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Zhou X, Dai N, Yu D, Niu T, Wang S. Exploring galectin-3's role in predicting mild cognitive impairment in type 2 diabetes and its regulation by miRNAs. Front Med (Lausanne) 2024; 11:1443133. [PMID: 39144658 PMCID: PMC11322075 DOI: 10.3389/fmed.2024.1443133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/22/2024] [Indexed: 08/16/2024] Open
Abstract
Objective This study aimed to investigate the role of galectin-3 (Gal-3; coded by LGALS3 gene), as a biomarker for MCI in T2DM patients and to develop and validate a predictive nomogram integrating galectin-3 with clinical risk factors for MCI prediction. Additionally, microRNA regulation of LGALS3 was explored. Methods The study employed a cross-sectional design. A total of 329 hospitalized T2DM patients were recruited and randomly allocated into a training cohort (n = 231) and a validation cohort (n = 98) using 7:3 ratio. Demographic data and neuropsychological assessments were recorded for all participants. Plasma levels of galectin-3 were measured using ELISA assay. We employed Spearman's correlation and multivariable linear regression to analyze the relationship between galectin-3 levels and cognitive performance. Furthermore, univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for MCI in T2DM patients. Based on these analyses, a predictive nomogram incorporating galectin-3 and clinical predictors was developed. The model's performance was evaluated in terms of discrimination, calibration, and clinical utility. Regulatory miRNAs were identified using bioinformatics and their interactions with LGALS3 were confirmed through qRT-PCR and luciferase reporter assays. Results Galectin-3 was identified as an independent risk factor for MCI, with significant correlations to cognitive decline in T2DM patients. The developed nomogram, incorporating Gal-3, age, and education levels, demonstrated excellent predictive performance with an AUC of 0.813 in the training cohort and 0.775 in the validation cohort. The model outperformed the baseline galectin-3 model and showed a higher net benefit in clinical decision-making. Hsa-miR-128-3p was significantly downregulated in MCI patients, correlating with increased Gal-3 levels, while Luciferase assays confirmed miR-128-3p's specific binding and influence on LGALS3. Conclusion Our findings emphasize the utility of Gal-3 as a viable biomarker for early detection of MCI in T2DM patients. The validated nomogram offers a practical tool for clinical decision-making, facilitating early interventions to potentially delay the progression of cognitive impairment. Additionally, further research on miRNA128's regulation of Gal-3 levels is essential to substantiate our results.
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Affiliation(s)
- Xueling Zhou
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Ning Dai
- Department of ENT, Maanshan People’s Hospital, Maanshan, China
| | - Dandan Yu
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Tong Niu
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
| | - Shaohua Wang
- School of Medicine, Southeast University, Nanjing, China
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, China
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Lin E, Lin CH, Lane HY. Inference of social cognition in schizophrenia patients with neurocognitive domains and neurocognitive tests using automated machine learning. Asian J Psychiatr 2024; 91:103866. [PMID: 38128351 DOI: 10.1016/j.ajp.2023.103866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
AIM It has been suggested that single neurocognitive domain or neurocognitive test can be used to determine the overall cognitive function in schizophrenia using machine learning algorithms. It is unknown whether social cognition in schizophrenia patients can be estimated with machine learning based on neurocognitive domains or neurocognitive tests. METHODS To predict social cognition in schizophrenia, we applied an automated machine learning (AutoML) framework resulting from the analysis of predictive factors such as six neurocognitive domain scores and nine neurocognitive test scores of 380 schizophrenia patients in the Taiwanese population. Four clinical parameters (i.e., age, gender, subgroup, and education) were also used as predictive factors. We utilized an AutoML framework called Tree-based Pipeline Optimization Tool (TPOT) to generate predictive pipelines automatically. RESULTS The analysis revealed that all neurocognitive domains and tests except the reasoning and problem solving domain/test showed significant associations with social cognition. In addition, a TPOT-generated pipeline can best predict social cognition in schizophrenia using seven predictive factors, including five neurocognitive domains (i.e., speed of processing, sustained attention, working memory, verbal learning and memory, and visual learning and memory) and two clinical parameters (i.e., age and gender). This predictive pipeline consists of machine learning algorithms such as function transformers, an approximate feature map, independent component analysis, and linear regression. CONCLUSION The study indicates that an AutoML framework such as TPOT may provide a promising way to produce truly effective machine learning pipelines for predicting social cognition in schizophrenia using neurocognitive domains and/or neurocognitive tests.
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Affiliation(s)
- Eugene Lin
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA; Department of Electrical & Computer Engineering, University of Washington, Seattle, WA 98195, USA; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Chieh-Hsin Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan; Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan; Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan.
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Zhang H, Yang S, Zhu W, Niu T, Wang J, Yang M, Liu E, Wang J, Li S, Zhang H. Exosomal miR-let-7c-5p is involved in the cognitive function of type 2 diabetes mellitus patients by interleukin 10: A cross-sectional study. J Diabetes 2023; 15:978-986. [PMID: 37532673 PMCID: PMC10667643 DOI: 10.1111/1753-0407.13450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/29/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Interleukin (IL)-10 plays a notable role in the inflammatory-associated mild cognitive impairment (MCI). We aimed to investigate whether IL-10 and its upstream factors exert an impact on MCI in type 2 diabetes mellitus (T2DM) patients. METHODS A total of 117 T2DM patients were recruited and divided into Control group and MCI group based on the presence or absence of MCI. Clinical parameters were collected. The Montreal Cognitive Assessment (MoCA) was conducted for global cognitive function. Digit Span Test (DST), Verbal Fluency Test (VFT), and Trail Making Test-B (TMTB) were used to evaluate the executive functions of the diabetic patients. Trail Making Test-A (TMTA) was performed to examine the information processing speed function. Patients' scene memory was examined by Logical Memory Test (LMT). After the baseline data were compared, correlation and regression analyses were performed to explore the relationship among IL-10, miR-let-7c-5p and cognitive function. RESULTS Compared to 80 patients in the control group, 37 patients in the MCI group exhibited lower IL-10 in plasma and higher miR-let-7c-5p levels in exosomes from plasma. The IL-10 level was negatively associated with MoCA. Likewise, miR-let-7c-5p levels were negatively correlated with IL-10 levels and MoCA. Elevated miR-let-7c-5p levels and decreased IL-10 levels are risk factors for MCI in T2DM patients. Increased miR-let-7c-5p and downregulated IL-10 may influence VFT and TMTB, respectively, associated with executive function. CONCLUSIONS We demonstrated that IL-10 is correlated to the executive function of T2DM patients. Decreased IL-10 may result from the regulation of miR-let-7c-5p in exosomes.
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Affiliation(s)
- Hui Zhang
- Henan Key Laboratory of Rare Diseases, Endocrinology and Metabolism CenterThe First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and TechnologyLuoyangChina
| | - Shufang Yang
- Department of EndocrinologyTaizhou People's HospitalTaizhouChina
- Department of EndocrinologyAffiliated Zhongda Hospital of Southeast UniversityNanjingChina
| | - Wenwen Zhu
- Department of EndocrinologyAffiliated Zhongda Hospital of Southeast UniversityNanjingChina
| | - Tong Niu
- Department of EndocrinologyAffiliated Zhongda Hospital of Southeast UniversityNanjingChina
| | - Jue Wang
- Department of EndocrinologyTaizhou People's HospitalTaizhouChina
- Medical SchoolDalian Medical UniversityDalianChina
| | - Mingyue Yang
- Department of EndocrinologyTaizhou People's HospitalTaizhouChina
- Medical SchoolDalian Medical UniversityDalianChina
| | - Enlin Liu
- Department of EndocrinologyTaizhou People's HospitalTaizhouChina
- Medical SchoolNantong UniversityNantongChina
| | - Jumei Wang
- Department of EndocrinologyThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefeiChina
| | - Sumei Li
- Department of EndocrinologyThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefeiChina
| | - Haoqiang Zhang
- Department of EndocrinologyThe First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of ChinaHefeiChina
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Kang Y, Zhang Y, Huang K, Wang Z. Recurrence quantification analysis of periodic dynamics in the default mode network in first-episode drug-naïve schizophrenia. Psychiatry Res Neuroimaging 2023; 329:111583. [PMID: 36577311 DOI: 10.1016/j.pscychresns.2022.111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Abnormal functional connectivity (FC) within the default model network (DMN) in schizophrenia has been frequently reported in previous studies. However, traditional FC analysis was mostly linear correlations based, with the information on nonlinear or temporally lagged brain signals largely overlooked. Fifty-five first-episode drug-naïve schizophrenia (FES) patients and 53 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging scanning. The DMN was extracted using independent component analysis. Recurrence quantification analysis was used to measure the duration, predictability, and complexity of the periodic processes of the nonlinear DMN time series. The Mann‒Whitney U test was conducted to compare these features between FES patients and HCs. The support vector machine was applied to discriminate FES from HCs based on these features. Determinism, which means predictability of periodic process activity, between the ventromedial prefrontal cortex (vMPFC) and posterior cingulate and between the vMPFC and precuneus, was significantly decreased in FES compared with HCs. Determinism between the vMPFC and precuneus was positively correlated with category fluency scores in FES. The classifier achieved 77% accuracy. Our results suggest that synchronized periodicity among DMN brain regions is dysregulated in FES, and the periodicity in BOLD signals may be a promising indicator of brain functional connectivity.
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Affiliation(s)
- Yafei Kang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Youming Zhang
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
| | - Kexin Huang
- West China Biomedical Big Data Centre, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Zhenhong Wang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, School of Psychology, Shaanxi Normal University, Xi'an, China.
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Normative Data for Adult Mandarin-Speaking Populations: A Systematic Review of Performance-Based Neuropsychological Instruments. J Int Neuropsychol Soc 2022; 28:520-540. [PMID: 34372960 DOI: 10.1017/s1355617721000667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Normative data are essential for neuropsychological evaluations, but they are scarce for Mandarin-speaking populations, despite Mandarin being the language with the most native speakers. Several normative data studies have been reported in recent years for Mandarin speakers, who reside in different countries/regions (e.g., mainland China, Taiwan, and Singapore, etc.). This review aims to serve as a reference guide to appropriate norms when working with a Mandarin-speaking patient and to guide future endeavors in test validation and development in areas where studies to date fall short. METHOD We conducted a systematic review utilizing the PsycInfo, PubMed, and China Knowledge Resource Integrated databases as well as additional literature search through citations. We performed evaluations of the existing norms based on their test selection, cognitive domains covered, sample size, language, regions of participant recruitment, stratification by age/gender/education levels, and reporting of other psychometric properties. We focused on articles that included performance-based tests for adults but excluded those with purely clinical norms or from commercial publishers. RESULTS We reviewed 1155 articles found through literature search and identified 43 articles reporting normative data for this population that met our inclusion criteria. Sixty-five distinctive tests and 127 versions were covered. The results are presented within two detailed tables organized by articles and tests, respectively. CONCLUSIONS We discussed the strengths and limitations of these normative reports. Practitioners are recommended to utilize normative data that most closely approximate a test-taker's cultural and demographic backgrounds. Limitations of the current review are also discussed.
