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Murthy V, Hanson E, DeMartinis N, Asgharnejad M, Dong C, Evans R, Ge T, Dunayevich E, Singh JB, Ratti E, Galderisi S. INTERACT: a randomized phase 2 study of the DAAO inhibitor luvadaxistat in adults with schizophrenia. Schizophr Res 2024; 270:249-257. [PMID: 38943928 DOI: 10.1016/j.schres.2024.06.017] [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: 12/06/2023] [Revised: 05/31/2024] [Accepted: 06/15/2024] [Indexed: 07/01/2024]
Abstract
Deficits in N-methyl-d-aspartate receptor (NMDAR) signaling are implicated in the pathogenesis of schizophrenia. Luvadaxistat (TAK-831/NBI-1065844) is an investigational d-amino acid oxidase (DAAO) inhibitor that increases d-serine levels at NMDAR coagonist sites. INTERACT is a phase 2 randomized, placebo-controlled study that evaluated the efficacy and safety of three doses of luvadaxistat, covering a range of DAAO occupancy and d-serine levels, in patients with schizophrenia with persistent negative symptoms. The study included a 14-day, single-blinded placebo run-in period and a 12-week, double-blinded treatment period. The primary efficacy endpoint was the 12-week change from baseline in Positive and Negative Syndrome Scale-Negative Symptom Factor Score (PANSS NSFS). Secondary efficacy endpoints included the 12-week changes from baseline in Brief Assessment of Cognition in Schizophrenia (BACS) score and Schizophrenia Cognition Rating Scale (SCoRS) score. Safety endpoints included adverse event assessments. The full analysis set included all randomized patients (N = 256 [placebo, n = 87; luvadaxistat 50 mg, n = 58; 125 mg, n = 56; 500 mg, n = 55]); 228 patients completed the study. No significant improvements in PANSS NSFS were observed at any dose versus placebo at week 12. Improvements were observed with luvadaxistat 50 mg versus placebo in cognitive endpoints: BACS composite score (nominal one-sided p = 0.031) and SCoRS interviewer total score (nominal one-sided p = 0.011). Luvadaxistat did not significantly improve negative symptoms of schizophrenia. However, luvadaxistat 50 mg met the prespecified secondary endpoints for cognitive performance (BACS) and function (SCoRS), warranting further investigation in patients with cognitive impairment associated with schizophrenia. Luvadaxistat was well-tolerated in INTERACT, with no new safety signals observed. ClinicalTrials.gov: NCT03382639.
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Affiliation(s)
- Venkatesha Murthy
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States.
| | - Elizabeth Hanson
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
| | - Nicholas DeMartinis
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
| | - Mahnaz Asgharnejad
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
| | - Cheng Dong
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
| | - Rebecca Evans
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
| | - Tingting Ge
- Neurocrine Biosciences, Inc., San Diego, California, United States
| | - Eduardo Dunayevich
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States; Neurocrine Biosciences, Inc., San Diego, California, United States
| | - Jaskaran B Singh
- Neurocrine Biosciences, Inc., San Diego, California, United States
| | - Emiliangelo Ratti
- Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, United States
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Domingo SZ. Response to "Clinical Outcome Assessment Instruments in Schizophrenia: A Scoping Literature Review with a Focus on the Potential of Patient-reported Outcomes". INNOVATIONS IN CLINICAL NEUROSCIENCE 2024; 21:8. [PMID: 38938534 PMCID: PMC11208006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
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3
