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Hitczenko K, Segal Y, Keshet J, Goldrick M, Mittal VA. Speech characteristics yield important clues about motor function: Speech variability in individuals at clinical high-risk for psychosis. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:60. [PMID: 37717025 PMCID: PMC10505148 DOI: 10.1038/s41537-023-00382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/24/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND AND HYPOTHESIS Motor abnormalities are predictive of psychosis onset in individuals at clinical high risk (CHR) for psychosis and are tied to its progression. We hypothesize that these motor abnormalities also disrupt their speech production (a highly complex motor behavior) and predict CHR individuals will produce more variable speech than healthy controls, and that this variability will relate to symptom severity, motor measures, and psychosis-risk calculator risk scores. STUDY DESIGN We measure variability in speech production (variability in consonants, vowels, speech rate, and pausing/timing) in N = 58 CHR participants and N = 67 healthy controls. Three different tasks are used to elicit speech: diadochokinetic speech (rapidly-repeated syllables e.g., papapa…, pataka…), read speech, and spontaneously-generated speech. STUDY RESULTS Individuals in the CHR group produced more variable consonants and exhibited greater speech rate variability than healthy controls in two of the three speech tasks (diadochokinetic and read speech). While there were no significant correlations between speech measures and remotely-obtained motor measures, symptom severity, or conversion risk scores, these comparisons may be under-powered (in part due to challenges of remote data collection during the COVID-19 pandemic). CONCLUSION This study provides a thorough and theory-driven first look at how speech production is affected in this at-risk population and speaks to the promise and challenges facing this approach moving forward.
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Affiliation(s)
- Kasia Hitczenko
- Laboratoire de Sciences Cognitives et Psycholinguistique, Département d'Études Cognitives, ENS, EHESS, CNRS, PSL University, Paris, France.
| | - Yael Segal
- Faculty of Electrical and Computer Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Joseph Keshet
- Faculty of Electrical and Computer Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Matthew Goldrick
- Department of Linguistics, Northwestern University, Evanston, IL, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Cognitive Science Program, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Cognitive Science Program, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Evanston, IL, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Institute for Innovations in Developmental Sciences, Evanston/Chicago, IL, USA
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2
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Ruiz SG, Brazil IA, Baskin-Sommers A. Distinct neurocognitive fingerprints reflect differential associations with risky and impulsive behavior in a neurotypical sample. Sci Rep 2023; 13:11782. [PMID: 37479846 PMCID: PMC10362008 DOI: 10.1038/s41598-023-38991-0] [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: 09/28/2022] [Accepted: 07/18/2023] [Indexed: 07/23/2023] Open
Abstract
Engagement in risky and impulsive behavior has long been associated with deficits in neurocognition. However, we have a limited understanding of how multiple subfunctions of neurocognition co-occur within individuals and which combinations of neurocognitive subfunctions are most relevant for risky and impulsive behavior. Using the neurotypical Nathan Kline Institute Rockland Sample (N = 673), we applied a Bayesian latent feature learning model-the Indian Buffet Process-to identify nuanced, individual-specific profiles of multiple neurocognitive subfunctions and examine their relationship to risky and impulsive behavior. All features were within a relatively normative range of neurocognition; however, there was subtle variability related to risky and impulsive behaviors. The relatively overall poorer neurocognition feature correlated with greater affective impulsivity and substance use patterns/problems. The poorer episodic memory and emotion feature correlated with greater trait externalizing and sensation-seeking. The poorer attention feature correlated with increased trait externalizing and negative urgency but decreased positive urgency and substance use. Finally, the average or mixed features negatively correlated with various risky and impulsive behaviors. Estimating nuanced patterns of co-occurring neurocognitive functions can inform our understanding of a continuum of risky and impulsive behaviors.
