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López-Carrilero R, Lo Monaco M, Frígola-Capell E, Ferrer-Quintero M, Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Vila-Badia R, Punsoda-Puche P, Birulés I, Peláez T, Pousa E, Grasa E, Barajas A, Ruiz-Delgado I, Barrigón ML, Gonzalez-Higueras F, Lorente-Rovira E, Gutiérrez-Zotes A, Cid J, Legido T, Ayesa-Arriola R, Moritz S, Ochoa S. Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024:S2950-2853(24)00009-7. [PMID: 38219901 DOI: 10.1016/j.sjpmh.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences. AIMS To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains. METHODS A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed. RESULTS A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men. CONCLUSIONS A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.
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Affiliation(s)
- Raquel López-Carrilero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercedes Lo Monaco
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Frígola-Capell
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Helena García-Mieres
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Regina Vila-Badia
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain
| | - Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther Pousa
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Salut Mental Parc Taulí, Sabadell, Hospital Universitari, UAB Universitat Autònoma de Barcelona, Sabadell, Spain; Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Programme, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Centre d'Higiene Mental Les Corts, Department of Research, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - María Luisa Barrigón
- Departamento de Psiquiatría, Hospital Universitario Virgen del Rocio, Sevilla, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Teresa Legido
- Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Investigación en Psiquiatría (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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2
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Catalan A, McCutcheon RA, Aymerich C, Pedruzo B, Radua J, Rodríguez V, Salazar de Pablo G, Pacho M, Pérez JL, Solmi M, McGuire P, Giuliano AJ, Stone WS, Murray RM, Gonzalez-Torres MA, Fusar-Poli P. The magnitude and variability of neurocognitive performance in first-episode psychosis: a systematic review and meta-analysis of longitudinal studies. Transl Psychiatry 2024; 14:15. [PMID: 38191534 PMCID: PMC10774360 DOI: 10.1038/s41398-023-02718-6] [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: 06/15/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
Neurocognitive deficits are a core feature of psychotic disorders, but it is unclear whether they affect all individuals uniformly. The aim of this systematic review and meta-analysis was to synthesize the evidence on the magnitude, progression, and variability of neurocognitive functioning in individuals with first-episode psychosis (FEP). A multistep literature search was conducted in several databases up to November 1, 2022. Original studies reporting on neurocognitive functioning in FEP were included. The researchers extracted the data and clustered the neurocognitive tasks according to the seven Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) domains and six additional domains. Random-effect model meta-analyses, assessment of publication biases and study quality, and meta-regressions were conducted. The primary effect size reported was Hedges g of (1) neurocognitive functioning in individuals at FEP measuring differences with healthy control (HC) individuals or (2) evolution of neurocognitive impairment across study follow-up intervals. Of 30,384 studies screened, 54 were included, comprising 3,925 FEP individuals and 1,285 HC individuals. Variability analyses indicated greater variability in FEP compared to HC at baseline and follow-up. We found better neurocognitive performance in the HC group at baseline and follow-up but no differences in longitudinal neurocognitive changes between groups. Across the 13 domains, individuals with FEP showed improvement from baseline in all studied domains, except for visual memory. Metaregressions showed some differences in several of the studied domains. The findings suggest that individuals with FEP have marked cognitive impairment, but there is greater variability in cognitive functioning in patients than in HC. This suggests that subgroups of individuals suffer severe disease-related cognitive impairments, whereas others may be much less affected. While these impairments seem stable in the medium term, certain indicators may suggest potential further decline in the long term for a specific subgroup of individuals, although more research is needed to clarify this. Overall, this study highlights the need for tailored neurocognitive interventions for individuals with FEP based on their specific deficits and progression.
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Affiliation(s)
- Ana Catalan
- Department of Neuroscience, University of the Basque Country UPV/EHU; Psychiatry Department. Basurto University Hospital; Biobizkaia Health Research Institute; Centro de Investigación en Red de Salud Mental. (CIBERSAM) Instituto de Salud Carlos III , OSI Bilbao-Basurto, Av. Montevideo 18, 48013, Bilbao, Spain.
