1
|
Correa-Ghisays P, Vicent Sánchez-Ortí J, Balanzá-Martínez V, Fuentes-Durá I, Martinez-Aran A, Ruiz-Bolo L, Correa-Estrada P, Ruiz-Ruiz JC, Selva-Vera G, Vila-Francés J, Macias Saint-Gerons D, San-Martín C, Ayesa-Arriola R, Tabarés-Seisdedos R. MICEmi: A method to identify cognitive endophenotypes of mental illnesses. Eur Psychiatry 2022; 65:e85. [PMID: 36440538 PMCID: PMC9807453 DOI: 10.1192/j.eurpsy.2022.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Characterizing neurocognitive endophenotypes of mental illnesses (MIs) could be useful for identifying at-risk individuals, increasing early diagnosis, improving disease subtyping, and proposing therapeutic strategies to reduce the negative effects of the symptoms, in addition to serving as a scientific basis to unravel the physiopathology of the disease. However, a standardized algorithm to determine cognitive endophenotypes has not yet been developed. The main objective of this study was to present a method for the identification of endophenotypes in MI research. METHODS For this purpose, a 14-expert working group used a scoping review methodology and designed a method that includes a scoring template with five criteria and indicators, a strategy for their verification, and a decision tree. CONCLUSIONS This work is ongoing since it is necessary to obtain external validation of the applicability of the method in future research.
Collapse
Affiliation(s)
- Patricia Correa-Ghisays
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vicent Sánchez-Ortí
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Vicent Balanzá-Martínez
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Inmaculada Fuentes-Durá
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Anabel Martinez-Aran
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,Bipolar Disorders Unit, Neurosciences Institute, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Catalonia, Spain
| | - Lara Ruiz-Bolo
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | - Juan Carlos Ruiz-Ruiz
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Gabriel Selva-Vera
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Joan Vila-Francés
- Intelligent Data Analysis Laboratory (IDAL), University of Valencia, Spain
| | - Diego Macias Saint-Gerons
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain
| | - Constanza San-Martín
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Rafael Tabarés-Seisdedos
- Center for Biomedical Research in Mental Health Network (CIBERSAM), ISCIII, Madrid, Spain.,INCLIVA Biomedical Research Institute, Valencia, Spain.,TMAP Unidad de Evaluación en Autonomía Personal, Dependencia y Trastornos Mentales Graves, Department of Medicine, University of Valencia, Valencia, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| |
Collapse
|
2
|
Soni S, Muthukrishnan SP, Samanchi R, Sood M, Kaur S, Sharma R. Pre-trial and pre-response EEG microstates in schizophrenia: An endophenotypic marker. Behav Brain Res 2019; 371:111964. [PMID: 31129232 DOI: 10.1016/j.bbr.2019.111964] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/17/2019] [Accepted: 05/18/2019] [Indexed: 01/15/2023]
Abstract
Cognitive deficits in Schizophrenia interfere with everyday functioning and social functioning. Strong familial associations in schizophrenia might serve to establish cognitive impairments as endophenotypic markers. Therefore, visuo-spatial working memory simulating day-to-day activities at high memory load was assessed in patients with schizophrenia, their first-degree relatives and healthy controls to explore pre-trial and pre-response EEG microstates and their intracranial generators. Twenty-eight patients with schizophrenia, first-degree relatives and matched healthy controls participated in the study. Brain activity during visuo-spatial working memory task was recorded using 128-channel electroencephalography. Pre-trial and pre-response microstate maps of correct and error trials were clustered across groups according to their topography. Microstate map parameters and underlying cortical sources were compared among groups. Pre-trial (correct) microstate Map 1 was significantly different between controls and patients which could qualify it as a state marker with its intracranial generator localized to right inferior frontal gyrus (rIFG). Pre-response (correct) microstate map was significantly different between controls and first-degree relatives which could be considered an endophenotypic marker for schizophrenia. No significant differences were observed for error trials between groups. rIFG which is involved in the execution of multi-component behaviour and selective inhibitory control could distinguish patients with schizophrenia from their first-degree relatives and healthy controls. Further, microstate based biomarkers have the potential to facilitate diagnosis of schizophrenia at a preclinical stage resulting in efficient diagnosis and better prognosis.