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Corrone M, Ratnayake R, de Oliveira N, Jaehne EJ, van den Buuse M. Methamphetamine-induced locomotor sensitization in mice is not associated with deficits in a range of cognitive, affective and social behaviours: interaction with brain-derived neurotrophic factor Val66Met genotype. Behav Pharmacol 2023; 34:20-36. [PMID: 36373697 DOI: 10.1097/fbp.0000000000000708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic methamphetamine (Meth) abuse may induce psychosis similar to that observed in schizophrenia. Brain-derived neurotrophic factor (BDNF) has been implicated in the development of psychosis. We have previously shown long-term protein expression changes in mice treated chronically with Meth depending on BDNF Val66Met genotype. The aim of this study was to investigate if these protein expression changes were associated with differential changes in a range of behavioural paradigms for cognition, anxiety, social and other behaviours. Male and female Val/Val, Val/Met and Met/Met mice were treated with an escalating Meth dose protocol from 6 to 9 weeks of age, with controls receiving saline injections. Several overlapping cohorts were tested in the Y-maze for short-term spatial memory, novel-object recognition test, context and cued fear conditioning, sociability and social preference, elevated plus maze for anxiety-like behaviour and prepulse inhibition (PPI) of acoustic startle. Finally, the animals were assessed for spontaneous exploratory locomotor activity and acute Meth-induced locomotor hyperactivity. Acute Meth caused significantly greater locomotor hyperactivity in mice previously treated with the drug than in saline-pretreated controls. Meth-pretreated female mice showed a mild increase in spontaneous locomotor activity. There were no Meth-induced deficits in any of the other behavioural tests. Val/Met mice showed higher overall social investigation time and lower PPI compared with the Val/Val genotype independent of pretreatment. These results show limited long-term effects of chronic Meth on a range of cognitive, affective and social behaviours despite marked drug-induced locomotor sensitization in mice. There was no interaction with BDNF Val66Met genotype.
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Affiliation(s)
- Michelle Corrone
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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Barch DM, Boudewyn MA, Carter CC, Erickson M, Frank MJ, Gold JM, Luck SJ, MacDonald AW, Ragland JD, Ranganath C, Silverstein SM, Yonelinas A. Cognitive [Computational] Neuroscience Test Reliability and Clinical Applications for Serious Mental Illness (CNTRaCS) Consortium: Progress and Future Directions. Curr Top Behav Neurosci 2022; 63:19-60. [PMID: 36173600 DOI: 10.1007/7854_2022_391] [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] [Indexed: 11/25/2022]
Abstract
The development of treatments for impaired cognition in schizophrenia has been characterized as the most important challenge facing psychiatry at the beginning of the twenty-first century. The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) project was designed to build on the potential benefits of using tasks and tools from cognitive neuroscience to better understanding and treat cognitive impairments in psychosis. These benefits include: (1) the use of fine-grained tasks that measure discrete cognitive processes; (2) the ability to design tasks that distinguish between specific cognitive domain deficits and poor performance due to generalized deficits resulting from sedation, low motivation, poor test taking skills, etc.; and (3) the ability to link cognitive deficits to specific neural systems, using animal models, neuropsychology, and functional imaging. CNTRICS convened a series of meetings to identify paradigms from cognitive neuroscience that maximize these benefits and identified the steps need for translation into use in clinical populations. The Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRaCS) Consortium was developed to help carry out these steps. CNTRaCS consists of investigators at five different sites across the country with diverse expertise relevant to a wide range of the cognitive systems identified as critical as part of CNTRICs. This work reports on the progress and current directions in the evaluation and optimization carried out by CNTRaCS of the tasks identified as part of the original CNTRICs process, as well as subsequent extensions into the Positive Valence systems domain of Research Domain Criteria (RDoC). We also describe the current focus of CNTRaCS, which involves taking a computational psychiatry approach to measuring cognitive and motivational function across the spectrum of psychosis. Specifically, the current iteration of CNTRaCS is using computational modeling to isolate parameters reflecting potentially more specific cognitive and visual processes that may provide greater interpretability in understanding shared and distinct impairments across psychiatric disorders.
