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Mantonakis L, Stefanatou P, Tsionis A, Konstantakopoulos G, Xenaki LA, Ntigrintaki AA, Ralli I, Dimitrakopoulos S, Kollias K, Stefanis NC. Cognitive Inflexibility Predicts Negative Symptoms Severity in Patients with First-Episode Psychosis: A 1-Year Follow-Up Study. Brain Sci 2024; 14:162. [PMID: 38391736 PMCID: PMC10886606 DOI: 10.3390/brainsci14020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Negative symptoms and cognitive deficits play a major role in psychosis and significantly influence the functional outcomes of patients, particularly those with a first episode of psychosis (FEP). However, limited research has explored the predictive capacity of cognitive deficits during FEP for subsequent negative symptomatology. Drawing from the Athens FEP research study, we conducted a retrospective longitudinal study in 80 individuals with FEP. All patients were drug naive at admission. Cognitive tests were administered at 1-month and 1-year post-admission, while negative symptomatology was assessed at the same time points using PANSS by trained raters. We considered confounding factors such as age, gender, duration of untreated psychosis (DUP), treatment received, premorbid social adjustment, and premorbid IQ. Univariate regression analysis identified cognitive domains that correlated with negative symptomatology. These, along with the confounders, were incorporated into a multiple regression, with the 1-year PANSS negative scale serving as the dependent variable. Employing the backward elimination technique, we found a statistically significant inverse relationship between the categories completed in the Wisconsin card sorting test (WCST) and the 1-year PANNS negative scale (p = 0.01), beyond the associations with DUP and the 1-month PANSS negative scale. Our results suggest that cognitive flexibility, a key component of executive functions, predicts negative symptom severity one year after FEP.
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Affiliation(s)
- Leonidas Mantonakis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Pentagiotissa Stefanatou
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Antonis Tsionis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - George Konstantakopoulos
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Research Department of Clinical, Education and Health Psychology, University College London, London WC1E 7HB, UK
| | - Lida-Alkisti Xenaki
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Angeliki-Aikaterini Ntigrintaki
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Irene Ralli
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Stefanos Dimitrakopoulos
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Psychiatric Clinic, 414 Military Hospital of Athens, 15236 Palea Penteli, Greece
| | - Konstantinos Kollias
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Nikos C Stefanis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
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Au-Yeung C, Penney D, Rae J, Carling H, Lassman L, Lepage M. The relationship between negative symptoms and MATRICS neurocognitive domains: A meta-analysis and systematic review. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110833. [PMID: 37482283 DOI: 10.1016/j.pnpbp.2023.110833] [Citation(s) in RCA: 4] [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: 04/28/2023] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Negative symptoms (NS) are a core symptom domain in schizophrenia spectrum disorders and are associated with poorer social and vocational functioning, and with increased likelihood and durations of hospital admission. NS are not well understood, limiting available interventions. However, numerous studies have reported associations between neurocognitive domains and NS severity. Thus, one promising area in understanding NS is in relation to neurocognition. Currently, the specificity of the relationship between NS and neurocognition is unknown, meaning that there is no consensus regarding which neurocognitive domain is most strongly associated with NS. There is a need to systematically examine the relationship between NS and various neurocognitive domains within study samples. METHODS A systematic search of Ovid PsycINFO, Ovid MEDLINE and Web of Science was performed for articles published since 2004 (year of MATRICS Consensus publication). Inclusion criteria were: 1) individuals with schizophrenia spectrum disorders, first episode psychosis or clinical high risk 2) assessed all six MATRICS neurocognitive domains (processing speed, attention, working memory, verbal learning & memory, visual learning & memory, reasoning & problem solving), 3) reported correlations between all six MATRICS neurocognitive domains and global NS. A three-level random effects hierarchical meta-analysis was performed to assess the relationship between NS (global, expressive, and experiential dimensions) and the six MATRICS neurocognitive domains. RESULTS 21 studies were included in the review (n = 3619). All MATRICS neurocognitive domains had small significant correlations with global NS (r = -0.16 to -0.20, p < 0.0001). This relationship was significantly moderated by diagnosis and the moderating effect of sex/ gender trended on significance. Analysis of a subset of the studies revealed that MATRICS neurocognitive domains also had small significant correlations with the two NS dimensions, expressive and experiential. Correlations were stronger with the expressive NS dimension. CONCLUSIONS This review is novel in assessing the relationship between multiple neurocognitive domains and NS within the same sample, by synthesizing close to two decades of research. Our results suggest that there is a non-specific relationship between neurocognition and NS, and that expressive NS may have a stronger relationship with neurocognitive functioning-based on the MATRICS classification of neurocognition and the neurocognitive assessments used in the included studies. This has implications on our understanding of NS and neurocognition, as well as their treatments. As we gain better understanding of the directionality of the NS-cognition relationship, it could suggest that NS, particularly in the expressive domain, could be improved by targeting cognition globally or that neurocognitive treatments could be more effective if NS are addressed first. Further implications of these results are discussed.