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Affiliation(s)
- Sonia G Ruiz
- Department of Psychology, Yale University, New Haven, CT, USA.
| | - Inti A Brazil
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands
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3
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Hayden CD, Murphy BP, Hardiman O, Murray D. Measurement of upper limb function in ALS: a structure review of current methods and future directions. J Neurol 2022; 269:4089-4101. [PMID: 35612658 PMCID: PMC9293830 DOI: 10.1007/s00415-022-11179-8] [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: 01/24/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022]
Abstract
Measurement of upper limb function is critical for tracking clinical severity in amyotrophic lateral sclerosis (ALS). The Amyotrophic Lateral Sclerosis Rating Scale-revised (ALSFRS-r) is the primary outcome measure utilised in clinical trials and research in ALS. This scale is limited by floor and ceiling effects within subscales, such that clinically meaningful changes for subjects are often missed, impacting upon the evaluation of new drugs and treatments. Technology has the potential to provide sensitive, objective outcome measurement. This paper is a structured review of current methods and future trends in the measurement of upper limb function with a particular focus on ALS. Technologies that have the potential to radically change the upper limb measurement field and explore the limitations of current technological sensors and solutions in terms of costs and user suitability are discussed. The field is expanding but there remains an unmet need for simple, sensitive and clinically meaningful tests of upper limb function in ALS along with identifying consensus on the direction technology must take to meet this need.
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Affiliation(s)
- C D Hayden
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland. .,Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland. .,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse St, Dublin 2, D02 R590, Ireland.
| | - B P Murphy
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.,Department of Mechanical, Manufacturing and Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research Centre (AMBER), Trinity College Dublin, Dublin 2, Ireland
| | - O Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse St, Dublin 2, D02 R590, Ireland.,Neurocent Directorate, Beaumont Hospital, Beaumont, Dublin 9, Ireland
| | - D Murray
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse St, Dublin 2, D02 R590, Ireland.,Neurocent Directorate, Beaumont Hospital, Beaumont, Dublin 9, Ireland
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Heaton A, Gooding A, Cherner M, Umlauf A, Franklin DR, Rivera Mindt M, Suárez P, Artiola I Fortuni L, Heaton RK, Marquine MJ. Demographically-adjusted norms for the Grooved Pegboard and Finger Tapping tests in Spanish-speaking adults: Results from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project. Clin Neuropsychol 2021; 35:396-418. [PMID: 32077791 PMCID: PMC7438231 DOI: 10.1080/13854046.2020.1713400] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE We developed demographically-corrected norms for Spanish-speakers from the U.S.-Mexico border regions of California and Arizona on two tests of motor skills - the Grooved Pegboard Test (Pegboard) and Finger Tapping Test (Tapping) - as part of a larger normative effort. METHOD Participants were native Spanish-speakers from the Neuropsychological Norms for the U.S.-Mexico Border Region in Spanish (NP-NUMBRS) Project (Pegboard: N = 254; Tapping: N = 183; age: 19-60 years; education: 0-20 years; 59% women). We examined the association of demographics (age, education and gender) with raw scores. Raw test scores were then converted to demographically-corrected T-scores via fractional polynomial equations. We also examined rates of impairment (T-score < 40) based on the current norms and on previously published norms for English-speaking non-Hispanic Whites and Blacks. RESULTS Having more years of education was associated with better raw test score performance on both tests (p < .001), and increased age was associated with worse performance on Pegboard (p < .001). Men outperformed women on Tapping, and older age was associated with lower raw scores in men only on the Tapping non-dominant hand trial (p = .02). The normed T-scores were confirmed to be normally distributed and free from demographic influences, and resulted in expected rates of impairment. Applying existing norms for English-speaking non-Hispanic Whites and Blacks to the raw scores of Spanish-speakers generally yielded lower than expected impairment rates (2-13%), with one exception: non-dominant Pegboard, for which non-Hispanic White norms overestimated impairment (23%). CONCLUSIONS Present findings underscore the importance of appropriate, population-specific normative data, even for tests of motor ability.