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Affiliation(s)
- Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA.
| | | | | | | | | | - James M Gold
- Maryland Psychiatric Research Center, Baltimore, MD, USA
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Yamada S, Takahashi S, Malchow B, Papazova I, Stöcklein S, Ertl-Wagner B, Papazov B, Kumpf U, Wobrock T, Keller-Varady K, Hasan A, Falkai P, Wagner E, Raabe FJ, Keeser D. Cognitive and functional deficits are associated with white matter abnormalities in two independent cohorts of patients with schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:957-969. [PMID: 34935072 PMCID: PMC9388472 DOI: 10.1007/s00406-021-01363-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/24/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Significant evidence links white matter (WM) microstructural abnormalities to cognitive impairment in schizophrenia (SZ), but the relationship of these abnormalities with functional outcome remains unclear. METHODS In two independent cohorts (C1, C2), patients with SZ were divided into two subgroups: patients with higher cognitive performance (SZ-HCP-C1, n = 25; SZ-HCP-C2, n = 24) and patients with lower cognitive performance (SZ-LCP-C1, n = 25; SZ-LCP-C2, n = 24). Healthy controls (HC) were included in both cohorts (HC-C1, n = 52; HC-C2, n = 27). We compared fractional anisotropy (FA) of the whole-brain WM skeleton between the three groups (SZ-LCP, SZ-HCP, HC) by a whole-brain exploratory approach and an atlas-defined WM regions-of-interest approach via tract-based spatial statistics. In addition, we explored whether FA values were associated with Global Assessment of Functioning (GAF) scores in the SZ groups. RESULTS In both cohorts, mean FA values of whole-brain WM skeleton were significantly lower in the SCZ-LCP group than in the SCZ-HCP group. Whereas in C1 the FA of the frontal part of the left inferior fronto-occipital fasciculus (IFOF) was positively correlated with GAF score, in C2 the FA of the temporal part of the left IFOF was positively correlated with GAF score. CONCLUSIONS We provide robust evidence for WM microstructural abnormalities in SZ. These abnormalities are more prominent in patients with low cognitive performance and are associated with the level of functioning.
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Affiliation(s)
- Shinichi Yamada
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.412857.d0000 0004 1763 1087Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan
| | - Shun Takahashi
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.412857.d0000 0004 1763 1087Department of Neuropsychiatry, Wakayama Medical University, Wakayama, Japan ,Clinical Research and Education Center, Asakayama General Hospital, Sakai, Japan
| | - Berend Malchow
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Irina Papazova
- grid.7307.30000 0001 2108 9006Department of Psychiatry Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Sophia Stöcklein
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- grid.42327.300000 0004 0473 9646Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada
| | - Boris Papazov
- grid.5252.00000 0004 1936 973XDepartment of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Ulrike Kumpf
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Wobrock
- grid.411984.10000 0001 0482 5331Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany ,Department of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Gross-Umstadt, Germany
| | - Katriona Keller-Varady
- grid.10423.340000 0000 9529 9877Institute of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Alkomiet Hasan
- grid.7307.30000 0001 2108 9006Department of Psychiatry Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Peter Falkai
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Elias Wagner
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Florian J. Raabe
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ,grid.4372.20000 0001 2105 1091International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany. .,Department of Radiology, University Hospital, LMU Munich, Munich, Germany. .,NeuroImaging Core Unit Munich (NICUM), University Hospital, LMU Munich, Munich, Germany.
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Non-Invasive Brain Stimulation Does Not Improve Working Memory in Schizophrenia: A Meta-Analysis of Randomised Controlled Trials. Neuropsychol Rev 2020; 31:115-138. [PMID: 32918254 DOI: 10.1007/s11065-020-09454-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
Poor working memory functioning is commonly found in schizophrenia. A number of studies have now tested whether non-invasive brain stimulation can improve this aspect of cognitive functioning. This report used meta-analysis to synthesise the results of these studies to examine whether transcranial electrical stimulation (tES) or repetitive transcranial magnetic stimulation (rTMS) can improve working memory in schizophrenia. The studies included in this meta-analysis were sham-controlled, randomised controlled trials that utilised either tES or rTMS to treat working memory problems in schizophrenia. A total of 22 studies were included in the review. Nine studies administered rTMS and 13 administered tES. Meta-analysis revealed that compared to sham/placebo stimulation, neither TMS nor tES significantly improved working memory. This was found when working memory was measured with respect to the accuracy on working memory tasks (TMS studies: Hedges' g = 0.112, CI95: -0.082, 0.305, p = .257; tES studies Hedges' g = 0.080, CI95: -0.117, 0.277, p = .427) or the speed working memory tasks were completed (rTMS studies: Hedges' g = 0.233, CI95: -0.212, 0.678, p = .305; tES studies Hedges' g = -0.016, CI95: -0.204, 0.173, p = .871). For tES studies, meta-regression analysis found that studies with a larger number of stimulation sessions were associated with larger treatment effects. This association was not found for TMS studies. At present, rTMS and tES is not associated with a reliable improvement in working memory for individuals with schizophrenia.
