reims, Champagne-Ardenne, Reims, France
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Katie M Lavigne
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada; Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
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14
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Castilla A, Borst G, Cohen D, Fradin J, Lefrançois C, Houdé O, Zaoui M, Berthoz A. A New Paradigm for the Study of Cognitive Flexibility in Children and Adolescents: The "Virtual House Locomotor Maze" (VHLM). Front Psychiatry 2021; 12:708378. [PMID: 34630176 PMCID: PMC8495412 DOI: 10.3389/fpsyt.2021.708378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/26/2021] [Indexed: 01/10/2023] Open
Abstract
Classical neuropsychological assessments are designed to explore cognitive brain functions using paper-and-pencil or digital tests. The purpose of this study was to design and to test a new protocol named the "Virtual House Locomotor Maze" (VHLM) for studying inhibitory control as well as mental flexibility using a visuo-spatial locomotor memory test. The VHLM is a simple maze including six houses using the technology of the Virtual Carpet Paradigm™. Ten typical development children (TD) were enrolled in this study. The participants were instructed to reach a target house as quickly as possible and to bear in mind the experimental instructions. We examined their planning and replanning abilities to take the shortest path to reach a target house. In order to study the cognitive processes during navigation, we implemented a spatio-temporal index based on the measure of kinematics behaviors (i.e., trajectories, tangential velocity and head direction). Replanning was tested by first repeating a path chosen by the subject to reach a given house. After learning this path, it was blocked imposing that the subject inhibited the learned trajectory and designed a new trajectory to reach the same house. We measured the latency of the departure after the presentation of each house and the initial direction of the trajectory. The results suggest that several strategies are used by the subjects for replanning and our measures could be used as an index of impulsivity.
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Affiliation(s)
- Alexander Castilla
- Université de Paris, LaPsyDÉ, CNRS, Paris, France
- Laboratoire de Psychologie et de Neurosciences, Institut de Médecine Environnementale (IME), Paris, France
- Centre Interdisciplinaire de recherche en Biologie (CIRB), Collège de France, Paris, France
| | - Gregoire Borst
- Université de Paris, LaPsyDÉ, CNRS, Paris, France
- Institut Universitaire de France (IUF), Paris, France
| | - David Cohen
- Département de Psychiatrie de l'Enfant et de l'Adolescent, AP-HP, Hôpital Pitié-Salpêtrière, and Institut des Systèmes Intelligents et de Robotiques, Sorbonne Université, Paris, France
| | - Jacques Fradin
- Laboratoire de Psychologie et de Neurosciences, Institut de Médecine Environnementale (IME), Paris, France
| | - Camille Lefrançois
- Laboratoire de Psychologie et de Neurosciences, Institut de Médecine Environnementale (IME), Paris, France
| | - Olivier Houdé
- Université de Paris, LaPsyDÉ, CNRS, Paris, France
- Institut Universitaire de France (IUF), Paris, France
| | - Mohamed Zaoui
- Centre Interdisciplinaire de recherche en Biologie (CIRB), Collège de France, Paris, France
| | - Alain Berthoz
- Centre Interdisciplinaire de recherche en Biologie (CIRB), Collège de France, Paris, France
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15
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Peruzzi M, Sanasi E, Pingitore A, Marullo AG, Carnevale R, Sciarretta S, Sciarra L, Frati G, Cavarretta E. An overview of cycling as active transportation and as benefit for health. Minerva Cardioangiol 2021; 68:81-97. [PMID: 32429627 DOI: 10.23736/s0026-4725.20.05182-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Active transportation is defined as travelling on foot, by bicycle or other non-motorized means, sometimes in combination with other forms of public transportation, in contrast with the use of motor vehicles. The prevalence of sedentary lifestyle and physical inactivity is a growing epidemic in most developed countries that spread over the last three decades; active transportation may be a promising approach to increase physical activity and reduce the risk of non-communicable diseases improving cardiorespiratory fitness and cardiometabolic health. The health benefits of physical activity in reducing mortality and morbidity have been proved by several publications. Cardiorespiratory fitness can be improved by regular physical activity with an amelioration of insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Active transportation as a daily physical activity is less expensive compared to motor vehicle use. The advantages are remarkable in terms of contrasting obesity and sedentary lifestyle, decrease motor traffic congestion and mitigate climate change. Massive investments in policies and interventions aimed to increase active transportation are not generally promoted and there are differences in the prevalence of active transportation in the daily routine among different areas. As in the literature several studies as randomized trials or observational studies have been published, with different end-points, in order to investigate if active commuting may be the right answer to improve cardiorespiratory fitness and cardiometabolic health, we aimed to review the available evidences of cycling as an active transportation and to consider its benefits on health.
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Affiliation(s)
| | - Elena Sanasi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | | | - Antonino G Marullo
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Naples, Italy.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Luigi Sciarra
- Division of Cardiology, Policlinico Casilino, Rome, Italy
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Department of Angio-Cardio-Neurology, IRCCS NeuroMed, Pozzilli, Isernia, Italy
| | - Elena Cavarretta
- Mediterranea Cardiocentro, Naples, Italy - .,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy
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16
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Learning from atypical development: A systematic review of executive functioning in children and adolescents with the 22q11.2 deletion syndrome. DEVELOPMENTAL REVIEW 2021. [DOI: 10.1016/j.dr.2021.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Tik N, Livny A, Gal S, Gigi K, Tsarfaty G, Weiser M, Tavor I. Predicting individual variability in task-evoked brain activity in schizophrenia. Hum Brain Mapp 2021; 42:3983-3992. [PMID: 34021674 PMCID: PMC8288090 DOI: 10.1002/hbm.25534] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/25/2021] [Accepted: 05/02/2021] [Indexed: 12/13/2022] Open
Abstract
What goes wrong in a schizophrenia patient's brain that makes it so different from a healthy brain? In this study, we tested the hypothesis that the abnormal brain activity in schizophrenia is tightly related to alterations in brain connectivity. Using functional magnetic resonance imaging (fMRI), we demonstrated that both resting‐state functional connectivity and brain activity during the well‐validated N‐back task differed significantly between schizophrenia patients and healthy controls. Nevertheless, using a machine‐learning approach we were able to use resting‐state functional connectivity measures extracted from healthy controls to accurately predict individual variability in the task‐evoked brain activation in the schizophrenia patients. The predictions were highly accurate, sensitive, and specific, offering novel insights regarding the strong coupling between brain connectivity and activity in schizophrenia. On a practical perspective, these findings may allow to generate task activity maps for clinical populations without the need to actually perform any tasks, thereby reducing patients inconvenience while saving time and money.
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Affiliation(s)
- Niv Tik
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Abigail Livny
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel.,Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel-Hashomer, Israel
| | - Shachar Gal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Karny Gigi
- Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
| | - Galia Tsarfaty
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
| | - Mark Weiser
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Psychiatry, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ido Tavor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Strauss Center for Computational Neuroimaging, Tel Aviv University, Tel Aviv, Israel
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18
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Malpetti M, Jones PS, Tsvetanov KA, Rittman T, van Swieten JC, Borroni B, Sanchez-Valle R, Moreno F, Laforce R, Graff C, Synofzik M, Galimberti D, Masellis M, Tartaglia MC, Finger E, Vandenberghe R, de Mendonça A, Tagliavini F, Santana I, Ducharme S, Butler CR, Gerhard A, Levin J, Danek A, Otto M, Frisoni GB, Ghidoni R, Sorbi S, Heller C, Todd EG, Bocchetta M, Cash DM, Convery RS, Peakman G, Moore KM, Rohrer JD, Kievit RA, Rowe JB, Genfi GFI. Apathy in presymptomatic genetic frontotemporal dementia predicts cognitive decline and is driven by structural brain changes. Alzheimers Dement 2020; 17:969-983. [PMID: 33316852 PMCID: PMC8247340 DOI: 10.1002/alz.12252] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/15/2020] [Accepted: 11/03/2020] [Indexed: 12/31/2022]
Abstract
Introduction Apathy adversely affects prognosis and survival of patients with frontotemporal dementia (FTD). We test whether apathy develops in presymptomatic genetic FTD, and is associated with cognitive decline and brain atrophy. Methods Presymptomatic carriers of MAPT, GRN or C9orf72 mutations (N = 304), and relatives without mutations (N = 296) underwent clinical assessments and MRI at baseline, and annually for 2 years. Longitudinal changes in apathy, cognition, gray matter volumes, and their relationships were analyzed with latent growth curve modeling. Results Apathy severity increased over time in presymptomatic carriers, but not in non‐carriers. In presymptomatic carriers, baseline apathy predicted cognitive decline over two years, but not vice versa. Apathy progression was associated with baseline low gray matter volume in frontal and cingulate regions. Discussion Apathy is an early marker of FTD‐related changes and predicts a subsequent subclinical deterioration of cognition before dementia onset. Apathy may be a modifiable factor in those at risk of FTD.