Collapse
Affiliation(s)
- Sunaina Soni
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Suriya Prakash Muthukrishnan
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Rupesh Samanchi
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Simran Kaur
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Ratna Sharma
- Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
3
|
Soni S, Muthukrishnan SP, Sood M, Kaur S, Mehta N, Sharma R. A novel method for assessing patients with schizophrenia and their first-degree relatives by increasing cognitive load of visuo-spatial working memory. Asia Pac Psychiatry 2018; 10:e12333. [PMID: 30191660 DOI: 10.1111/appy.12333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/17/2018] [Accepted: 08/02/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION In patients with schizophrenia, social and functional outcome is determined by the cognitive impairment. Assessment of visuo-spatial working memory (VSWM) which can simulate the day-to-day activities by simultaneous involvement of various elements of working memory may reflect disorganized thinking and fragmentation of thoughts in schizophrenia. METHODS Thirty-six patients with schizophrenia, 29 first-degree relatives of patients, and 25 healthy controls performed a VSWM task with three memory loads (comprising three pairs, six pairs, and eight pairs of abstract pictures). They were administered Hindi version of the Mini Mental State Examination, Scale for the Assessment of Negative Symptoms and Scale for the Assessment of Positive Symptoms, and Edinburgh handedness inventory. RESULTS Patients (mean age 27.29(5.98) years) committed significantly higher number of errors than healthy controls (mean age 26.76(6.08) years) in load 3 (P = 0.012) and total errors (P = 0.018). Within all the groups, errors in load 3 were significantly higher than in load 2. Significant correlation was observed between years of education (r = -0.388, P = 0.021), treatment duration (r = -0.880, P < 0.001), negative symptoms scores (r = 0.345, P = 0.039), and the total errors committed by patients. DISCUSSION Visuo-spatial working memory was impaired in schizophrenia with increasing cognitive load with no difference in search time between the groups.
Collapse
Affiliation(s)
- Sunaina Soni
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Mamta Sood
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Simran Kaur
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Nalin Mehta
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ratna Sharma
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
4
|
Ettinger U, Aichert DS, Wöstmann N, Dehning S, Riedel M, Kumari V. Response inhibition and interference control: Effects of schizophrenia, genetic risk, and schizotypy. J Neuropsychol 2017; 12:484-510. [DOI: 10.1111/jnp.12126] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 03/06/2017] [Indexed: 01/18/2023]
Affiliation(s)
| | | | | | - Sandra Dehning
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy; University of Munich; Germany
| | | | - Veena Kumari
- Research and Development; Sovereign Health Group; San Clemente California USA
| |
Collapse
|
5
|
Chen G, Ding W, Zhang L, Cui H, Jiang Z, Li Y. Neurophysiological Evidence of Compensatory Brain Mechanisms Underlying Attentional-Related Processes in Symptomatically Remitted Patients with Schizophrenia. Front Psychol 2017; 8:550. [PMID: 28473782 PMCID: PMC5397525 DOI: 10.3389/fpsyg.2017.00550] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 03/24/2017] [Indexed: 11/13/2022] Open
Abstract
A recent electrophysiological study suggests existing compensatory brain activity as a mechanism for functional recovery of visual attention detection (the capacity for detecting external cues) in symptomatically remitted schizophrenia patients. Despite such evidence, little is known about other aspects of attentional-related processes in schizophrenia during clinical remission, such as their capacity to concentrate on the task at hands without being interfered by distracting information. To this end, we recorded event-related brain potentials (ERPs) from 20 symptomatically remitted schizophrenia patients and 20 healthy controls while they engaged in a classic Stroop task. Symptomatically remitted patients showed comparable Stroop interference to healthy controls, indicating a degree of functional recovery of such a capacity in these patients. On the neural level, the N450 over the fronto-central and central regions, a component of the ERPs related to conflict detection, was found across both groups, although patients presented a reduced N450 relative to healthy controls. By contrast, the amplitude of the sustained potential (SP) (600-800 ms) over the parieto-central and parietal regions, a component of the ERPs related to conflict resolution, was significantly increased in patients relative to healthy controls. Furthermore, such increased SP amplitude correlated positively with improved behavioral accuracy in symptomatically remitted patients with schizophrenia. These findings reveal that symptomatically remitted patients with schizophrenia increasingly recruited the parietal activity involving successful conflict resolution to offset reduced conflict detection. Therefore, this provides further insight into compensatory mechanisms potentially involving a degree of functional recovery of attentional-related processes in schizophrenia during clinical remission.