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Zhang H, Yang S, Zhu W, Niu T, Wang Z, An K, Xie Z, Wang P, Huang X, Wang C, Shangguan H, Yuan Y, Wang S. Free Triiodothyronine Levels are Related to Executive Function and Scene Memory in Type 2 Diabetes Mellitus Patients Without Diagnosed Thyroid Diseases. Diabetes Metab Syndr Obes 2022; 15:1041-1050. [PMID: 35411164 PMCID: PMC8994555 DOI: 10.2147/dmso.s355656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE We aim to determine the role of free triiodothyronine (FT3), the main active ingredient of thyroid hormones (THs), in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI). PATIENTS AND METHODS A total of 255 T2DM patients without diagnosed thyroid diseases were recruited and divided into MCI group and healthy cognition group. Neuropsychological functions were observed by multidimensional cognitive function scales in including MoCA, Digit Span Test (DST), Verbal Fluency Test (VFT), Clock drawing test (CDT), Trail Making Test (TMT) A and B, Instantaneously Recalled Auditory Verbal Learning Test (AVLT-IR), Delayed Recalled Auditory Verbal Learning Test (AVLT-DR) and Logical Memory Test (LMT). Correlation and logistic regression analyses were performed to explore the association between FT3 and diabetic cognitive dysfunction. RESULTS Compared with 147 normal cognition patients, 108 MCI patients exhibited lower FT3 and higher HOMA-IR. FT3 level was not only positively correlated with MoCA scores, but DST, VFT and LMT, while negatively associated with TMTB. Furthermore, there is a negative association between FT3 and HOMA-IR. Logistic regression showed that decreased FT3 is a risk factor of MCI in T2DM patients. Although FT3 is not the risk factor of MCI after homeostasis model assessment of insulin resistance (HOMA-IR) was entered as an independent variable, lower FT3 is associated with VFT and LMT adjusted by age, education, BMI, DM duration, HBP duration, smoking, HbA1c and HOMA-IR. CONCLUSION Lower FT3 levels may involve in MCI, especially for executive function and scene memory in T2DM patients without diagnosed thyroid diseases.
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Affiliation(s)
- Haoqiang Zhang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, People’s Republic of China
| | - Shufang Yang
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
- Department of Endocrinology, Taizhou People’s Hospital, Taizhou, People’s Republic of China
| | - Wenwen Zhu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Tong Niu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Zheng Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Ke An
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Zuoling Xie
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Pin Wang
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Xi Huang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Chenchen Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Haiyan Shangguan
- School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yang Yuan
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, Nanjing, People’s Republic of China
- Correspondence: Shaohua Wang; Yang Yuan, Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No. 87 Dingjiaqiao Road, Nanjing, 210009, People’s Republic of China, Tel +86-25-83262815; +86-13814003661, Fax +86-25-83285132, Email ;
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Yang H, Liu Y, Yang C, Lin X. The effect of systemic antidepressant treatments in early stage on neurocognitive function of euthymic bipolar patients initiated with a depressive onset: An observational, cross-sectional, single-blind study protocol. Brain Behav 2021; 11:e2360. [PMID: 34520638 PMCID: PMC8553326 DOI: 10.1002/brb3.2360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Patients with bipolar disorder (BD) have a wide range of neurocognitive dysfunction even in euthymic state, leading to impaired psychosocial function and reduced quality of life. However, the understanding on risk factors related to neurocognitive impairment in such group of people is limited. In view of significantly delayed diagnosis of BD and common use of antidepressants prior to the BD diagnosis, the study aims to clarify whether systemic antidepressant use in early stage, defined as from the initial depressive episode to the diagnosis of BD, could impact neurocognitive function of euthymic bipolar patients. METHODS It is an observational, cross-sectional, single-blind trial, making a comparison in neurocognitive function between euthymic bipolar patients who had a depressive episode as initial onset and being with and without systemic antidepressant treatments in early stage (n = 62 and 62, respectively); secondary outcomes include the impact of systemic antidepressant use on global function, quality of life, sleep quality, positive and negative affect, and peripheral level of neuron-specific enolase. DISCUSSION The study will provide a comprehensive and in-depth understanding on the effect of systemic antidepressant treatments in early stage in such group of patients. It is expected to better guide the related prevention and treatment work of BD management. TRIAL REGISTRATION The study was registered on Clinicaltrials.gov with protocol ID (TJAH2020-18) and clinicaltrials.gov ID (NCT04564573).
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Affiliation(s)
- Huizeng Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Chenghao Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Zhang H, Zhu W, Niu T, Wang Z, An K, Cao W, Shi J, Wang S. Inverted U-shaped correlation between serum low-density lipoprotein cholesterol levels and cognitive functions of patients with type 2 diabetes mellitus. Lipids Health Dis 2021; 20:103. [PMID: 34511118 PMCID: PMC8436464 DOI: 10.1186/s12944-021-01534-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Low-density lipoprotein cholesterol (LDL-C) metabolic disorder is common in individuals with diabetes. The role of LDL-C in mild cognitive impairment (MCI) remains to be explored. We aim to investigate the associations between LDL-C at different levels and details of cognition decline in patients with type 2 diabetes mellitus (T2DM). METHODS Patients with T2DM (n = 497) were recruited. Clinical parameters and neuropsychological tests were compared between patients with MCI and controls. Goodness of fit was assessed to determine the linear or U-shaped relationship between LDL-C and cognitive function. The cut-off point of LDL-C was calculated. Correlation and regression were carried out to explore the relationship between cognitive dysfunction and LDL-C levels above and below the cut-off point. RESULTS Although no significant difference in LDL-C levels was detected in 235 patients with MCI, compared with 262 patients without MCI, inverted-U-shaped association was determined between LDL-C and Montreal Cognitive Assessment (MoCA). The cut-off point of LDL-C is 2.686 mmol/l. LDL-C (>2.686 mmol/l) is positively related to Trail Making Test B (TMTB) indicating executive function. LDL-C (<2.686 mmol/l) is positively associated with Clock Drawing Test (CDT) reflecting visual space function in patients with T2DM. CONCLUSION Inverted U-shaped correlation was found between serum LDL-C and cognitive function in patients with T2DM. Despite that the mechanisms of different LDL-C levels involved in special cognitive dysfunctions remain incompletely clarified, excessive LDL-C damages executive function, while the deficient LDL-C impairs visual space function. TRIAL REGISTRATION ChiCTR-OCC-15006060 .
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Affiliation(s)
- Haoqiang Zhang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Wenwen Zhu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Tong Niu
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Zheng Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Ke An
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Wuyou Cao
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Jijing Shi
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China.,School of Medicine, Southeast University, Nanjing, 210009, PR China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 Dingjiaqiao Road, Nanjing, 210009, PR China. .,School of Medicine, Southeast University, Nanjing, 210009, PR China.
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Tian S, Huang R, Guo D, Lin H, Wang J, An K, Wang S. Associations of Plasma BACE1 Level and BACE1 C786G Gene Polymorphism with Cognitive Functions in Patients with Type 2 Diabetes: A Cross- Sectional Study. Curr Alzheimer Res 2021; 17:355-364. [PMID: 32442083 DOI: 10.2174/1567205017666200522210957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/05/2020] [Accepted: 03/25/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND β-Site APP-cleaving enzyme 1 (BACE1) is a key enzyme involved in the pathophysiology of Type 2 Diabetes Mellitus (T2DM) and Mild Cognitive Impairment (MCI). We aimed to investigate the potential associations of plasma BACE1 levels and BACE1 gene polymorphism with different cognitive performances in T2DM patients with MCI. METHODS The recruited 186 T2DM subjects were divided into 92 MCI group and 94 healthy-cognition controls, according to the Montreal Cognitive Assessment (MoCA) scores. Sociodemographic characteristics, clinical parameters and neuropsychological tests were assessed. BACE1 C786G gene polymorphism and plasma BACE1 level were determined. RESULTS Compared to controls, MCI patients exhibited higher plasma BACE1 levels. Plasma BACE1 levels were negatively associated with MoCA, Clock Drawing Test and Logical Memory Test scores, whereas positively associated with Trail Making Test-B time in the MCI group (all p<0.05), after adjusting fasting blood glucose, glycosylated hemoglobin, and homeostasis model assessment of insulin resistance by C-peptide. Multivariable logistic regression analysis showed a significant trend towards increased MCI risk with high plasma BACE1 level in T2DM patients (OR = 1.492, p = 0.027). The plasma BACE1 levels of GG and GC genotypes were obviously higher than that of CC genotype in T2DM-MCI patients (p = 0.035; p = 0.026, respectively). CONCLUSION Increased plasma BACE1 levels were associated with poor overall cognition functions, especially visuospatial abilities, visual/logical memory and executive functions in T2DM-MCI patients. Additionally, elevated plasma BACE1 level was a risk factor for MCI in T2DM patients, and might be influenced by BACE1 C786G gene mutations.
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Affiliation(s)
- Sai Tian
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Rong Huang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Dan Guo
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Hongyan Lin
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Jiaqi Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Ke An
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Shaohua Wang
- Department of Endocrinology, Affiliated Zhongda Hospital of Southeast University, No.87 DingJiaQiao Road, Nanjing, China
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Li J, Mu J, Shen C, Yao G, Feng K, Zhang X, Liu P. Abnormal Cortical Activation Patterns Among Chinese-Speaking Schizophrenia Patients During Category and Letter Verbal Fluency Tasks Revealed by Multi-Channel Functional Near-Infrared Spectroscopy. Front Psychiatry 2021; 12:790732. [PMID: 34899442 PMCID: PMC8663721 DOI: 10.3389/fpsyt.2021.790732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Functional near-infrared spectroscopy (fNIRS) has many advantages over other neuroimaging modalities for routine measurement of task-dependent cortical activation, but most fNIRS studies of schizophrenia have used letter fluency tasks (LFTs). Further, performances on category fluency tasks (CFTs) and LFTs may be distinct in Chinese patients due to the unique semantic features of Chinese written characters. To identify unique disease biomarkers measurable by fNIRS in Chinese schizophrenia patients, this study compared cortical oxygenated hemoglobin changes ([oxy-Hb]) during a Chinese LFT and CFT between patients and healthy controls. Methods: Inpatients of the Second Affiliated Hospital of Xinxiang Medical University were recruited from Match 2020 to July 2021. The Positive and Negative Symptom Scale (PANSS) was used to evaluate psychiatric symptoms. Dynamic changes in [oxy-Hb], an indicator of neural activity, were measured during CFT and LFT performance by 52-channel fNIRS. Results: Forty-seven schizophrenia inpatients and 29 healthy controls completed all tests. Schizophrenia patients showed significant cortical activation at 15 channels covering the left hemisphere and 17 channels over the right hemisphere during the CFT. During the LFT, activity was significantly increased at only six channels, all over the left hemisphere (FDR P < 0.05). In healthy controls, significant [oxy-Hb] increases were found at 24 channels over the left hemisphere and 19 channels over the right hemisphere during CFT. While during the LFT, the significant increases were found at 7 channels all over the left hemisphere (FDR P < 0.05). When years of education was included as a covariate, the schizophrenia group demonstrated no significant hypoactivation relative to healthy controls at any channel after FDR correction (FDR P < 0.05) during CFT while demonstrated significant hypoactivation at channel 11 during LFT (FDR P < 0.05). There were no significant associations between PANSS scores and [oxy-Hb] changes after FDR correction (FDR P < 0.05). Conclusions: Left lateralization during CFT was reduced among schizophrenia patients and may be related to the semantic deficit. The Chinese-CFT could be a more sensitive indicator of frontal-temporal dysfunction in schizophrenia.