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Jalewa J, Todd J, Michie PT, Hodgson DM, Harms L. Do rat auditory event related potentials exhibit human mismatch negativity attributes related to predictive coding? Hear Res 2020; 399:107992. [PMID: 32571607 DOI: 10.1016/j.heares.2020.107992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 01/11/2023]
Abstract
Rodent models play a significant role in understanding disease mechanisms and the screening of new treatments. With regard to psychiatric disorders such as schizophrenia, however, it is difficult to replicate the human symptoms in rodents because these symptoms are often either 'uniquely human' or are only conveyed via self-report. There is a growing interest in rodent mismatch responses (MMRs) as a translatable 'biomarker' for disorders such as schizophrenia. In this review, we will summarize the attributes of human MMN, and discuss the scope of exploring the attributes of human MMN in rodents. Here, we examine how reliably MMRs that are measured in rats mimic human attributes, and present original data examining whether manipulations of stimulus conditions known to modulate human MMN, do the same for rat MMRs. Using surgically-implanted epidural electroencephalographic electrodes and wireless telemetry in freely-moving rats, we observed human-like modulations of MMRs, namely that larger MMRs were elicited to unexpected (deviant) stimuli that a) had a larger change in pitch compared to the expected (standard) stimulus, b) were less frequently presented (lower probability), and c) had no jitter (stable stimulus onset asynchrony) compared to high jitter. Overall, these findings contribute to the mounting evidence for rat MMRs as a good analogue of human MMN, bolstering the development of a novel approach in future to validate the preclinical models based on a translatable biomarker, MMN.
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Affiliation(s)
- Jaishree Jalewa
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia
| | - Juanita Todd
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Deborah M Hodgson
- School of Psychology, University of Newcastle, Callaghan, New South Wales, Australia; Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Lauren Harms
- Priority Research Centre for Brain and Mental Health Research, University of Newcastle, Callaghan, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia.
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Yamada S, Takahashi S, Ohoshi Y, Ishida T, Tsuji T, Shinosaki K, Terada M, Ukai S. Widespread white matter microstructural abnormalities and cognitive impairment in schizophrenia, bipolar disorder, and major depressive disorder: Tract-based spatial statistics study. Psychiatry Res Neuroimaging 2020; 298:111045. [PMID: 32087457 DOI: 10.1016/j.pscychresns.2020.111045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/01/2020] [Accepted: 02/06/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Shinichi Yamada
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan.