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Affiliation(s)
- Christy Au-Yeung
- Department of Psychology, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montréal, Québec, Canada
| | - Danielle Penney
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Jesse Rae
- Douglas Research Centre, Montréal, Québec, Canada
| | - Hannah Carling
- Department of Psychology, McGill University, Montreal, Quebec, Canada; Douglas Research Centre, Montréal, Québec, Canada
| | - Libby Lassman
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Martin Lepage
- Douglas Research Centre, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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McWhinney SR, Brosch K, Calhoun VD, Crespo-Facorro B, Crossley NA, Dannlowski U, Dickie E, Dietze LMF, Donohoe G, Du Plessis S, Ehrlich S, Emsley R, Furstova P, Glahn DC, Gonzalez-Valderrama A, Grotegerd D, Holleran L, Kircher TTJ, Knytl P, Kolenic M, Lencer R, Nenadić I, Opel N, Pfarr JK, Rodrigue AL, Rootes-Murdy K, Ross AJ, Sim K, Škoch A, Spaniel F, Stein F, Švancer P, Tordesillas-Gutiérrez D, Undurraga J, Vázquez-Bourgon J, Voineskos A, Walton E, Weickert TW, Weickert CS, Thompson PM, van Erp TGM, Turner JA, Hajek T. Obesity and brain structure in schizophrenia - ENIGMA study in 3021 individuals. Mol Psychiatry 2022; 27:3731-3737. [PMID: 35739320 PMCID: PMC9902274 DOI: 10.1038/s41380-022-01616-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 02/08/2023]
Abstract
Schizophrenia is frequently associated with obesity, which is linked with neurostructural alterations. Yet, we do not understand how the brain correlates of obesity map onto the brain changes in schizophrenia. We obtained MRI-derived brain cortical and subcortical measures and body mass index (BMI) from 1260 individuals with schizophrenia and 1761 controls from 12 independent research sites within the ENIGMA-Schizophrenia Working Group. We jointly modeled the statistical effects of schizophrenia and BMI using mixed effects. BMI was additively associated with structure of many of the same brain regions as schizophrenia, but the cortical and subcortical alterations in schizophrenia were more widespread and pronounced. Both BMI and schizophrenia were primarily associated with changes in cortical thickness, with fewer correlates in surface area. While, BMI was negatively associated with cortical thickness, the significant associations between BMI and surface area or subcortical volumes were positive. Lastly, the brain correlates of obesity were replicated among large studies and closely resembled neurostructural changes in major depressive disorders. We confirmed widespread associations between BMI and brain structure in individuals with schizophrenia. People with both obesity and schizophrenia showed more pronounced brain alterations than people with only one of these conditions. Obesity appears to be a relevant factor which could account for heterogeneity of brain imaging findings and for differences in brain imaging outcomes among people with schizophrenia.