Collapse
Affiliation(s)
- Guoliang Chen
- 215th Clinical Division, 406th Hospital of PLADalian, China
| | - Weiyan Ding
- 215th Clinical Division, 406th Hospital of PLADalian, China
| | - Lei Zhang
- 215th Clinical Division, 406th Hospital of PLADalian, China
| | - Hong Cui
- Department of Medical Psychology, Military General Hospital of PLABeijing, China
| | | | - Yansong Li
- Reward, Competition and Decision Neuroscience Team, Department of Psychology, School of Social and Behavioral Sciences, Nanjing UniversityNanjing, China.,The Institute of Advanced Studies in Humanities and Social Sciences, Nanjing UniversityNanjing, China.,The Research Center for Social and Behavioral Sciences of Jiangsu ProvinceNanjing, China
| |
Collapse
|
6
|
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.
Collapse
Affiliation(s)
- Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland.
| | | | | | | |
Collapse
|
7
|
Poletti S, Mazza E, Bollettini I, Locatelli C, Cavallaro R, Smeraldi E, Benedetti F. Adverse childhood experiences influence white matter microstructure in patients with schizophrenia. Psychiatry Res 2015; 234:35-43. [PMID: 26341951 DOI: 10.1016/j.pscychresns.2015.08.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 07/15/2015] [Accepted: 08/13/2015] [Indexed: 12/18/2022]
Abstract
Integrity of brain white matter (WM) tracts in adulthood could be detrimentally affected by exposure to adverse childhood experiences (ACE). Changes of diffusion tensor imaging (DTI) measures suggesting WM disruption have been reported in patients with schizophrenia together with a history of childhood maltreatment. We therefore hypothesized that ACE could be associated with altered DTI measures of WM integrity in patients with schizophrenia. We tested this hypothesis in 83 schizophrenia patients using whole brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial, and mean diffusivity (MD), and fractional anisotropy (FA). We observed an inverse correlation between severity of ACE and DTI measures of FA, and a positive correlation with MD in several WM tracts including corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus. Lower FA and higher MD are indexes of a reduction in fibre coherence and integrity. The association of ACE to reduced FA and increased MD in key WM tracts contributing to the functional integrity of the brain suggests that ACE might contribute to the pathophysiology of schizophrenia through a detrimental action on structural connectivity in critical cortico-limbic networks.
Collapse
Affiliation(s)
- Sara Poletti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy.
| | - Elena Mazza
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Irene Bollettini
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Clara Locatelli
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Enrico Smeraldi
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute Ospedale San Raffaele, Milan, Italy; C.E.R.M.A.C. (Centro di Eccellenza Risonanza Magnetica ad Alto Campo), University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
8
|
Hyunjoo Song. Validity of Child-Adolescent Self-reported Executive Function Difficulty Screening Questionnaire. ACTA ACUST UNITED AC 2014. [DOI: 10.15842/kjcp.2014.33.1.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
9
|
Yao L, Lui S, Liao Y, Du MY, Hu N, Thomas JA, Gong QY. White matter deficits in first episode schizophrenia: an activation likelihood estimation meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2013; 45:100-6. [PMID: 23648972 DOI: 10.1016/j.pnpbp.2013.04.019] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/26/2013] [Accepted: 04/26/2013] [Indexed: 02/05/2023]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) has been widely used in psychiatric research and has provided evidence of white matter abnormalities in first episode schizophrenia (FES). The goal of the present meta-analysis was to identify white matter deficits by DTI in FES. METHODS A systematic search was conducted to collect DTI studies with voxel-wised analysis of the fractional anisotropy (FA) in FES. The coordinates of regions with FA changes were meta-analyzed using the activation likelihood estimation (ALE) method which weighs each study on the basis of its sample size. RESULTS A total of 8 primary studies were selected, including 271 FES patients and 297 healthy controls. Among these studies, 52 regions showed reductions in the FA in FES while 2 regions had increased FA. Consistent FA reductions in the white matter of the right deep frontal and left deep temporal lobes were identified in all FES patients relative to healthy controls. Fiber tracking showed that the main tracts involved were the cingulum bundle, the left inferior longitudinal fasciculus, the left inferior fronto-occipital fasciculus and the interhemispheric fibers running through the corpus callosum. CONCLUSIONS The current findings provide evidence confirming the lack of connection in the fronto-limbic circuitry at the early stages of the schizophrenia. Because the coordinates reported in the primary literature were highly variable, future investigations with large samples would be required to support the identified white matter changes in FES.