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Affiliation(s)
- Maura Malpetti
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK
| | | | - Barbara Borroni
- Department of Clinical and Experimental Sciences, Centre for Neurodegenerative Disorders, University of Brescia, Brescia, Italy
| | - Raquel Sanchez-Valle
- Alzheimer's disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Fermin Moreno
- Department of Neurology, Cognitive Disorders Unit, Donostia Universitary Hospital, San Sebastian, Spain.,Neuroscience Area, Biodonostia Health Research Institute, San Sebastian, Gipuzkoa, Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Faculté de Médecine, Université Laval, Québec, Canada
| | - Caroline Graff
- Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Bioclinicum, Karolinska Institutet, Solna, Sweden.,Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Daniela Galimberti
- Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.,Centro Dino Ferrari, University of Milan, Milan, Italy
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada
| | - Rik Vandenberghe
- Department of Neurosciences, Laboratory for Cognitive Neurology, KU Leuven, Leuven, Belgium.,Neurology Service, University Hospitals Leuven, Leuven, Belgium.,KU Leuven, Leuven Brain Institute, Leuven, Belgium
| | | | | | - Isabel Santana
- University Hospital of Coimbra (HUC), Neurology Service, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Simon Ducharme
- Department of Psychiatry, McGill University Health Centre, McGill University, Montreal, Québec, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg- Essen, Duisburg, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandro Sorbi
- Department of Neuroscience Psychology Drug Research and Child Health, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Carolin Heller
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Emily G Todd
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - David M Cash
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Rhian S Convery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Georgia Peakman
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Katrina M Moore
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Rogier A Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.,Cognitive Neuroscience Department, Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, Nijmegen, Netherlands
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge, UK.,MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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19
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Izaute M, Thuaire F, Méot A, Rondepierre F, Jalenques I. Metacognitive preserved generation strategy benefits for both younger and elderly participants with schizophrenia. PLoS One 2020; 15:e0241356. [PMID: 33216755 PMCID: PMC7679005 DOI: 10.1371/journal.pone.0241356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
Cognitive memory and introspection disturbances are considered core features of schizophrenia. Moreover, it remains unclear whether or not participants with schizophrenia are more cognitively impaired with ageing than healthy participants. The aims of this study were to use a metacognitive approach to determine whether elderly participants with schizophrenia are able to improve their memory performance using a specific generation strategy and to evaluate the memory benefits for them using this strategy. 20 younger and 20 older participants with schizophrenia and their comparison participants matched for age, gender and education learned paired associates words with either reading or generation, rated judgment of learning (JOL) and performed cued recall. Participants with schizophrenia recalled fewer words than healthy comparison participants, but they benefited more from generation, and this difference was stable with ageing. Their JOL magnitude was lower than that of healthy comparison participants, but JOL accuracy was not affected by either age or the pathology. In spite of their memory deficit, elderly and younger participants with schizophrenia benefited remarkably from the memory generation strategy. This result gives some cause for optimism as to the possibility for participants with schizophrenia to reduce memory impairment if learning conditions lead them to encode deeply.
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Affiliation(s)
- Marie Izaute
- Université Clermont Auvergne, CNRS, LAPSCO, Clermont-Ferrand, France
- * E-mail:
| | - Flavien Thuaire
- Université Clermont Auvergne, CNRS, LAPSCO, Clermont-Ferrand, France
| | - Alain Méot
- Université Clermont Auvergne, CNRS, LAPSCO, Clermont-Ferrand, France
| | - Fabien Rondepierre
- Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Isabelle Jalenques
- Service de Psychiatrie de l’Adulte A et Psychologie Médicale, Centre Mémoire de Ressources et de Recherche, CHU Clermont-Ferrand, Institut de Psychiatrie-GDR 3557, Université Clermont Auvergne, Clermont-Ferrand, France
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20
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Resting-state hyperconnectivity within the default mode network impedes the ability to initiate cognitive performance in first-episode schizophrenia patients. Prog Neuropsychopharmacol Biol Psychiatry 2020; 102:109959. [PMID: 32376341 DOI: 10.1016/j.pnpbp.2020.109959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/15/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
Among multiple cognitive impairments present in schizophrenia, a decline in fast information processing is one of the most severe neuropsychological deficit. Reduced ability to efficiently launch a coherent cognitive activity might be a significant factor contributing to poor results in time-limited tasks obtained by schizophrenia patients. The aim of this study was to identify neurophysiological predictors of expected cognitive initiation failures in a group of first-episode schizophrenia individuals (SZ). To evaluate the effectiveness of initiation, a dynamic analysis of design fluency test was applied, assessing to what extent the productivity was focused within the first interval of the performance, what is a typical way healthy subjects execute this task. Resting-state EEG recordings were obtained from SZ patients (n = 34) and controls (n = 30) to examine functional connectivity between 84 intra-cortical current sources determined by eLORETA (exact low-resolution brain electromagnetic tomography) for six conventionally analyzed frequencies. The nonparametric randomization approach was used to identify hypo- and hyper-connections, i.e. synchronizations significantly differentiating the studied samples in terms of connectivity strength. Generally, SZ patients obtained poor outcomes in fluency test and dynamic analysis of performance confirmed the presence of initiation deficit in clinical sample, which was a single factor explaining the intergroup difference regarding the entire task. In the majority of frequencies, the arrangement of synchronizations in SZ group was dominated by hypo-connections, except for the theta band, in which the strength of synchronizations between posterior cingulate cortex, cuneus and precuneus was significantly higher for SZ group. These theta-band hyper-connections turned out to be significant predictors of cognitive initiation failure in the clinical sample. Additionally, theta hyper-connections correlated negatively with the total number of unique designs generated by patients, however, the strength of this correlation was weaker than regarding initiation index. The results of this study suggest that baseline hyperconnectivity within the posterior hub of the Default Mode Network, containing posterior cingulate gyrus and precuneus, might disturb effective cognitive outcome, not only by interfering with task-positive functional networks but also by delaying the starting phase of performance, which might be specifically deleterious for the execution of time-limited tests.
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21
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Abstract
Cognitive performance is typically conceptualized in terms of domains of
functioning. These domains are hierarchical in nature, with the bottom referring to more
basic sensory and perceptual processes and the top referring to elements of executive
functioning and cognitive control. Domains are not independent of each other and
executive functioning exerts control over the utilization of more basic processes.
Assessments are typically targeted at subdomains of each ability area and careful
combination of tasks can reveal patterns of performance consistent with a variety of
different neurological and neuropsychiatric conditions. This review covers the general
structures of domains, the patterns of impairments across domains seen in common
neuropsychiatric conditions, and use of assessment strategies to differentiate, to the
extent possible, between different types of conditions manifesting cognitive
impairment.
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Affiliation(s)
- Philip D Harvey
- Author affiliations: University of Miami Miller School of Medicine, Research Service, Bruce W. Carter VA Medical Center, Miami, Florida, US. Address for correspondence: 1120 NW 14th Street, Suite 1450, Miami, FL 33136 US.
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22
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Inflammatory markers are associated with psychomotor slowing in patients with schizophrenia compared to healthy controls. NPJ SCHIZOPHRENIA 2020; 6:8. [PMID: 32238816 PMCID: PMC7113262 DOI: 10.1038/s41537-020-0098-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/28/2020] [Indexed: 01/18/2023]
Abstract
Patients with schizophrenia exhibit psychomotor deficits that are associated with poor functional outcomes. One pathway that may be associated with psychomotor slowing is inflammation. Inflammatory markers have been shown to be elevated in patients with schizophrenia and are associated with psychomotor deficits in both animal and human studies. Forty-three patients with schizophrenia and 29 healthy controls were recruited and underwent a battery of psychomotor tasks. The following immune measures in peripheral blood were assayed: IL-6, IL-1 beta, IL-10, TNF, MCP-1, IL-6sr, IL-1RA, and TNFR2. Generalized linear models were used to determine which immune markers, in addition to their interaction with diagnosis, were associated with performance on the psychomotor tasks. As expected, patients with schizophrenia demonstrated slower performance compared with healthy controls on the finger tapping test (FTT, tested on dominant and non-dominant hands), trail making test (TMT), and symbol coding test (SC). Interactive effects with diagnosis were found for TNF, IL-10, IL-6sr, and TNFR2 for the FTT (dominant), IL-10 and IL-6sr for FTT (non-dominant), TNF and IL-10 for TMT and TNF, IL-10, IL-6sr, TNFR2, and IL-1RA for SC. The results of this study provide evidence that peripheral inflammatory markers contribute to psychomotor slowing in patients with schizophrenia. These data are consistent with a growing literature, demonstrating that inflammation may target the basal ganglia to contribute to psychomotor deficits as is seen in other psychiatric disorders such as depression. These data also indicate that psychomotor speed may be a relevant construct to target in studies of the immune system in schizophrenia.