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Robert A McCutcheon
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry. University of Oxford, Warneford Hospital, Headington, OX3 7JX, UK
- Oxford Health NHS foundation trust, Oxford, UK
| | - Claudia Aymerich
- Department of Neuroscience, University of the Basque CountryUPV/EHU. Psychiatry Department. Basurto University Hospital. BiBiobizkaia Health Research Institute. Centro de Investigaciónen Red de Salud Mental. (CIBERSAM), Instituto de Salud Carlos III, Avenida de Montevideo 18, 48013, Bilbao, Spain
| | - Borja Pedruzo
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Joaquim Radua
- Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Victoria Rodríguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gonzalo Salazar de Pablo
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Malein Pacho
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Jose Luis Pérez
- Psychiatry Department. Basurto University Hospital, OSI Bilbao-Basurto, Bizkaia, Spain
| | - Marco Solmi
- Charité Universitätsmedizin Berlin, Department of Child and Adolescent Psychiatry, Berlin, Germany
- SCIENCES lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry. University of Oxford, Warneford Hospital, Headington, OX3 7JX, UK
| | - Anthony J Giuliano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Miguel Angel Gonzalez-Torres
- Department of Neuroscience, University of the Basque Country UPV/EHU; Psychiatry Department. Basurto University Hospital; Biobizkaia Health Research Institute; Centro de Investigación en Red de Salud Mental. (CIBERSAM) Instituto de Salud Carlos III , OSI Bilbao-Basurto, Av. Montevideo 18, 48013, Bilbao, Spain
| | - Paolo Fusar-Poli
- Early Psychosis Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, , Pavia, Italy
- Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
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Watson AJ, Harrison L, Preti A, Wykes T, Cella M. Cognitive trajectories following onset of psychosis: a meta-analysis. Br J Psychiatry 2022; 221:714-721. [PMID: 36149012 DOI: 10.1192/bjp.2022.131] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia, associated with poor functional outcomes. The course of cognitive function in the years following illness onset has remained a subject of debate, with a previous analysis finding no worsening, providing support for the neurodevelopmental model of schizophrenia. Since then, many more studies have reported on longitudinal cognitive performance in early psychosis, with some indicating deterioration, which does not align with this view. AIMS This study aims to quantitatively review the literature on the longitudinal trajectory of cognitive deficits in the years following psychosis onset, in comparison with healthy controls. It is the first to also synthesise longitudinal data on social cognition. METHOD Electronic databases ('PubMed', 'PsycInfo' and 'Scopus') were searched (to end September 2021). Meta-analyses of 25 longitudinal studies of cognition in early psychosis were conducted (1480 patients, 789 health controls). Unlike previous analyses, randomised controlled trials and those with multiple cognitive testing periods within the first year were excluded to minimise bias (PROSPERO, ID: CRD42021241525). RESULTS Small improvements were observed for global cognition (g = 0.25, 95% CI 0.17-0.33) and individual cognitive domains, but these were comparable with healthy controls and likely an artefact of practice effects. CONCLUSIONS There is no evidence of continued cognitive decline or improvement in the early years following psychosis onset, with a need for more studies over longer follow-up periods. Practice effects highlight the importance of including control samples in longitudinal and intervention studies. Further data are needed to evaluate the course of social cognition subdomains.
