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Sklar AL, Matinrazm S, Esseku A, López-Caballero F, Ren X, Chlpka L, Curtis M, Coffman BA, Salisbury DF. Intensity-dependent modulation of the early auditory gamma-band response in first-episode schizophrenia and its association with disease symptoms. Schizophr Res 2024; 267:261-268. [PMID: 38581829 PMCID: PMC11102840 DOI: 10.1016/j.schres.2024.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Gamma-band activity has been the focus of considerable research in schizophrenia. Discrepancies exist regarding the integrity of the early auditory gamma-band response (EAGBR), a stimulus-evoked oscillation, and its relationship to symptoms in early disease. Variability in task design may play a role. This study examined sensitivity of the EAGBR to stimulus intensity and its relation to symptoms and functional impairments in the first-episode schizophrenia spectrum (FESz). METHOD Magnetoencephalography was recorded from 35 FESz and 40 matched healthy controls (HC) during presentation of 3 tone intensities (75 dB, 80 dB, 85 dB). MRIs were collected to localize auditory cortex activity. Wavelet-transformed single trial epochs and trial averages were used to assess EAGBR intertrial phase coherence (ITPC) and evoked power, respectively. Symptoms were assessed using the Positive and Negative Syndrome Scale. RESULTS Groups did not differ in overall EAGBR power or ITPC. While HC exhibited EAGBR enhancement to increasing intensity, FESz exhibited reduced power to the 80 dB tone and, relative to HC, increased power to the 75 dB tone. Larger power and ITPC were correlated with more severe negative, thought disorganization, and resistance symptoms. Stronger ITPC was associated with impaired social functioning. DISCUSSION EAGBR showed no overall deficit at disease onset. Rather, FESz exhibited a differential response across tone intensity relative to HC, emphasizing the importance of stimulus characteristics in EAGBR studies. Associations between larger EAGBR and more severe symptoms suggest aberrant synchronization driving overinclusive perceptual binding that may relate to deficits in executive inhibition of initial sensory activity.
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Affiliation(s)
- Alfredo L Sklar
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Sayna Matinrazm
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Annika Esseku
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Fran López-Caballero
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Xi Ren
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Lydia Chlpka
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Mark Curtis
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Brian A Coffman
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Dean F Salisbury
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA.
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Morais S, d’Almeida OC, Caldeira S, Meneses S, Areias G, Girão V, Bettencourt C, Pereira DJ, Macedo A, Castelo-Branco M. Executive function in schizophrenia and autism in adults shares common components separating high and low performance groups. Front Psychiatry 2024; 15:1381526. [PMID: 38699455 PMCID: PMC11064061 DOI: 10.3389/fpsyt.2024.1381526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/27/2024] [Indexed: 05/05/2024] Open
Abstract
The profile of executive function (EF) in adults with Schizophrenia (SCZ) and autism spectrum disorder (ASD) remains unclear. This study aims to ascertain if distinct EF patterns can be identified between each clinical condition by comparing the neuropsychological profile of adults with SCZ and ASD, for whom the differential diagnosis is still highly challenging. Forty-five individuals (15 SCZ, 15 ASD, 15 controls) matched for age, sex, education level, and handedness underwent intelligence evaluation and neuropsychological testing for working memory, inhibition, planning and set-shifting, and verbal fluency subdomains. Principal component analysis (2D-PCA) using variables representing 4 domains was employed to identify patterns in neuropsychological profiles. The ASD group had lower scores on the Digits Forward subtest compared to the SCZ group (7.2 ± 2.1 vs. 9.3 ± 1.9, p = 0.003; Cohen's d: 1.05). ASD also performed significantly worse on the Stroop Word Test compared to the control group (77.7± 17.9 vs. 98.0 ± 12.7, p = 0.009; Cohen's d: 1.31). No significant differences were observed between ASD and SCZ on other EF measures. The larger contributors for the dimensions in 2D-PCA were the Digits Forward subtest and Stroop Word Test. Still, there was substantial overlap between the clinical groups. This study suggests a high degree of similarity of EF between SCZ and ASD. Through four EF measures, the discrimination of low and high-functioning EF groups spanning both diagnostic categories may help to identify the individuals who could better benefit from cognitive rehabilitation strategies.
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Affiliation(s)
- Sofia Morais
- Psychiatry Department, Coimbra Hospital and University Centre, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Otília C. d’Almeida
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Salomé Caldeira
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Sofia Meneses
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Graça Areias
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Vanessa Girão
- Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Catarina Bettencourt
- Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Daniela Jardim Pereira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Neurorradiology Functional Area, Imaging Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - António Macedo
- Psychiatry Department, Coimbra Hospital and University Centre, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
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MacDonald R, Baker-Ericzén M, Roesch S, Yeh M, Dickson KS, Smith J. The latent structure of the Delis-Kaplan system for autism. Autism Res 2024; 17:728-738. [PMID: 38590022 DOI: 10.1002/aur.3122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/28/2024] [Indexed: 04/10/2024]
Abstract
A core feature of autism is deficits in executive functioning (EF), including difficulty with planning, cognitive flexibility, and working memory. Despite a growing need for evidence-based assessments of EF for autism populations, statistical models of many commonly used measures of EF, including the Delis-Kaplan Executive Function System (D-KEFS), have not been investigated for a sample of autistic participants. The purpose of this study was to address a gap in the literature regarding the latent structure of the D-KEFS in a sample of autistic individuals. The D-KEFS is one of the most widely used clinical assessments of executive function, but its factor structure has not been examined in a sample of autistic participants. Reliability analyses were performed for sample subgroups based on participants' clinical and demographic characteristics, including IQ, autism severity, age, and race/ethnicity. Verbal Fluency (VF) was found to consistently decrease or not affect the overall reliability score. Additionally, one- and two-factor structure models were tested for the D-KEFS with a sample of autistic participants. The one-factor model was not found to be a good fit for the data. However, the two-factor model, with Cognitive Flexibility and Abstraction latent factors, was found to fit the data relatively well. This two-factor model was reexamined excluding the VF observed variable, resulting in a better overall model fit. Communication deficits are a common feature of autism, which explains why the VF task, that requires participants to produce novel words, may not be an adequate measure of executive function for autism populations.