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Affiliation(s)
- Juan Li
- School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Junlin Mu
- Department of Neuroelectrophysiology, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Chenyu Shen
- Department of Psychiatry, Tsinghua University Yuquan Hospital (Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine), Beijing, China
| | - Guanqun Yao
- School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Kun Feng
- Department of Psychiatry, Tsinghua University Yuquan Hospital (Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine), Beijing, China
| | - Xiaoqian Zhang
- Department of Psychiatry, Tsinghua University Yuquan Hospital (Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine), Beijing, China
| | - Pozi Liu
- School of Clinical Medicine, Tsinghua University, Beijing, China.,Department of Psychiatry, Tsinghua University Yuquan Hospital (Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine), Beijing, China
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11
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Luo X, Zhu Y, Lu D, Zong K, Lin X. Subjective cognitive dysfunction in patients with bipolar disorder: The prevalence, related factors and effects on predicting psychosocial functioning and suicidal ideation. Psychiatry Res 2020; 284:112669. [PMID: 31740217 DOI: 10.1016/j.psychres.2019.112669] [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: 06/29/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023]
Abstract
Persistent cognitive deficits are prevalent during all stages of bipolar disorder (BD). However, few studies have examined subjective cognitive complaints in patients with BD. This study aimed to investigate the prevalence and relevant factors of subjective cognitive functioning and its potential effects on predicting psychosocial functioning and suicidal ideation in BD. Ninety-two patients with BD type I (including 42 depressed patients and 50 euthymic patients) and 60 healthy individuals were recruited for this study. All participants were assessed with a battery of neuropsychological tests examining attention and processing speed, visual memory, working memory and executive functions, as well as the Cognitive Complaints in Bipolar Disorder Rating Assessment, the Global Assessment of Functioning scale and the Beck Scale for Suicide Ideation. Bipolar patients exhibited worse subjective cognitive dysfunction compared with healthy individuals, and depressed patients expressed more cognitive complaints than euthymic bipolar patients. In bipolar group, psychosocial functioning, suicidal ideation and occupational status were the main relevant factors of subjective cognitive functioning. Subjective cognitive functioning could also predict psychosocial functioning and suicidal ideation. Depressive symptoms moderated the associations between objective cognitive functioning and suicidal ideation, but could not moderate the correlations between cognitive functioning and psychosocial functioning. These findings suggest that subjective cognitive assessment should be further emphasized in clinical practice.
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Affiliation(s)
- Xia Luo
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
| | - Yinghua Zhu
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
| | - Dali Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Kunlun Zong
- Department of Psychiatry,The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China.
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12
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Lin X, Lu D, Zhu Y, Luo X, Huang Z, Chen W. The effects of cognitive reserve on predicting and moderating the cognitive and psychosocial functioning of patients with bipolar disorder. J Affect Disord 2020; 260:222-231. [PMID: 31505400 DOI: 10.1016/j.jad.2019.09.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/28/2019] [Accepted: 09/02/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Cognitive reserve (CR) reflects the resilience of the brain to cope with neuropathological changes and minimize clinical manifestations. In the present study, we explore the association between CR and cognitive and psychosocial functioning, and examined the potential moderating role of CR in patients with bipolar disorder (BD). METHODS One hundred and twenty-five outpatients with BD type I and sixty healthy individuals were recruited. All participants were assessed with a neuropsychological battery examining attention and processing speed, working memory, visual memory and executive functioning, the Global Assessment of Functioning scale and the Cognitive Complaints in Bipolar Disorder Rating Assessment. Proxies for cognitive reserve included premorbid intelligence and educational level. RESULTS Patients with bipolar disorder presented with worse cognitive performance and psychosocial functioning than healthy controls. Multiple regression models revealed that educational level negatively associated with all assessed domain-specific cognition scores and premorbid intelligence predicted attention and processing speed and psychosocial functioning. Notably, premorbid intelligence significantly moderated the associations between the number of episodes (total, hypo/manic and depressed) and neurocognitive functioning, and the educational level also moderated the relationships between the numbers of hypo/manic and total episodes and subjective cognitive functioning. CONCLUSIONS Cognitive reserve contributes to functional outcomes in patients with BD and may emerge as a key factor contributing to the course and prognosis of patients with BD. In the future, cognitive reserve must be considered in both research and clinical interventions related to bipolar disorder.
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Affiliation(s)
- Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China.
| | - Dali Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Yinghua Zhu
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China
| | - Xia Luo
- School of Nursing, Sun Yat-sen University, Guangzhou 510089, China
| | - Zhixin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
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13
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Lin X, Lu D, Huang Z, Chen W, Luo X, Zhu Y. The associations between subjective and objective cognitive functioning across manic or hypomanic, depressed, and euthymic states in Chinese bipolar patients. J Affect Disord 2019; 249:73-81. [PMID: 30763798 DOI: 10.1016/j.jad.2019.02.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patients may present cognitive deficits during all stages of bipolar disorder (BD). Few studies have examined self-reported cognitive difficulties and its relation to neurocognitive dysfunction during symptomatic periods of BD. This study aimed to compare subjective cognitive functioning and explore associations between subjective and objective cognitive functioning across different BD clinical states, and investigate the predicting and moderating roles of mood symptoms. METHODS Subjective cognitive functioning (measured by Cognitive Complaints in Bipolar Disorder Rating Assessment, COBRA) and several domains of cognitive functioning (assessed by a neuropsychological battery), including executive functions, attention and processing speed, and visual memory, were examined in 48 hypomanic or manic patients, 42 depressed bipolar patients, 50 euthymic bipolar patients and 60 healthy comparisons. RESULTS All patients exhibited subjective and objective cognitive deficits in relation to healthy comparisons. There was a significant association between subjective and objective cognitive functioning in euthymic group, but the association was not significant in acute symptomatic groups, which could be moderated by depressive or manic symptoms in depressive or manic group, respectively. Subjective cognitive functioning was significantly correlated with mood symptoms, and the best predictor of subjective cognitive functioning was depressive symptoms. LIMITATIONS This was a cross-sectional study with a mixed sample of inpatients and outpatients. The medication effect was not adjusted. CONCLUSIONS The associations between subjective and objective cognitive dysfunction varied in clinical states, and mood symptoms moderated the associations. A neuropsychological test battery is required to substantiate actual cognitive dysfunction in clinical settings, irrespective of subjective cognitive deficits.
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Affiliation(s)
- Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China.
| | - Dali Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Zhixin Huang
- Department of Neurology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
| | - Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, China
| | - Xia Luo
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
| | - Yinghua Zhu
- School of Nursing, Sun Yat-sen University, Guangzhou 510078, China
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14
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Weibell MA, Johannessen JO, Auestad B, Bramness J, Brønnick K, Haahr U, Joa I, Larsen TK, Melle I, Opjordsmoen S, Rund BR, Røssberg JI, Simonsen E, Vaglum P, Stain H, Friis S, Hegelstad WTV. Early Substance Use Cessation Improves Cognition-10 Years Outcome in First-Episode Psychosis Patients. Front Psychiatry 2019; 10:495. [PMID: 31354551 PMCID: PMC6640174 DOI: 10.3389/fpsyt.2019.00495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 06/24/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Cognitive impairment may be a risk factor for, as well as a consequence of, psychosis. Non-remitting symptoms, premorbid functioning, level of education, and socioeconomic background are known correlates. A possible confounder of these associations is substance use, which is common among patients with psychosis and linked to worse clinical outcomes. Studies however show mixed results for the effect of substance use on cognitive outcomes. In this study, the long-term associations of substance use with cognition in a representative sample of first-episode psychosis patients were examined. Methods: The sample consisted of 195 patients. They were assessed for symptom levels, function, and neurocognition at 1, 2, 5, and 10 years after first treatment. Test scores were grouped into factor analysis-based indices: motor speed, verbal learning, visuomotor processing, verbal fluency, and executive functioning. A standardized composite score of all tests was also used. Patients were divided into four groups based on substance-use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users, and nonusers. Data were analyzed using linear mixed effects modeling. Results: Gender, premorbid academic functioning, and previous education were the strongest predictors of cognitive trajectories. However, on motor speed and verbal learning indices, patients who stopped using substances within the first 2 years of follow-up improved over time, whereas the other groups did not. For verbal fluency, the longitudinal course was parallel for all four groups, while patients who stopped using substances demonstrated superior performances compared with nonusers. Persistent users demonstrated impaired visuomotor processing speed compared with nonusers. Within the stop- and episodic use groups, patients with narrow schizophrenia diagnoses performed worse compared with patients with other diagnoses on verbal learning and on the overall composite neurocognitive index. Discussion: This study is one of very few long-term studies on cognitive impairments in first-episode psychosis focusing explicitly on substance use. Early cessation of substance use was associated with less cognitive impairment and some improvement over time on some cognitive measures, indicating a milder illness course and superior cognitive reserves to draw from in recovering from psychosis.
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Affiliation(s)
- Melissa A Weibell
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Jan Olav Johannessen
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Bjørn Auestad
- Department of Mathematics and Physics, University of Stavanger, Stavanger, Norway.,Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Jørgen Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorder, Innland Hospital Trust, Hamar, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kolbjørn Brønnick
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Ulrik Haahr
- Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Inge Joa
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Tor Ketil Larsen
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.,Institute of Psychiatry, University of Bergen, Bergen, Norway
| | - Ingrid Melle
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Stein Opjordsmoen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, Oslo, Norway.,Vestre Viken Hospital Trust, Drammen, Norway
| | - Jan Ivar Røssberg
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Vaglum
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
| | - Helen Stain
- School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Svein Friis
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway
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15
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Wang Y, Zhong S, Chen G, Liu T, Zhao L, Sun Y, Jia Y, Huang L. Altered cerebellar functional connectivity in remitted bipolar disorder: A resting-state functional magnetic resonance imaging study. Aust N Z J Psychiatry 2018; 52:962-971. [PMID: 29232968 DOI: 10.1177/0004867417745996] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Several recent studies have reported a strong association between the cerebellar structural and functional abnormalities and psychiatric disorders. However, there are no studies to investigate possible changes in cerebellar functional connectivity in bipolar disorder. This study aimed to examine the whole-brain functional connectivity pattern of patients with remitted bipolar disorder II, in particular in the cerebellum. METHODS A total of 25 patients with remitted bipolar disorder II and 25 controls underwent resting-state functional magnetic resonance imaging and neuropsychological tests. Voxel-wise whole-brain connectivity was analyzed using a graph theory approach: functional connectivity strength. A seed-based resting-state functional connectivity analysis was further performed to investigate abnormal functional connectivity pattern of those regions with changed functional connectivity strength. RESULTS Remitted bipolar disorder II patients had significantly decreased functional connectivity strength in the bilateral posterior lobes of cerebellum (mainly lobules VIIb/VIIIa). The seed-based functional connectivity analyses revealed decreased functional connectivity between the right posterior cerebellum and the default mode network (i.e. right posterior cingulate cortex/precuneus and right superior temporal gyrus), bilateral hippocampus, right putamen, left paracentral lobule and bilateral posterior cerebellum and decreased functional connectivity between the left posterior cerebellum and the right inferior parietal lobule and bilateral posterior cerebellum in patients with remitted bipolar disorder II. CONCLUSION Our results suggest that cerebellar dysconnectivity, in particular distributed cerebellar-cerebral functional connectivity, might be associated with the pathogenesis of bipolar disorder.