| | - Shun Takahashi
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Yuji Ohoshi
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Takuya Ishida
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | - Tomikimi Tsuji
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
| | | | | | - Satoshi Ukai
- Department of Neuropsychiatry, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012 Japan
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Chiu EC, Lee SC. Test-retest reliability of the Wisconsin Card Sorting Test in people with schizophrenia. Disabil Rehabil 2019; 43:996-1000. [PMID: 31361972 DOI: 10.1080/09638288.2019.1647295] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to examine the test-retest reliability of the Wisconsin Card Sorting Test in people with schizophrenia. In this study, minimal detectable change (MDC) was calculated and systematic measurement errors were evaluated. METHOD Sixty-three people with schizophrenia underwent the WCST twice with a two-week interval. Test-retest reliability was evaluated using intraclass correlation coefficient. Systematic measurement error was examined using paired t-test and effect size (Cohen's d). RESULTS The values of intraclass correlation coefficient were >0.70, except for two indices ("nonperseverative errors" and "failure to maintain set" with intraclass correlation coefficient of 0.56 and 0.30, respectively). Seven indices showed nonsignificant differences between the two assessments (t(62)= -0.84 to 1.38, p > 0.05) and negligible effect sizes (d = 0.03-0.13). The values of MDC with 95% certainty were 32.3, 42.0, 31.2, 36.9, 40.1, 3.3, and 3.8 for the "total number correct," "perseverative responses," "perseverative errors," "nonperseverative errors," "conceptual level responses," "number of categories completed," and "failure to maintain set" indices, respectively. CONCLUSIONS The WCST has acceptable test-retest reliability. Two indices ("nonperseverative errors" and "failure to maintain set") revealed lower levels of consistency in scores over repeated assessments. Clinicians and researchers should be cautious when using these two indices to interpret of the re-assessment results in people with schizophrenia.IMPLICATIONS FOR REHABILITATIONThe Wisconsin Card Sorting Test showed acceptable test-retest reliability in people with schizophrenia.Six indices of the Wisconsin Card Sorting Test revealed substantial random measurement errors, which should be used cautiously to interpret executive functions over repeated assessments.
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Affiliation(s)
- En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Shu-Chun Lee
- Department of Occupational Therapy, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan, ROC.,School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
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Gaertner B, Wagner M, Luck T, Buttery AK, Fuchs J, Busch MA. Normative data for the Digit Symbol Substitution Test in a population-based sample aged 65-79 years: Results from the German Health Interview and Examination Survey for Adults (DEGS1). Clin Neuropsychol 2018; 32:114-132. [PMID: 29911493 DOI: 10.1080/13854046.2018.1484168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To provide normative data for the Digit Symbol Substitution Test (DSST) of the Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III) in a population-based sample of community-dwelling older adults in Germany according to age, sex, and level of education. METHOD The sample comprised 1385 participants aged 65-79 years from the nationwide representative 'German Health Interview and Examination Survey for Adults' (DEGS1, 2008-2011). Participants with known cognitive impairment or dementia, other medical conditions affecting cognition, or currently using psychotropic drugs were excluded. Educational level was categorized as low, medium, and high according to the Comparative Analyses of Social Mobility in Industrial Nations (CASMIN) scale. Normative values for the DSST according to age, sex, and level of education were estimated by multiple linear regression using population weights. RESULTS Mean age was 71.1 years, 48.6% were men and low, medium, and high education levels were 62.8, 24.6, and 12.6%, respectively. Younger age, female sex, and higher level of education were significantly associated with higher DSST scores. Regression-based normative data for the DSST is provided according to age, sex, and level of education. In addition, a normative score calculator is provided. CONCLUSIONS These are the first age-, sex-, and education-specific normative data for older individuals for the DSST of the WAIS-III in Germany. These normative data will enable future population-level analyses on impaired cognitive function according to DSST.