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Affiliation(s)
- Andrew J Watson
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Lauren Harrison
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Antonio Preti
- Dipartimento di Neuroscienze, Università degli studi di Torino, Italy
| | - Til Wykes
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
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4
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Flaaten CB, Melle I, Bjella T, Engen MJ, Åsbø G, Wold KF, Widing L, Gardsjord E, Sæther LS, Øie MG, Lyngstad SH, Haatveit B, Simonsen C, Ueland T. Domain-specific cognitive course in schizophrenia: Group- and individual-level changes over 10 years. Schizophr Res Cogn 2022; 30:100263. [PMID: 35783460 PMCID: PMC9240854 DOI: 10.1016/j.scog.2022.100263] [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: 02/25/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022] Open
Abstract
Cognitive impairments in schizophrenia are well-documented, present across several cognitive domains and found to be relatively stable over time. However, there is a high degree of heterogeneity and indications of domain-specific developmental courses. The present study investigated the 10-year cognitive course in participants with first-episode schizophrenia (FES) and healthy controls on eight cognitive domains and a composite score, looking at group- and individual-level changes. A total of 75 FES participants and 91 healthy controls underwent cognitive assessment at baseline and follow-up. Linear mixed models were used for group-level analyses and reliable change index (RCI) analyses were used to investigate individual change. The prevalence of clinically significant impairment was explored at both time points, using a cut-off of < −1.5 SD, with significant cognitive impairment defined as impairment on ≥2 domains. Group-level analyses found main effects of group and time, and time by group interactions. Memory, psychomotor processing speed and verbal fluency improved, while learning, mental processing speed and working memory were stable in both groups. FES participants showed deteriorations in attention and cognitive control. Individual-level analyses mainly indicated stability in both FES and controls, except for a higher prevalence of decline in cognitive control in FES. At baseline, 68.8 % of FES participants had clinically significant impairment, compared to 62.3 % at follow-up. We mainly found long-term stability and modest increases in cognition over time in FES, as well as a high degree of within-group heterogeneity. We also found indications of deterioration in participants with worse cognitive performance at baseline.
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Affiliation(s)
- Camilla Bärthel Flaaten
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
- Corresponding author at: NORMENT, Oslo University Hospital, Division of Mental Health and Addiction, P.O. Box 4956 Nydalen, 0424 Oslo, Norway.
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Thomas Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Magnus Johan Engen
- Division of Mental Health and Addiction, Nydalen DPS, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
| | - Gina Åsbø
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Kristin Fjelnseth Wold
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Line Widing
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Erlend Gardsjord
- Division of Mental Health and Addiction, Unit for Early Intervention in Psychosis, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
| | - Linn-Sofie Sæther
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
| | - Siv Hege Lyngstad
- Division of Mental Health and Addiction, Nydalen DPS, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway
| | - Beathe Haatveit
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Carmen Simonsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, P. O. box 4956 Nydalen, 0424 Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, P. O. box 4956 Nydalen, 0424 Oslo, Norway
- Department of Psychology, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
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Pihlaja M, Failla L, Peräkylä J, Hartikainen KM. Reduced Frontal Nogo-N2 With Uncompromised Response Inhibition During Transcutaneous Vagus Nerve Stimulation-More Efficient Cognitive Control? Front Hum Neurosci 2020; 14:561780. [PMID: 33132877 PMCID: PMC7573492 DOI: 10.3389/fnhum.2020.561780] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/24/2020] [Indexed: 12/11/2022] Open
Abstract
We have previously shown invasive vagus nerve stimulation to improve attention and working memory and alter emotion-attention interaction in patients with refractory epilepsy, suggesting that VNS might be useful in the treatment of cognitive impairment. The current research focuses on whether non-invasive, transcutaneous vagus nerve stimulation (tVNS) has similar effects to VNS. Furthermore, we aimed to assess whether tVNS has an impact on cognitive control in general or on underlying brain physiology in a task that mimics everyday life demands where multiple executive functions are engaged while encountering intervening emotional stimuli. Event-related potentials (ERP) evoked in such a task, specifically centro-parietal P3 and frontal N2 were used as biomarkers for attention allocation and cognitive control required to carry out the task. A single-blinded, sham-controlled, within-subject study on healthy subjects (n = 25) was conducted using Executive Reaction Time Test (RT-test), a Go/NoGo task engaging multiple executive functions along with intervening threat-related distractors while EEG was recorded. tVNS at the left tragus and sham stimulation at the left ear lobe was alternately delivered throughout the task. To assess the impact of tVNS on neural activity underlying attention and cognitive control, centro-parietal P3 and frontal N2 peak amplitudes were measured in Go and NoGo conditions. Task performance was assessed with RTs and different error types reflecting cognitive control in general and distinct executive functions, such as working memory and response inhibition.No significant effects due to tVNS on performance in the Executive RT-test were observed. For N2 there was a main effect of stimulator status and a significant interaction of trial type (Go, NoGo) and stimulator status. Post hoc analysis revealed that tVNS resulted in a significant reduction of frontal N2 only in the NoGo condition. No significant effects were observed for P3 nor were there any effects of emotion. Diminished NoGo-N2 potential along with unaltered task performance during tVNS suggests fewer cognitive control resources were required to successfully withhold a prepotent response. Though caution is warranted, we suggest that tVNS may lead to more efficient neural processing with fewer resources needed for successful cognitive control, providing promise for its potential use in cognitive enhancement.