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Affiliation(s)
- Sean R McWhinney
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Vince D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory University, Atlanta, GA, USA
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- IBiS, University Hospital Virgen del Rocio, Sevilla, Spain
- Department of Psychiatry, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Nicolas A Crossley
- Department of Psychiatry, School of Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, King's College London, London, UK
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Erin Dickie
- Centre for Addiction & Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Gary Donohoe
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Stefan Du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- SAMRC Genomics of Brain Disorders Unit, Cape Town, South Africa
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Robin Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Petra Furstova
- National Institute of Mental Health, Klecany, Czech Republic
| | - David C Glahn
- Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, USA
| | - Alfonso Gonzalez-Valderrama
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
- Early Intervention in Psychosis Program, Instituto Psiquiátrico 'Dr. José Horwitz B.', Santiago, Chile
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Laurena Holleran
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Tilo T J Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Pavel Knytl
- National Institute of Mental Health, Klecany, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Marian Kolenic
- National Institute of Mental Health, Klecany, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Rebekka Lencer
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Pscyhiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Nils Opel
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Amanda L Rodrigue
- Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Alex J Ross
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Antonín Škoch
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Patrik Švancer
- National Institute of Mental Health, Klecany, Czech Republic
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Diana Tordesillas-Gutiérrez
- Department of Radiology, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
- Computación Avanzada y Ciencia, Instituto de Física de Cantabria, CSIC, Santander, Spain
| | - Juan Undurraga
- Early Intervention in Psychosis Program, Instituto Psiquiátrico 'Dr. José Horwitz B.', Santiago, Chile
- Department of Neurology and Psychiatry. Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Javier Vázquez-Bourgon
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Santander, Spain
| | - Aristotle Voineskos
- Centre for Addiction & Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Esther Walton
- Department of Psychology, University of Bath, Bath, UK
| | - Thomas W Weickert
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Cynthia Shannon Weickert
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
- Neuroscience Research Australia, Randwick, NSW, Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - Theo G M van Erp
- Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California Irvine, Irvine, CA, USA
| | - Jessica A Turner
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
- National Institute of Mental Health, Klecany, Czech Republic.
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Karcher NR, Merchant J, Pine J, Kilciksiz CM. Cognitive Dysfunction as a Risk Factor for Psychosis. Curr Top Behav Neurosci 2022; 63:173-203. [PMID: 35989398 DOI: 10.1007/7854_2022_387] [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] [Indexed: 11/25/2022]
Abstract
The current chapter summarizes recent evidence for cognition as a risk factor for the development of psychosis, including the range of cognitive impairments that exist across the spectrum of psychosis risk symptoms. The chapter examines several possible theories linking cognitive deficits with the development of psychotic symptoms, including evidence that cognitive deficits may be an intermediate risk factor linking genetic and/or neural metrics to psychosis spectrum symptoms. Although there is not strong evidence for unique cognitive markers associated specifically with psychosis compared to other forms of psychopathology, psychotic disorders are generally associated with the greatest severity of cognitive deficits. Cognitive deficits precede the development of psychotic symptoms and may be detectable as early as childhood. Across the psychosis spectrum, both the presence and severity of psychotic symptoms are associated with mild to moderate impairments across cognitive domains, perhaps most consistently for language, cognitive control, and working memory domains. Research generally indicates the size of these cognitive impairments worsens as psychosis symptom severity increases. The chapter points out areas of unclarity and unanswered questions in each of these areas, including regarding the mechanisms contributing to the association between cognition and psychosis, the timing of deficits, and whether any cognitive systems can be identified that function as specific predictors of psychosis risk symptoms.
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Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA.