Collapse
Affiliation(s)
- Li Yao
- Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, PR China
| | | | | | | | | | | | | |
Collapse
|
10
|
Scala S, Lasalvia A, Cristofalo D, Bonetto C, Ruggeri M. Neurocognitive profile and its association with psychopathology in first-degree relatives of patients with schizophrenia. a case-control study. Psychiatry Res 2012; 200:137-43. [PMID: 22652345 DOI: 10.1016/j.psychres.2012.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 04/30/2012] [Accepted: 05/05/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND People with schizophrenia show a broad range of neurocognitive deficits, which are considered as core features of the disorder and are thought to be partly heritable. Similar deficits, albeit at a lesser degree, have been also found in their healthy biological relatives. These deficits, if better characterized, might represent underlying vulnerable traits for psychosis. METHODS This case-control study compared neurocognitive functioning of adult first-degree relatives of patients with schizophrenia (SCZ-RELs) (n=55) with healthy control subjects (n=55) and explored its association with the negative symptoms. Subjects in both study and control group were assessed with an extensive neurocognitive test battery (Trail Making test, Phonemic Verbal fluency, Wisconsin Card Sorting Test, Bushke Fuld Test, Stroop Test, n-Back and Digit span) and a set of clinical measures (SANS, GAF and DAS). RESULTS SCZ-RELs were more significantly impaired on executive function tasks (i.e. Wisconsin Card Sorting Test and the Phonemic Verbal fluency) and displayed significantly more severe negative symptoms and poorer social functioning than control subjects. Significant correlations between neurocognitive measures and negative symptoms were found in the study group, whereas no significant correlations were detected among the controls. DISCUSSION Subtle executive impairments, associated with negative symptoms, are shown to be evident in healthy relatives of patients with schizophrenia. These deficits, which reflect subtle dysfunction in concept formation, flexibility and mental shifting, may be seen as potential phenotypic markers of vulnerability for schizophrenia. This raises the question of underlying prefrontal dysfunction as core feature of the disorder.
Collapse
Affiliation(s)
- Silvia Scala
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, P.le L.A. Scuro, 10 37134 Verona, Italy.
| | | | | | | | | |
Collapse
|
11
|
Vercammen A, Morris R, Green MJ, Lenroot R, Kulkarni J, Carr VJ, Weickert CS, Weickert TW. Reduced neural activity of the prefrontal cognitive control circuitry during response inhibition to negative words in people with schizophrenia. J Psychiatry Neurosci 2012; 37:379-88. [PMID: 22617625 PMCID: PMC3493093 DOI: 10.1503/jpn.110088] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Schizophrenia is characterized by deficits in executive control and impairments in emotion processing. This study assessed the nature and extent of potential alterations in the neural substrates supporting the interaction between cognitive control mechanisms and emotion attribution processes in people with schizophrenia. METHODS Functional magnetic resonance imaging was performed during a verbal emotional go/no-go task. People with schizophrenia and healthy controls responded to word stimuli of a prespecified emotional valence (positive, negative or neutral) while inhibiting responses to stimuli of a different valence. RESULTS We enrolled 20 people with schizophrenia and 23 controls in the study. Healthy controls activated an extensive dorsal prefrontal-parietal network while inhibiting responses to negative words compared to neutral words, but showed deactivation of the midcingulate cortex while inhibiting responses to positive words compared to neutral words. People with schizophrenia failed to activate this network during response inhibition to negative words, whereas during response inhibition to positive words they did not deactivate the cingulate, but showed increased responsivity in the frontal cortex. LIMITATIONS Sample heterogeneity is characteristic of studies of schizophrenia and may have contributed to more variable neural responses in the patient sample despite the care taken to control for potentially confounding variables. CONCLUSION Our results showed that schizophrenia is associated with aberrant modulation of neural responses during the interaction between cognitive control and emotion processing. Failure of the frontal circuitry to regulate goal-directed behaviour based on emotion attributions may contribute to deficits in psychosocial functioning in daily life.