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Affiliation(s)
- Mia Pihlaja
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Laura Failla
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Kaisa M Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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6
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Gallardo-Ruiz R, Crespo-Facorro B, Setién-Suero E, Tordesillas-Gutierrez D. Long-Term Grey Matter Changes in First Episode Psychosis: A Systematic Review. Psychiatry Investig 2019; 16:336-345. [PMID: 31132837 PMCID: PMC6539265 DOI: 10.30773/pi.2019.02.10.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/21/2018] [Accepted: 02/10/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To determine possible progressive changes of the grey matter at the first stages of the schizophrenia spectrum disorders, and to determine what regions are involved in these changes. METHODS We searched the literature concerning studies on longitudinal changes in grey matter in first-episode psychosis using magnetic resonance imaging, especially studies with an interval between scans of more than a year. Only articles published before 2018 were searched. We selected 19 magnetic resonance imaging longitudinal studies that used different neuroimaging analysis techniques to study changes in cerebral grey matter in a group of patients with a first episode of psychosis. RESULTS Patients with first episode of psychosis showed a decrease over time in cortical grey matter compared with a group of control subjects in frontal, temporal (specifically in superior regions), parietal, and subcortical regions. In addition to the above, studies indicate that patients showed a grey matter decrease in cerebellum and lateral ventricles volume. CONCLUSION The results suggest a decrease in grey matter in the years after the first episode of psychosis. Furthermore, the results of the studies showed consistency, regardless of the methods used in their analyses, as well as the time intervals between image collections.
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Affiliation(s)
- Ruth Gallardo-Ruiz
- Neuroimaging Unit, Technological Facilities,Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
| | - Benedicto Crespo-Facorro
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Esther Setién-Suero
- Marqués de Valdecilla University Hospital, Department of Psychiatry, School of Medicine, University of Cantabria, IDIVAL, Santander, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
| | - Diana Tordesillas-Gutierrez
- Neuroimaging Unit, Technological Facilities,Valdecilla Biomedical Research Institute IDIVAL, Santander, Cantabria, Spain
- CIBERSAM, Biomedical Research Network on Mental Health Area, Madrid, Spain
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Vidarsdottir OG, Roberts DL, Twamley EW, Gudmundsdottir B, Sigurdsson E, Magnusdottir BB. Integrative cognitive remediation for early psychosis: Results from a randomized controlled trial. Psychiatry Res 2019; 273:690-698. [PMID: 31207854 DOI: 10.1016/j.psychres.2019.02.007] [Citation(s) in RCA: 20] [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: 11/14/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 01/19/2023]
Abstract
Early application of cognitive remediation may help prevent the development of long-term functional impairments that characterize psychotic disorders. Interventions that encompass both neurocognitive and social-cognitive training may work synergistically to bridge the gap between cognitive gains and functional outcomes in early psychosis. We integrated three cognitive remediation approaches: Neuropsychological Educational Approach to Remediation (NEAR), Compensatory Cognitive Training (CCT), and Social Cognition and Interaction Training (SCIT), and evaluated the effects on cognition, clinical symptoms, self-assessed and informant-assessed social functioning in early psychosis. A total of 49 patients diagnosed with primary psychotic disorder seeking service at an early-intervention service in Iceland were randomized to either a waiting-list control group (n = 24) or a 12-week group-based integrative cognitive remediation (n = 25). Neurocognition, social cognition, community functioning and clinical symptoms were assessed at baseline and post-treatment. The intervention group showed significant improvements in verbal memory, cognitive flexibility, working memory, ToM and a significant reduction in hostile attributions, compared to those receiving standard treatment alone, but there were no differences between groups on measures of social functioning or clinical symptoms. The intervention was well tolerated and received high treatment satisfaction ratings. Findings indicate that integrated cognitive remediation has potential to improve neurocognition and social cognition in early psychosis.