| | - Jaisal Merchant
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Jacob Pine
- Department of Brain and Psychological Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Can Misel Kilciksiz
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Far transfer effects of executive working memory training on cognitive flexibility. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Macoveanu J, Freeman KO, Kjaerstad HL, Knudsen GM, Kessing LV, Miskowiak KW. Structural brain abnormalities associated with cognitive impairments in bipolar disorder. Acta Psychiatr Scand 2021; 144:379-391. [PMID: 34245569 DOI: 10.1111/acps.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Cognitive impairment has been highlighted as a core feature of bipolar disorder (BD) that often persists during remission. The specific brain correlates of cognitive impairment in BD remain unclear which impedes efficient therapeutic approaches. In a large sample of remitted BD patients, we investigated whether morphological brain abnormalities within dorsal prefrontal cortex (PFC) and hippocampus were related to cognitive deficits. METHODS Remitted BD patients (n = 153) and healthy controls (n = 52) underwent neuropsychological assessment and structural MRI. Based on hierarchical cluster analysis of neuropsychological test performance, patients were classified as either cognitively impaired (n = 91) or cognitively normal (n = 62). The neurocognitive subgroups were compared amongst each other and with healthy controls in terms of dorsal PFC cortical thickness and volume, hippocampus shape and volume, and total cerebral grey and white matter volumes. RESULTS Cognitively impaired patients displayed greater left dorsomedial prefrontal thickness compared to cognitively normal patients and healthy controls. Hippocampal grey matter volume and shape were similar across patient subgroups and healthy controls. At a whole-brain level, cognitively impaired patients had lower cerebral white matter volume compared to the other groups. Across all participants, lower white matter volume correlated with more impaired neuropsychological test performance. CONCLUSIONS Our findings associate cognitive impairment in bipolar disorder with cerebral white matter deficits, factors which may relate to the observed morphological changes in dorsomedial PFC possibly due to increased neurocognitive effort to maintain symptom stability in these remitted patients.
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Affiliation(s)
- Julian Macoveanu
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Katherine Olivia Freeman
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Lie Kjaerstad
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit and Center for Integrated Molecular imaging, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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McWhinney S, Kolenic M, Franke K, Fialova M, Knytl P, Matejka M, Spaniel F, Hajek T. Obesity as a Risk Factor for Accelerated Brain Ageing in First-Episode Psychosis-A Longitudinal Study. Schizophr Bull 2021; 47:1772-1781. [PMID: 34080013 PMCID: PMC8530396 DOI: 10.1093/schbul/sbab064] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Obesity is highly prevalent in schizophrenia, with implications for psychiatric prognosis, possibly through links between obesity and brain structure. In this longitudinal study in first episode of psychosis (FEP), we used machine learning and structural magnetic resonance imaging (MRI) to study the impact of psychotic illness and obesity on brain ageing/neuroprogression shortly after illness onset. METHODS We acquired 2 prospective MRI scans on average 1.61 years apart in 183 FEP and 155 control individuals. We used a machine learning model trained on an independent sample of 504 controls to estimate the individual brain ages of study participants and calculated BrainAGE by subtracting chronological from the estimated brain age. RESULTS Individuals with FEP had a higher initial BrainAGE than controls (3.39 ± 6.36 vs 1.72 ± 5.56 years; β = 1.68, t(336) = 2.59, P = .01), but similar annual rates of brain ageing over time (1.28 ± 2.40 vs 1.07±1.74 estimated years/actual year; t(333) = 0.93, P = .18). Across both cohorts, greater baseline body mass index (BMI) predicted faster brain ageing (β = 0.08, t(333) = 2.59, P = .01). For each additional BMI point, the brain aged by an additional month per year. Worsening of functioning over time (Global Assessment of Functioning; β = -0.04, t(164) = -2.48, P = .01) and increases especially in negative symptoms on the Positive and Negative Syndrome Scale (β = 0.11, t(175) = 3.11, P = .002) were associated with faster brain ageing in FEP. CONCLUSIONS Brain alterations in psychosis are manifest already during the first episode and over time get worse in those with worsening clinical outcomes or higher baseline BMI. As baseline BMI predicted faster brain ageing, obesity may represent a modifiable risk factor in FEP that is linked with psychiatric outcomes via effects on brain structure.