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Affiliation(s)
- Reilly MacDonald
- Department of Psychology, San Diego State University, San Diego, California, USA
- San Diego Leadership Education in Neurodevelopmental and Other Related Disabilities, University of California San Diego, La Jolla, California, USA
| | - Mary Baker-Ericzén
- San Diego Leadership Education in Neurodevelopmental and Other Related Disabilities, University of California San Diego, La Jolla, California, USA
- Department of Administration, Rehabilitation and Post-Secondary Education, San Diego State University, San Diego, California, USA
- Child and Adolescent Services Research Center, San Diego State University, San Diego, California, USA
- Interwork Institute, San Diego State University, San Diego, California, USA
| | - Scott Roesch
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - May Yeh
- Department of Psychology, San Diego State University, San Diego, California, USA
- Child and Adolescent Services Research Center, San Diego State University, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Kelsey S Dickson
- Child and Adolescent Services Research Center, San Diego State University, San Diego, California, USA
- Department of Child and Family Development, San Diego State University, San Diego, California, USA
| | - Jasmine Smith
- San Diego Leadership Education in Neurodevelopmental and Other Related Disabilities, University of California San Diego, La Jolla, California, USA
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Aleksandrowicz A, Kowalski J, Stefaniak I, Elert K, Gawęda Ł. Cognitive correlates of auditory hallucinations in schizophrenia spectrum disorders. Psychiatry Res 2023; 327:115372. [PMID: 37619509 DOI: 10.1016/j.psychres.2023.115372] [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: 04/12/2023] [Revised: 06/09/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
Auditory hallucinations (AHs) are one of the central symptoms of schizophrenia spectrum disorders (SSD). Current cognitive models of AH implicate source monitoring, top-down processes, and inhibitory control. However, research combining these processes is limited. Our study aimed to examine how source monitoring bias, top-down processes, and inhibitory control contribute to AHs in individuals with SSD. Eighty seven patients (aged 18-45 years) with SSD were included in the analyses. Participants completed cognitive tasks assessing source monitoring (Action Memory Task), top-down processes (False Perception Task; FPT), and inhibitory control (Auditory Go/NoGo task). AH was positively associated with response bias on the FPT. Correlations between AH and the other cognitive tasks were nonsignificant. Source monitoring errors correlated positively with response bias measures and negatively with Hits on the FPT. PANSS total score was positively correlated with source monitoring bias and False Alarms on the Go/NoGo task. The severity of disorganized symptoms was related to Source Monitoring Errors and False Alarms in the Go/NoGo task. Negative symptoms were associated with Hits and False Alarms in the Go/NoGo task. Future studies are necessary to further elucidate the relationships between different cognitive processes that may be related to clinical symptoms of psychosis.
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Affiliation(s)
- Adrianna Aleksandrowicz
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
| | - Joachim Kowalski
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Izabela Stefaniak
- First Department of Psychiatry Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland
| | - Katarzyna Elert
- First Department of Psychiatry Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.
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Oudman E, Wijnia JW, Bidesie J, Al-Hassaan Z, Laenen S, Jong-Tjien-Fa AV. Young Nonalcoholic Wernicke Encephalopathy Patient Achieves Remission Following Prolonged Thiamine Treatment and Cognitive Rehabilitation. J Clin Med 2023; 12:jcm12082901. [PMID: 37109239 PMCID: PMC10143616 DOI: 10.3390/jcm12082901] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Wernicke encephalopathy (WE), a neurological emergency commonly associated with alcohol use disorder, results from a severe deficiency of vitamin B1. If left untreated, patients either succumb to the illness or develop chronic Korsakoff's syndrome (KS). Recently, an increasing number of nonalcoholic WE case studies have been published, highlighting a lack of understanding of malnutrition-related disorders among high-functioning patients. We present the case of a 26 year old female who developed life-threatening WE after COVID-19-complicated obesity surgery. She experienced the full triad of WE symptoms, including eye-movement disorders, delirium, and ataxia, and suffered for over 70 days before receiving her initial WE diagnosis. Late treatment resulted in progression of WE symptoms. Despite the severity, the patient achieved remission of some of the symptoms in the post-acute phase due to prolonged parenteral thiamine injections and intensive specialized rehabilitation designed for young traumatic brain injury (TBI) patients. The rehabilitation resulted in gradual remission of amnesia symptomatology, mainly increasing her autonomy. The late recognition of this case highlights the importance of early diagnosis and prompt, targeted intervention in the management of nonalcoholic WE, as well as underscores the potential for positive outcomes after delayed treatment through intensive cognitive rehabilitation in specialized treatment centers.
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Affiliation(s)
- Erik Oudman
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands
- Slingedael Korsakoff Expertise Center, Lelie Care Group, 3086 EZ Rotterdam, The Netherlands
| | - Jan W Wijnia
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands
- Slingedael Korsakoff Expertise Center, Lelie Care Group, 3086 EZ Rotterdam, The Netherlands
| | - Janice Bidesie
- Experimental Psychology, Helmholtz Institute, Utrecht University, 3584 CS Utrecht, The Netherlands
- Slingedael Korsakoff Expertise Center, Lelie Care Group, 3086 EZ Rotterdam, The Netherlands
| | - Zyneb Al-Hassaan
- Daan Theeuwes Center for Intensive Neurorehabilitation, 3447 GN Woerden, The Netherlands
| | - Sascha Laenen
- Daan Theeuwes Center for Intensive Neurorehabilitation, 3447 GN Woerden, The Netherlands
| | - Amy V Jong-Tjien-Fa
- Daan Theeuwes Center for Intensive Neurorehabilitation, 3447 GN Woerden, The Netherlands
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6
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Herold CJ, Lässer MM, Schröder J. Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates. J Neuropsychol 2023; 17:89-107. [PMID: 36065152 DOI: 10.1111/jnp.12288] [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: 01/28/2022] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
Abstract
Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.
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Affiliation(s)
- Christina J Herold
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Marc M Lässer
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.,Rehaklinik Zihlschlacht, Centre for Neurological Rehabilitation, Zihlschlacht, Switzerland
| | - Johannes Schröder
- Section of Geriatric Psychiatry, Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany
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7
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Burton SMI, Sallis HM, Hatoum AS, Munafò MR, Reed ZE. Is there a causal relationship between executive function and liability to mental health and substance use? A Mendelian randomization approach. ROYAL SOCIETY OPEN SCIENCE 2022; 9:220631. [PMID: 36533203 PMCID: PMC9748493 DOI: 10.1098/rsos.220631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Poorer performance in tasks testing executive function (EF) is associated with a range of psychopathologies such as schizophrenia, major depressive disorder (MDD) and anxiety, as well as smoking and alcohol consumption. We used two-sample bidirectional Mendelian randomization to examine whether these may reflect causal relationships and the direction of causation. We used genome-wide association study summary data (N = 17 310 to 848 460) for a common EF factor score (cEF), schizophrenia, MDD, anxiety, smoking initiation, alcohol consumption, alcohol dependence and cannabis use disorder (CUD). We found evidence of increased cEF on reduced schizophrenia liability (OR = 0.10; CI: 0.05 to 0.19; p-value = 3.43 × 10-12), MDD liability (OR = 0.52; CI: 0.38 to 0.72; p-value = 5.23 × 10-05), drinks per week (β = -0.06; CI: -0.10 to -0.02; p-value = 0.003) and CUD liability (OR = 0.27; CI: 0.12 to 0.61; p-value = 1.58 × 10-03). We also found evidence of increased schizophrenia liability (β = -0.04; CI: -0.04 to -0.03; p-value = 3.25 × 10-27) and smoking initiation on decreased cEF (β = -0.06; CI: -0.09 to -0.03; p-value = 6.11 × 10-05). Our results indicate potential causal relationships between cEF and mental health and substance use. Further studies are required to improve our understanding of the underlying mechanisms of these effects, but our results suggest that EF may be a promising intervention target for mental health and substance use.