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Affiliation(s)
- Ying Wang
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.,2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Shuming Zhong
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guanmao Chen
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tao Liu
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.,4 The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, China
| | - Lianping Zhao
- 1 Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yao Sun
- 2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
| | - Yanbin Jia
- 3 Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Li Huang
- 2 Institute of Molecular and Functional Imaging, Jinan University, Guangzhou, China
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16
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Neu P, Gooren T, Niebuhr U, Schlattmann P. Cognitive impairment in schizophrenia and depression: A comparison of stability and course. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 26:215-228. [PMID: 29161150 DOI: 10.1080/23279095.2017.1392962] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Cognitive deficits are clinically relevant features in schizophrenia and depression, yet little comparative data on changes in both disorders is available. This study compares cognitive performance of inpatients with schizophrenia (N = 52) and unipolar major depression (N = 67) during psychiatric treatment, assessing performance twice: after admission to hospital (acute) and prior to discharge (postacute) on average seven weeks later. A group of healthy controls was tested at comparable intervals. Data was analyzed using a multivariate linear model. Patients with schizophrenia and depression showed significantly impaired performance compared to healthy controls. On follow-up both patient groups showed improved performance. Contrary to expectation, patients with schizophrenia showed greater improvement in verbal memory, visual memory, and psychomotor speed than depressive patients. Verbal fluency presented as a possible candidate to differentiate between both disorders. Similar profiles of generalized cognitive deficits were observed in both patient-groups on acute and postacute assessment, which might indicate trait-like deficits with persistent functional implications in both disorders. Findings do not support assumptions of greater cognitive impairment in schizophrenia compared to depression. A distinction of the disorders on the grounds of cognitive functioning seems to be less specific than presumed.
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Affiliation(s)
- Peter Neu
- a Clinic of Psychiatry and Psychotherapy , Charité - University Medicine Berlin , Berlin , Germany.,b Clinic of Psychiatry and Psychotherapy , Jewish Hospital , Berlin , Germany
| | - Tina Gooren
- a Clinic of Psychiatry and Psychotherapy , Charité - University Medicine Berlin , Berlin , Germany
| | - Ulrike Niebuhr
- c Clinic of Psychiatry and Psychotherapy , Vivantes Hospital Neukölln , Berlin , Germany
| | - Peter Schlattmann
- d Department of Medical Statistics, Computer Sciences and Documentation , Jena University Hospital , Jena , Germany
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17
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Lin K, Xu G, Shi L, Lu W, Guan L, Ouyang H, Chen K, Dang Y, Zhou L, So KF. CACNA1C polymorphisms Impact Cognitive Recovery in Patients with Bipolar Disorder in a Six-week Open-label Trial. Sci Rep 2017; 7:7022. [PMID: 28765577 PMCID: PMC5539285 DOI: 10.1038/s41598-017-07368-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/28/2017] [Indexed: 11/21/2022] Open
Abstract
Cognitive impairments in bipolar patients deteriorate as the disorder progresses. Little is known about whether genetic risks impact cognitive recovery during the course from depression to remission. In this six-week open-label trial, we shed light on the impacts of six single nucleotide polymorphisms (SNPs) in the calcium voltage-gated channel subunit alpha1 C (CACNA1C) gene on cognitive recovery in 192 bipolar patients suffering a major depressive episode (MDE). The primary outcome measures were changes in a battery of neuropsychological tests following 6-week treatment. Carriers with rs10466907 GT genotype did not significantly improve their executive function total scores on the Wisconsin Card Sorting Test after six weeks of treatment compared to the TT genotypes (β = −0.944, 95% Confidence Interval (CI) = −1.482–−0.405). Moreover, during a MDE carriers with rs58619945 GG and GA genotypes performed significantly worse than those with AA genotype on the categories completed (p = 0.013 and p = 0.001), total errors (p = 0.039 and p = 0.009), and random errors (p = 0.055 and p = 0.014, respectively). Our data suggest that the tested CACNA1C SNPs may have impacts on cognitive recovery from depression.
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Affiliation(s)
- Kangguang Lin
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Guiyun Xu
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China. .,Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Lingling Shi
- GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China.,Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, China.,Co-Innovation Center for Neuroregeneration, Nantong University, Nantong, China
| | - Weicong Lu
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijie Guan
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Huiyi Ouyang
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Kun Chen
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.,Laboratory of Emotion and Cognition, The Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yamei Dang
- Department of Affective Disorders, The Affiliated Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Libing Zhou
- GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China.,Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, China.,Co-Innovation Center for Neuroregeneration, Nantong University, Nantong, China
| | - Kwok-Fai So
- GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China. .,Ministry of Education Joint International Research Laboratory of CNS Regeneration, Jinan University, Guangzhou, China. .,Co-Innovation Center for Neuroregeneration, Nantong University, Nantong, China. .,The State Key Laboratory of Brain and Cognitive Sciences and Department of Ophthalmology, The University of Hong Kong, Hong Kong, Hong Kong.
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18
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Liang S, Deng W, Wang Q, Ma X, Li M, Brown MRG, Hu X, Li X, Greenshaw AJ, Li T. Performance of Verbal Fluency as an Endophenotype in Patients with Familial versus Sporadic Schizophrenia and Their Parents. Sci Rep 2016; 6:32597. [PMID: 27581658 PMCID: PMC5007652 DOI: 10.1038/srep32597] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/08/2016] [Indexed: 02/05/2023] Open
Abstract
What’s the neurocognitive deficit as an endophenotype to familial schizophrenia? Here, we investigate the neurocognitive endophenotype in first-episode patients with familial schizophrenia (FS) and sporadic schizophrenia (SS), and their parents. 98 FS patients and their 105 parents; 190 SS patients and their 207 parents; 195 controls matched with patients, and 190 controls matched with the patients’ parents, were assessed with the short version of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), the immediate and delayed logical memory tests from the Wechsler Memory Scale-Revised in China (WMS-RC), the Verbal Fluency Test (VFT), the Trail Making Test Parts A and B-Modified (TMA, TMB-M), and the Modified Wisconsin Card Sorting Test (WCST-M). The results showed that with age, gender, and education as covariates, after controlling for false discovery rates, the FS group and their parent group performed worse than the SS group and their parent group on VFT. No significant differences were found for other neurocognitive tests between the FS and SS patient groups, and their respective parent groups. Our findings suggest the patients with familial and sporadic schizophrenia and their respective parent groups may have a different genetic predisposition in relation to a cognitive endophenotype.
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Affiliation(s)
- Sugai Liang
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Wei Deng
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qiang Wang
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaohong Ma
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Mingli Li
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Matthew R G Brown
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Xun Hu
- Huaxi Biobank, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xinmin Li
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G2B3, Canada
| | - Tao Li
- Department of Psychiatry and Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.,West China Brain Research Centre, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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19
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Longitudinal change in neurocognition and its relation to symptomatic and functional changes over 2years in individuals at clinical high-risk for psychosis. Schizophr Res 2016; 174:50-57. [PMID: 27068568 DOI: 10.1016/j.schres.2016.03.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/16/2016] [Accepted: 03/24/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Negative symptoms and functional disability represent the core of schizophrenia and both are associated with cognitive impairments. We explored the course of cognitive change and its relation to symptomatic and functional changes in individuals at clinical high-risk (CHR) for psychosis to identify cognitive indicators of long-term course. Such attempts may offer insight into the pathological changes associated with the development of illness in the prodromal state. METHODS Forty-seven CHR individuals completed neurocognitive, clinical, and functional assessments at baseline and 2-year follow-up; twenty-eight healthy controls were assessed for neurocognitive and functional measures at baseline and 2-year follow-up. The delta values of CHR individuals in neurocognitive, clinical, and functional domains were determined from differences between baseline and follow-up scores to estimate the degree of change. RESULTS Although overall longitudinal cognitive performance of CHR individuals improved, the magnitude of improvement was not statistically different from that of normal controls at the group level. However, the individual data yielded two groups of CHR subjects showing opposite trajectories of cognitive change in semantic fluency (i.e., improvement or decline), which was significantly associated with changes in negative symptoms and functioning. Moreover, the relationships between negative symptoms and functioning were more strengthened over time than baseline. CONCLUSIONS Our findings show that semantic fluency seems to be a neurocognitive indicator reflecting clinical courses in CHR individuals. The longitudinal relationship of negative symptoms and functioning with semantic fluency may represent ongoing pathological processes in neural systems involving aberrant fronto-temporal interaction in the early phase of schizophrenia.
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Gu CZ, He HL, Duan HF, Su ZH, Chen H, Gan JL. Predictors of neurocognitive impairment at 2years after a first-episode major depressive disorder. Compr Psychiatry 2016; 68:24-33. [PMID: 27234179 DOI: 10.1016/j.comppsych.2016.03.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/26/2016] [Accepted: 03/28/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Neurocognitive impairment is a contributor to major depressive disorder (MDD). However, MDD patients show great variability in the level and course of deficits. The present longitudinal study was to identify predictors of neurocognitive impairment in first-episode MDD patients. METHODS Neurocognitive performance was analyzed in a cohort of 100 patients at 2years after a first-episode MDD. Subgroups, deficit type vs. non-deficit type, were compared on baseline clinical, neuropsychological, premorbid and sociodemographic characteristics. The analysis was performed using the multivariate logistic regression to obtain a model for neurocognitive impairment determination. The predicted probabilities of multivariate logistic regression were analyzed using receiver operating characteristic (ROC) curve. RESULTS Fifty-two percent of MDD participants presented general neurocognitive impairment. The regression analyses demonstrated that clinical and sociodemographic characteristics were not predictive variables. A model composed of processing speed, executive function, and attention, dexterity correctly classified 85.8% of the MDD patients with deficit type. ROC curve indicated that the changes of these three cognitions could identify MDD with deficit type from MDD with non-deficit type. In addition, ROC curve also indicated that processing speed and executive function could identify MDD from CN subjects. Finally, processing speed performance was negatively correlated with Hamilton Depression Scale scores in both MDD with deficit and non-deficit type. CONCLUSION The present study provides novel insights on frequency and neurocognitive profile of subtypes of patients showing impairment. Our results suggest that processing speed impairment is a trait dimension of the disorder related to specific cognitive dysfunctions and the severity of depression.
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Affiliation(s)
- Chuan-Zheng Gu
- The Third Psychiatric Department, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People's Republic of China; The Third Psychiatric Department, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People's Republic of China.
| | - Hui-Li He
- The Third Psychiatric Department, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People's Republic of China; The Third Psychiatric Department, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People's Republic of China
| | - Hui-Feng Duan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, 454003, Shandong Province, People's Republic of China
| | - Zhong-Hua Su
- Department of Geriatric Psychiatry, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People's Republic of China; Department of Geriatric Psychiatry, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People's Republic of China
| | - Hong Chen
- Department of Geriatric Psychiatry, Jining Psychiatric Hospital, Jining, 272051, Shandong Province, People's Republic of China; Department of Geriatric Psychiatry, The Second Affiliated Hospital of Jining Medical University, Jining, 272051, Shandong Province, People's Republic of China
| | - Jing-Li Gan
- Department of Psychiatry, Mental Diseases Prevention and Treatment Institute of PLA, PLA 91st Central Hospital, Jiaozuo, 454003, Shandong Province, People's Republic of China.
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Whalley HC, Whyte MC, Johnstone EC, Lawrie SM. Neural Correlates of Enhanced Genetic Risk for Schizophrenia. Neuroscientist 2016; 11:238-49. [PMID: 15911873 DOI: 10.1177/1073858404274111] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Schizophrenia is a disabling psychotic disorder characterized by hallucinations, delusions, and impaired functioning in many aspects of everyday life. The established condition generally becomes manifest in early adulthood, and evidence suggests that one of the most important risk factors for developing the disorder is inherited vulnerability. The established illness has been shown to be associated with deficits in many domains of cognitive function, along with structural and functional brain abnormalities, most notably in pre-frontal and temporal lobes. However, such studies have not been able to determine the extent to which such deficits relate to the presence of a schizophrenic predisposition, the presence of symptoms, and/or medication effects. A number of research groups have therefore turned to the study of relatives of affected individuals with the aim of determining if similar cognitive deficits and brain abnormalities are also found in those with increased genetic vulnerability to the disorder. In this article, studies on such individuals are discussed. It is concluded that deficits are apparent in relatives that are similar to but less marked than those seen in patients with schizophrenia.