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23
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Ryu J, Jung JH, Kim J, Kim CH, Lee HB, Kim DH, Lee SK, Shin JH, Roh D. Outdoor cycling improves clinical symptoms, cognition and objectively measured physical activity in patients with schizophrenia: A randomized controlled trial. J Psychiatr Res 2020; 120:144-153. [PMID: 31678749 DOI: 10.1016/j.jpsychires.2019.10.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The therapeutic effects of outdoor cycling (OC) and its benefits on physical activity (PA) were investigated in people with schizophrenia. METHODS Sixty patients with schizophrenia were randomly assigned to 16-weeks of Outdoor Cycling (OC) (n = 30, 50% male; mean age, 38.7 ± 10.1) or Occupational Therapy (OT) (n = 30, 50% male; mean age, 39.0 ± 8.6). OC and OT involved one 90-min group session per week. OC consisted of structured exercise programs and OT addressed daily living skills. Primary outcome measurements were mental health variables, such as Brief Psychiatric Rating Scale, Beck's Depression Inventory, State and Trait Anxiety Inventory, Rosenberg Self-Esteem Scale, Global Assessment of Functioning and executive function (Wisconsin Card Sorting Test, WCST). Secondary measures were the adherence and PA. PA was measured by responding to the Physical Activity Scale (K-PASE) and wearing a pedometer for 2 days. RESULTS Repeated measures ANOVA revealed improved psychotic symptoms (p = .014), depression (p = .007), state (p = .031) and trait anxiety (p = .002) and global functions (p = .024) in the OC group compared with OT group. The OC group showed increased correct rates (p = .022) and categories completed (p = .033) in the WCST. There was no difference in total K-PASE score between groups; however, there was a significant improvement in the number of daily steps in the OC group compared with the OT group (p = .030). CONCLUSION OC significantly improved mental health and executive function in individuals with schizophrenia. Further, OC significantly increased PA measured by the pedometers. These findings suggest that OC offers a safe and attrition-lowering intervention promoting mental health and PA. TRIAL REGISTRATION cris.nih.go.kr identifier: KCT-0000873.
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Affiliation(s)
- Jehkwang Ryu
- Department of Physical Education, College of Education, Dongguk University, Seoul, Republic of Korea
| | - Jae Hoon Jung
- Department of Psychiatry and Mind-neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Jiheon Kim
- Department of Psychiatry and Mind-neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Chan-Hyung Kim
- Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Hwa-Bock Lee
- Gwangmyeong Community Mental Health Center, Gwangmyeong, Republic of Korea
| | - Do-Hoon Kim
- Department of Psychiatry and Mind-neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Sang-Kyu Lee
- Department of Psychiatry and Mind-neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Ji-Hyeon Shin
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Daeyoung Roh
- Department of Psychiatry and Mind-neuromodulation Laboratory, Hallym University College of Medicine, Chuncheon, Republic of Korea.
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24
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Clesse C, Salime S, Dumand I, Concetta-Ciciarelli SB, Lavenir S, Kacemi K, Heckel-Chalet P, Sissung F, Poinsignon A, Simon A, Decker M, Batt M. The French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS): Modelization of an Adapted Assessment Method Toward Long-Term Psychiatric Inpatients With Disabling, Severe and Persistent Mental Illness. Front Psychiatry 2020; 11:540680. [PMID: 33192655 PMCID: PMC7531021 DOI: 10.3389/fpsyt.2020.540680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs. In this context, considering the absence of an assessment battery designed for French individuals with particularly disabling, severe, and persistent mental illness (IDSPMI), we constructed an integrative assessment model adapted to this specific population. To select the most suitable tools for this population, a literature review (inspired by the PRISMA protocol) and a systematic review were combined with a clinical assessment study. The literature review first identified the cognitive and psycho-affective functions which mainly influence the day-to-day life adaptation of individuals engaged in a PSR/deinstitutionalization program. The systematic review then gathered all of the useable French validated tools to assess the initially selected dimensions (n = 87). To finish, for each dimension, the selected 87 tools were included in a clinical assessment study performed within a French psychiatric hospital. The authors collected and verified the characteristics of each tool (validity, French norms, French version, the average speed of the test, ease of use, ability to assess other dimensions). Their suitability was also assessed when applied to IDSPMI. Based on this final clinical evaluation, the authors selected one tool per function to create the French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS). This battery is an assessment tailored to the neurocognitive and psycho-affective potentials of IDSPMI. While further validation studies of this battery are ultimately required, the practical/clinical implications of this battery are presented and discussed.
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Affiliation(s)
- Christophe Clesse
- Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barth & The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom.,Centre Hospitalier de Jury-les-Metz, Metz, France.,Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,IREPS Grand-Est, Laxou, France
| | - S Salime
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,Association Espoir 54, Nancy, France
| | - I Dumand
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - S Lavenir
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - K Kacemi
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - Frank Sissung
- Association d'Information et d'Entraide Mosellane, Metz, France
| | - Aurore Poinsignon
- Association d'Information et d'Entraide Mosellane, Metz, France.,Association Famille Rurale de Moselle, Solgne, France
| | - Anthony Simon
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
| | - M Decker
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - M Batt
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
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25
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Hong W, Zhao Z, Shen Z, Sun B, Li S, Mekbib DB, Xu Y, Huang M, Xu D. Uncoupled relationship in the brain between regional homogeneity and attention function in first-episode, drug-naïve schizophrenia. Psychiatry Res Neuroimaging 2019; 294:110990. [PMID: 31706152 DOI: 10.1016/j.pscychresns.2019.110990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 01/04/2023]
Abstract
The relationship between the cognitive impairment and the structural and functional abnormalities in the brains of patients with schizophrenia (SZ) is not yet clear. This study aims to investigate the relationship, thereby exploring the neuromechanism underlying SZ. We collected multimodal MRI data from 68 first-episode, drug-naïve patients with SZ, and 64 well-matched healthy controls, and used regional homogeneity (ReHo) and gray matter volume (GMV) to assess the functional and structural integrity of the brains, respectively. We then evaluated in the entire brain the correlations between ReHo/GMV and the participants' neuropsychological assessment scores for each group using a partial correlation analysis controlling for age and sex. We found significant uncoupling between attention performance and mean ReHo in the left middle frontal gyrus, right superior/inferior parietal lobe (IPL), right angular gyrus (AG) and right middle/inferior temporal lobe (ITG) in SZ compared with healthy controls. Moreover, we found that the SZ group showed decreased GMV in the right IPL and AG, and a significant coupling between ReHo and GMV in the right ITG. Our findings suggest that the attention dysfunction found in SZ may be associated with the structural and functional abnormalities as well as the structure-function interrelation in several SZ-related brain regions.
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Affiliation(s)
- Wenjun Hong
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai 200062, China; Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310027, China; Columbia University & New York State Psychiatric Institute, New York 10032, USA
| | - Zhe Shen
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Bin Sun
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Shangda Li
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Destaw B Mekbib
- Zhejiang University Interdisciplinary Institute of Neuroscience and Technology, Hangzhou 310003, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou 310003, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou 310003, China.
| | - Dongrong Xu
- Columbia University & New York State Psychiatric Institute, New York 10032, USA.