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Affiliation(s)
| | - Hannah M. Sallis
- School of Psychological Science, University of Bristol, Bristol BS8 1TH, UK
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol BS8 1TH, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
| | - Alexander S. Hatoum
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol BS8 1TH, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS28 2BN, UK
| | - Zoe E. Reed
- School of Psychological Science, University of Bristol, Bristol BS8 1TH, UK
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
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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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Executive function in methamphetamine users with and without psychosis. Psychiatry Res 2022; 317:114820. [PMID: 36075151 DOI: 10.1016/j.psychres.2022.114820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 01/04/2023]
Abstract
Methamphetamine abuse is associated with cognitive deficits across a wide range of domains. It is unclear, however, whether methamphetamine-dependent individuals with co-occurring psychosis are more impaired than those without psychosis on tests assessing executive function. We therefore aimed to compare the executive function performance of three groups: methamphetamine-dependent individuals with methamphetamine-induced psychosis (MA+; n = 20), methamphetamine-dependent individuals without psychosis (MA-; n = 19), and healthy controls (HC; n = 20). All participants were administered a neuropsychological test battery that assessed executive functioning across six sub domains (problem solving, working memory, verbal generativity, inhibition, set switching, and decision making). Analyses of covariance (controlling for between-group differences in IQ) detected significant between-group differences on tests assessing verbal generativity and inhibition, with MA+ participants performing significantly more poorly than HC. The finding that methamphetamine-induced psychosis is associated with performance impairments in particular subdomains of executive function may have implications for treatment adherence and relapse prevention.
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Protocol for a cluster randomised crossover pilot trial of Goal Management Training + (GMT +) for methamphetamine use disorder. Contemp Clin Trials Commun 2022; 29:100969. [PMID: 36033363 PMCID: PMC9399476 DOI: 10.1016/j.conctc.2022.100969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background Methamphetamine use disorder (MUD) is associated with executive dysfunctions, which are linked with poorer treatment outcomes. However, current treatments for MUD do not directly address cognition. We recently modified Goal Management Training (now Goal Management Training+; GMT+), a group-based intervention originally designed to improve executive functions after brain injury, to enhance suitability for MUD. Here, we describe the rationale and design of a trial which aims to determine the acceptability and feasibility of GMT+ during residential rehabilitation for MUD, and its impact on executive functions and clinical outcomes. Methods We used a cluster randomised crossover design: participants are randomised at the cluster level to receive either GMT+ or psychoeducation-control (Brain Health Workshop; BHW). GMT+ is delivered in four 90-min weekly sessions and includes a between-session journal with 10-min daily activities. The program targets attention, impulse control, goal-setting, and decision-making. BHW is a health-oriented intervention that delivers information about the brain and promotes healthy exercise, diet, and sleep. It is matched to GMT+ on program format, length, and time with therapists. We will recruit forty-eight participants with MUD from residential treatment services. Our primary outcomes are acceptability, feasibility, and self-reported executive functioning. Secondary outcomes include craving, quality of life and cognitive performance. Outcome assessments are performed at baseline, post-interventions, 4-week follow-up, and 12-week follow-up. Conclusions This study will provide GMT+ feasibility and acceptability data and will indicate initial efficacy on executive functions and clinical outcomes in residential treatment for MUD. Information from this pilot trial will inform a powered RCT.
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Vita-Barrull N, March-Llanes J, Guzmán N, Estrada-Plana V, Mayoral M, Moya-Higueras J. The Cognitive Processes Behind Commercialized Board Games for Intervening in Mental Health and Education: A Committee of Experts. Games Health J 2022; 11:414-424. [PMID: 36094826 DOI: 10.1089/g4h.2022.0109] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: The use of modern board games has been growing past years in education, research, and mental health attendance. Often one professional selects games by his/her criteria depending on his/her objective with them. We evaluated the cognitive processes inherent to each modern board game to obtain a consensus of the cognitive profile of each. We explain how to choose the most suitable board games in future interventions. Materials and Methods: Fifteen education, mental health, and neuroscience research professionals with board games experience participated in an online assessment of 27 modern board games. Experts received a virtual neuroeducation formation and played the games selection for further analysis. Participants answered a Likert scale about 12 cognitive processes activated with each game. Results: All modern board games obtained a high level of agreement (intraclass correlation [ICC] > 0.75). Besides, most cognitive processes reached a high agreement, except for cognitive flexibility and problem-solving (moderate range: 0.5 > ICC > 0.75). Differentiated cognitive profiles have been obtained for each game, some of which could work on more than one cognitive domain at a time. Finally, initial evidence about which board game mechanisms activate with cognitive domain was found. Conclusion: To conclude, this expert consensus methodology became a useful tool for assessing the cognitive profile behind modern board and card games. The results obtained may facilitate the choice of games to be used in future studies depending on the objective cognitive domain to be trained under a criterion based on the observations of a group of experts and not just the researcher's individual criteria.
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Affiliation(s)
- Nuria Vita-Barrull
- Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
- Mercurio Distribuciones, Móstoles, Spain
| | - Jaume March-Llanes
- Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
| | - Núria Guzmán
- Atención, Familia, Infancia, Mayores (AFIM21), Almería, Spain
| | - Verónica Estrada-Plana
- Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
| | - Maria Mayoral
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Jorge Moya-Higueras
- Department of Psychology, Faculty of Education, Psychology and Social Work, University of Lleida, Lleida, Spain
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
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12
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Chiu LY, Lee SC, Chiu EC. Psychometric Properties of Two Tasks in the Allen Cognitive Level Screen-Sixth Edition for Community-Dwelling People Living With Schizophrenia. Am J Occup Ther 2022; 76:23904. [PMID: 36053732 DOI: 10.5014/ajot.2022.049133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Empirical evidence is needed on the psychometric properties of the Allen Cognitive Level Screen-Sixth Edition (ACLS-6), an instrument that assesses cognitive functions and is commonly used for people living with schizophrenia. OBJECTIVE To examine the convergent validity, discriminative validity, and test-retest reliability of two tasks, stitching and copying, in the ACLS-6 for community-dwelling people living with schizophrenia. DESIGN Prospective observational study. SETTING Psychiatric center. PARTICIPANTS 110 people living with schizophrenia. OUTCOMES AND MEASURES To examine convergent validity, we calculated correlations (Pearson's r) between the two tasks and between these two tasks and three cognitive measures. We checked for floor and ceiling effects and conducted independent t tests to evaluate discriminative validity. We calculated intraclass correlation coefficients (ICCs) to investigate test-retest reliability. RESULTS We found a strong correlation (r = .88) between the two tasks and moderate correlations (rs = .32-.52) between the two tasks and the three cognitive measures. No floor or ceiling effects were observed for the two tasks, and t tests showed significant differences between two participant groups with marginal and mild clinical symptoms (p < .001). The ICC values for the two tasks were .71-.74. CONCLUSION AND RELEVANCE The stitching and copying tasks of the ACLS-6 have good convergent validity, discriminative validity, and test-retest reliability for community-dwelling people living with schizophrenia. The copying task showed a strong correlation with the stitching task and a similar score range, so practitioners can consider using the copying task as a substitute for the stitching task. What This Article Adds: The stitching and copying tasks of the ACLS-6 have sound psychometric properties for measuring cognitive functions in community-dwelling people living with schizophrenia.