Collapse
Affiliation(s)
- Ans Vercammen
- Neuroscience Research Australia, Randwick, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
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.
Collapse
|
13
|
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.
Collapse
|
14
|
Besnier N, Richard F, Zendjidjian X, Kaladjian A, Mazzola-Pomietto P, Adida M, Azorin JM. Stroop and emotional Stroop interference in unaffected relatives of patients with schizophrenic and bipolar disorders: distinct markers of vulnerability? World J Biol Psychiatry 2010; 10:809-18. [PMID: 19707957 DOI: 10.1080/15622970903131589] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Reduced inhibition has been demonstrated in both schizophrenic and bipolar patients through the findings of increased interference on the Stroop Colour-Word Task (SCWT) and increased emotional interference on specific versions of the Emotional Stroop Task (EST). Despite previous findings of enhanced interference in unaffected relatives of schizophrenic and bipolar patients, it remains unclear whether interference might be a candidate endophenotype to both disorders. Moreover, data regarding emotional interference in unaffected relatives are critically lacking. In the present study, we aimed to compare unaffected relatives of patients with schizophrenia (SZ-rel, N = 30) and bipolar disorder (BD-rel, N= 30) with normal controls (N = 60) when performing the SCWT and an EST designed with neutral, depressive, paranoid and manic words. SZ-rel exhibited greater interference effect on both the SCWT and the EST as compared to either BD-rel or normal controls. BD-rel, and by contrast to SZ-rel and controls, showed increased emotional interference effect on the EST that was specifically associated to the disease-related words. The findings support the hypothesis of different markers of vulnerability to schizophrenic and bipolar disorders; impairment in cognitive inhibition could characterize high-risk individuals for schizophrenia whereas an emotional bias towards mood-related information could be a trait marker of bipolar disease.
Collapse
Affiliation(s)
- Nathalie Besnier
- Pôle de Psychiatrie, Hôpital Sainte Marguerite, Marseille, France.
| | | | | | | | | | | | | |
Collapse
|
15
|
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.
Collapse
Affiliation(s)
- Hee Jung Nam
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Pfeifer S, Krabbendam L, Myin‐Germeys I, Derom C, Wichers M, Jacobs N, Thiery EW, van Os J. A cognitive intermediate phenotype study confirming possible gene–early adversity interaction in psychosis outcome: A general population twin study. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2010. [DOI: 10.1080/17522430903197384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Heritability of Trail Making Test performance in multiplex schizophrenia families: implications for the search for an endophenotype. Eur Arch Psychiatry Clin Neurosci 2009; 259:475-81. [PMID: 19399358 DOI: 10.1007/s00406-009-0012-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Accepted: 04/07/2009] [Indexed: 01/08/2023]
Abstract
The impairment of the Trail Making Test (TMT) performance as a measure of executive function deficits has been found both in patients with schizophrenia and in their unaffected first-degree relatives, suggesting that it might be considered as a familial vulnerability marker, but its heritability estimates are not well known. This study investigated the genetic heritability of impairments in TMT performance using a sample of 80 schizophrenia patients, 145 unaffected first-degree relatives and 127 healthy controls from families with multiple members with schizophrenia. Consistent with previous reports in the literature, relatives performed in between healthy controls and schizophrenia patients. Based on these results, a variance component-analysis provided small, but significant additive heritability estimates for performance indices relating performance in TMT-version A to TMT-version B. These results showed that this significant but small evidence of heritability on the one hand suggests an association with genetic predisposition to schizophrenia, but that TMT performance is also associated with epigenetic or environmental factors.