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Affiliation(s)
- Anne Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Amanda Gooding
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Mariana Cherner
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Anya Umlauf
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Donald R Franklin
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Monica Rivera Mindt
- Department of Psychology and Latin American Latino Studies Institute, Fordham University, Bronx, NY, USA
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paola Suárez
- Hispanic Neuropsychiatric Center of Excellence - Cultural Neuropsychology Program, Semel Institute for NeuroScience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, CA, USA
| | | | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - María J Marquine
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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Scott JC, Van Pelt AE, Port AM, Njokweni L, Gur RC, Moore TM, Phoi O, Tshume O, Matshaba M, Ruparel K, Chapman J, Lowenthal ED. Development of a computerised neurocognitive battery for children and adolescents with HIV in Botswana: study design and protocol for the Ntemoga study. BMJ Open 2020; 10:e041099. [PMID: 32847928 PMCID: PMC7451956 DOI: 10.1136/bmjopen-2020-041099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Neurodevelopmental delays and cognitive impairments are common in youth living with HIV. Unfortunately, in resource-limited settings, where HIV infection impacts millions of children, cognitive and neurodevelopmental disorders commonly go undetected because of a lack of appropriate assessment instruments and local expertise. Here, we present a protocol to culturally adapt and validate the Penn Computerized Neurocognitive Battery (PennCNB) and examine its validity for detecting both advanced and subtle neurodevelopmental problems among school-aged children affected by HIV in resource-limited settings. METHODS AND ANALYSIS This is a prospective, observational cohort study. The venue for this study is Gaborone, Botswana, a resource-limited setting with high rates of perinatal exposure to HIV and limited neurocognitive assessment tools and expertise. We aim to validate the PennCNB in this setting by culturally adapting and then administering the adapted version of the battery to 200 HIV-infected, 200 HIV-exposed uninfected and 240 HIV-unexposed uninfected children. A series of analyses will be conducted to examine the reliability and construct validity of the PennCNB in these populations. ETHICS AND DISSEMINATION This project received ethical approval from local and university Institutional Review Boards and involved extensive input from local stakeholders. If successful, the proposed tools will provide practical screening and streamlined, comprehensive assessments that could be implemented in resource-limited settings to identify children with cognitive deficits within programmes focused on the care and treatment of children affected by HIV. The utility of such assessments could also extend beyond children affected by HIV, increasing general access to paediatric cognitive assessments in resource-limited settings.
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Affiliation(s)
- J Cobb Scott
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- VISN4 Mental Illness Research, Education, and Clinical Center, Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Amelia E Van Pelt
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Allison M Port
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lucky Njokweni
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Onkemetse Phoi
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
| | - Ontibile Tshume
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
| | - Mogomotsi Matshaba
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
- Baylor College of Medicine, Gaborone, Botswana
| | - Kosha Ruparel
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jennifer Chapman
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth D Lowenthal
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Pediatrics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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6
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Detecting motor slowing in clinical high risk for psychosis in a computerized finger tapping model. Eur Arch Psychiatry Clin Neurosci 2020; 270:393-397. [PMID: 31432263 PMCID: PMC7031007 DOI: 10.1007/s00406-019-01059-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/13/2019] [Indexed: 10/26/2022]
Abstract
Finger tapping is sensitive to motor slowing and emerging symptoms in individuals at clinical high risk for psychosis (CHR). A sensitive, computerized finger tapping task would be beneficial in early psychosis screening batteries. The study included 41 CHR and 32 healthy volunteers, who completed a computerized finger tapping task and clinical interviews. This computerized finger tapping task was sensitive to slowing in the CHR group compared to healthy volunteers, and as expected negative but not positive symptoms related to motor slowing. Computerized finger tapping tasks may be an easily dispersible tool for early symptom detection battery relevant to emerging negative symptoms.
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7
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Simpson HB, van den Heuvel OA, Miguel EC, Reddy YCJ, Stein DJ, Lewis-Fernández R, Shavitt RG, Lochner C, Pouwels PJW, Narayanawamy JC, Venkatasubramanian G, Hezel DM, Vriend C, Batistuzzo MC, Hoexter MQ, de Joode NT, Costa DL, de Mathis MA, Sheshachala K, Narayan M, van Balkom AJLM, Batelaan NM, Venkataram S, Cherian A, Marincowitz C, Pannekoek N, Stovezky YR, Mare K, Liu F, Otaduy MCG, Pastorello B, Rao R, Katechis M, Van Meter P, Wall M. Toward identifying reproducible brain signatures of obsessive-compulsive profiles: rationale and methods for a new global initiative. BMC Psychiatry 2020; 20:68. [PMID: 32059696 PMCID: PMC7023814 DOI: 10.1186/s12888-020-2439-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/10/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results. METHODS We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations. DISCUSSION Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.