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Affiliation(s)
- Li-Yu Chiu
- Li-Yu Chiu, MS, is Occupational Therapist, Occupational Therapy Department, Pei-Ling Hospital, Taipei, Taiwan
| | - Shu-Chun Lee
- Shu-Chun Lee, MS, is Occupational Therapist, Department of Occupational Therapy, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan and Lecturer, Department of Special Education, University of Taipei, Taipei, Taiwan
| | - En-Chi Chiu
- En-Chi Chiu, OTD, PhD, is Associate Professor, Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, and Associate Researcher, Department of Occupational Therapy, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan;
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Andersson P, Tistad M, Eriksson Å, Enebrink P, Sturidsson K. Implementation and evaluation of Illness Management and Recovery (IMR) in mandated forensic psychiatric care – Study protocol for a multicenter cluster randomized trial. Contemp Clin Trials Commun 2022; 27:100907. [PMID: 35499065 PMCID: PMC9038540 DOI: 10.1016/j.conctc.2022.100907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/13/2022] [Accepted: 02/26/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Forensic mental health care is hampered by lack of evidence-based treatments. The Swedish forensic mental health population consists of patients suffering from severe illnesses such as schizophrenia and bipolar disorders, similar to populations in international studies. Illness Management and Recovery (IMR) is an intervention for patients with serious mental illness, based on psychoeducational, cognitive-behavioral and motivational components. The purpose is to strengthen participants’ illness management skills and recovery. Objective To test effectiveness of IMR within forensic mental health by comparing it to treatment as usual. Method This is a cluster-randomized controlled trial. Patients in forensic mental health inpatient units are randomized to an active (IMR) or a control condition (treatment as usual). Clustering of patients is based on ward-units where inpatients are admitted. Patients in the active condition receive two group and one individual IMR sessions per week. The treatment phase is estimated to last nine months. Outcomes include illness related disability, illness management skills, sense of recovery, hope, mental health and security related problems. Outcomes are measured at baseline, four months into treatment, at treatment completion and at three months follow-up. Staff experiences of implementing IMR will be explored by a self-report measure and semi-structured interview based on Normalization Process Theory. Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Registration No. 2020–02046). Participation will be voluntary based on written informed consent. Results will be disseminated through peer-reviewed articles and conferences. The study is registered in the US registry of clinical trials (NCT04695132).
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Affiliation(s)
- Peter Andersson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
- Centre for Clinical Research Dalarna, Uppsala University, Nissers väg 3, 791 82, Falun, Sweden
- Corresponding author. Nissers väg 3, 791 82, Falun, Sweden.
| | - Malin Tistad
- School of Health and Welfare, Dalarna University, 791 88, Falun, Sweden
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183, Huddinge, Sweden
| | - Åsa Eriksson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Pia Enebrink
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Knut Sturidsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
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Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. Eur Arch Psychiatry Clin Neurosci 2022; 272:1139-1155. [PMID: 35633394 PMCID: PMC9508017 DOI: 10.1007/s00406-022-01416-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/11/2022] [Indexed: 01/08/2023]
Abstract
Cognitive impairment is one of the core symptoms of schizophrenia. Quite a number of systematic reviews were published related to cognitive impairment in people with schizophrenia (PWS). This umbrella review, therefore, aimed at reviewing and synthesizing the findings of systematic reviews related to domains of cognition impaired and associated factors in PWS. We searched four electronic databases. Data related to domains, occurrence, and associated factors of cognitive impairment in PWS were extracted. The quality of all eligible systematic reviews was assessed using A MeaSurement Tool to Assess methodological quality of systematic Review (AMSTAR) tool. Results are summarized and presented in a narrative form. We identified 63 systematic reviews fulfilling the eligibility criteria. The included reviews showed that PWS had lower cognitive functioning compared to both healthy controls and people with affective disorders. Similar findings were reported among psychotropic free cases and people with first episode psychosis. Greater impairment of cognition was reported in processing speed, verbal memory, and working memory domains. Greater cognitive impairment was reported to be associated with worse functionality and poor insight. Cognitive impairment was also reported to be associated with childhood trauma and aggressive behaviour. According to our quality assessment, the majority of the reviews had moderate quality. We were able to find a good number of systematic reviews on cognitive impairment in PWS. The reviews showed that PWS had higher impairment in different cognitive domains compared to healthy controls and people with affective disorders. Impairment in domains of memory and processing speed were reported frequently.
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Affiliation(s)
- Yohannes Gebreegziabhere
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Kassahun Habatmu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Awoke Mihretu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, England UK
| | - Atalay Alem
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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15
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Vita A, Gaebel W, Mucci A, Sachs G, Erfurth A, Barlati S, Zanca F, Giordano GM, Birkedal Glenthøj L, Nordentoft M, Galderisi S. European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia. Eur Psychiatry 2022; 65:e58. [PMID: 36059109 PMCID: PMC9532219 DOI: 10.1192/j.eurpsy.2022.2316] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Impairment in a wide range of cognitive abilities has been consistently reported in individuals with schizophrenia. Both neurocognitive and social cognitive deficits are thought to underlie severe functional disabilities associated with schizophrenia. Despite the key role in schizophrenia outcome, cognition is still poorly assessed in both research and clinical settings. Methods In this guidance paper, we provide a systematic review of the scientific literature and elaborate several recommendations for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice. Results Expert consensus and systematic reviews provided guidance for the optimal assessment of cognitive functions in schizophrenia. Based on the reviewed evidence, we recommend a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. This European Psychiatric Association guidance recommends not only the use of observer reports but also self-reports and interview-based cognitive assessment tools. The guidance also provides a systematic review of the state of the art of assessment in the first episode of psychosis patients and in individuals at risk for psychosis. Conclusion The comprehensive review of the evidence and the recommendations might contribute to advance the field, allowing a better cognitive assessment, and avoiding overlaps with other psychopathological dimensions. The dissemination of this guidance paper may promote the development of shared guidelines concerning the assessment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to obtain recovery.
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16
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Giordano GM, Perrottelli A, Mucci A, Di Lorenzo G, Altamura M, Bellomo A, Brugnoli R, Corrivetti G, Girardi P, Monteleone P, Niolu C, Galderisi S, Maj M. Investigating the Relationships of P3b with Negative Symptoms and Neurocognition in Subjects with Chronic Schizophrenia. Brain Sci 2021; 11:1632. [PMID: 34942934 PMCID: PMC8699055 DOI: 10.3390/brainsci11121632] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/26/2021] [Accepted: 12/08/2021] [Indexed: 01/06/2023] Open
Abstract
Neurocognitive deficits and negative symptoms (NS) have a pivotal role in subjects with schizophrenia (SCZ) due to their impact on patients' functioning in everyday life and their influence on goal-directed behavior and decision-making. P3b is considered an optimal electrophysiological candidate biomarker of neurocognitive impairment for its association with the allocation of attentional resources to task-relevant stimuli, an important factor for efficient decision-making, as well as for motivation-related processes. Furthermore, associations between P3b deficits and NS have been reported. The current research aims to fill the lack of studies investigating, in the same subjects, the associations of P3b with multiple cognitive domains and the expressive and motivation-related domains of NS, evaluated with state-of-the-art instruments. One hundred and fourteen SCZ and 63 healthy controls (HCs) were included in the study. P3b amplitude was significantly reduced and P3b latency prolonged in SCZ as compared to HCs. In SCZ, a positive correlation was found between P3b latency and age and between P3b amplitude and the Attention-vigilance domain, while no significant correlations were found between P3b and the two NS domains. Our results indicate that the effortful allocation of attention to task-relevant stimuli, an important component of decision-making, is compromised in SCZ, independently of motivation deficits or other NS.
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Affiliation(s)
- Giulia M. Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.G.); (A.P.); (S.G.); (M.M.)
| | - Andrea Perrottelli
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.G.); (A.P.); (S.G.); (M.M.)
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.G.); (A.P.); (S.G.); (M.M.)
| | - Giorgio Di Lorenzo
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (C.N.)
| | - Mario Altamura
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Antonello Bellomo
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.A.); (A.B.)
| | - Roberto Brugnoli
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (R.B.); (P.G.)
| | - Giulio Corrivetti
- Department of Mental Health, University of Salerno, 84133 Salerno, Italy;
| | - Paolo Girardi
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, University of Rome “La Sapienza”, 00189 Rome, Italy; (R.B.); (P.G.)
| | - Palmiero Monteleone
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry, ‘Scuola Medica Salernitana’, University of Salerno, 84081 Salerno, Italy;
| | - Cinzia Niolu
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (G.D.L.); (C.N.)