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Affiliation(s)
- Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland.
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Lin K, Xu G, Lu W, Ouyang H, Dang Y, Guo Y, So KF, Lee TM. Neuropsychological performance of patients with soft bipolar spectrum disorders. Bipolar Disord 2015; 17:194-204. [PMID: 25048414 DOI: 10.1111/bdi.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/09/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVES There is much evidence that shows that a substantial number of individuals with DSM-IV-defined unipolar depression (UP) manifest hypomanic sub-syndrome and bipolar diathesis. Other definitions have conceptualized the term soft bipolar spectrum (SBP) for these individuals. Little is known about the cognitive profiles of individuals with SBP. We hypothesized that they are representative of individuals with bipolar II disorder and are different from that of 'strict' UP. METHODS Consecutive referrals suffering major depressive episodes were categorically assigned to groups of either bipolar I disorder (n = 98), bipolar II disorder (n = 138), or UP (n = 300). Based on the SBP criteria by Akiskal and Pinto (17), patients with UP were subdivided into 81 SBP and 219 strict UP. We administered self- and clinician-administered scales to evaluate affective temperaments, and neuropsychological tests to assess seven cognitive domains. RESULTS Patients with SBP performed significantly better than strict UP patients in the domains of processing speed (p = 0.002), visual-spatial memory (p = 0.017), and verbal working memory (p = 0.017). Compared to patients with bipolar I disorder, patients with SBP were significantly better in set shifting (p < 0.001) and visual-spatial memory (p = 0.042). Patients with SBP performed similarly to patients with bipolar II disorder in all of the cognitive domains tested (p > 0.05). There was a group × cognitive domain interaction effect between bipolar I disorder, bipolar II disorder, SBP, and strict UP groups [Pillai's F = 2.231, df = (18,1437), p = 0.002]. CONCLUSIONS Our data suggest that patients with SBP differ from patients with UP not only in external validators (e.g., family history of bipolar disorder) and hypomanic symptoms, but also in neuropsychological performance and that the profiles of cognitive functioning were different across bipolar I disorder and 'bipolar II spectrum' that subsumes bipolar II disorder and SBP.
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Affiliation(s)
- Kangguang Lin
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Department of Psychiatry, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong
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Lin K, Xu G, Lu W, Ouyang H, Dang Y, Lorenzo-Seva U, Guo Y, Bessonov D, Akiskal HS, So KF, Lee TMC. Neuropsychological performance in melancholic, atypical and undifferentiated major depression during depressed and remitted states: a prospective longitudinal study. J Affect Disord 2014; 168:184-91. [PMID: 25061955 DOI: 10.1016/j.jad.2014.06.032] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 06/05/2014] [Accepted: 06/24/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND Considerable evidence has demonstrated that melancholic and atypical major depression have distinct biological correlates relative to undifferentiated major depression, but few studies have specifically delineated neuropsychological performance for them. METHOD In a six-week prospective longitudinal study, we simultaneously compared neuropsychological performance among melancholic depression (n=142), atypical depression (n=76), undifferentiated major depression (n=91), and healthy controls (n=200) during a major depressive episode and a clinically remitted state, respectively. We administered neuropsychological tests assessing processing speed, attention, shifting, planning, verbal fluency, visual spatial memory, and verbal working memory to all participants. RESULTS During the depressive state, the three subtypes displayed extensive cognitive impairment, except for attention, when compared with the healthy controls. Melancholic depression significantly differed from atypical depression in processing speed and verbal fluency. In the remitted state, the three subtypes recovered their visual spatial memory and verbal working memory functions to the healthy control level. The recovery of the other domains (processing speed, set shifting, planning, and verbal fluency), however, was different across the subtypes. No predictive relationship existed between neuropsychological performance and the treatment outcome. LIMITATIONS The drop-out rate in the six-week longitudinal study was relatively high. CONCLUSION Our data provide preliminary evidence that during depressed states the three major depressive subtypes display similar cognitive deficits in some domains but differ in such domains as processing speed and verbal fluency. The recovery of the cognitive deficits following clinical remission from depression may be associated with subtypes of major depressive disorder.
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Affiliation(s)
- Kangguang Lin
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong
| | - Guiyun Xu
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China.
| | - Weicong Lu
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Huiyi Ouyang
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Yamei Dang
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Urbano Lorenzo-Seva
- Research Centre for Behavioral Assessment, Department of Psychology, Rovira i Virgili University, Tarragona, Spain
| | - Yangbo Guo
- Department of Psychiatry, Guangzhou Psychiatric Hospital, 36 Mingxin Road, Fangcun district, Affiliated Hospital of Guangzhou Medical University, Guangdong Province, Guangzhou 510370, China
| | - Daniel Bessonov
- International Mood Center, University of California at San Diego, La Jolla, USA
| | - Hagop S Akiskal
- International Mood Center, University of California at San Diego, La Jolla, USA
| | - Kwok-Fai So
- Department of Ophthalmology, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; GMH Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong.
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Xu G, Lu W, Ouyang H, Dang Y, Guo Y, Miao G, Bessonov D, Akiskal KK, Akiskal HS, Lin K. Association of affective temperaments measured by TEMPS-a with cognitive deficits in patients with bipolar disorder. J Affect Disord 2014; 161:109-15. [PMID: 24751317 DOI: 10.1016/j.jad.2014.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 03/06/2014] [Accepted: 03/06/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Affective temperaments such as cyclothymia, which may be the fundamental substrates for bipolar disorder and bipolar II in particular, have been reported to be associated with abnormalities in the regions that are related to cognitive deficits in bipolar disorder. However, few studies have examined the effects of affective temperaments on neuropsychological performance in individuals with bipolar disorder. METHOD In a six-week prospective study, we administered Chinese version of TEMPS-A (Temperament Evaluation of Memphis, Pisa, San Diego-Autoquestionnair) to 93 patients with bipolar I depression, 135 patients with bipolar II depression, and 101 healthy controls. Cognitive function was assessed with a battery of neuropsychological tasks, including attention, processing speed, set shifting, planning, verbal working memory, verbal fluency, and visual spatial memory. Mixed-effects statistical models were used to assess the effects of affective temperaments on cognitive function. RESULTS Bipolar patients with hyperthymic temperament showed greater cognitive deficits in set shifting (p=0.05) and verbal working memory (p=0.026) than did bipolar patients with non-predominant temperaments (predominant temperament was defined as one standard deviation above the mean). The differences in estimated marginal means were -0.624 (95% CI, -1.25 to 0) and -0.429 (95% CI, -0.81 to -0.05), respectively. Significant temperament X bipolar subtype interaction effects were observed for set shifting (Wald X(2)=18.161, p<0.001), planning (Wald X(2)=7.906, p=0.048), and visual spatial memory (Wald X(2)=16.418, p=0.001). LIMITATION The anxious temperament was not evaluated. CONCLUSION Our data suggest that hyperthymic temperament may be associated with cognitive deficits in some specific domains in bipolar disorder; and that the effect of temperaments may be different across subtypes of bipolar disorder.
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Affiliation(s)
- Guiyun Xu
- Department of Affective Disorder, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Weicong Lu
- Department of Affective Disorder, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Huiyi Ouyang
- Psychiatric Neuroscience Research Institute, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yamei Dang
- Department of Affective Disorder, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yangbo Guo
- Department of Psychology, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guodong Miao
- Department of Affective Disorder, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Daniel Bessonov
- International Mood Center, University of California, San Diego, La Jolla, CA, USA
| | - Kareen K Akiskal
- International Mood Center, University of California, San Diego, La Jolla, CA, USA
| | - Hagop S Akiskal
- International Mood Center, University of California, San Diego, La Jolla, CA, USA
| | - Kangguang Lin
- Department of Affective Disorder, Guangzhou Psychiatric Hospital, Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam Road, Hong Kong; Laboratory of Cognitive Affective Neuroscience, The University of Hong Kong, Pokfulam Road, Hong Kong.
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Lee TY, Shin YS, Shin NY, Kim SN, Jang JH, Kang DH, Kwon JS. Neurocognitive function as a possible marker for remission from clinical high risk for psychosis. Schizophr Res 2014; 153:48-53. [PMID: 24529365 DOI: 10.1016/j.schres.2014.01.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 12/16/2013] [Accepted: 01/18/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Recent studies revealed that nonconverters at clinical high risk (CHR) for psychosis comprise those who later remit from initial CHR state and those who do not remit and continue to have attenuated positive symptoms. CHR subjects who remit symptomatically are comparable to healthy controls for both baseline and longitudinal symptoms. However, the neurocognitive characteristics of this population are still obscure. METHODS Seventy-five CHR subjects and 61 healthy controls were recruited, and their neurocognitive functions were assessed. CHR subjects were divided into converter, remitter, and non-remitter groups according to their clinical state during a 12 to 24month follow-up. RESULTS Only the remitter group was comparable to healthy controls in terms of baseline neurocognitive functions. We observed that remitters showed better performance at baseline on tasks of attention, immediate/delayed verbal memory, verbal fluency, and immediate visual memory compared with converters. Moreover, we found that performance on semantic fluency was significantly improved in remitters but declined in non-remitters over the 2-year follow-up; however, there was no significant difference between these two groups at baseline. CONCLUSION CHR nonconverters who later remit from an initial prodromal state do not show reduced neurocognitive functioning compared with healthy controls at baseline. Therefore, an advanced research diagnostic criterion for a CHR state that considers neurocognitive functions is needed to more precisely predict which patients will develop psychosis.
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Affiliation(s)
- Tae Young Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Ye Seul Shin
- Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Na Young Shin
- Interdisciplinary Cognitive Science Program, Seoul National University, Seoul, Republic of Korea
| | - Sung Nyun Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joon Hwan Jang
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Do-Hyung Kang
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea; Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea; Interdisciplinary Cognitive Science Program, Seoul National University, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Iwashiro N, Suga M, Takano Y, Inoue H, Natsubori T, Satomura Y, Koike S, Yahata N, Murakami M, Katsura M, Gonoi W, Sasaki H, Takao H, Abe O, Kasai K, Yamasue H. Localized gray matter volume reductions in the pars triangularis of the inferior frontal gyrus in individuals at clinical high-risk for psychosis and first episode for schizophrenia. Schizophr Res 2012; 137:124-31. [PMID: 22425035 DOI: 10.1016/j.schres.2012.02.024] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Revised: 02/06/2012] [Accepted: 02/21/2012] [Indexed: 12/21/2022]
Abstract
Recent studies have suggested an important role for Broca's region and its right hemisphere counterpart in the pathophysiology of schizophrenia, owing to its roles in language and interpersonal information processing. Broca's region consists of the pars opercularis (PO) and the pars triangularis (PT). Neuroimaging studies have suggested that they have differential functional roles in healthy individuals and contribute differentially to the pathogenesis of schizophrenic symptoms. However, volume changes in these regions in subjects with ultra-high risk for psychosis (UHR) or first-episode schizophrenia (FES) have not been clarified. In the present 3 Tesla magnetic resonance imaging study, we separately measured the gray matter volumes of the PO and PT using a reliable manual-tracing volumetry in 80 participants (20 with UHR, 20 with FES, and 40 matched controls). The controls constituted two groups: the first group was matched for age, sex, parental socioeconomic background, and intelligence quotient to UHR (n=20); the second was matched for those to FES (n=20). Compared with matched controls, the volume of the bilateral PT, but not that of the PO, was significantly reduced in the subjects with UHR and FES. The reduced right PT volume, which showed the largest effect size among regions-of-interest in the both UHR and FES groups, correlated with the severity of the positive symptoms also in the both groups. These results suggest that localized gray matter volume reductions of the bilateral PT represent a vulnerability to schizophrenia in contrast to the PO volume, which was previously found to be reduced in patients with chronic schizophrenia. The right PT might preferentially contribute to the pathogenesis of psychotic symptoms.