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Affiliation(s)
- Helen Blair Simpson
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Odile A. van den Heuvel
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Euripedes C. Miguel
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Y. C. Janardhan Reddy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dan J. Stein
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Roberto Lewis-Fernández
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Roseli Gedanke Shavitt
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Christine Lochner
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Petra J. W. Pouwels
- grid.12380.380000 0004 1754 9227Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Janardhanan C. Narayanawamy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Ganesan Venkatasubramanian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dianne M. Hezel
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Chris Vriend
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Marcelo C. Batistuzzo
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Marcelo Q. Hoexter
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Niels T. de Joode
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Daniel Lucas Costa
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Maria Alice de Mathis
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Karthik Sheshachala
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Madhuri Narayan
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Shivakumar Venkataram
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anish Cherian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Clara Marincowitz
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Nienke Pannekoek
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Yael R. Stovezky
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Karen Mare
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Feng Liu
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Maria Concepcion Garcia Otaduy
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Bruno Pastorello
- grid.11899.380000 0004 1937 0722Institute of Radiology, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Rashmi Rao
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Martha Katechis
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Page Van Meter
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Melanie Wall
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
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Maaß SC, van Rijn H. 1-s Productions: A Validation of an Efficient Measure of Clock Variability. Front Hum Neurosci 2018; 12:519. [PMID: 30622465 PMCID: PMC6309103 DOI: 10.3389/fnhum.2018.00519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/10/2018] [Indexed: 12/11/2022] Open
Abstract
Objective: Clock variance is an important statistic in many clinical and developmental studies. Existing methods require a large number of trials for accurate clock variability assessment, which is problematic in studies using clinical or either young or aged participants. Furthermore, these existing methods often implicitly convolute clock and memory processes, making it difficult to disentangle whether the clock or memory system are driving the observed deviations. Here we assessed whether 20 repeated productions of a well-engrained interval (1 s), a task that does not incorporate memory updating nor the processing of feedback, could provide an accurate assessment of clock variability. Method: Sixty-eight undergraduate students completed two tasks: a 1-s production task in which they were asked to produce a 1-s duration by ending a tone by a keypress, and a multi-duration reproduction task. Durations presented in the reproduction task were tones lasting 1.17, 1.4 and 1.68 s. No feedback was presented in either task, and the order of presentation was counterbalanced between participants. Results: The observed central tendency in the reproduction task was better explained by models including the measures of clock variability derived from the 1-s production task than by models without it. Three clock variability measures were calculated for each participant [standard deviation, root mean squared residuals (RMSRs) from an estimated linear slope, and RMSR scaled by mean production duration]. The model including the scaled RMSR was preferred over the alternative models, and no notable effects of the order of task presentation were observed. These results suggest that: (1) measures of variability should account for drift; (2) the presentation of another timing task before a 1-s production task did not influence the assessment of the clock variability; and (3) the observed variability adheres to the scalar property and predicts temporal performance, and is thus a usable index of clock variability. Conclusion: This study shows that just 20 repeated productions of 1 s provide a reliable index of clock variability. As administering this task is fast and easy, it could prove to be useful in a large variety of developmental and clinical populations.