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.G.); (A.P.); (S.G.); (M.M.)
| | - Mario Maj
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.G.); (A.P.); (S.G.); (M.M.)
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Barrios-Fernandez S, Gozalo M, Amado-Fuentes M, Carlos-Vivas J, Garcia-Gomez A. A Short Version of the EFECO Online Questionnaire for the Assessment of Executive Functions in School-Age Children. CHILDREN (BASEL, SWITZERLAND) 2021; 8:799. [PMID: 34572231 PMCID: PMC8465183 DOI: 10.3390/children8090799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/01/2021] [Accepted: 09/10/2021] [Indexed: 01/06/2023]
Abstract
Executive function (EF) is a group of processes that allow individuals to be goal-oriented and to have adaptive functioning, so that adequate performance is essential for success in activities of daily living, at school and in other activities. The present study aims to create a short version of the Executive Functioning Questionnaire (EFECO) since there is a gap in the Spanish literature due to the lack of behavioural observation questionnaires at school age. A total of 3926 participants completed the online questionnaire. Subsequently, the validity and reliability of the data are analysed. The results show that the short version of the questionnaire, the EFECO-S, has a structure with five dimensions (emotional self-control, initiation, working memory, inhibition, and spatial organisation), as well as a second-order factor (global executive skill) and high reliability (ordinal Alpha = 0.68-0.88). The EFECO is composed of 67 items, while the EFECO-S has 20 items, four per factor, which turns it into a quick and easy to apply test. Therefore, it becomes an interesting alternative to be applied in screening processes with children who may be experiencing executive difficulties.
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Affiliation(s)
- Sabina Barrios-Fernandez
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Cáceres, Spain;
| | - Margarita Gozalo
- Psychology and Anthropology Department, University of Extremadura, 10003 Cáceres, Spain;
| | - Maria Amado-Fuentes
- Psychology and Anthropology Department, University of Extremadura, 10003 Cáceres, Spain;
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | - Andres Garcia-Gomez
- Education Sciences Department, University of Extremadura, 10003 Cáceres, Spain;
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Tyburski E, Mak M, Sokołowski A, Starkowska A, Karabanowicz E, Kerestey M, Lebiecka Z, Preś J, Sagan L, Samochowiec J, Jansari AS. Executive Dysfunctions in Schizophrenia: A Critical Review of Traditional, Ecological, and Virtual Reality Assessments. J Clin Med 2021; 10:jcm10132782. [PMID: 34202881 PMCID: PMC8267962 DOI: 10.3390/jcm10132782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/19/2023] Open
Abstract
In recent years, interest has grown in measuring executive function in schizophrenia with ecological and virtual reality (VR) tools. However, there is a lack of critical analysis comparing those tools with traditional ones. This paper aims to characterize executive dysfunction in schizophrenia by comparing ecological and virtual reality assessments with traditional tools, and to describe the neurobiological and psychopathological correlates. The analysis revealed that ecological and VR tests have higher levels of verisimilitude and similar levels of veridicality compared to traditional tools. Both negative symptoms and disorganization correlate significantly with executive dysfunction as measured by traditional tools, but their relationships with measures based on ecological and VR methods are still unclear. Although there is much research on brain correlates of executive impairments in schizophrenia with traditional tools, it is uncertain if these results will be confirmed with the use of ecological and VR tools. In the diagnosis of executive dysfunction, it is important to use a variety of neuropsychological methods—especially those with confirmed ecological validity—to properly recognize the underlying characteristics of the observed deficits and to implement effective forms of therapy.
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Affiliation(s)
- Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 61-719 Poznań, Poland
- Correspondence: ; Tel.: +48-61-271-12-22
| | - Monika Mak
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Andrzej Sokołowski
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94143, USA;
| | - Anna Starkowska
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, 53-238 Wrocław, Poland;
| | - Ewa Karabanowicz
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (E.K.); (M.K.)
| | - Magdalena Kerestey
- Institute of Psychology, University of Szczecin, 71-017 Szczecin, Poland; (E.K.); (M.K.)
| | - Zofia Lebiecka
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Joanna Preś
- Department of Health Psychology, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland; (M.M.); (Z.L.); (J.P.)
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland;
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 71-457 Szczecin, Poland;
| | - Ashok S. Jansari
- Department of Psychology, Goldsmiths, University of London, New Cross, London SE14 6NW, UK;
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Kobori A, Miyashita M, Miyano Y, Suzuki K, Toriumi K, Niizato K, Oshima K, Imai A, Nagase Y, Yoshikawa A, Horiuchi Y, Yamasaki S, Nishida A, Usami S, Takizawa S, Itokawa M, Arai H, Arai M. Advanced glycation end products and cognitive impairment in schizophrenia. PLoS One 2021; 16:e0251283. [PMID: 34038433 PMCID: PMC8153415 DOI: 10.1371/journal.pone.0251283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
Advanced glycation end products play a key role in the pathophysiology of schizophrenia. Cognitive impairment is one of the central features of schizophrenia; however, the association between advanced glycation end products and cognitive impairment remains unknown. This study investigated whether advanced glycation end products affect the cognitive domain in patients with schizophrenia. A total of 58 patients with chronic schizophrenia were included in this cross-sectional study. Plasma advanced glycation end products were measured using high-performance liquid chromatography (HPLC). Neuropsychological and cognitive functions were assessed using the Wechsler Adult Intelligence Scale, Third Version, and the Wisconsin Card Sorting Test Keio-FS version. Multiple regression analysis adjusted for age, sex, body mass index, educational years, daily dose of antipsychotics, and psychotic symptoms revealed that processing speed was significantly associated with plasma pentosidine, a representative advanced glycation end product (standardized β = -0.425; p = 0.009). Processing speed is the cognitive domain affected by advanced glycation end products. Considering preceding evidence that impaired processing speed is related to poor functional outcome, interventions targeted at reducing advanced glycation end products may contribute to promoting recovery of patients with schizophrenia as well as cognitive function improvement.