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Affiliation(s)
- Olina G Vidarsdottir
- Landspitali, Department of Psychiatry, National University Hospital, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland.
| | - David L Roberts
- Department of Psychiatry, Division of Community Recovery, Research and Training, University of Texas Health Science Center, San Antonio, TX, USA.
| | - Elizabeth W Twamley
- Department of Psychiatry, University of California, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health and Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
| | - Berglind Gudmundsdottir
- Landspitali, Department of Psychiatry, National University Hospital, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland.
| | - Engilbert Sigurdsson
- Landspitali, Department of Psychiatry, National University Hospital, Reykjavik, Iceland; Faculty of Medicine, School of Health Sciences, University of Iceland, Vatnsmyrarvegur 16, 101 Reykjavik, Iceland.
| | - Brynja B Magnusdottir
- Landspitali, Department of Psychiatry, National University Hospital, Reykjavik, Iceland; Department of Psychology, Reykjavik University, Menntavegur 1, 101 Reykjavik, Iceland.
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8
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Erkkilä M, Peräkylä J, Hartikainen KM. Executive Functions and Emotion-Attention Interaction in Assessment of Brain Health: Reliability of Repeated Testing With Executive RT Test and Correlation With BRIEF-A Questionnaire. Front Psychol 2018; 9:2556. [PMID: 30618977 PMCID: PMC6297677 DOI: 10.3389/fpsyg.2018.02556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 11/29/2018] [Indexed: 12/17/2022] Open
Abstract
Executive functions (EF) rely on intact fronto-subcortical networks. An insult, disorder or treatment compromising brain health may impair the functioning of these widespread networks and consequently disrupt EF. Changes in brain health due to treatment or disorder can be assessed by repeating an EF test at different time points, but practice effect may confound the results. In this study we examined reliability of repeated testing using a computer-based test of EF, Executive Reaction Time (RT) Test, that allows assessment of different executive functions and emotion–attention interaction. In addition, we investigated whether performance measures correlate with scores derived from a clinically validated questionnaire of executive functions, Behavior Rating Inventory of Executive Function, Adult version (BRIEF-A). Healthy subjects performed the test twice, 3–4 weeks apart. When the entire tests were compared, subjects were faster and their odds to make an error reflecting disruption of working memory was lower in the second test. When two (error analysis) or four (RT analysis) blocks out of total eight test blocks were removed from the beginning of the test, the differences disappeared. In the first test emotional distractors prolonged RTs of younger, but not older, participants. In the second test emotional distractors had no effect on RTs of either age group. RTs correlated with Global Executive Composite score of BRIEF-A. Test–retest reliability analysis showed that the Executive RT Test is reliable in repeated testing with 0.83 intraclass correlation coefficient for RTs, 0.72 for total errors and 0.68 for working memory related errors. In summary, performance speed in the Executive RT Test correlate with subjective evaluations of executive functions and is reliable in repeated assessment when enough practice is ensured before the actual test. Thus, the Executive RT test holds promise as a potential indicator of brain health reflecting level of executive functions linked with daily life demands as well as typical emotion–attention interaction or possible aberrations in it.