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26
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Little B, Gallagher P, Zimmerer V, Varley R, Douglas M, Spencer H, Çokal D, Deamer F, Turkington D, Ferrier IN, Hinzen W, Watson S. Language in schizophrenia and aphasia: the relationship with non-verbal cognition and thought disorder. Cogn Neuropsychiatry 2019; 24:389-405. [PMID: 31550981 DOI: 10.1080/13546805.2019.1668758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To determine the relationship between language abnormalities and broader cognitive impairment and thought disorder by examining language and cognition in schizophrenia and aphasia (a primary language disorder).Methods: Cognitive and linguistic profiles were measured with a battery of standardised tests, and compared in a clinical population of n = 50 (n = 30 with schizophrenia and n = 20 with aphasia) and n = 61 non-clinical comparisons (n = 45 healthy controls and n = 16 non-affected first-degree relatives of patients with schizophrenia).Results: Both clinical groups showed linguistic deficits. Verbal impairment was more severe in participants with aphasia, whereas non-verbal performance was more affected in participants with schizophrenia. In schizophrenia, but not in aphasia, verbal and non-verbal performance were associated. Formal thought disorder was associated with impairment in executive function and in grammatical, but not naming, tasks.Conclusion: While patients with schizophrenia and aphasia showed language impairments, the nature and cognitive basis of these impairments may be different; language performance disassociates from broader cognitive functioning in aphasia but may be an intrinsic expression of a broader cognitive impairment in schizophrenia. Thought disorder may represent a core malfunction of grammatical processing. Results suggests that communicative ability may be a valid target in cognitive remediation strategies in schizophrenia.
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Affiliation(s)
- Bethany Little
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Peter Gallagher
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Vitor Zimmerer
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Rosemary Varley
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Maggie Douglas
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Helen Spencer
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Derya Çokal
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,School of Electronic Engineering and Computer Science, Cognitive Science Research Group, Queen Mary University of London, London
| | - Felicity Deamer
- Department of Philosophy, Durham University, Durham, UK.,Department of English Studies, Durham University, Durham, UK
| | - Douglas Turkington
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Wolfram Hinzen
- ICREA (Catalan Institute of Advanced Studies and Research), Universitat Pompeu Fabra, Barcelona, Spain.,Department of Translation and Language Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,FIDMAG Germanes Hospitalaries Research Foundation, Benito Menni Hospital, Barcelona, Spain
| | - Stuart Watson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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27
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Vanes LD, Mouchlianitis E, Patel K, Barry E, Wong K, Thomas M, Szentgyorgyi T, Joyce D, Shergill S. Neural correlates of positive and negative symptoms through the illness course: an fMRI study in early psychosis and chronic schizophrenia. Sci Rep 2019; 9:14444. [PMID: 31595009 PMCID: PMC6783468 DOI: 10.1038/s41598-019-51023-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 09/23/2019] [Indexed: 12/14/2022] Open
Abstract
Psychotic illness is associated with cognitive control deficits and abnormal recruitment of neural circuits subserving cognitive control. It is unclear to what extent this dysfunction underlies the development and/or maintenance of positive and negative symptoms typically observed in schizophrenia. In this study we compared fMRI activation on a standard Stroop task and its relationship with positive and negative symptoms in early psychosis (EP, N = 88) and chronic schizophrenia (CHR-SZ, N = 38) patients. CHR-SZ patients showed reduced frontal, striatal, and parietal activation across incongruent and congruent trials compared to EP patients. Higher positive symptom severity was associated with reduced activation across both trial types in supplementary motor area (SMA), middle temporal gyrus and cerebellum in EP, but not CHR-SZ patients. Higher negative symptom severity was associated with reduced cerebellar activation in EP, but not in CHR-SZ patients. A negative correlation between negative symptoms and activation in SMA and precentral gyrus was observed in EP patients and in CHR-SZ patients. The results suggest that the neural substrate of positive symptoms changes with illness chronicity, and that cognitive control related neural circuits may be most relevant in the initial development phase of positive symptoms. These findings also highlight a changing role for the cerebellum in the development and later maintenance of both positive and negative symptoms.
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Affiliation(s)
- Lucy D Vanes
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London, WC1N 3AR, United Kingdom.
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Krisna Patel
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Erica Barry
- Institute Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Katie Wong
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Megan Thomas
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Timea Szentgyorgyi
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Dan Joyce
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
| | - Sukhwinder Shergill
- Institute of Psychiatry, Psychology and Neuroscience, de Crespigny Park, London, SE5 8AF, United Kingdom
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28
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Akiyama K, Saito A, Saito S, Ozeki Y, Watanabe T, Fujii K, Shimoda K. Association of genetic variants at 22q11.2 chromosomal region with cognitive performance in Japanese patients with schizophrenia. Schizophr Res Cogn 2019; 17:100134. [PMID: 31193788 PMCID: PMC6543121 DOI: 10.1016/j.scog.2019.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 11/11/2022] Open
Abstract
22q11.2 heterozygous multigene deletions confer an increased risk of schizophrenia with marked impairment of cognition. We explored whether genes on 22q11.2 are associated with cognitive performance in patients with idiopathic schizophrenia. A total of 240 schizophrenia patients and 240 healthy controls underwent the Japanese-language version of the Brief Assessment of Cognition in Schizophrenia (BACS) and were genotyped for 115 tag single-nucleotide polymorphisms (tag SNPs) at the 22q11.2 region using the golden gate assay (Illumina®). Associations between z-scores of the BACS cognitive domains and SNPs and haplotypes were analyzed using linear regression in PLINK 1.07. An additional set of 149 patients with bipolar disorder were included for cognitive assessment and selected SNPs were genotyped using real-time PCR. Patients with schizophrenia and bipolar disorder showed qualitatively comparable profiles of cognitive impairment across BACS subdomains, as revealed by significant correlation between the two groups in the resulting cognitive effect sizes relative to controls. rs4819522 (TBX1) and rs2238769 (UFD1L) were significantly and nominally associated, respectively, with symbol coding in patients with schizophrenia. Haplotype analyses revealed that haplotypes containing the A allele at rs4819522 and G allele at rs2238769 showed significant negative associations with symbol coding in patients with schizophrenia. There was no effect of any haplotypes on cognition in patients with bipolar disorder. Our results have implications for the understanding of the role of haplotypes of UFD1L and TBX1 genes associated with symbol coding in patients with schizophrenia. Further replication studies in a cohort of newly diagnosed patients and other ethnicities are warranted.
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29
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Chu AOK, Chang WC, Chan SKW, Lee EHM, Hui CLM, Chen EYH. Comparison of cognitive functions between first-episode schizophrenia patients, their unaffected siblings and individuals at clinical high-risk for psychosis. Psychol Med 2019; 49:1929-1936. [PMID: 30226125 DOI: 10.1017/s0033291718002726] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia and has been observed in both familial (FHR) and clinical high-risk (CHR) samples. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in these two high-risk states and first-episode schizophrenia. This study aimed to compare cognitive functions in patients with first-episode schizophrenia-spectrum disorder (FES), their unaffected siblings (FHR), CHR individuals and healthy controls. METHOD A standardized battery of cognitive assessments was administered to 69 FES patients, 71 help-seeking CHR individuals without family history of psychotic disorder, 50 FHR participants and 68 controls. FES and CHR participants were recruited from territory-wide early intervention service for psychosis in Hong Kong. CHR status was ascertained using Comprehensive Assessment of At-Risk Mental State. RESULTS Among four groups, FES patients displayed the largest global cognitive impairment and had medium-to-large deficits across all cognitive tests relative to controls. CHR and FHR participants significantly underperformed in most cognitive tests than controls. Among various cognitive tests, digit symbol coding demonstrated the greatest magnitude of impairment in FES and CHR groups compared with controls. No significant difference between two high-risk groups was observed in global cognition and all individual cognitive tests except digit symbol coding which showed greater deficits in CHR than in FHR participants. CONCLUSION Clinical and familial risk groups experienced largely comparable cognitive impairment that was intermediate between FES and controls. Digit symbol coding may have the greatest discriminant capacity in distinguishing FES and CHR from healthy controls, and between two high-risk samples.
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van Steenbergen H, Eikemo M, Leknes S. The role of the opioid system in decision making and cognitive control: A review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 19:435-458. [PMID: 30963411 PMCID: PMC6599188 DOI: 10.3758/s13415-019-00710-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The opioid system regulates affective processing, including pain, pleasure, and reward. Restricting the role of this system to hedonic modulation may be an underestimation, however. Opioid receptors are distributed widely in the human brain, including the more "cognitive" regions in the frontal and parietal lobes. Nonhuman animal research points to opioid modulation of cognitive and decision-making processes. We review emerging evidence on whether acute opioid drug modulation in healthy humans can influence cognitive function, such as how we choose between actions of different values and how we control our behavior in the face of distracting information. Specifically, we review studies employing opioid agonists or antagonists together with experimental paradigms of reward-based decision making, impulsivity, executive functioning, attention, inhibition, and effort. Although this field is still in its infancy, the emerging picture suggests that the mu-opioid system can influence higher-level cognitive function via modulation of valuation, motivation, and control circuits dense in mu-opioid receptors, including orbitofrontal cortex, basal ganglia, amygdalae, anterior cingulate cortex, and prefrontal cortex. The framework that we put forward proposes that opioids influence decision making and cognitive control by increasing the subjective value of reward and reducing aversive arousal. We highlight potential mechanisms that might underlie the effects of mu-opioid signaling on decision making and cognitive control and provide directions for future research.