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Affiliation(s)
- Norichika Iwashiro
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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Neuropsychological performance in bipolar I, bipolar II and unipolar depression patients: a longitudinal, naturalistic study. J Affect Disord 2012; 136:328-39. [PMID: 22169253 DOI: 10.1016/j.jad.2011.11.029] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 10/23/2011] [Accepted: 11/14/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND It has been suggested that cognitive deficits existed in mood disorders. Nevertheless, whether neuropsychological profiles differ three main subtypes of mood disorder (Bipolar I, Bipolar II and UP) remain understudied because most current studies include either mixed samples of bipolar I and bipolar II patients or mixed samples of different states of the illness. The main aim of the present study is to determine whether, or to some extent, specific cognitive domains could differentiate the main subtypes of mood disorders in the depressed and clinically remitted status. METHOD Three groups of bipolar I (n=92), bipolar II (n=131) and unipolar depression (UP) patients (n=293) were tested with a battery of neuropsychological tests both at baseline (during a depressive episode) and after 6 weeks of treatment, contrasting with 202 healthy controls on cognitive performance. The cognitive domains include processing speed, attention, memory, verbal fluency and executive function. RESULTS At the acute depressive state, the three patient groups (bipolar I, bipolar II and UP) showed cognitive dysfunction in processing speed, memory, verbal fluency and executive function but not in attention compared with controls. Post comparisons revealed that bipolar I depressed patients performed significantly worse in verbal fluency and executive function than bipolar II and UP depressed patients. No difference was found between bipolar II and UP depressed patients except for the visual memory. After 6 weeks of treatment, clinically remitted bipolar I and bipolar II patients only displayed cognitive impairment in processing speed and visual memory. Remitted UP patients showed cognitive impairment in executive function in addition to processing speed and visual memory. The three remitted patient groups scored similarly in processing speed and visual memory. LIMITATION Clinically remitted patients were just recovered from a major depressive episode after 6 weeks of treatment and in relatively unstable state. CONCLUSION Bipolar I, bipolar II and UP patients have a similar pattern of cognitive impairment during the state of acute depressive episode, but bipolar I patients experience greater impairment than bipolar II and UP patients. In clinical remission, both bipolar and UP patients show cognitive deficits in processing speed and visual memory, and executive dysfunction might be a status-maker for bipolar disorder, but a trait-marker for UP.
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Hu M, Chen J, Li L, Zheng Y, Wang J, Guo X, Wu R, Zhao J. Semantic fluency and executive functions as candidate endophenotypes for the early diagnosis of schizophrenia in Han Chinese. Neurosci Lett 2011; 502:173-7. [PMID: 21827833 DOI: 10.1016/j.neulet.2011.07.037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Revised: 07/19/2011] [Accepted: 07/25/2011] [Indexed: 11/19/2022]
Abstract
Neurocognitive deficits are recognized as core features of schizophrenia. The aim of this study was to compare the cognitive performance of antipsychotic, drug-naive patients with first-episode schizophrenia (FES patients) to their healthy siblings and to healthy controls from the Han Chinese population for exploring potential endophenotypes for the early detection of schizophrenia. A battery of cognitive assessment tools was used to measure seven cognitive domains in matched groups consisting of 56 subjects each. Cognitive tests included the grooved pegboard test (GPT), the category fluency test (CFT), the trail making test A (TMT-A), the Wechsler memory scale-III spatial span test (WMS-III SST), the Hopkins verbal learning test-revised (HVLT-R), the brief visuospatial memory test-revised (BVMT-R), the paced auditory serial addition test (PASAT), and the Wisconsin card sorting test-64 cards version (WCST-64). The performances of FEP patients were inferior to normal controls on all neuropsychological tests, while siblings were lower than healthy controls in many of the same tasks. Patients' performances were lower than siblings' on all tests except for the CFT, the WMS-III SST backward test, and four subtests of the WCST-64. Our data suggest that FEP patients exhibited pronounced impairment of fine motor skills, speed of processing, attention, verbal memory, visual memory, and executive function, while siblings exhibited deficits intermediate between those of schizophrenic patients and the control group. Semantic fluency function and executive function may be potential endophenotypes for the early diagnosis of schizophrenia.
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Affiliation(s)
- Maorong Hu
- Institute of Mental Health, the Second Xiangya Hospital, Central South University, Changsha, PR China
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Mukkala S, Ilonen T, Nordström T, Miettunen J, Loukkola J, Barnett JH, Murray GK, Jääskeläinen E, Mäki P, Taanila A, Moilanen I, Jones PB, Heinimaa M, Veijola J. Different vulnerability indicators for psychosis and their neuropsychological characteristics in the Northern Finland 1986 Birth Cohort. J Clin Exp Neuropsychol 2011; 33:385-94. [PMID: 21462045 PMCID: PMC3082776 DOI: 10.1080/13803395.2010.524148] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study is one of very few that has investigated the neuropsychological functioning of both familial and clinical high risk subjects for psychosis. Participants (N = 164) were members of the Northern Finland 1986 Birth Cohort in the following four groups: familial risk for psychosis (n = 62), clinical risk for psychosis (n = 20), psychosis (n = 13), and control subjects (n = 69). The neurocognitive performance of these groups was compared across 19 cognitive variables. The two risk groups did not differ significantly from controls, but differed from the psychosis group in fine motor function. Neuropsychological impairments were not evident in a non-help-seeking high-risk sample.
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Affiliation(s)
- Sari Mukkala
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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Jameson KG, Nasrallah HA, Northern TG, Welge JA. Executive function impairment in first-degree relatives of persons with schizophrenia: A meta-analysis of controlled studies. Asian J Psychiatr 2011; 4:96-9. [PMID: 23051074 DOI: 10.1016/j.ajp.2011.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 03/15/2011] [Accepted: 04/09/2011] [Indexed: 12/01/2022]
Abstract
A meta-analysis of past research evaluated the relationship between deficits in executive functioning among unaffected first-degree relatives of schizophrenia patients and healthy controls. The Wisconsin Cart Sorting Test (WCST), a reliable measurement of cognition and abstract thinking, was examined as the dependent variable. Unaffected first-degree relatives perform worse than controls on two important dimensions of the WCST. They achieve significantly less categories and significantly more perseverative errors.
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Wang Q, Sun J, Ma X, Wang Y, Yao J, Deng W, Liu X, Collier DA, Li T. Normative data on a battery of neuropsychological tests in the Han Chinese population. J Neuropsychol 2011; 5:126-42. [DOI: 10.1348/174866410x516803] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Magaud E, Kebir O, Gut A, Willard D, Chauchot F, Olie JP, Kazes M, Krebs MO. Altered semantic but not phonological verbal fluency in young help-seeking individuals with ultra high risk of psychosis. Schizophr Res 2010; 123:53-8. [PMID: 20605416 DOI: 10.1016/j.schres.2010.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 04/02/2010] [Accepted: 05/08/2010] [Indexed: 11/17/2022]
Abstract
Some of the cognitive impairments of schizophrenia are already detectable before the onset of the disease, and could help to identify individuals at higher risk of psychosis. In patients with schizophrenia, semantic verbal fluency (VF) is more impaired than phonological fluency. We investigated whether the same profile is present in young patients at Ultra High Risk of psychosis (UHR). One hundred and fifty six young patients (15-30y.o.) consecutively seeking help at our specialized youth mental health center with no definite psychiatric diagnoses were recruited and assessed with the CAARMS. Individuals meeting the criteria for UHR were compared to the remaining patients considered as Help Seeker Controls (HSCo). UHR individuals had a lower mean total semantic fluency score than HSCo. This effect was significant for each semantic category ('animals' and 'fruits'). By contrast, there were no differences in phonological fluency scores between UHR and HSCo either in the total score or when each letter ('P' and 'R') was considered separately. Semantic but not phonological VF differentiated UHR individuals from non-psychotic help-seeking young adults. These results suggest that semantic deficits are present during the prodromal phase, prior to clinical expression of full-blown psychosis, and suggest that prodromes could be associated with alteration in temporal brain areas.
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Keshavan MS, Kulkarni S, Bhojraj T, Francis A, Diwadkar V, Montrose DM, Seidman LJ, Sweeney J. Premorbid cognitive deficits in young relatives of schizophrenia patients. Front Hum Neurosci 2010; 3:62. [PMID: 20300465 PMCID: PMC2839849 DOI: 10.3389/neuro.09.062.2009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Accepted: 11/20/2009] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune "window" to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed.
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Affiliation(s)
- Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, Harvard Medical School Boston, MA, USA
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Nam HJ, Kim N, Park T, Oh S, Jeon HO, Yoon SC, Lee YS, Lee WK, Ha K, Kim JH, Hong KS. Cognitive profiles of healthy siblings of schizophrenia patients: application of the cognitive domains of the MATRICS consensus battery. World J Biol Psychiatry 2010; 10:452-60. [PMID: 18792857 DOI: 10.1080/15622970802314815] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Even though a large body of data suggests the presence of various types of cognitive deficits in the unaffected relatives of schizophrenia patients, more study is needed to clarify the comparative sensitivities of specific cognitive measures for relative-control differences. In this study, the authors compared the cognitive profiles of unaffected siblings of schizophrenia patients and those of patients and normal controls, and attempted to identify cognitive markers that might be associated with genetic liability to schizophrenia. Eighty-eight clinically stable schizophrenia patients, 44 healthy patient siblings, and 100 normal controls were evaluated using comprehensive neuropsychological tests. The domain structure of the MATRICS consensus cognitive battery was adopted, and both domain scores and individual test scores were used in the analysis. Performances of the sibling group were intermediate between those of patients and controls on most measures. A significant difference between the sibling and control groups was observed only in the Category Fluency Test. This cognitive deficit might be caused by familial predisposition to schizophrenia and could be a candidate of endophenotype for schizophrenia.
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Affiliation(s)
- Hee Jung Nam
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Wang Q, Vassos E, Deng W, Ma X, Hu X, Murray RM, Collier DA, Li T. Factor structures of the neurocognitive assessments and familial analysis in first-episode schizophrenia patients, their relatives and controls. Aust N Z J Psychiatry 2010; 44:109-19. [PMID: 20113299 DOI: 10.3109/00048670903270381] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Schizophrenia patients have a wide range of cognitive deficits. To explore the structure of these deficits and index their psychometric properties in order to define the major separable factors, exploratory factor analysis (EFA) was performed on a series of neuropsychological test results in a sample of Han Chinese first-episode schizophrenia patients, their relatives and controls without mental illness. METHODS The factors derived from the composite sample were tested with confirmatory factor analysis (CFA) in each of the subsamples. The heritability of each factor was estimated by using the mixed linear model in order to determine whether the common factor scores describe the familiarity of the data. RESULTS A six-factor model of general mental activity, sort and shift, attention and anti-interference, logical memory, reasoning and problem-solving/executive function, and visual reproduction were extracted and confirmed on EFA and CFA. There was a hierarchy in cognitive performance deficits in relatives depending on their relatedness to probands. Patients performed more poorly than siblings/offspring in general mental activity, sort and shift, attention and anti-interference, logical memory, planning and problem-solving, but not in visual reproduction. The logical memory domain was found to be significantly heritable (h(2)=0.34), and reasoning and problem-solving had a marginal heritability of around 0.19. CONCLUSIONS Generalized cognitive deficit accounts for the majority of the overall variance of cognitive deficits in schizophrenia. Estimates of heritability were modest. The present results also support the hypothesis that neurocognitive deficits of schizophrenia are familial and could serve as endophenotypes, especially logical memory, which is the most heritable.