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Affiliation(s)
- Mikko Erkkilä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jari Peräkylä
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Kaisa M Hartikainen
- Behavioral Neurology Research Unit, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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9
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Sánchez-Torres AM, Moreno-Izco L, Lorente-Omeñaca R, Cabrera B, Lobo A, González-Pinto AM, Merchán-Naranjo J, Corripio I, Vieta E, de la Serna E, Butjosa A, Contreras F, Sarró S, Mezquida G, Ribeiro M, Bernardo M, Cuesta MJ. Individual trajectories of cognitive performance in first episode psychosis: a 2-year follow-up study. Eur Arch Psychiatry Clin Neurosci 2018; 268:699-711. [PMID: 29164332 DOI: 10.1007/s00406-017-0857-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 11/14/2017] [Indexed: 11/28/2022]
Abstract
Individual changes over time in cognition in patients with psychotic disorders have been studied very little, especially in the case of first episode psychosis (FEP). We aimed to establish whether change in individual trajectories in cognition over 2 years of a sample of 159 FEP patients was reliable and clinically significant, using the reliable change index (RCI) and clinically significant change (CSC) methods. We also studied a sample of 151 matched healthy controls. Patients and controls were assessed with a set of neuropsychological tests, as well as premorbid, clinical and functionality measures. We analysed the course of cognitive measures over time, using analysis of variance, and the individual trajectories in the cognitive measures with the regression-based RCI (RCISRB) and the CSC. The RCISRB showed that between 5.4 and 31.2% of the patients showed deterioration patterns, and between 0.6 and 8.8% showed improvement patterns in these tests over time. Patients showing better cognitive profiles according to RCISRB (worsening in zero to two cognitive measures) showed better premorbid, clinical and functional profiles than patients showing deterioration patterns in more than three tests. When combining RCISRB and CSC values, we found that less than 10% of patients showed improvement or deterioration patterns in executive function and attention measures. These results support the view that cognitive impairments are stable over the first 2 years of illness, but also that the analysis of individual trajectories could help to identify a subgroup of patients with particular phenotypes, who may require specific interventions.
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Affiliation(s)
- A M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, c/Irunlarrea 3, 31008, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - L Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, c/Irunlarrea 3, 31008, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - R Lorente-Omeñaca
- Department of Psychiatry, Complejo Hospitalario de Navarra, c/Irunlarrea 3, 31008, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - B Cabrera
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - A Lobo
- Department of Medicine and Psychiatry, Aragon Institute for Health Research (IIS Aragon), University of Zaragoza, Saragossa, Spain
| | - A M González-Pinto
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba University Hospital, Vitoria, Spain
- University of the Basque Country, Vitoria, Spain
| | - J Merchán-Naranjo
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Child and Adolescent Psychiatry Department, School of Medicine, Hospital General Universitario Gregorio Marañón, IISGM, Universidad Complutense, Madrid, Spain
| | - I Corripio
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - E Vieta
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Psychology, Clinical Institute for the Neurosciences, Hospital Clinic of Barcelona, Catalonia, Spain
- August Pi i Sunyer Institute for Biomedical Research (IDIBAPS), Catalonia, Barcelona, Spain
- Department of Psychiatry and Clinical Psychology, University of Barcelona, Catalonia, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - E de la Serna
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - A Butjosa
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Sant Boi de Llobregat, Barcelona, Spain
- Sant Joan de Déu Research Foundation. Esplugues de Llobregat, Barcelona, Spain
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - F Contreras
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Psychiatry Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - S Sarró
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- FIDMAG Hermanas Hospitalarias Research Foundation, Barcelona, Spain
| | - G Mezquida
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Ribeiro
- Department of Psychiatry, Complejo Hospitalario de Navarra, c/Irunlarrea 3, 31008, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - M Bernardo
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, Barcelona, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Clinical Psychobiology, University of Barcelona, IDIBAPS, Barcelona, Spain
| | - M J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, c/Irunlarrea 3, 31008, Pamplona, Spain.