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Affiliation(s)
- Henk van Steenbergen
- Cognitive Psychology Unit, Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Marie Eikemo
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Siri Leknes
- Department of Psychology, University of Oslo, Oslo, Norway
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Knowles EEM, Mathias SR, Pearlson GD, Barrett J, Mollon J, Denbow D, Aberzik K, Zatony M, Glahn DC. Clinical correlates of subsyndromal depression in African American individuals with psychosis: The relationship with positive symptoms and comorbid substance dependence. Schizophr Res 2019; 206:333-346. [PMID: 30482645 PMCID: PMC6486464 DOI: 10.1016/j.schres.2018.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 12/15/2022]
Abstract
Patients with psychosis exhibit subsyndromal depressive symptoms during the course of illness and yet the clinical correlates of these symptoms remain under-investigated. We aimed to investigate the clinical correlates of subsyndromal depression in psychosis including the extent to which they mediate commonly observed comorbid substance dependence. We developed a model of depression in a non-clinical sample recruited via Amazon's Mechanical Turk (N = 266), and confirmed that model in a locally recruited African-American clinical sample comprising psychotic and non-psychotic individuals (N = 256). Using scores from this model we tested: the strength of relationships between depressive symptomatology and positive, negative and disorganized symptoms in a range of psychotic disorders; whether depressive symptoms were higher in individuals with affective psychoses versus schizophrenia; and if depressive symptomatology mediated the relationship between psychosis and substance dependence. Subsyndromal depressive symptomatology was significantly higher in individuals with psychosis than without psychosis, but did not significantly differ between affective and non-affective psychotic groups. Depressive symptomatology was significantly related to positive (but not negative or disorganized) psychotic symptoms, and mediated the relationship between psychosis and substance dependence. The present study underlines the importance of assessing subsyndromal depression in patients with psychosis, and generates a number of testable predictions for future work. In particular, the examination of the relationships between comorbid psychopathology, namely depression and substance abuse, may improve insight into the neurobiology of psychosis.
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Affiliation(s)
- Emma E. M. Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Samuel. R. Mathias
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Godfrey D. Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Jennifer Barrett
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Josephine Mollon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Dominique Denbow
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Katrina Aberzik
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Molly Zatony
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
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32
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Cognition, social cognition, and Self-assessment in schizophrenia: prediction of different elements of everyday functional outcomes. CNS Spectr 2019; 24:88-93. [PMID: 30683165 PMCID: PMC6414257 DOI: 10.1017/s1092852918001414] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A growing body of research has shown that two domains of cognition, neurocognition and social cognition, predict different domains of real-world outcomes in people with schizophrenia. Social cognition has been shown to predict social outcomes but not non-social outcomes (e.g. living independently), and neurocognition provides minimal prediction of social outcomes (e.g. interpersonal relationships). The differing predictive value of neurocognition and social cognition has led to an exploration of potential factors that interact with cognition to influence everyday outcomes. Functional skills, negative symptoms, and self-assessment have shown particularly promising relationships with cognitive ability. Several consensus studies have pinpointed valid performance-based assessments. High-contact informant ratings have additionally been shown to be highly accurate. The emerging understanding of divergent patterns of predicting outcomes and reliable assessments present an opportunity to improve treatment targets and real-world outcomes for individuals with schizophrenia. In particular, a recently defined component of metacognition has shown particular promise. Introspective accuracy (IA) addresses how well individuals evaluate their own abilities. Emerging research has found that IA of neurocognitive ability better predicts everyday functional deficits than scores on performance-based measures of neurocognitive skills and has found that IA of social cognition accounts unique variance in real world disability above social cognitive abilities. Intriguingly, IA of neurocognition appears to preferentially predict non-social outcomes while IA of social cognition predicts social outcomes.
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Combining training leads to better results: Implications for clinical delivery of computerized cognitive and social cognitive training. Schizophr Res 2018; 202:48-49. [PMID: 30029832 DOI: 10.1016/j.schres.2018.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 11/21/2022]
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Sheffield JM, Karcher NR, Barch DM. Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective. Neuropsychol Rev 2018; 28:509-533. [PMID: 30343458 DOI: 10.1007/s11065-018-9388-2] [Citation(s) in RCA: 256] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with poorer functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.
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Affiliation(s)
- Julia M Sheffield
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Nashville, TN, 37212, USA.
| | - Nicole R Karcher
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.,Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA.,Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA
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35
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Lam M, Lee J, Rapisarda A, See YM, Yang Z, Lee SA, Abdul-Rashid NA, Kraus M, Subramaniam M, Chong SA, Keefe RSE. Longitudinal Cognitive Changes in Young Individuals at Ultrahigh Risk for Psychosis. JAMA Psychiatry 2018; 75:929-939. [PMID: 30046827 PMCID: PMC6142925 DOI: 10.1001/jamapsychiatry.2018.1668] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
IMPORTANCE Cognitive deficits are a key feature of risk for psychosis. Longitudinal changes in cognitive architecture may be associated with the social and occupational functioning in young people. OBJECTIVES To examine longitudinal profiles of cognition in individuals at ultrahigh risk (UHR) for psychosis, compared with healthy controls, and to investigate the association of cognition with functioning. DESIGN, SETTING, AND PARTICIPANTS This study has a multiple-group prospective design completed in 24 months and was conducted from January 1, 2009, to November 11, 2012, as part of the Longitudinal Youth at-Risk Study conducted in Singapore. Participants either were recruited from psychiatric outpatient clinics, educational institutions, and community mental health agencies or self-referred. Follow-up assessments were performed every 6 months for 2 years or until conversion to psychosis. Individuals with medical causes for psychosis, current illicit substance use, or color blindness were excluded. Data analysis was conducted from June 2014 to May 2018. MAIN OUTCOMES AND MEASURES Neuropsychological, perceptual, and social cognitive tasks; semi-structured interviews, and the Structured Clinical Interview for DSM-IV Axis I disorders were administered every 6 months. The UHR status of nonconverters, converters, remitters, and nonremitters was monitored. Cognitive domain scores and functioning were investigated longitudinally. RESULTS In total, 384 healthy controls and 173 UHR individuals between ages 14 and 29 years were evaluated prospectively. Of the 384 healthy controls, 153 (39.8%) were female and 231 (60.2%) were male with a mean (SD) age of 21.69 (3.26) years. Of the 173 individuals at UHR for psychosis, 56 (32.4%) were female and 117 (67.6%) were male with a mean (SD) age of 21.27 (3.52) years). After 24 months of follow-up, 383 healthy controls (99.7%) and 122 individuals at UHR for psychosis (70.5%) remained. Baseline cognitive deficits were associated with psychosis conversion later (mean odds ratio [OR], 1.66; combined 95% CI, 1.08-2.83; P = .04) and nonremission of UHR status (mean OR, 1.67; combined 95% CI, 1.09-2.95; P = .04). Five cognitive components-social cognition, attention, verbal fluency, general cognitive function, and perception-were obtained from principal components analysis. Longitudinal component structure change was observed in general cognitive function (maximum vertical deviation = 0.59; χ2 = 8.03; P = .01). Group-by-time interaction on general cognitive function (F = 12.23; η2 = 0.047; P < .001) and perception (F = 8.33; η2 = 0.032; P < .001) was present. Changes in attention (F = 5.65; η2 = 0.013; P = .02) and general cognitive function (F = 7.18; η2 = 0.014; P = .01) accounted for longitudinal changes in social and occupational functioning. CONCLUSIONS AND RELEVANCE Individuals in this study who met the UHR criteria appeared to demonstrate cognitive deficits, and those whose UHR status remitted were seen to recover cognitively. Cognition appeared as poor in nonremitters and appeared to be associated with poor functional outcome. This study suggests that cognitive dimensions are sensitive to the identification of young individuals at risk for psychosis and to the longitudinal course of those at highest risk.