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Affiliation(s)
- Akiko Kobori
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Takatsuki Hospital, Hachioji, Tokyo, Japan
| | - Yasuhiro Miyano
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
| | - Kazuhiro Suzuki
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Takatsuki Hospital, Hachioji, Tokyo, Japan
| | - Kazuya Toriumi
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Kazuhiro Niizato
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
| | - Kenichi Oshima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
| | - Atsushi Imai
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
| | - Yukihiro Nagase
- Department of Psychiatry, Takatsuki Hospital, Hachioji, Tokyo, Japan
| | - Akane Yoshikawa
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Yasue Horiuchi
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shunya Takizawa
- Division of Neurology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Masanari Itokawa
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Setagaya-ku, Tokyo, Japan
| | - Heii Arai
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Makoto Arai
- Department of Psychiatry and Behavioral Sciences, Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan
- * E-mail:
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20
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Dubey S, Ghosh R, Chatterjee S, Dubey MJ, Sengupta S, Chatterjee S, Kanti Ray B, Modrego PJ, Benito-León J. Frontal Dysexecutive Syndrome in Brain Tumors: A Pragmatic Insight to an Old Problem. Case Rep Oncol 2021; 14:325-332. [PMID: 33776724 PMCID: PMC7983608 DOI: 10.1159/000513744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/10/2020] [Indexed: 11/19/2022] Open
Abstract
Brain tumors have long been considered one of the most prevalent causes of potentially reversible cognitive impairment. An accurate underlying cause of cognitive impairment due to brain tumor needs to be evaluated pragmatically. Patterns of cognitive impairment associated with brain tumors depend mainly on their location, lateralization, pathological classification and secondary effects of the treatment, as well as the structural plasticity and diaschisis. Hence, it is not rare that lesions with different locations and histologies may manifest with a similar pattern of cognitive impairment due to the complex interplay of determinants. We herein report 3 patients with brain tumors affecting different locations and with differing histologies, who shared a similar presentation as “frontal dysexecutive syndrome” masqueraded as psychiatric conditions. Detailed examination of saccades and pursuit along with eye movements and conventional motor examinations were essential not only to diagnose brain tumor as the potential cause of cognitive impairment, but also to rule out other coexisting etiologies with completely different underlying pathological mechanisms (i.e., Huntington's disease in 1 of the cases). A detailed neurological examination, including eye movement assessment, in patients with psychiatric symptoms provides not only important clues to delineate the underlying anatomical substrate involved, but also helps clinicians to make an accurate diagnosis and to select appropriate therapeutic options.
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, India
| | - Subhankar Chatterjee
- Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampore Mental Hospital, Murshidabad, India
| | - Samya Sengupta
- Department of General Medicine, Apollo Gleneagles Hospitals, Kolkata, India
| | - Subham Chatterjee
- Department of Psychiatry, Institute of Psychiatry, Institute of Post-Graduate Medical Education and Research, Kolkata, India
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Pedro J Modrego
- Department of Neurology, University Hospital Miguel Servet, Zaragoza, Spain
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
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21
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Sánchez-González A, Thougaard E, Tapias-Espinosa C, Cañete T, Sampedro-Viana D, Saunders JM, Toneatti R, Tobeña A, Gónzalez-Maeso J, Aznar S, Fernández-Teruel A. Increased thin-spine density in frontal cortex pyramidal neurons in a genetic rat model of schizophrenia-relevant features. Eur Neuropsychopharmacol 2021; 44:79-91. [PMID: 33485732 PMCID: PMC7902438 DOI: 10.1016/j.euroneuro.2021.01.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/09/2020] [Accepted: 01/10/2021] [Indexed: 12/13/2022]
Abstract
The cellular mechanisms altered during brain wiring leading to cognitive disturbances in neurodevelopmental disorders remain unknown. We have previously reported altered cortical expression of neurodevelopmentally regulated synaptic markers in a genetic animal model of schizophrenia-relevant behavioral features, the Roman-High Avoidance rat strain (RHA-I). To further explore this phenotype, we looked at dendritic spines in cortical pyramidal neurons, as changes in spine density and morphology are one of the main processes taking place during adolescence. An HSV-viral vector carrying green fluorescent protein (GFP) was injected into the frontal cortex (FC) of a group of 11 RHA-I and 12 Roman-Low Avoidance (RLA-I) male rats. GFP labeled dendrites from pyramidal cells were 3D reconstructed and number and types of spines quantified. We observed an increased spine density in the RHA-I, corresponding to a larger fraction of immature thin spines, with no differences in stubby and mushroom spines. Glia cells, parvalbumin (PV) and somatostatin (SST) interneurons and surrounding perineuronal net (PNN) density are known to participate in FC and pyramidal neuron dendritic spine maturation. We determined by stereological-based quantification a significantly higher number of GFAP-positive astrocytes in the FC of the RHA-I strain, with no difference in microglia (Iba1-positive cells). The number of inhibitory PV, SST interneurons or PNN density, on the contrary, was unchanged. Results support our belief that the RHA-I strain presents a more immature FC, with some structural features like those observed during adolescence, adding construct validity to this strain as a genetic behavioral model of neurodevelopmental disorders.
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Affiliation(s)
- A Sánchez-González
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - E Thougaard
- Research Laboratory for Stereology and Neuroscience, Bispebjerg Copenhagen University Hospital, 2400 Copenhagen, Denmark
| | - C Tapias-Espinosa
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - T Cañete
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - D Sampedro-Viana
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - J M Saunders
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - R Toneatti
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - A Tobeña
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain
| | - J Gónzalez-Maeso
- Department of Physiology and Biophysics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - S Aznar
- Research Laboratory for Stereology and Neuroscience, Bispebjerg Copenhagen University Hospital, 2400 Copenhagen, Denmark; Copenhagen Center for Translational Research, Bispebjerg Copenhagen University Hospital, Copenhagen, Denmark.
| | - A Fernández-Teruel
- Medical Psychology Unit, Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universidad Autónoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
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22
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Tagini S, Solca F, Torre S, Brugnera A, Ciammola A, Mazzocco K, Ferrucci R, Silani V, Pravettoni G, Poletti B. Counterfactual thinking in psychiatric and neurological diseases: A scoping review. PLoS One 2021; 16:e0246388. [PMID: 33592003 PMCID: PMC7886174 DOI: 10.1371/journal.pone.0246388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/16/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The ability to simulate alternatives to factual events is called counterfactual thinking (CFT) and it is involved both in emotional and behavioral regulation. CFT deficits have been reported in psychiatric and neurological conditions, possibly contributing to patients' difficulties in modulating behaviors and affections. Thus, acknowledging the presence and possible consequences of CFT impairments might be essential for optimal clinical management. OBJECTIVES This scoping review aims to summarize the previous evidence about CFT in psychiatric and neurological diseases to determine the extent of the previous research and what has been discovered so far, the variety of clinical conditions considered, the methodologies adopted, and the relevant issues to be addressed by future investigations. METHODS PsycInfo, PubMed, Scopus, and Web of Science were searched to identify articles published up to January 2020, written in English and focused on CFT in adults affected by psychiatric or neurological conditions. RESULTS Twenty-nine studies have been included; most of them focused on psychiatric conditions, a minority considered neurological diseases. The generation of counterfactual thoughts related to a negative real-life or a fictional event and the counterfactual inference test were the most popular tasks adopted. CFT impairments were reported in both psychiatric and neurological conditions, likely associated with a fronto-executive dysfunction. CONCLUSIONS Future research might further explore CFT in those psychiatric and neurological conditions in which CFT difficulties have been preliminary reported. Furthermore, it would be recommendable to extend this investigation to all the clinical conditions possibly at risk of fronto-executive dysfunction. In the end, we speculate that since CFT plays a role in driving everyday behaviors, it might be crucial also when medical decisions are involved; thus, future research might extend the investigation of CFT especially to those populations that implicate complex clinical management.