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Affiliation(s)
- Qiang Wang
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
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Doughty OJ, Done DJ. Is semantic memory impaired in schizophrenia? A systematic review and meta-analysis of 91 studies. Cogn Neuropsychiatry 2009; 14:473-509. [PMID: 19894144 DOI: 10.1080/13546800903073291] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Semantic memory impairments in schizophrenia have been reported across a wide range of neuropsychological tests. Set against a backdrop of fairly widespread cognitive impairments, it is difficult to know whether there is a primary, or secondary, impairment of semantic memory in schizophrenia. Also, whether there is a profile of differential impairment across the range of neuropsychological tests. METHODS Employing a systematic search strategy, 91 papers were identified which have assessed participants with schizophrenia on a measure of semantic memory. A series of meta-analyses were then conducted which provided combined weighted means for performance on tasks of naming, word-picture matching, verbal fluency, priming, and categorisation. RESULTS An uneven profile of impairment is reported with large effect sizes for tests of naming and verbal fluency, medium effect sizes for word-picture matching and association and small effect sizes for categorisation and priming tests. CONCLUSIONS This uneven profile supports the claim that a degradation of semantic knowledge may not be adequate in explaining the semantic memory impairment in schizophrenia. This conclusion is supported by the data which report a relationship between an executive dysfunction and poor priming and fluency performance particularly. The data support a link between Formal Thought Disorder and semantic memory impairments on tests of naming and verbal fluency but on other tests evidence is equivocal.
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Affiliation(s)
- O J Doughty
- School of Psychology, University of Hertfordshire, Hatfield, UK.
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Markov V, Krug A, Krach S, Whitney C, Eggermann T, Zerres K, Stöcker T, Shah N, Nöthen M, Treutlein J, Rietschel M, Kircher T. Genetic variation in schizophrenia-risk-gene dysbindin 1 modulates brain activation in anterior cingulate cortex and right temporal gyrus during language production in healthy individuals. Neuroimage 2009; 47:2016-22. [DOI: 10.1016/j.neuroimage.2009.05.067] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 05/06/2009] [Accepted: 05/21/2009] [Indexed: 10/20/2022] Open
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Maziade M, Rouleau N, Gingras N, Boutin P, Paradis ME, Jomphe V, Boutin J, Létourneau K, Gilbert E, Lefebvre AA, Doré MC, Marino C, Battaglia M, Mérette C, Roy MA. Shared neurocognitive dysfunctions in young offspring at extreme risk for schizophrenia or bipolar disorder in eastern quebec multigenerational families. Schizophr Bull 2009; 35:919-30. [PMID: 18550590 PMCID: PMC2728815 DOI: 10.1093/schbul/sbn058] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Adult patients having schizophrenia (SZ) or bipolar disorder (BP) may have in common neurocognitive deficits. Former evidence suggests impairments in several neuropsychological functions in young offspring at genetic risk for SZ or BP. Moreover, a dose-response relation may exist between the degree of familial loading and cognitive impairments. This study examines the cognitive functioning of high-risk (HR) offspring of parents having schizophrenia (HRSZ) and high-risk offspring of parents having bipolar disorder (HRBP) descending from densely affected kindreds. METHODS The sample consisted of 45 young offspring (mean age of 17.3 years) born to a parent having SZ or BP descending from large multigenerational families of Eastern Québec that are densely affected by SZ or BP and followed up since 1989. The offspring were administered a lifetime best-estimate diagnostic procedure (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) and an extensive standard neuropsychological battery. Raw scores were compared with age- and gender-matched controls. RESULTS The offspring displayed differences in memory and executive functions when compared with controls. Moderate to large effect sizes (Cohen d) ranging from 0.65 to 1.25 (for IQ and memory) were observed. Several of the cognitive dysfunctions were present in both HRSZ and HRBP, even when considering DSM-IV clinical status. CONCLUSIONS HRSZ and HRBP shared several aspects of their cognitive impairment. Our data suggest that the extremely high genetic and familial loading of these HRs may have contributed to a quantitatively increased magnitude of the cognitive impairments in both HR subgroups, especially in memory. These offspring at heightened risk present difficulties in processing information that warrant preventive research.
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Affiliation(s)
- Michel Maziade
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de Canardiére, F-4500, Québec QC G1J 2G3, Canada.
| | - Nancie Rouleau
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada,École de psychologie, Université Laval, Québec, Canada
| | - Nathalie Gingras
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
| | - Pierrette Boutin
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
| | - Marie-Eve Paradis
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
| | - Valérie Jomphe
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
| | - Julie Boutin
- École de psychologie, Université Laval, Québec, Canada
| | | | - Elsa Gilbert
- École de psychologie, Université Laval, Québec, Canada
| | | | | | - Cecilia Marino
- Department of Child Psychiatry, Eugenio Medea Institute, Via Don luigi Monza, 2023842 Bosisio Parini (Lecco), Italy
| | - Marco Battaglia
- Department of Neuropsychiatric Sciences, San Raffaele “Vita Salute” University, 20 via Stamira d'Ancona, 20127 Milan, Italy
| | - Chantal Mérette
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
| | - Marc-André Roy
- Centre de recherche Université Laval Robert-Giffard, 2601, Chemin de la Canardière, F-4500, Québec QC G1J 2G3, Canada
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Abstract
BACKGROUND Memory impairment is being recognized increasingly as an important feature of the neuropsychology of schizophrenia. Dysfunction of working memory, a system for the short-term storage and manipulation of information, may relate to a number of core symptoms of schizophrenia. Many studies have examined working memory function in schizophrenia but a clear understanding of the nature and extent of any deficit has been elusive. METHOD A systematic review and meta-analysis of studies comparing working memory function in subjects with schizophrenia and healthy controls was performed. Following a comprehensive literature search, meta-analyses were conducted on 36 measures of phonological, visuospatial and central executive working memory functioning, encompassing 441 separate results from 187 different studies. RESULTS Statistically significant effect sizes were found for all working memory measures, indicating deficits in schizophrenia groups. Some of these were robust findings in the absence of evidence of significant heterogeneity or publication bias. Meta-regression analyses showed that the working memory deficit was not simply explained by discrepancies in current IQ between schizophrenia and control groups. CONCLUSIONS Large deficits in working memory were demonstrated in schizophrenia groups across all three working memory domains. There were, however, no clear differences across subdomains or between particular working memory tasks. There was substantial heterogeneity across results that could only be partly explained.
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Sumiyoshi C, Ertugrul A, Anil Yagcioglu AE, Sumiyoshi T. Semantic memory deficits based on category fluency performance in schizophrenia: similar impairment patterns of semantic organization across Turkish and Japanese patients. Psychiatry Res 2009; 167:47-57. [PMID: 19362375 DOI: 10.1016/j.psychres.2007.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 11/12/2007] [Accepted: 12/17/2007] [Indexed: 11/29/2022]
Abstract
Patients with schizophrenia exhibit a wide range of cognitive dysfunction, including impairments in semantic memory and verbal fluency. Previous studies report that semantic memory, i.e. associated meaning of words or knowledge, is specifically disorganized in patients who use the English or Japanese language. The purpose of the present study was to determine if semantic memory, as evaluated by verbal fluency data, shows similar patterns of semantic disorganization in non-English-speaking patients who do (Turkish) or do not (Japanese) use an alphabetical language. Turkish (N=20) and Japanese (N=22) patients with schizophrenia, as well as Japanese normal controls (N=22), entered the study. As a measure of semantic memory organization, two types of cluster analyses, i.e. ADDTREE and hierarchical cluster analysis, were performed on category fluency task data. The cluster analyses revealed a greater similarity between the Turkish patients vs. Japanese patients comparison than the Japanese patients vs. Japanese controls comparison. The results provide further support to the concept that impaired semantic memory organization is one of the core features of schizophrenia, and is independent of the language system or cultural backgrounds.
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Affiliation(s)
- Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
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Hoekstra RA, Bartels M, van Leeuwen M, Boomsma DI. Genetic architecture of verbal abilities in children and adolescents. Dev Sci 2009; 12:1041-53. [DOI: 10.1111/j.1467-7687.2009.00843.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kebir O, Mouaffak F, Chayet M, Leroy S, Tordjman S, Amado I, Krebs MO. Semantic but not phonological verbal fluency associated with BDNF Val66Met polymorphism in schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:441-2. [PMID: 18535997 DOI: 10.1002/ajmg.b.30794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dibben CRM, Rice C, Laws K, McKenna PJ. Is executive impairment associated with schizophrenic syndromes? A meta-analysis. Psychol Med 2009; 39:381-392. [PMID: 18588741 DOI: 10.1017/s0033291708003887] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND A key neuropsychological proposal in schizophrenia is that negative and disorganization symptoms are associated with different patterns of impairment on executive tasks. METHOD Studies reporting correlations between positive, negative or disorganization symptoms and any type of executive test were meta-analysed. The influence of moderating factors was also examined, including age, treatment and stage of illness and whether symptoms were relapsing or persistent. The magnitudes of the correlations were compared with those for general intellectual impairment. RESULTS Pooled correlations between executive impairment and both negative symptoms and disorganization were significant in the small-to-moderate range. That for positive symptoms ('reality distortion'), however, was close to zero. The pattern of correlations among different executive tests differed significantly for negative symptoms and disorganization. Patients with stable clinical pictures showed significantly higher correlations with executive impairment than those with relapsing and remitting illnesses. Both negative symptoms and disorganization also correlated significantly with general intellectual function as indexed by current IQ. CONCLUSIONS Meta-analysis supports the view that negative symptoms and disorganization are associated with partially dissociable patterns of executive impairment. However, co-existent general intellectual impairment has been an important confounding factor in the studies to date.
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Wuang YP, Wang CC, Huang MH, Su CY. Profiles and cognitive predictors of motor functions among early school-age children with mild intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:1048-1060. [PMID: 18557969 DOI: 10.1111/j.1365-2788.2008.01096.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The purpose of the study was to describe sensorimotor profile in children with mild intellectual disability (ID), and to examine the association between cognitive and motor function. METHODS A total of 233 children with mild ID aged 7 to 8 years were evaluated with measures of cognitive, motor and sensory integrative functioning. RESULTS Children with mild ID performed significantly less well on all test measures. 44.2% of children scored in the impaired range on seven out of 22 sensorimotor measures. They had weaker fine motor skills than gross motor skills. Sensory integrative functions were only mildly impaired. Total IQ substantially predicted overall performance on each motor test. Specifically, verbal comprehension and processing speed indexes were significant predictors of gross and fine motor function. CONCLUSIONS Sensorimotor dysfunctions were found to be very frequent in children with mild ID. Early identification of sensorimotor impairments is essential to prompt early intervention and facilitate better integration into regular school settings.