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Affiliation(s)
- Max Lam
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore,Department of General Psychiatry 1, Institute of
Mental Health, Singapore, Singapore
| | - Attilio Rapisarda
- Research Division, Institute of Mental Health,
Singapore, Singapore,Neuroscience and Behavioural Disorders, Duke-NUS
Medical School, Singapore, Singapore
| | - Yuen Mei See
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Zixu Yang
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Sara-Ann Lee
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | | | - Michael Kraus
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
| | | | - Siow-Ann Chong
- Research Division, Institute of Mental Health,
Singapore, Singapore
| | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke
University Medical Center, Durham, North Carolina
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Palsetia D, Chandrasekhar K, Reddy MS, De Sousa A, Karia S. Executive function in patients with schizophrenia based on socio-occupational impairment: A cross-sectional study. Ind Psychiatry J 2018; 27:181-189. [PMID: 31359969 PMCID: PMC6592205 DOI: 10.4103/ipj.ipj_85_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Executive dysfunction deficit is the functionally most important cognitive deficit noted in schizophrenia. There is a dearth of Indian literature on the subject. The current study aimed at studying these executive functions in patients with schizophrenia in remission. METHODOLOGY Sixty outpatients with a diagnosis of schizophrenia as per international classification of diseases-10 criteria; in remission as measured by Positive and Negative Syndrome Scale scores were divided into two groups using the personal and social performance scale. The patients with and without socio-occupational impairment formed the two groups. All patients were administered the Wisconsin Card Sorting Test (WCST), Stroop test, Color Trails Test 1 and 2, Phonemic Fluency (Controlled Oral Word Association Test), and category fluency (animal names test) tests and the tower of London test to ascertain deficits in executive functions. The data obtained were subjected to statistical analysis. RESULTS The two groups were well matched. The group with socio-occupational impairment showed a lesser number of categories completed (P = 0.001), more perseverative errors (P = 0.001), and greater percentage of the same (P = 0.001) on the WCST. Statistically significant differences between both groups were observed for scores on phonemic fluency (P = 0.012) and category fluency (P = 0.049) tests as well as the Tower of London test (P = 0.021). They also showed differences on the Stroop test and Color Trail tests, but this was not statistically significant. CONCLUSIONS Performance on executive function tests is significantly correlated with functional outcome. It is important that future studies explore the role of these tests as a marker of socio-occupational impairment in schizophrenia.
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Affiliation(s)
- Delnaz Palsetia
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
| | - K Chandrasekhar
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
| | - M S Reddy
- Department of Psychiatry, Asha Hospital, Hyderabad, Telangana, India
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
| | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
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ZNF804A Variation May Affect Hippocampal-Prefrontal Resting-State Functional Connectivity in Schizophrenic and Healthy Individuals. Neurosci Bull 2018; 34:507-516. [PMID: 29611035 DOI: 10.1007/s12264-018-0221-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/05/2018] [Indexed: 01/05/2023] Open
Abstract
The ZNF804A variant rs1344706 has consistently been associated with schizophrenia and plays a role in hippocampal-prefrontal functional connectivity during working memory. Whether the effect exists in the resting state and in patients with schizophrenia remains unclear. In this study, we investigated the ZNF804A polymorphism at rs1344706 in 92 schizophrenic patients and 99 healthy controls of Han Chinese descent, and used resting-state functional magnetic resonance imaging to explore the functional connectivity in the participants. We found a significant main effect of genotype on the resting-state functional connectivity (RSFC) between the hippocampus and the dorsolateral prefrontal cortex (DLPFC) in both schizophrenic patients and healthy controls. The homozygous ZNF804A rs1344706 genotype (AA) conferred a high risk of schizophrenia, and also exhibited significantly decreased resting functional coupling between the left hippocampus and right DLPFC (F(2,165) = 13.43, P < 0.001). The RSFC strength was also correlated with cognitive performance and the severity of psychosis in schizophrenia. The current findings identified the neural impact of the ZNF804A rs1344706 on hippocampal-prefrontal RSFC associated with schizophrenia.
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Spagna A, He G, Jin S, Gao L, Mackie MA, Tian Y, Wang K, Fan J. Deficit of supramodal executive control of attention in schizophrenia. J Psychiatr Res 2018; 97:22-29. [PMID: 29172174 DOI: 10.1016/j.jpsychires.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/21/2017] [Accepted: 11/02/2017] [Indexed: 01/30/2023]
Abstract
Although a deficit in executive control of attention is one of the hallmarks in schizophrenia that has significant impact on everyday functioning due to its relationship with thought processing, whether this deficit occurs across modalities, i.e., is supramodal, remains unclear. To investigate the supramodal mechanism in SZ, we examined cross-modal correlations between visual and auditory executive control of attention in a group of patients with schizophrenia (SZ, n = 55) compared to neurotypical controls (NC, n = 55). While the executive control effects were significantly correlated between the two modalities in the NC group, these effects were not correlated in the SZ group, with a significant group difference in the correlation. Further, the inconsistency and magnitude of the cross-modal executive control effects were significantly larger in the SZ group compared to the NC group. Together, these results suggest that there is a disruption of a common supramodal executive control mechanism in patients with schizophrenia, which may be related to the thought processing disorder characterizing the disorder.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Genxia He
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Department of Neurology, The Second Hospital of Anhui Province, Hefei, Anhui Province, China
| | - Shengchun Jin
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Liling Gao
- Anhui Mental Health Center, Hefei, Anhui Province, China
| | - Melissa-Ann Mackie
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA
| | - Yanghua Tian
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China.
| | - Jin Fan
- Department of Psychology, Queens College, The City University of New York, Queens, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Berrett AN, Gale SD, Erickson LD, Brown BL, Hedges DW. Helicobacter pylori moderates the association between 5-MTHF concentration and cognitive function in older adults. PLoS One 2018; 13:e0190475. [PMID: 29364915 PMCID: PMC5783346 DOI: 10.1371/journal.pone.0190475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 12/11/2017] [Indexed: 01/02/2023] Open
Abstract
Objective To explore potential interactions between folate-cycle factors and Helicobacter pylori seropositivity in the prediction of cognitive function. Methods We used data obtained from the 1999–2000 continuous National Health and Nutrition Examination Survey produced by the United States’ Centers for Disease Control and Prevention. Using Ordinary Least Squares regression, we tested for associations between multiple folate-cycle factors, Helicobacter pylori seropositivity, and cognitive function assessed by the digit symbol coding subtest of the Wechsler Adult Intelligence Scale-III. We then tested for interactions between each of the folate-cycle factors and Helicobacter pylori in the prediction of cognitive function. Results Although Helicobacter pylori seropositivity, 5-methyltetrahydrofolate, vitamin B-12, and homocysteine were not associated with performance on the digit symbol coding task, Helicobacter pylori seropositivity interacted with 5-methyltetrahydrofolate concentration to predict performance on the digit symbol coding task. The Helicobacter pylori seropositive group performed worse on the digit symbol coding task as 5-methyltetrahydrofolate concentration decreased. Conclusion The interaction between Helicobacter pylori seropositivity and reduced folate-cycle factor 5-methyltetrahydrofolate might impair aspects of cognitive function.
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Affiliation(s)
- Andrew N Berrett
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Shawn D Gale
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
| | - Lance D Erickson
- Department of Sociology, Brigham Young University, Provo, Utah, United States of America
| | - Bruce L Brown
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
| | - Dawson W Hedges
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America
- The Neuroscience Center, Brigham Young University, Provo, Utah, United States of America
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40
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Deckler E, Hodgins GE, Pinkham AE, Penn DL, Harvey PD. Social Cognition and Neurocognition in Schizophrenia and Healthy Controls: Intercorrelations of Performance and Effects of Manipulations Aimed at Increasing Task Difficulty. Front Psychiatry 2018; 9:356. [PMID: 30131729 PMCID: PMC6091232 DOI: 10.3389/fpsyt.2018.00356] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/18/2018] [Indexed: 11/13/2022] Open
Abstract
Social cognition (SC) and neurocognition appear to predict different aspects of functional outcome in people with schizophrenia. However, the correlations between performance on these domains have not been tested extensively and compared cross-diagnostically with healthy controls. Further, some social cognitive measures appeared to have potential ceiling effects, particularly for healthy people, in previous research, so increasing their difficulty is of interest. In this paper we report on two studies wherein we examined the correlations between neurocognitive ability and performance on SC tests. In the first study the correlations between measures of social perception, emotion processing, and theory of mind and performance on a brief neuropsychological (NP) assessment were examined in 179 schizophrenia (SCZ) patients and 104 healthy controls (HC). In the second study, we instructed participants to perform a subset of the tasks as rapidly as possible in order to increase task difficulty, and we examined the effects of those instructions on task difficulty, task psychometrics, and correlations between SC and NP tests in 218 SCZ patients and 154 HC. In the first study, both HC and SCZ manifested a domain specific pattern of correlation between NP and SC test performance. Controlling for group differences in NP performance did not eliminate SC performance differences between the groups. In the second study, no differences in task performance, intercorrelations other SC tests, or test-retest stability were induced by the difficulty manipulation in the samples who performed the tasks with speed demands compared to the performance of the previous sample. These data suggest that simple manipulations aimed at increasing task difficulty may not have the desired effect and that despite consistent correlations between SC and NP test performance, impairments in social cognitive functioning are not fully explained by NP performance deficits.