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
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10
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Demmo C, Lagerberg TV, Aminoff SR, Hellvin T, Kvitland LR, Simonsen C, Haatveit B, Andreassen OA, Melle I, Ueland T. Course of neurocognitive function in first treatment bipolar I disorder: One-year follow-up study. Psychiatry Res 2017; 249:286-292. [PMID: 28142102 DOI: 10.1016/j.psychres.2016.12.048] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 11/09/2016] [Accepted: 12/29/2016] [Indexed: 11/28/2022]
Abstract
Neurocognitive impairment has been found to be a marked feature in bipolar disorder (BD), also in the early phase of the illness. The longitudinal course of neurocognitive functioning, however, remains sparsely investigated. The aims of the study were to investigate the course of neurocognitive function in BD I, and to what degree neurocognitive change or stability is observed also on the individual level. Forty-two patients and 153 comparable healthy controls were assessed at baseline and one-year follow-up. Compared to the healthy control (HC) group BD I patients perform significantly poorer at both baseline and follow-up across all neurocognitive domains and on most neurocognitive subtests. Neurocognitive impairment remained stable for most patients from baseline to follow-up, both on a group level and when investigating individual trajectories, indicative of a relatively stable course of neurocognitive functioning in the early phase of BD I.
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Affiliation(s)
- Christine Demmo
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychology, University of Oslo, Norway.
| | - Trine Vik Lagerberg
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Sofie R Aminoff
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Norway
| | - Tone Hellvin
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Levi R Kvitland
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Carmen Simonsen
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Beathe Haatveit
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Ole A Andreassen
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Ingrid Melle
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway
| | - Torill Ueland
- NORMENT KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway; Department of Psychology, University of Oslo, Norway
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11
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Gkintoni E, Pallis EG, Bitsios P, Giakoumaki SG. Neurocognitive performance, psychopathology and social functioning in individuals at high risk for schizophrenia or psychotic bipolar disorder. J Affect Disord 2017; 208:512-520. [PMID: 27810272 DOI: 10.1016/j.jad.2016.10.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/05/2016] [Accepted: 10/22/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Although cognitive deficits are consistent endophenotypes of schizophrenia and bipolar disorder, findings in psychotic bipolar disorder (BDP) are inconsistent. In this study we compared adult unaffected first-degree relatives of schizophrenia and BDP patients on cognition, psychopathology, social functioning and quality of life. METHODS Sixty-six unaffected first-degree relatives of schizophrenia patients (SUnR), 36 unaffected first-degree relatives of BDP patients (BDPUnR) and 102 controls participated in the study. Between-group differences were examined and Discriminant Function Analysis (DFA) predicted group membership. RESULTS Visual memory, control inhibition, working memory, cognitive flexibility and abstract reasoning were linearly impaired in the relatives' groups. Poorer verbal fluency and processing speed were evident only in the SUnR group. The SUnR group had higher depressive and somatization symptoms while the BDPUnR group had higher anxiety and lower social functioning compared with the controls. Individuals with superior cognition were more likely to be classified as controls; those with higher social functioning, prolonged processing speed and lower anxiety were more likely to be classified as SUnR. LIMITATIONS The relatives' sample is quite heterogeneous; the effects of genetic or environmental risk-factors were not examined. CONCLUSIONS Cognitive functions mediated by a fronto-parietal network, show linear impairments in unaffected relatives of BDP and schizophrenia patients; processing speed and verbal fluency impairments were evident only in schizophrenia relatives. Self-perceived symptomatology and social functioning also differ between schizophrenia and BDP relatives. The continuum seen in patients in several indices was also seen in the cognitive impairments in unaffected relatives of schizophrenia and BDP patients.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychology, Gallos University campus, University of Crete, Rethymno, Crete, Greece
| | - Eleftherios G Pallis
- Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Panos Bitsios
- Department of Psychiatry & Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stella G Giakoumaki
- Department of Psychology, Gallos University campus, University of Crete, Rethymno, Crete, Greece.