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Affiliation(s)
- Sofia Tagini
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Federica Solca
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, University of Milan, Milan, Italy
| | - Silvia Torre
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Andrea Ciammola
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division on Cognitive and Psychological Sciences, European Institute of Oncology, Milan, Italy
| | - Roberta Ferrucci
- Department of Health Sciences, Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, International Medical School, University of Milan, Milan, Italy
- ASST Santi Paolo e Carlo, Neurology Clinic III, Milan, Italy
- IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, “Dino Ferrari” Center, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division on Cognitive and Psychological Sciences, European Institute of Oncology, Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience—IRCCS Istituto Auxologico Italiano, Milan, Italy
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23
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Noel J, Viswanathan SA, Kuruvilla A. Nature and Correlates of Executive Dysfunction in Schizophrenia: An Exploratory Study. Indian J Psychol Med 2021; 43:16-23. [PMID: 34349302 PMCID: PMC8295581 DOI: 10.1177/0253717620929494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Executive function (EF) impairment has been demonstrated in patients with schizophrenia. This study attempted to examine the clinical and demographic correlates associated with the different components of EF in these patients using a comprehensive battery of neuropsychological tests. MATERIALS AND METHODS Consecutive inpatients with schizophrenia in remission were recruited. The following instruments were administered: (a) Positive and Negative Syndrome Scale (PANSS), (b)World Health Organization Disability Assessment Schedule 2.0, (c) Tower of London, (d) Stroop Test, (e) Controlled Oral Word Association Test, (f) Animal Names Test, and (g) Verbal N-Back Test. Sociodemographic and clinical details were also recorded. Data was analyzed using standard bivariate and multivariate statistics. RESULTS A total of 50 patients were recruited. The mean age of the population was 30 years (standard deviation [SD]: 7.74). The majority were male, literate, single, from a rural background, from a middle socioeconomic background, and unemployed. The mean dose of antipsychotic medication was 618.57 mg (SD: 282.08) of chlorpromazine equivalents per day. Impairment was found in the different sub-components of EF. On multivariate analysis, factors significantly associated with executive dysfunction were lower education, unemployment, lower income, positive PANSS score, higher antipsychotic dose, and history of treatment with electroconvulsive therapy. CONCLUSION EFs encompass a wide range of cognitive processes that influence an individual's ability to adapt and function in the society. These are often impaired in patients with schizophrenia. Clinicians need to be aware of these deficits and factors associated with them, to plan appropriate and effective remedial measures.
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Affiliation(s)
- Joseph Noel
- Dept. of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Anju Kuruvilla
- Dept. of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
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24
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Ahuir M, Crosas JM, Estrada F, Zabala W, Pérez-Muñoz S, González-Fernández A, Tost M, Aguayo R, Montalvo I, Miñano MJ, Gago E, Pàmias M, Monreal JA, Palao D, Labad J. Cognitive biases are associated with clinical and functional variables in psychosis: A comparison across schizophrenia, early psychosis and healthy individuals. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 14:4-15. [PMID: 32950409 DOI: 10.1016/j.rpsm.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 06/18/2020] [Accepted: 07/04/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We investigated the presence of cognitive biases in people with a recent-onset psychosis (ROP), schizophrenia and healthy adolescents and explored potential associations between these biases and psychopathology. METHODS Three groups were studied: schizophrenia (N=63), ROP (N=43) and healthy adolescents (N=45). Cognitive biases were assessed with the Cognitive Biases Questionnaire for Psychosis (CBQ). Positive, negative and depressive symptoms were assessed with the PANSS and Calgary Depression Scale (ROP; schizophrenia) and with the CAPE-42 (healthy adolescents). Cannabis use was registered. The association between CBQ and psychopathology scales was tested with multiple linear regression analyses. RESULTS People with schizophrenia reported more cognitive biases (46.1±9.0) than ROP (40±5.9), without statistically significant differences when compared to healthy adolescents (43.7±7.3). Cognitive biases were significantly associated with positive symptoms in both healthy adolescents (Standardized β=0.365, p=0.018) and people with psychotic disorders (β=0.258, p=0.011). Cognitive biases were significantly associated with depressive symptoms in healthy adolescents (β=0.359, p=0.019) but in patients with psychotic disorders a significant interaction between schizophrenia diagnosis and CBQ was found (β=1.804, p=0.011), which suggests that the pattern differs between ROP and schizophrenia groups (positive association only found in the schizophrenia group). Concerning CBQ domains, jumping to conclusions was associated with positive and depressive symptoms in people with schizophrenia and with cannabis use in ROP individuals. Dichotomous thinking was associated with positive and depressive symptoms in all groups. CONCLUSIONS Cognitive biases contribute to the expression of positive and depressive symptoms in both people with psychotic disorders and healthy individuals.
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Affiliation(s)
- Maribel Ahuir
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Psychiatry and Clinical Psychology Service, Institute of Neuroscience, Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - Josep Maria Crosas
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Francesc Estrada
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Wanda Zabala
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Sara Pérez-Muñoz
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Alba González-Fernández
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Meritxell Tost
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Raquel Aguayo
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Itziar Montalvo
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Maria José Miñano
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain
| | - Estefania Gago
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain
| | - Montserrat Pàmias
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - José Antonio Monreal
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Diego Palao
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Javier Labad
- Department of Mental Health, Parc Taulí Hospital Universitari, I3PT, Sabadell, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.
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25
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Shi L, Bergson CM. Neuregulin 1: an intriguing therapeutic target for neurodevelopmental disorders. Transl Psychiatry 2020; 10:190. [PMID: 32546684 PMCID: PMC7297728 DOI: 10.1038/s41398-020-00868-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 05/14/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022] Open
Abstract
Neurodevelopmental psychiatric disorders including schizophrenia (Sz) and attention deficit hyperactivity disorder (ADHD) are chronic mental illnesses, which place costly and painful burdens on patients, their families and society. In recent years, the epidermal growth factor (EGF) family member Neuregulin 1 (NRG1) and one of its receptors, ErbB4, have received considerable attention due to their regulation of inhibitory local neural circuit mechanisms important for information processing, attention, and cognitive flexibility. Here we examine an emerging body of work indicating that either decreasing NRG1-ErbB4 signaling in fast-spiking parvalbumin positive (PV+) interneurons or increasing it in vasoactive intestinal peptide positive (VIP+) interneurons could reactivate cortical plasticity, potentially making it a future target for gene therapy in adults with neurodevelopmental disorders. We propose preclinical studies to explore this model in prefrontal cortex (PFC), but also review the many challenges in pursuing cell type and brain-region-specific therapeutic approaches for the NRG1 system.
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Affiliation(s)
- Liang Shi
- grid.410427.40000 0001 2284 9329Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, 1460 Laney Walker Boulevard, Augusta, GA 30912 USA ,grid.189967.80000 0001 0941 6502Present Address: Department of Cell Biology, Emory University School of Medicine, Atlanta, GA USA
| | - Clare M. Bergson
- grid.410427.40000 0001 2284 9329Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, 1460 Laney Walker Boulevard, Augusta, GA 30912 USA
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26
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Puveendrakumaran P, Fervaha G, Caravaggio F, Remington G. Assessing analytic and intuitive reasoning using the cognitive reflection test in young patients with schizophrenia. Psychiatry Res 2020; 284:112683. [PMID: 31818543 DOI: 10.1016/j.psychres.2019.112683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 09/27/2019] [Accepted: 11/06/2019] [Indexed: 12/29/2022]
Abstract
Cognitive biases may contribute to the formation and maintenance of positive symptoms in patients with schizophrenia. However, cognitive reflection (i.e., the ability to use analytical thinking to override intuitive responses) has not been explicitly examined in schizophrenia patients using the cognitive reflection test (CRT). Using the CRT, we examined the degree of analytical and intuitive reasoning employed during problem solving in patients with schizophrenia versus healthy controls. Fifty-eight outpatients with schizophrenia and fifty-eight age- and sex-matched healthy controls (18-35 years of age) participated in this study. In addition to CRT performance, neurocognition, apathy, impulsivity, depression, insight, and clinical symptoms were evaluated. Patients with schizophrenia produced significantly fewer analytical responses (U = 1167.00, p<0.05) and more intuitive responses (U = 1273.50, p<0.05) compared to healthy controls. Patients without significant cognitive impairment also produced fewer analytical responses compared to controls (U = 894.50, p<0.05). Among patients, analytical thinking was positively correlated with working memory (r = 0.27, p<0.05), and affective symptoms (r = 0.31, p<0.05). Analytical reasoning was not significantly correlated with positive symptoms, avolition, or impulsivity. Patients with schizophrenia demonstrate less analytical and more intuitive reasoning while problem solving compared to healthy controls. This reduction in cognitive reflection is not significantly explained by global cognitive impairment or motivational deficits.