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Affiliation(s)
- Elizabeth Deckler
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Gabrielle E Hodgins
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, United States
| | - David L Penn
- Department of Psychology, University of North Carolina, Chapel Hill, NC, United States.,Department of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.,Research Service, Miami VA Healthcare System, Miami, FL, United States
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Waterreus A, Badcock JC, Di Prinzio P, Martin-Iverson M, Morgan VA. The impact of current cannabis use on general cognitive function in people with psychotic illness. Schizophr Res 2017; 190:164-171. [PMID: 28381332 DOI: 10.1016/j.schres.2017.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite growing research, it remains unclear if cannabis use is associated with additive cognitive impairment in people with psychotic illness and whether exposure in early adolescence is associated with poorer cognitive performance in adulthood. METHODS This cross-sectional study of a nationally representative sample of 1199 adults with psychotic illness compared current cognition (digit symbol coding) of 297 current users of cannabis (used in the past year), 460 past users (used previously but not in the past year) and 442 non-users (never used). Multiple logistic regression was used to examine whether cognitive performance of cannabis-user groups varied by exposure age and diagnosis (non-affective/affective psychoses). RESULTS Unadjusted analysis showed current cannabis users had significantly higher odds of impaired cognitive function compared to non-users (odds ratio=1.52, 95%CI=1.04-2.22). After adjusting for potential confounders, differences between the three groups were not significant. Exposure age was not significant in adjusted analysis. In participants with nonaffective psychoses, cognitive ability of current cannabis users did not differ from non-users. However, in participants with affective psychoses, using cannabis in the last year was a significant predictor of impaired cognitive function (odds ratio=2.25, 95%CI=1.05-4.84). CONCLUSION Among people with psychotic illness, there was no significant difference in cognitive function between current, past and non-users of cannabis. However, when we compared cognitive performance of the three cannabis groups by diagnostic grouping, current cannabis use had a significant negative relationship with cognitive function in people with affective psychoses, but not in those with non-affective psychoses. This finding requires replication and further investigation.
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Affiliation(s)
- Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia.
| | - Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Mathew Martin-Iverson
- Pharmacology, M510, School of Biomedical Sciences, University of Western Australia, Stirling Highway, Crawley, 6009, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
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Lahera G, Ruiz A, Brañas A, Vicens M, Orozco A. Tiempo de reacción, velocidad de procesamiento y atención sostenida en esquizofrenia: impacto sobre el funcionamiento social. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:197-205. [DOI: 10.1016/j.rpsm.2017.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 02/21/2017] [Accepted: 04/12/2017] [Indexed: 01/27/2023]
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Lowe CJ, Safati A, Hall PA. The neurocognitive consequences of sleep restriction: A meta-analytic review. Neurosci Biobehav Rev 2017; 80:586-604. [PMID: 28757454 DOI: 10.1016/j.neubiorev.2017.07.010] [Citation(s) in RCA: 242] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/26/2017] [Accepted: 07/24/2017] [Indexed: 01/17/2023]
Abstract
The current meta-analytic review evaluated the effects of experimentally manipulated sleep restriction on neurocognitive functioning. Random-effects models were employed to estimate the overall effect size and the differential effect size across cognitive domains. Age, time of day, age-adjusted sleep deficit, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were examined as potential moderators of the effect. Based on a sample of 61 studies, from 71 different populations, findings revealed a significant negative effect of sleep restriction on cognitive processing across cognitive domains (g=-0.383, p<0.001). This effect held for executive functioning (g=-0.324, p<0.001), sustained attention (g=-0.409, p<0.001), and long-term memory (g=-0.192, p=0.002). There was insufficient evidence to detect an effect within the domains of attention, multitask, impulsive decision-making or intelligence. Age group, time of day, cumulative days of restricted sleep, sleep latency, subjective sleepiness, and biological sex were all significant moderators of the overall effect. In conclusion, the current meta-analysis is the first comprehensive review to provide evidence that short-term sleep restriction significantly impairs waking neurocognitive functioning.
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Affiliation(s)
- Cassandra J Lowe
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada.
| | - Adrian Safati
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Peter A Hall
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
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Mathias SR, Knowles EEM, Barrett J, Leach O, Buccheri S, Beetham T, Blangero J, Poldrack RA, Glahn DC. The Processing-Speed Impairment in Psychosis Is More Than Just Accelerated Aging. Schizophr Bull 2017; 43:814-823. [PMID: 28062652 PMCID: PMC5472152 DOI: 10.1093/schbul/sbw168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Processing speed is impaired in patients with psychosis, and deteriorates as a function of normal aging. These observations, in combination with other lines of research, suggest that psychosis may be a syndrome of accelerated aging. But do patients with psychosis perform poorly on tasks of processing speed for the same reasons as older adults? Fifty-one patients with psychotic illnesses and 90 controls with similar mean IQ (aged 19-69 years, all African American) completed a computerized processing-speed task, reminiscent of the classic digit-symbol coding task. The data were analyzed using the drift-diffusion model (DDM), and Bayesian inference was used to determine whether psychosis and aging had similar or divergent effects on the DDM parameters. Psychosis and aging were both associated with poor performance, but had divergent effects on the DDM parameters. Patients had lower information-processing efficiency ("drift rate") and longer nondecision time than controls, and psychosis per se did not influence response caution. By contrast, the primary effect of aging was to increase response caution, and had inconsistent effects on drift rate and nondecision time across patients and controls. The results reveal that psychosis and aging influenced performance in different ways, suggesting that the processing-speed impairment in psychosis is more than just accelerated aging. This study also demonstrates the potential utility of computational models and Bayesian inference for finely mapping the contributions of cognitive functions on simple neurocognitive tests.
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Affiliation(s)
- Samuel R. Mathias
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511
| | - Emma E. M. Knowles
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511;,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | - Jennifer Barrett
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | - Olivia Leach
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
| | | | - Tamara Beetham
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511
| | - John Blangero
- South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX
| | | | - David. C. Glahn
- Neurocognition, Neurocomputation and Neurogenetics (n3) Division, Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, Room 694, New Haven, CT 06511;,Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT
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Sawada K, Kanehara A, Sakakibara E, Eguchi S, Tada M, Satomura Y, Suga M, Koike S, Kasai K. Identifying neurocognitive markers for outcome prediction of global functioning in individuals with first-episode and ultra-high-risk for psychosis. Psychiatry Clin Neurosci 2017; 71:318-327. [PMID: 28294477 DOI: 10.1111/pcn.12522] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 02/05/2017] [Accepted: 03/07/2017] [Indexed: 02/04/2023]
Abstract
AIM There is an increasing need for identifying neurocognitive predictors of global functional outcome in early psychosis toward optimizing an early intervention strategy. METHODS We conducted a longitudinal observational study to investigate an association between neurocognitive assessments at baseline and global functional outcome at an average of 1-year follow up. Participants included ultra-high-risk for psychosis (UHR) individuals who had not converted to psychosis during the follow-up period (UHR-NP) and those with first-episode psychosis (FEP). We evaluated neurocognition at baseline using the Brief Assessment of Cognition in Schizophrenia Japanese version, including Verbal Memory, Working Memory, Motor Speed, Verbal Fluency, Attention/Processing Speed, and Executive Function. We also assessed global functional outcome using the modified Global Assessment of Functioning (mGAF) scale both at baseline and after the follow-up period. RESULTS Thirty-four UHR-NP individuals (34/47, 72%) and 29 FEP individuals (29/36, 81%) completed assessment of neurocognitive function at baseline and functional outcome at follow up. In the UHR-NP group, Attention/Processing Speed was significantly associated with the mGAF score at follow up. In the FEP group, Executive Function was significantly associated with the average mGAF score during follow up. CONCLUSION Attention/Processing Speed and Executive Function at baseline may predict global functional outcome of early psychosis. These neurocognitive tests are easy to incorporate in clinical settings and, if replicated in independent samples, may be included in routine clinical assessments for prediction of functional outcome in early psychosis.