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Affiliation(s)
- Sarah C Maaß
- Department of Experimental Psychology, University of Groningen, Groningen, Netherlands.,Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, Netherlands
| | - Hedderik van Rijn
- Department of Experimental Psychology, University of Groningen, Groningen, Netherlands
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9
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Elhakeem A, Hardy R, Bann D, Kuh D, Cooper R. Motor performance in early life and participation in leisure-time physical activity up to age 68 years. Paediatr Perinat Epidemiol 2018; 32:327-334. [PMID: 29664176 PMCID: PMC6099324 DOI: 10.1111/ppe.12467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examined associations between motor performance in early life and leisure-time physical activity (LTPA) participation across adulthood, and whether these changed with age. METHODS Data were from 2526 participants from the Medical Research Council National Survey of Health and Development. Motor indicators were mother-reported ages at first standing and walking, teacher-rated games ability at age 13, and finger- and foot-tapping speed at age 15. LTPA was reported at ages 36, 43, 53, 60-64, and 68 years and classed at each age as none, moderate (1-4/mo), or regular (≥5/mo). Associations were examined using mixed-effects Poisson regression models with robust error variance. RESULTS Better ability at games and faster tapping speed were associated with more frequent participation in LTPA across adulthood, for example, fully adjusted relative risk of regular LTPA across adulthood (vs none) for above-average ability (vs below average or average) = 1.46 (95% CI 1.32, 1.61); and per 10-unit higher number of finger-taps/15 seconds = 1.04 (95% CI 1.02, 1.07). These associations did not vary by age (P ≥ .33 for interactions with age at LTPA). Ages at reaching motor milestones were not associated with LTPA (eg, fully adjusted relative risk of regular LTPA across adulthood for walking ≤10 and ≥18 months (vs 11-17 months) were 1.01 (95% CI 0.86, 1.20) and 0.89 (95% CI 0.75, 1.06) respectively. CONCLUSIONS Better ability at games and faster tapping speed in adolescence were associated with greater participation in LTPA throughout adult life; from age 36 up to age 68. Childhood motor skill interventions may therefore have the potential to promote lifelong LTPA.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK,MRC Integrative Epidemiology Unit at University of BristolBristolUK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
| | - David Bann
- Centre for Longitudinal StudiesUCL Institute of EducationLondonUK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCLLondonUK
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10
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Wilquin H, Delevoye-Turrell Y, Dione M, Giersch A. Motor Synchronization in Patients With Schizophrenia: Preserved Time Representation With Abnormalities in Predictive Timing. Front Hum Neurosci 2018; 12:193. [PMID: 29867416 PMCID: PMC5965021 DOI: 10.3389/fnhum.2018.00193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/20/2018] [Indexed: 11/13/2022] Open
Abstract
Objective: Basic temporal dysfunctions have been described in patients with schizophrenia, which may impact their ability to connect and synchronize with the outer world. The present study was conducted with the aim to distinguish between interval timing and synchronization difficulties and more generally the spatial-temporal organization disturbances for voluntary actions. A new sensorimotor synchronization task was developed to test these abilities. Method: Twenty-four chronic schizophrenia patients matched with 27 controls performed a spatial-tapping task in which finger taps were to be produced in synchrony with a regular metronome to six visual targets presented around a virtual circle on a tactile screen. Isochronous (time intervals of 500 ms) and non-isochronous auditory sequences (alternated time intervals of 300/600 ms) were presented. The capacity to produce time intervals accurately versus the ability to synchronize own actions (tap) with external events (tone) were measured. Results: Patients with schizophrenia were able to produce the tapping patterns of both isochronous and non-isochronous auditory sequences as accurately as controls producing inter-response intervals close to the expected interval of 500 and 900 ms, respectively. However, the synchronization performances revealed significantly more positive asynchrony means (but similar variances) in the patient group than in the control group for both types of auditory sequences. Conclusion: The patterns of results suggest that patients with schizophrenia are able to perceive and produce both simple and complex sequences of time intervals but are impaired in the ability to synchronize their actions with external events. These findings suggest a specific deficit in predictive timing, which may be at the core of early symptoms previously described in schizophrenia.