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Affiliation(s)
- Pugaliya Puveendrakumaran
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada
| | - Gagan Fervaha
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Fernando Caravaggio
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada.
| | - Gary Remington
- Research Imaging Centre, Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada
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27
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Clesse C, Salime S, Dumand I, Concetta-Ciciarelli SB, Lavenir S, Kacemi K, Heckel-Chalet P, Sissung F, Poinsignon A, Simon A, Decker M, Batt M. The French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS): Modelization of an Adapted Assessment Method Toward Long-Term Psychiatric Inpatients With Disabling, Severe and Persistent Mental Illness. Front Psychiatry 2020; 11:540680. [PMID: 33192655 PMCID: PMC7531021 DOI: 10.3389/fpsyt.2020.540680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
For the past forty years, the generalization of community-based approaches has prompted psychiatry into promoting a deinstitutionalization movement and a psychosocial rehabilitation approach (PSR) for individuals with schizophrenia and related difficulties. Unfortunately, this approach generally does not involve the most severe cognitive and psycho-affective clinical situations among this population despite an increasing number of publications advocating that all individuals should be included in PSR and deinstitutionalization programs. In this context, considering the absence of an assessment battery designed for French individuals with particularly disabling, severe, and persistent mental illness (IDSPMI), we constructed an integrative assessment model adapted to this specific population. To select the most suitable tools for this population, a literature review (inspired by the PRISMA protocol) and a systematic review were combined with a clinical assessment study. The literature review first identified the cognitive and psycho-affective functions which mainly influence the day-to-day life adaptation of individuals engaged in a PSR/deinstitutionalization program. The systematic review then gathered all of the useable French validated tools to assess the initially selected dimensions (n = 87). To finish, for each dimension, the selected 87 tools were included in a clinical assessment study performed within a French psychiatric hospital. The authors collected and verified the characteristics of each tool (validity, French norms, French version, the average speed of the test, ease of use, ability to assess other dimensions). Their suitability was also assessed when applied to IDSPMI. Based on this final clinical evaluation, the authors selected one tool per function to create the French Integrative Psychosocial Rehabilitation Assessment for Complex Situations (FIPRACS). This battery is an assessment tailored to the neurocognitive and psycho-affective potentials of IDSPMI. While further validation studies of this battery are ultimately required, the practical/clinical implications of this battery are presented and discussed.
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Affiliation(s)
- Christophe Clesse
- Center for Psychiatry, Wolfson Institute of Preventive Medicine, Barth & The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom.,Centre Hospitalier de Jury-les-Metz, Metz, France.,Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,IREPS Grand-Est, Laxou, France
| | - S Salime
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France.,Association Espoir 54, Nancy, France
| | - I Dumand
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - S Lavenir
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - K Kacemi
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | | | - Frank Sissung
- Association d'Information et d'Entraide Mosellane, Metz, France
| | - Aurore Poinsignon
- Association d'Information et d'Entraide Mosellane, Metz, France.,Association Famille Rurale de Moselle, Solgne, France
| | - Anthony Simon
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
| | - M Decker
- Centre Hospitalier de Jury-les-Metz, Metz, France
| | - M Batt
- Laboratoire INTERPSY (EA 4432), Université de Lorraine, Nancy, France
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28
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Karamaouna P, Zouraraki C, Giakoumaki SG. Cognitive Functioning and Schizotypy: A Four-Years Study. Front Psychiatry 2020; 11:613015. [PMID: 33488431 PMCID: PMC7820122 DOI: 10.3389/fpsyt.2020.613015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/08/2020] [Indexed: 12/02/2022] Open
Abstract
Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants ("schizotypy congruent") that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, Faculty of Social Sciences, University of Crete, Rethymno, Greece.,University of Crete Research Center for the Humanities, The Social and Educational Sciences (UCRC), University of Crete, Rethymno, Greece
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29
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Twin studies of brain structure and cognition in schizophrenia. Neurosci Biobehav Rev 2019; 109:103-113. [PMID: 31843545 DOI: 10.1016/j.neubiorev.2019.12.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 11/20/2022]
Abstract
Twin studies in schizophrenia have been crucial in establishing estimates for the heritability and thus providing evidence for a genetic component in this disorder. Recent years have seen the application of the twin study paradigm to both putative intermediate phenotypes and biomarkers of disease as well as a diversification of its use in schizophrenia research. This review addressed studies of brain structure (T1 morphometry) and cognition in schizophrenia using twin study designs. We review major findings such as the overlap of genetic variance between schizophrenia and cognition as a model for the emergence of psychopathology. The use of novel hybrid models integrating molecular genetic risk markers, as well as the use of twin studies in epigenetics might prove to significantly enhance schizophrenia research in the post-GWAS era.
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Xiu MH, Wang DM, Du XD, Chen N, Tan SP, Tan YL, Yang FD, Cho RY, Zhang XY. Interaction of BDNF and cytokines in executive dysfunction in patients with chronic schizophrenia. Psychoneuroendocrinology 2019; 108:110-117. [PMID: 31255950 DOI: 10.1016/j.psyneuen.2019.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/15/2019] [Accepted: 06/11/2019] [Indexed: 12/21/2022]
Abstract
Multiple lines of evidence indicate that patients with chronic schizophrenia (SCZ) display executive dysfunction across the illness course. However, the potential molecular pathophysiologic mechanisms remain poorly elucidated. Neurodevelopmental changes caused by alterations of inflammatory mediators and neurotrophins have been shown to occur in the earliest stages of SCZ, and be associated with executive dysfunction (ED) in SCZ. Therefore, the current study was to investigate whether the interplay between BDNF and inflammatory mediators was involved in the disruption of executive function of long-term hospitalized patients with chronic SCZ. Serum cytokines and BDNF levels were measured in 112 long-term hospitalized patients with chronic SCZ and 44 healthy normal controls. Executive functions were assessed by verbal fluency tests (VFT), the Stroop word-color test (Stroop), and the Wisconsin card sorting tests (WCST).The results showed that the patients had higher IL-2, IL-6, IL-8, but lower TNF-α and BDNF compared to control subjects. In the patient group, BDNF was positively associated with IL-2 and IL-8 levels, while lower BDNF levels were correlated with ED measured by VFT and WCST tests. Multiple stepwise regression analyses confirmed that BDNF × IL-8 and BDNF × TNF-α were factors influencing the total score of VFT, while BDNF × IL-8 and BDNF × TNF-α were recognized as influencing factors for WCST scores. Our results suggest complex interactions between BDNF and cytokines were involved in the pathophysiology of executive function impairments in patients with SCZ.
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Affiliation(s)
- Mei Hong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Dong Mei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang Dong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Nan Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Shu Ping Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Yun Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Fu De Yang
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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