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Affiliation(s)
- Kingo Sawada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akiko Kanehara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eisuke Sakakibara
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Eguchi
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Tada
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshihiro Satomura
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motomu Suga
- Department of Rehabilitation, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), Tokyo, Japan.,Center for Evolutionary Cognitive Sciences, Graduate School of Art and Sciences, The University of Tokyo, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Bruce HA, Kochunov P, Paciga SA, Hyde CL, Chen X, Xie Z, Zhang B, Xi HS, O'Donnell P, Whelan C, Schubert CR, Bellon A, Ament SA, Shukla DK, Du X, Rowland LM, O'Neill H, Hong LE. Potassium channel gene associations with joint processing speed and white matter impairments in schizophrenia. GENES BRAIN AND BEHAVIOR 2017; 16:515-521. [PMID: 28188958 DOI: 10.1111/gbb.12372] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/14/2017] [Accepted: 02/07/2017] [Indexed: 12/17/2022]
Abstract
Patients with schizophrenia show decreased processing speed on neuropsychological testing and decreased white matter integrity as measured by diffusion tensor imaging, two traits shown to be both heritable and genetically associated indicating that there may be genes that influence both traits as well as schizophrenia disease risk. The potassium channel gene family is a reasonable candidate to harbor such a gene given the prominent role potassium channels play in the central nervous system in signal transduction, particularly in myelinated axons. We genotyped members of the large potassium channel gene family focusing on putatively functional single nucleotide polymorphisms (SNPs) in a population of 363 controls, 194 patients with schizophrenia spectrum disorder (SSD) and 28 patients with affective disorders with psychotic features who completed imaging and neuropsychological testing. We then performed three association analyses using three phenotypes - processing speed, whole-brain white matter fractional anisotropy (FA) and schizophrenia spectrum diagnosis. We extracted SNPs showing an association at a nominal P value of <0.05 with all three phenotypes in the expected direction: decreased processing speed, decreased FA and increased risk of SSD. A single SNP, rs8234, in the 3' untranslated region of voltage-gated potassium channel subfamily Q member 1 (KCNQ1) was identified. Rs8234 has been shown to affect KCNQ1 expression levels, and KCNQ1 levels have been shown to affect neuronal action potentials. This exploratory analysis provides preliminary data suggesting that KCNQ1 may contribute to the shared risk for diminished processing speed, diminished white mater integrity and increased risk of schizophrenia.
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Affiliation(s)
- H A Bruce
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - P Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - S A Paciga
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - C L Hyde
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - X Chen
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - Z Xie
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - B Zhang
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - H S Xi
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - P O'Donnell
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | - C Whelan
- Pfizer Inc., Worldwide Research and Development, Cambridge, MA
| | | | - A Bellon
- Department of Psychiatry, Penn State Hershey Medical Center, Hershey, PA, USA
| | - S A Ament
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - D K Shukla
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - X Du
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - L M Rowland
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - H O'Neill
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
| | - L E Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD
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Fonctions cognitives sous-jacentes aux déficits de fluence verbale dans la schizophrénie : revue de la littérature. ANNALES MEDICO-PSYCHOLOGIQUES 2017. [DOI: 10.1016/j.amp.2016.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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48
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Bitter NA, Roeg DPK, van Nieuwenhuizen C, van Weeghel J. Identifying profiles of service users in housing services and exploring their quality of life and care needs. BMC Psychiatry 2016; 16:419. [PMID: 27881159 PMCID: PMC5120432 DOI: 10.1186/s12888-016-1122-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. METHODS Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. RESULTS Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. CONCLUSIONS The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be provided on all dimensions of recovery at the same time, therefore mental health care organisations should work together and integrate their services. TRIAL REGISTRATION ISRCTN registry ISRCTN77355880 retrospectively registered 05/07/2013.
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Affiliation(s)
- Neis A. Bitter
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Diana P. K. Roeg
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Chijs van Nieuwenhuizen
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Jaap van Weeghel
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,Phrenos Centre of Expertise, PO Box 1203, 3500 BE Utrecht, The Netherlands ,Parnassia Group, Dijk en Duin Mental Health Centre, PO Box 305, 1900 AH Castricum, The Netherlands
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Stenfors CUD, Hanson LM, Theorell T, Osika WS. Executive Cognitive Functioning and Cardiovascular Autonomic Regulation in a Population-Based Sample of Working Adults. Front Psychol 2016; 7:1536. [PMID: 27761124 PMCID: PMC5050226 DOI: 10.3389/fpsyg.2016.01536] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/21/2016] [Indexed: 01/06/2023] Open
Abstract
Objective: Executive cognitive functioning is essential in private and working life and is sensitive to stress and aging. Cardiovascular (CV) health factors are related to cognitive decline and dementia, but there is relatively few studies of the role of CV autonomic regulation, a key component in stress responses and risk factor for cardiovascular disease (CVD), and executive processes. An emerging pattern of results from previous studies suggest that different executive processes may be differentially associated with CV autonomic regulation. The aim was thus to study the associations between multiple measures of CV autonomic regulation and measures of different executive cognitive processes. Method: Participants were 119 healthy working adults (79% women), from the Swedish Longitudinal Occupational Survey of Health. Electrocardiogram was sampled for analysis of heart rate variability (HRV) measures, including the Standard Deviation of NN, here heart beats (SDNN), root of the mean squares of successive differences (RMSSD), high frequency (HF) power band from spectral analyses, and QT variability index (QTVI), a measure of myocardial repolarization patterns. Executive cognitive functioning was measured by seven neuropsychological tests. The relationships between CV autonomic regulation measures and executive cognitive measures were tested with bivariate and partial correlational analyses, controlling for demographic variables, and mental health symptoms. Results: Higher SDNN and RMSSD and lower QTVI were significantly associated with better performance on cognitive tests tapping inhibition, updating, shifting, and psychomotor speed. After adjustments for demographic factors however (age being the greatest confounder), only QTVI was clearly associated with these executive tests. No such associations were seen for working memory capacity. Conclusion: Poorer CV autonomic regulation in terms of lower SDNN and RMSSD and higher QTVI was associated with poorer executive cognitive functioning in terms of inhibition, shifting, updating, and speed in healthy working adults. Age could largely explain the associations between the executive measures and SDNN and RMSSD, while associations with QTVI remained. QTVI may be a useful measure of autonomic regulation and promising as an early indicator of risk among otherwise healthy adults, compared to traditional HRV measures, as associations between QTVI and executive functioning was not affected by age.
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Affiliation(s)
- Cecilia U D Stenfors
- Aging Research Center, Department of Neurobiology, Care Science and Society, Karolinska InstituteStockholm, Sweden; Environmental Neuroscience Lab, Department of Psychology, University of ChicagoChicago, IL, USA
| | - Linda M Hanson
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Töres Theorell
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Walter S Osika
- Department of Neurobiology, Care Science and Society, Center for Social Sustainability, Karolinska InstituteStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstituteStockholm, Sweden
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Correlation of social cognition and neurocognition on psychotic outcome: a naturalistic follow-up study of subjects with attenuated psychosis syndrome. Sci Rep 2016; 6:35017. [PMID: 27721394 PMCID: PMC5056353 DOI: 10.1038/srep35017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 09/22/2016] [Indexed: 11/17/2022] Open
Abstract
Neurocognitive decline has been observed in patients with psychosis as well as attenuated psychosis syndrome (APS). We tested the hypothesis that APS increases dependence on neurocognition during the interpretation of others’ mental states and that a combination index of Theory of Mind (ToM) and neurocognition improves the predictive accuracy of psychosis conversion. A sample of 83 APS individuals and 90 healthy controls (HC) were assessed by comprehensive cognitive tests. The cohort also completed a one-year follow-up. In the APS group, ToM was associated with an apparent increase in neurocognition, but this trend was not evident in the HC group. Using the new index of combined neurocognition and ToM scores, the sensitivity for predicting psychosis-proneness was 75% and the specificity was 69%. Our data suggest that the correlations between ToM function and neurocognition in APS subjects were stronger than those in healthy controls. A composite index of neurocognition and ToM could improve the predictive validity of a future conversion to psychosis.
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