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Affiliation(s)
- Y-P Wuang
- Department of Occupational Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan
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Cognitive deficits in early-onset schizophrenia spectrum patients and their non-psychotic siblings: a comparison with ADHD. Schizophr Res 2008; 99:85-95. [PMID: 18083349 DOI: 10.1016/j.schres.2007.11.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Revised: 11/08/2007] [Accepted: 11/09/2007] [Indexed: 11/22/2022]
Abstract
BACKGROUND Previous research has shown cognitive deficits in patients with schizophrenia spectrum disorders in the areas of executive function, verbal memory and attention. Subtle deficits have been shown in healthy first-degree relatives of patients, suggesting that they may be trait markers. The specificity of these markers for schizophrenia compared with another neurodevelopmental disorder, Attention Deficit Hyperactivity Disorder (ADHD) has not been reliably established. METHODS The Rey Auditory Verbal Learning Test (RAVLT), Hayling Sentence Completion Test (HSCT), FAS Test of orthographic verbal fluency (FAS) and Continuous Performance Test-Identical Pairs (CPT-IP) were administered to adolescent schizophrenia spectrum patients (SZ; n=30), adolescent siblings of schizophrenia spectrum patients (SZ-SIB; n=36), healthy control participants (HC; n=72); a neurodevelopmental comparison group of adolescents with ADHD (n=27). RESULTS The SZ group were impaired on all measures. The SZ-SIB group were impaired on IQ, immediate recall (RAVLT), target sensitivity (CPT-IP), response initiation (HSCT); error rates for the FAS and HSCT. There were no significant differences between the SZ-SIB and ADHD groups on individual measures of cognitive function. Principal Components Analysis revealed four factors on which further analyses were conducted. The SZ-SIB and ADHD groups showed different profiles of impairment on components related to response initiation and sustained attention/vigilance when each was compared with the HC group. CONCLUSIONS Deficits in intellectual function, verbal memory and response initiation/inhibition were found in the SZ-SIB group indicating that these are markers of risk for schizophrenia. Subtle differences in profiles of impairment in the SZ-SIB and ADHD groups on composite measures of attention and response initiation require further investigation.
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Ma X, Wang Q, Sham PC, Liu X, Rabe-Hesketh S, Sun X, Hu J, Meng H, Chen W, Chen EYH, Deng W, Chan RCK, Murray RM, Collier DA, Li T. Neurocognitive deficits in first-episode schizophrenic patients and their first-degree relatives. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:407-16. [PMID: 17440937 DOI: 10.1002/ajmg.b.30330] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Some neuropsychological abilities, particularly those affecting memory, attention and executive function, are impaired amongst both schizophrenic patients and their unaffected relatives, implying that these deficits are at least partly genetic in origin. However neuropsychological performance can be altered by medication, and has rarely been examined in first onset, drug naive patients. The objective of this study was to determine whether selected neurocognitive abilities are impaired in first-onset schizophrenic patients and their relatives compared to controls. We examined attention and speed of information processing, memory and learning, verbal function, visuoconstructive abilities and executive function in 207 first-episode schizophrenic patients (163 of whom were drug naïve), 322 of their first-degree relatives and 133 unrelated normal controls. The data were subjected to multilevel modeling to compare neurocognitive performance between schizophrenic probands, relatives and controls while taking into account potential correlations among members of the same family; age, gender, and years of education were included as covariates. Of the three groups, schizophrenic patients performed poorest at all neuropsychological tests, suggestive of a broad range of neurocognitive deficits. Their first-degree relatives showed a narrower pattern of poor performance at Digit Symbol, Digit Span, Trail Making, Verbal Fluency test, Tower of Hanoi, and WCST-M tests. Our findings show that selected neurocognitive deficits especially attention and executive function are impaired in the families of schizophrenic patients. These patterns of neurocognitive deficits may represent "endophenotypes" denoting varying degrees of vulnerability to schizophrenia and may be of value in future molecular genetic studies.
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Affiliation(s)
- Xiaohong Ma
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P R China
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Pukrop R, Schultze-Lutter F, Ruhrmann S, Brockhaus-Dumke A, Tendolkar I, Bechdolf A, Matuschek E, Klosterkötter J. Neurocognitive Functioning in Subjects at Risk for a First Episode of Psychosis Compared with First- and Multiple-episode Schizophrenia. J Clin Exp Neuropsychol 2007; 28:1388-407. [PMID: 17050266 DOI: 10.1080/13803390500434425] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Evidence from neurobiological studies suggests that schizophrenia arises from an early abnormality in brain development and possibly further progressive developmental mechanisms. Despite a delay between the acquisition of neuropathology and the triggering of psychosis, neurobiological susceptibility is likely to be expressed subclinically by biobehavioral markers in the premorbid stage. The exploratory study aims at identifying potential neurocognitive risk factors and investigating the unfolding of the illness within a cross-sectional design by comparing neurocognitive profiles in 179 healthy controls, 38 clinically identified subjects in an early initial prodromal state (EIPS) for psychosis, 90 subjects in a late initial prodromal state (LIPS), 86 first-episode patients with schizophrenia, and 88 multiple-episode patients. Subjects at risk were substantially impaired in verbal executive and verbal memory functions. Compared to EIPS subjects, LIPS subjects demonstrated additional attentional deficits. Both EIPS and LIPS subjects were superior to first-episode patients who presented a generalized neuropsychological deficit profile, and to multiple-episode patients who showed evidence for further decline. Although results were influenced by general intellectual abilities and demographic and clinical characteristics, they could not account for total group differences. Results support a neurodevelopmental model of psychosis with further progressive mechanisms and are consistent with a primary involvement of left frontotemporal networks in the prodromal phase.
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Affiliation(s)
- Ralf Pukrop
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
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Egeland J, Landrø NI, Tjemsland E, Walbaekken K. Norwegian Norms and Factor-Structure of Phonemic and Semantic Word List Generation. Clin Neuropsychol 2006; 20:716-28. [PMID: 16980257 DOI: 10.1080/13854040500351008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Word list generation (WLG) tasks are used world wide as measures of executive function, although the tests are sensitive also to deficits in other cognitive functions. Norms derived from English-speaking samples are often used in Norway, even though the consequences of language differences are not yet been assessed. The reliability of WLG testing in Norway is increased by the norms presented in the first part of the study. The validity of WLG tests as measures of executive function is addressed in the second part, by performing a factor-analysis of neuropsychological performance in a mixed psychiatric sample. Education contributed most to performance. There were no sex-differences in overall performance. Factor analysis indicated that phonemic WLG is a more specific measure of executive function than semantic WLG. Semantic WLG correlated higher with basal processing speed, thus being more sensitive to aging. In conclusion the clinical neuropsychologist is advised to control for reduction in basal processing speed before interpreting WLG scores as specific deficits in executive function. The Norwegian norms correspond well with most comparable studies in other languages, thus failing to show any language specific effects.
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Affiliation(s)
- Jens Egeland
- Vestfold Mental Health Care Trust, Tønsberg, Norway.
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Whyte MC, Brett C, Harrison LK, Byrne M, Miller P, Lawrie SM, Johnstone EC. Neuropsychological performance over time in people at high risk of developing schizophrenia and controls. Biol Psychiatry 2006; 59:730-9. [PMID: 16388781 DOI: 10.1016/j.biopsych.2005.08.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2004] [Revised: 10/20/2004] [Accepted: 08/11/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Neuropsychological assessments of relatives of schizophrenics have shown subtle impairments in verbal memory, executive and intellectual function, which are stable in those beyond the age of maximum risk for the disorder. We sought to: (1) determine baseline neurocognitive predictors of psychosis, and (2) compare performance over time between relatives within the age of maximum risk, and controls. METHODS (1) and (2) were examined in 118 individuals at familial high risk of schizophrenia (HR) and 30 controls (C), using one-way analyses of variance (ANOVAs) and repeated measures analyses of covariance (ANCOVAs), controlling for intelligence quotient, time between and number of assessments, and correcting for multiple comparisons. RESULTS HR who became ill (n = 13) performed nonsignificantly less well at baseline than HR who did not (n = 105) on a test of verbal learning (t(109) = 2.1, p = .03). Across assessments, C performed significantly better than the entire HR group on immediate (F(3,133) = 5.11, p = .002) and delayed (F(3,133) = 5.02, p = .002) story recall. There were no significant interactions of time by group. CONCLUSIONS Results suggest greater verbal memory impairment in HR who go on to develop schizophrenia. Stable differences between groups over time suggest a trait deficit, which is relatively unaffected by the presence of psychotic symptoms and psychosis onset. Alternatively, small numbers may have precluded detection of group by time interactions.
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Affiliation(s)
- Marie-Claire Whyte
- Division of Psychiatry, University of Edinburgh, Morningside Park, Edinburgh, United Kingdom
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Trandafir A, Méary A, Schürhoff F, Leboyer M, Szöke A. Memory tests in first-degree adult relatives of schizophrenic patients: a meta-analysis. Schizophr Res 2006; 81:217-26. [PMID: 16246526 PMCID: PMC1950161 DOI: 10.1016/j.schres.2005.09.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Revised: 09/09/2005] [Accepted: 09/10/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND Memory deficits have been clearly demonstrated in schizophrenic patients. However, studies of memory performances in their relatives compared to normal controls provide conflicting results. A meta-analysis was carried out to synthesize all the published data. Unlike previous meta-analyses, which were based on composite scores, we analyzed each memory test separately. This prevents theoretically questionable choices in grouping variables, leads to results with clearer implications for applied research (e.g. the best choice of a test according to its sensitivity) and is more productive in suggesting explanatory hypotheses. METHOD We initially selected 77 potentially relevant articles, but only 19 met our inclusion criteria. These articles provided data on eight different tasks, from five different memory tests: four tests from the Wechsler Memory Scale (WMS) and the California Verbal Learning Test (CVLT). For each task, we assessed data homogeneity, identified the outliers if any and then estimated effect sizes and tested publication bias using funnel plots. RESULTS Adult relatives of schizophrenic patients were significantly impaired on most, but not all, tasks. The largest deficits were observed for the verbal paired associates test, the logical stories the digit span forward test and the digit span backward test. We found no significant differences in tasks of delayed recall, when deficits in immediate conditions (reflecting encoding) were taken into account. CONCLUSIONS Adult relatives of schizophrenic patients have wide but not severe memory impairments. The size of estimated effects suggests that encoding processes are impaired, whereas storage and retrieval processes are relatively unaffected.
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Affiliation(s)
- Anca Trandafir
- Service de psychiatrie
AP-HP Hôpital Henri Mondor Hôpital Albert ChenevierCréteil,FR
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de Marne8, Rue du Général Sarrail
Créteil,FR
| | - Alexandre Méary
- Service de psychiatrie
AP-HP Hôpital Henri Mondor Hôpital Albert ChenevierCréteil,FR
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de Marne8, Rue du Général Sarrail
Créteil,FR
- Service de pharmacologie clinique
AP-HP Hôpital Henri MondorUniversité Paris XII Val de Marne51, av du Maréchal de Tassigny, Créteil,FR
| | - Franck Schürhoff
- Service de psychiatrie
AP-HP Hôpital Henri Mondor Hôpital Albert ChenevierCréteil,FR
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de Marne8, Rue du Général Sarrail
Créteil,FR
| | - Marion Leboyer
- Service de psychiatrie
AP-HP Hôpital Henri Mondor Hôpital Albert ChenevierCréteil,FR
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de Marne8, Rue du Général Sarrail
Créteil,FR
| | - Andrei Szöke
- Service de psychiatrie
AP-HP Hôpital Henri Mondor Hôpital Albert ChenevierCréteil,FR
- Neurobiologie et Psychiatrie
INSERM : U513Université Paris XII Val de Marne8, Rue du Général Sarrail
Créteil,FR
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