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12
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Gupta CN, Castro E, Rachkonda S, van Erp TGM, Potkin S, Ford JM, Mathalon D, Lee HJ, Mueller BA, Greve DN, Andreassen OA, Agartz I, Mayer AR, Stephen J, Jung RE, Bustillo J, Calhoun VD, Turner JA. Biclustered Independent Component Analysis for Complex Biomarker and Subtype Identification from Structural Magnetic Resonance Images in Schizophrenia. Front Psychiatry 2017; 8:179. [PMID: 29018368 PMCID: PMC5623192 DOI: 10.3389/fpsyt.2017.00179] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/07/2017] [Indexed: 12/14/2022] Open
Abstract
Clinical and cognitive symptoms domain-based subtyping in schizophrenia (Sz) has been critiqued due to the lack of neurobiological correlates and heterogeneity in symptom scores. We, therefore, present a novel data-driven framework using biclustered independent component analysis to detect subtypes from the reliable and stable gray matter concentration (GMC) of patients with Sz. The developed methodology consists of the following steps: source-based morphometry (SBM) decomposition, selection and sorting of two component loadings, subtype component reconstruction using group information-guided ICA (GIG-ICA). This framework was applied to the top two group discriminative components namely the insula/superior temporal gyrus/inferior frontal gyrus (I-STG-IFG component) and the superior frontal gyrus/middle frontal gyrus/medial frontal gyrus (SFG-MiFG-MFG component) from our previous SBM study, which showed diagnostic group difference and had the highest effect sizes. The aggregated multisite dataset consisted of 382 patients with Sz regressed of age, gender, and site voxelwise. We observed two subtypes (i.e., two different subsets of subjects) each heavily weighted on these two components, respectively. These subsets of subjects were characterized by significant differences in positive and negative syndrome scale (PANSS) positive clinical symptoms (p = 0.005). We also observed an overlapping subtype weighing heavily on both of these components. The PANSS general clinical symptom of this subtype was trend level correlated with the loading coefficients of the SFG-MiFG-MFG component (r = 0.25; p = 0.07). The reconstructed subtype-specific component using GIG-ICA showed variations in voxel regions, when compared to the group component. We observed deviations from mean GMC along with conjunction of features from two components characterizing each deciphered subtype. These inherent variations in GMC among patients with Sz could possibly indicate the need for personalized treatment and targeted drug development.
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Affiliation(s)
- Cota Navin Gupta
- The Mind Research Network, Albuquerque, NM, United States.,Department of Biosciences and Bioengineering, Indian Institute of Technology, Guwahati, India
| | - Eduardo Castro
- The Mind Research Network, Albuquerque, NM, United States.,Computational Biology Center, IBM Thomas J. Watson Research, Yorktown Heights, NY, United States
| | | | - Theo G M van Erp
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Steven Potkin
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Judith M Ford
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel Mathalon
- Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Hyo Jong Lee
- Divisions of Electronics and Information Engineering, Chonbuk National University, Jeonju, South Korea
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Douglas N Greve
- MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States
| | - Ole A Andreassen
- NORMENT, KG Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- NORMENT, KG Jebsen Center for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Department of Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Andrew R Mayer
- The Mind Research Network, Albuquerque, NM, United States
| | - Julia Stephen
- The Mind Research Network, Albuquerque, NM, United States
| | - Rex E Jung
- Department of Neurosurgery, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Juan Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, United States
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, NM, United States.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM, United States
| | - Jessica A Turner
- The Mind Research Network, Albuquerque, NM, United States.,Department of Psychology, Neuroscience Institute, Georgia State University, Atlanta, GA, United States
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