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Affiliation(s)
- Hélène Wilquin
- Aix Marseille Univ, Laboratory of Clinical Psychology, Psychopathology and Psychoanalysis, Aix-en-Provence, France
| | - Yvonne Delevoye-Turrell
- SCALab, UMR 9193 – National Center for Scientific Research, University of Lille, Villeneuve d’Ascq, France
| | - Mariama Dione
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne Giersch
- INSERM U1114, Department of Psychiatry, Federation of Translational Medicine of Strasbourg, Strasbourg University Hospital, Strasbourg, France
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11
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Térémetz M, Carment L, Brénugat-Herne L, Croca M, Bleton JP, Krebs MO, Maier MA, Amado I, Lindberg PG. Manual Dexterity in Schizophrenia-A Neglected Clinical Marker? Front Psychiatry 2017; 8:120. [PMID: 28740470 PMCID: PMC5502278 DOI: 10.3389/fpsyt.2017.00120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/23/2017] [Indexed: 01/30/2023] Open
Abstract
Impaired manual dexterity is commonly observed in schizophrenia. However, a quantitative description of key sensorimotor components contributing to impaired dexterity is lacking. Whether the key components of dexterity are differentially affected and how they relate to clinical characteristics also remains unclear. We quantified the degree of dexterity in 35 stabilized patients with schizophrenia and in 20 age-matched control subjects using four visuomotor tasks: (i) force tracking to quantify visuomotor precision, (ii) sequential finger tapping to measure motor sequence recall, (iii) single-finger tapping to assess temporal regularity, and (iv) multi-finger tapping to measure independence of finger movements. Diverse clinical and neuropsychological tests were also applied. A patient subgroup (N = 15) participated in a 14-week cognitive remediation protocol and was assessed before and after remediation. Compared to control subjects, patients with schizophrenia showed greater error in force tracking, poorer recall of tapping sequences, decreased tapping regularity, and reduced degree of finger individuation. A composite performance measure discriminated patients from controls with sensitivity = 0.79 and specificity = 0.9. Aside from force-tracking error, no other dexterity components correlated with antipsychotic medication. In patients, some dexterity components correlated with neurological soft signs, Positive and Negative Syndrome Scale (PANSS), or neuropsychological scores. This suggests differential cognitive contributions to these components. Cognitive remediation lead to significant improvement in PANSS, tracking error, and sequence recall (without change in medication). These findings show that multiple aspects of sensorimotor control contribute to impaired manual dexterity in schizophrenia. Only visuomotor precision was related to antipsychotic medication. Good diagnostic accuracy and responsiveness to treatment suggest that manual dexterity may represent a useful clinical marker in schizophrenia.
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Affiliation(s)
- Maxime Térémetz
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Loïc Carment
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Lindsay Brénugat-Herne
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marta Croca
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Marie-Odile Krebs
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marc A Maier
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Isabelle Amado
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Påvel G Lindberg
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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12
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Anderson VM, McIlwain ME, Kydd RR, Russell BR. Does cognitive impairment in treatment-resistant and ultra-treatment-resistant schizophrenia differ from that in treatment responders? Psychiatry Res 2015; 230:811-8. [PMID: 26564550 DOI: 10.1016/j.psychres.2015.10.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/29/2015] [Accepted: 10/30/2015] [Indexed: 12/31/2022]
Abstract
This study aimed to investigate whether cognitive impairment is more pronounced in people with treatment-resistant schizophrenia compared with those who respond well to first-line antipsychotic medication. Fifty-one patients with schizophrenia were assigned to one of three groups dependent on their clinical history: (i) 16 people who had responded well to first-line antipsychotic medication, (ii) 20 people who were treatment-resistant but responding to clozapine monotherapy, (iii) 15 people who were ultra-treatment-resistant/clozapine-resistant but responding to antipsychotic polypharmacy. Twenty-two controls were also recruited. Groups were matched for age, sex, disease duration and psychopathology. All participants undertook a computerised battery of neuropsychological tests that assessed multiple cognitive domains. Raw data were converted to z-scores, and test performance was compared between groups. People with schizophrenia performed significantly worse than controls in the majority of neuropsychological tests, with verbal memory, sustained attention, and sensorimotor the most commonly impaired domains. No significant differences in performance between people deemed to be treatment-resistant or ultra-treatment-resistant, and those who responded well to first-line antipsychotic medication were observed. There was no significant relationship between antipsychotic dose and scores on any of the neuropsychological tests. Cognitive impairment is a central feature of schizophrenia, but our results suggest that treatment-resistance may not be associated with more severe deficits.