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Affiliation(s)
- Sean McWhinney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marian Kolenic
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katja Franke
- Structural Brain Mapping Group, Department of Neurology, Jena University Hospital, Jena, Germany
| | - Marketa Fialova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Klecany, Czech Republic
| | - Martin Matejka
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada,National Institute of Mental Health, Klecany, Czech Republic,To whom correspondence should be addressed; Department of Psychiatry, Dalhousie University, QEII HSC, A. J. Lane Building, Room 3093, 5909 Veteran’s Memorial Lane, Halifax, Nova Scotia B3H 2E2, Canada; tel: (902) 473-8299, fax: (902) 473-1583, e-mail:
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8
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Tronchin G, McPhilemy G, Ahmed M, Kilmartin L, Costello L, Forde NJ, Nabulsi L, Akudjedu TN, Holleran L, Hallahan B, Cannon DM, McDonald C. White matter microstructure and structural networks in treatment-resistant schizophrenia patients after commencing clozapine treatment: A longitudinal diffusion imaging study. Psychiatry Res 2021; 298:113772. [PMID: 33556689 DOI: 10.1016/j.psychres.2021.113772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/26/2021] [Indexed: 02/08/2023]
Abstract
This study investigates changes on white matter microstructure and neural networks after 6 months of switching to clozapine in schizophrenia patients compared to controls, and whether any changes are related to clinical variables. T1 and diffusion-weighted MRI images were acquired at baseline before commencing clozapine and after 6 months of treatment for 22 patients with treatment-resistant schizophrenia and 23 controls. The Tract-based spatial statistics approach was used to compare changes over time between groups in fractional anisotropy (FA). Changes in structural network organisation weighted by FA and number of streamlines were assessed using graph theory. Patients displayed a significant reduction of FA over time (p<0.05) compared to controls in the genu and body of the corpus callosum and bilaterally in the anterior and superior corona radiata. There was no correlation between FA change in patients and changes in clinical variables or serum level of clozapine. There was no changes in structural network organisation between groups (F(7,280)=2.80;p = 0.187). This longitudinal study demonstrated progressive focal FA abnormalities in key anterior tracts, but preserved brain structural network organisation in patients. The FA reduction was independent of any clinical measures and may reflect progression of the underlying pathophysiology of this malignant form of schizophrenia illness.
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Affiliation(s)
- Giulia Tronchin
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland.
| | - Genevieve McPhilemy
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Mohamed Ahmed
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Liam Kilmartin
- College of Science and Engineering, National University of Ireland Galway, Galway, Republic of Ireland
| | - Laura Costello
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Natalie J Forde
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands
| | - Leila Nabulsi
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland; Imaging Genetics Center, Mark and Mary Stevens Neuroimaging & Informatics Institute, University of Southern California, Marina del Rey, CA 90292, USA
| | - Theophilus N Akudjedu
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland; Institute of Medical Imaging & Visualisation, Faculty of Health & Social Science, Bournemouth University, Bournemouth, United Kingdom
| | - Laurena Holleran
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Brian Hallahan
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Dara M Cannon
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
| | - Colm McDonald
- Centre for Neuroimaging & Cognitive Genomics (NICOG), Clinical Neuroimaging Laboratory, NCBES Galway Neuroscience Centre, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, H91TK33 Galway, Ireland
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Stavroulaki V, Giakoumaki SG, Sidiropoulou K. Working memory training effects across the lifespan: Evidence from human and experimental animal studies. Mech Ageing Dev 2020; 194:111415. [PMID: 33338498 DOI: 10.1016/j.mad.2020.111415] [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: 04/30/2020] [Revised: 11/23/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Working memory refers to a cognitive function that provides temporary storage and manipulation of the information necessary for complex cognitive tasks. Due to its central role in general cognition, several studies have investigated the possibility that training on working memory tasks could improve not only working memory function but also increase other cognitive abilities or modulate other behaviors. This possibility is still highly controversial, with prior studies providing contradictory findings. The lack of systematic approaches and methodological shortcomings complicates this debate even more. This review highlights the impact of working memory training at different ages on humans. Finally, it demonstrates several findings about the neural substrate of training in both humans and experimental animals, including non-human primates and rodents.
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Affiliation(s)
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Gallos University Campus, University of Crete, Rethymno, 74100, Crete, Greece; University of Crete Research Center for the Humanities, The Social and Educational Sciences, University of Crete, Rethymno, 74100, Crete, Greece
| | - Kyriaki Sidiropoulou
- Dept of Biology, University of Crete, Greece; Institute of Molecular Biology and Biotechnology - Foundation for Research and Technology Hellas, Greece.
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