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Affiliation(s)
- Beate Gaertner
- a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany
| | - Michael Wagner
- b Department of Psychiatry and Psychotherapy , University of Bonn , Bonn , Germany.,c German Center for Neurodegenerative Diseases (DZNE) , Bonn , Germany
| | - Tobias Luck
- d Department of Economic and Social Sciences , University of Applied Sciences Nordhausen , Nordhausen , Germany
| | - Amanda K Buttery
- a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany.,e Faculty of Life Sciences and Medicine , King's College London , London , UK
| | - Judith Fuchs
- a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany
| | - Markus A Busch
- a Department of Epidemiology and Health Monitoring , Robert Koch Institute , Berlin , Germany
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Blokland GAM, Mesholam-Gately RI, Toulopoulou T, del Re EC, Lam M, DeLisi LE, Donohoe G, Walters JTR, Seidman LJ, Petryshen TL. Heritability of Neuropsychological Measures in Schizophrenia and Nonpsychiatric Populations: A Systematic Review and Meta-analysis. Schizophr Bull 2017; 43:788-800. [PMID: 27872257 PMCID: PMC5472145 DOI: 10.1093/schbul/sbw146] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Schizophrenia is characterized by neuropsychological deficits across many cognitive domains. Cognitive phenotypes with high heritability and genetic overlap with schizophrenia liability can help elucidate the mechanisms leading from genes to psychopathology. We performed a meta-analysis of 170 published twin and family heritability studies of >800 000 nonpsychiatric and schizophrenia subjects to accurately estimate heritability across many neuropsychological tests and cognitive domains. The proportion of total variance of each phenotype due to additive genetic effects (A), shared environment (C), and unshared environment and error (E), was calculated by averaging A, C, and E estimates across studies and weighting by sample size. Heritability ranged across phenotypes, likely due to differences in genetic and environmental effects, with the highest heritability for General Cognitive Ability (32%-67%), Verbal Ability (43%-72%), Visuospatial Ability (20%-80%), and Attention/Processing Speed (28%-74%), while the lowest heritability was observed for Executive Function (20%-40%). These results confirm that many cognitive phenotypes are under strong genetic influences. Heritability estimates were comparable in nonpsychiatric and schizophrenia samples, suggesting that environmental factors and illness-related moderators (eg, medication) do not substantially decrease heritability in schizophrenia samples, and that genetic studies in schizophrenia samples are informative for elucidating the genetic basis of cognitive deficits. Substantial genetic overlap between cognitive phenotypes and schizophrenia liability (average rg = -.58) in twin studies supports partially shared genetic etiology. It will be important to conduct comparative studies in well-powered samples to determine whether the same or different genes and genetic variants influence cognition in schizophrenia patients and the general population.
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Affiliation(s)
- Gabriëlla A. M. Blokland
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Raquelle I. Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Commonwealth Research Center, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA
| | - Timothea Toulopoulou
- Psychology Department, Bilkent University, Ankara, Turkey;,Department of Psychology, University of Hong Kong, Pokfulam, Hong Kong;,Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Elisabetta C. del Re
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton, MA
| | - Max Lam
- Institute of Mental Health, Woodbridge Hospital, Singapore
| | - Lynn E. DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Clinical Neuroscience Division, Laboratory of Neuroscience, Department of Psychiatry, Veterans Affairs Boston Healthcare System, Brockton, MA
| | - Gary Donohoe
- School of Psychology, National University of Ireland, Galway, Ireland;,Neuropsychiatric Genetics Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - James T. R. Walters
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | | | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA;,Commonwealth Research Center, Harvard Medical School, Boston, MA;,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA
| | - Tracey L. Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA;,Department of Psychiatry, Harvard Medical School, Boston, MA;,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA
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Omega-3 fatty acids related to cognitive impairment in patients with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2017; 9:8-12. [PMID: 28740828 PMCID: PMC5514384 DOI: 10.1016/j.scog.2017.05.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 11/24/2022]
Abstract
Cognitive impairment is strongly associated with functional outcome in patients with schizophrenia but its pathophysiology remains largely unclear. Involvement of omega-3 fatty acids in the cognitive function of healthy individuals and patients with neuropsychiatric disease has received increasing attention. The aim of this study was to examine the relationship between omega-3 fatty acids with cognitive function, social function, and psychiatric symptoms in patients with schizophrenia. The subjects included 30 patients with schizophrenia or schizoaffective disorder. Psychiatric symptoms, cognitive function, and social function were assessed using the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in Schizophrenia (BACS), and the Social Functioning Scale (SFS), respectively. Blood serum omega-3 fatty acids were assessed using gas chromatography. The BACS composite score was significantly correlated with blood eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels. In addition, a daily dose of antipsychotic medication was negatively and significantly correlated with the blood DHA level and with the BACS composite score. Step-wise multiple regression analyses demonstrated that the SFS score was significantly associated with the BACS composite score. Our results indicate that reduced blood omega-3 fatty acids are associated with cognitive impairment, which then impacts social functioning outcomes in schizophrenia.