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Affiliation(s)
- Valerie M Anderson
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Meghan E McIlwain
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Robert R Kydd
- Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Bruce R Russell
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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13
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Ekşioğlu M, İşeri A. An estimation of finger-tapping rates and load capacities and the effects of various factors. HUMAN FACTORS 2015; 57:634-648. [PMID: 25850109 DOI: 10.1177/0018720814563976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The aim of this study was to estimate the finger-tapping rates and finger load capacities of eight fingers (excluding thumbs) for a healthy adult population and investigate the effects of various factors on tapping rate. BACKGROUND Finger-tapping rate, the total number of finger taps per unit of time, can be used as a design parameter of various products and also as a psychomotor test for evaluating patients with neurologic problems. METHOD A 1-min tapping task was performed by 148 participants with maximum volitional tempo for each of eight fingers. For each of the tapping tasks, the participant with the corresponding finger tapped the associated key in the standard position on the home row of a conventional keyboard for touch typing. RESULTS The index and middle fingers were the fastest fingers for both hands, and little fingers the slowest. All dominant-hand fingers, except little finger, had higher tapping rates than the fastest finger of the nondominant hand. Tapping rate decreased with age and smokers tapped faster than nonsmokers. Tapping duration and exercise had also significant effect on tapping rate. CONCLUSION Normative data of tapping rates and load capacities of eight fingers were estimated for the adult population. In designs of psychomotor tests that require the use of tapping rate or finger load capacity data, the effects of finger, age, smoking, and tapping duration need to be taken into account. APPLICATION The findings can be used for ergonomic designs requiring finger-tapping capacity and also as a reference in psychomotor tests.
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14
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Gur RC, Braff DL, Calkins ME, Dobie DJ, Freedman R, Green MF, Greenwood TA, Lazzeroni LC, Light GA, Nuechterlein KH, Olincy A, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Sprock J, Stone WS, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Gur RE. Neurocognitive performance in family-based and case-control studies of schizophrenia. Schizophr Res 2015; 163:17-23. [PMID: 25432636 PMCID: PMC4441547 DOI: 10.1016/j.schres.2014.10.049] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 10/19/2014] [Accepted: 10/21/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Neurocognitive deficits in schizophrenia (SZ) are established and the Consortium on the Genetics of Schizophrenia (COGS) investigated such measures as endophenotypes in family-based (COGS-1) and case-control (COGS-2) studies. By requiring family participation, family-based sampling may result in samples that vary demographically and perform better on neurocognitive measures. METHODS The Penn computerized neurocognitive battery (CNB) evaluates accuracy and speed of performance for several domains and was administered across sites in COGS-1 and COGS-2. Most tests were included in both studies. COGS-1 included 328 patients with SZ and 497 healthy comparison subjects (HCS) and COGS-2 included 1195 patients and 1009 HCS. RESULTS Demographically, COGS-1 participants were younger, more educated, with more educated parents and higher estimated IQ compared to COGS-2 participants. After controlling for demographics, the two samples produced very similar performance profiles compared to their respective controls. As expected, performance was better and with smaller effect sizes compared to controls in COGS-1 relative to COGS-2. Better performance was most pronounced for spatial processing while emotion identification had large effect sizes for both accuracy and speed in both samples. Performance was positively correlated with functioning and negatively with negative and positive symptoms in both samples, but correlations were attenuated in COGS-2, especially with positive symptoms. CONCLUSIONS Patients ascertained through family-based design have more favorable demographics and better performance on some neurocognitive domains. Thus, studies that use case-control ascertainment may tap into populations with more severe forms of illness that are exposed to less favorable factors compared to those ascertained with family-based designs.
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Affiliation(s)
- Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - David L. Braff
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - Dorcas J. Dobie
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver,
Aurora, CO
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen
School of Medicine, University of California Los Angeles, Los Angeles, CA; VA
Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Tiffany A. Greenwood
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | | | - Gregory A. Light
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen
School of Medicine, University of California Los Angeles, Los Angeles, CA; VA
Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver,
Aurora, CO
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston,
MA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel
Deaconess Medical Center, Boston, MA
| | - Larry J. Siever
- Department of Psychiatry, The Mount Sinai School of
Medicine, New York, NY; 13James J. Peters VA Medical Center, New York, NY
| | - Jeremy M. Silverman
- Department of Psychiatry, The Mount Sinai School of
Medicine, New York, NY; 13James J. Peters VA Medical Center, New York, NY
| | - Joyce Sprock
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston,
MA; Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel
Deaconess Medical Center, Boston, MA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los
Angeles School of Public Health, Los Angeles, CA
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Sciences,
University of Washington, Seattle, WA; VA Puget Sound Health Care System, Seattle,
WA
| | - Ming T. Tsuang
- Department of Psychiatry, University of California San
Diego, La Jolla, CA; VISN-22 Mental Illness, Research, Education and Clinical Center
(MIRECC), VA San Diego Healthcare System
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania,
Philadelphia, PA
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