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EPICOG-SCH: A brief battery to screen cognitive impact of schizophrenia in stable outpatients. SCHIZOPHRENIA RESEARCH-COGNITION 2017; 8:7-20. [PMID: 28740826 PMCID: PMC5514304 DOI: 10.1016/j.scog.2017.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/01/2017] [Accepted: 03/04/2017] [Indexed: 11/21/2022]
Abstract
Brief batteries in schizophrenia, are needed to screen for the cognitive impact of schizophrenia. We aimed to validate and co-norm the Epidemiological Study of Cognitive Impairment in Schizophrenia (EPICOG-SCH) derived brief cognitive battery. A cross-sectional outpatient evaluation was conducted of six-hundred-seventy-two patients recruited from 234 centers. The brief battery included well-known subtests available worldwide that cover cognitive domains related to functional outcomes: WAIS-III-Letter-Number-Sequencing-LNS, Category Fluency Test-CFT, Logical-Memory Immediate Recall-LM, and Digit-Symbol-Coding-DSC. CGI-SCH Severity and WHO-DAS-S were used to assess clinical severity and functional impairment, respectively. Unit Composite Score (UCS) and functional regression-weighted Composite Scores (FWCS) were obtained; discriminant properties of FWCS to identify patients with different levels of functional disability were analyzed using receiver-operating characteristic (ROC) technique. The battery showed good internal consistency, Cronbach's alpha = 0.78. The differences between cognitive performance across CGI-SCH severity level subscales ranged from 0.5 to 1 SD. Discriminant capacity of the battery in identifying patients with up to moderate disability levels showed fair discriminant accuracy with areas under the curve (AUC) > 0.70, p < 0.0001. An FWCS mean cut-off score ≥ 100 showed likelihood ratios (LR) up to 4.7, with an LR + of 2.3 and a LR - of 0.5. An FWCS cut-off ≥ 96 provided the best balance between sensitivity (0.74) and specificity (0.62). The EPICOG-SCH proved to be a useful brief tool to screen for the cognitive impact of schizophrenia, and its regression-weighted Composite Score was an efficient complement to clinical interviews for confirming patients' potential functional outcomes and can be useful for monitoring cognition during routine outpatient follow-up visits.
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Vakhrusheva J, Marino B, Stroup TS, Kimhy D. Aerobic Exercise in People with Schizophrenia: Neural and Neurocognitive Benefits. Curr Behav Neurosci Rep 2016; 3:165-175. [PMID: 27766192 DOI: 10.1007/s40473-016-0077-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Schizophrenia is characterized by extensive neurocognitive deficits, which are linked to greater disability, poorer functional outcome, and have been suggested to impact daily functioning more than clinical symptoms. Aerobic exercise (AE) has emerged as a potential intervention. This review examines the impact of AE on brain structure and function along with neurocognitive performance in individuals with schizophrenia. Preliminary evidence indicates that AE can increase hippocampal volume and cortical thickness, in addition to exerting a neuroprotective effect against hippocampal volume decrease and cortical thinning. There is also evidence that AE is able to significantly increase serum brain-derived neurotrophic factor (BDNF) levels, which are implicated in neurogenesis, neuroplasticity, and cognitive improvement. Finally, evidence suggests that AE plays a significant role in improving overall cognition, including improvements in processing speed, working memory, and visual learning. The authors discuss the implications of the findings and provide recommendations for future research and areas of inquiry.
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Affiliation(s)
- Julia Vakhrusheva
- Department of Psychiatry Westchester Division, Weill Cornell Medical College, Outpatient Department, 21 Bloomingdale Road, White Plains, NY 10605, USA
| | - Brielle Marino
- Department of Psychiatry Westchester Division, Weill Cornell Medical College, Outpatient Department, 21 Bloomingdale Road, White Plains, NY 10605, USA
| | - T Scott Stroup
- Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - David Kimhy
- Department of Psychiatry, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
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