Collapse
|
18
|
Anselmetti S, Bechi M, Bosia M, Quarticelli C, Ermoli E, Smeraldi E, Cavallaro R. 'Theory' of mind impairment in patients affected by schizophrenia and in their parents. Schizophr Res 2009; 115:278-85. [PMID: 19818586 DOI: 10.1016/j.schres.2009.09.018] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 09/09/2009] [Accepted: 09/16/2009] [Indexed: 10/20/2022]
Abstract
"Theory of mind" (ToM) is the ability to judge the mental states of the self and others. It is currently considered as a part of the broader concept of social cognition, known to influence the social behaviour of patients affected by schizophrenia. Recently it has been hypothesized that the impairment of ToM is a trait that can be detected both in patients with schizophrenia and in non-psychotic relatives of patients, but it still not clear what the contribution of the familial patterns of cognitive impairment is. The aim of this study is to assess parental impairments of ToM performance considering the effects of the neurocognitive abilities known to be impaired in their first-degree relatives and to influence ToM in schizophrenic patients. Patients, their parents and control trios were assessed with the Wisconsin Card Sorting Test (WCST), the Symbol Coding Task and the ToM Picture Sequencing Task. The ANCOVA analysis on 47 trios including a schizophrenic offspring and 47 healthy trios showed a statistically significant poorer performance of patients and their parents in comparison to control trios at Symbol Coding Task and ToM task. Moreover a regression analysis showed that the neuropsychological abilities tested were significant predictors of ToM performance only in patients. Results confirm a ToM impairment among parents of patients with schizophrenia that is not directly correlated to other aspects of neurocognitive functioning.
Collapse
Affiliation(s)
- S Anselmetti
- Department of Clinical Neurosciences, San Raffaele Universitary Scientific Institute Hospital, Via Stamira d'Ancona 20, 20127 Milano, Italy.
| | | | | | | | | | | | | |
Collapse
|
19
|
Gray matter abnormalities in subjects at ultra-high risk for schizophrenia and first-episode schizophrenic patients compared to healthy controls. Psychiatry Res 2009; 173:163-9. [PMID: 19616415 DOI: 10.1016/j.pscychresns.2008.08.002] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Revised: 05/02/2008] [Accepted: 08/18/2008] [Indexed: 11/22/2022]
Abstract
Neuroimaging studies have revealed gray matter abnormalities in schizophrenia in various regions of the brain. It is, however, still unclear whether such abnormalities are already present in individuals at ultra-high risk (UHR) for transition into psychosis. We investigated this issue using voxel-based morphometry of structural magnetic resonance images (MRI) and compared UHR patients with first-episode patients with schizophrenia and healthy controls. Gray matter volume maps from high-resolution MR T1-weighted whole brain images were analyzed in a cross-sectional study in 30 UHR patients, 23 first-episode schizophrenic patients and 29 controls. UHR patients showed significantly lower gray matter volume in the cingulate gyrus bilaterally, in the right inferior frontal and right superior temporal gyrus, as well as in the left and right hippocampus in comparison to healthy subjects. First-episode patients with schizophrenia showed smaller gray matter volume in the cingulate cortex bilaterally, in the left orbitofrontal gyrus, in the right inferior frontal and superior temporal gyrus, in the right temporal pole, in the left and right hippocampus, in the left parahippocampus, left amygdala, and in the left fusiform gyrus compared to the UHR patients. This study provides further evidence that gray matter brain volume, especially in the anterior cingulate cortex, is already reduced in the prodromal state of schizophrenia.
Collapse
|
20
|
Familial aggregation of clinical and neurocognitive features in sibling pairs with and without schizophrenia. Schizophr Res 2009; 111:159-66. [PMID: 19398304 PMCID: PMC2813565 DOI: 10.1016/j.schres.2009.03.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 03/19/2009] [Accepted: 03/20/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Neurocognitive impairment was found to be heritable in individuals with schizophrenia and their relatives. However, the heritability of neurocognitive measures in families with and without schizophrenia has not been directly compared. In this study, we examined the genetic structure of clinical and neurocognitive measures in sibling pairs with and without schizophrenia to test the hypothesis that the familial aggregation of such measures may be altered by having schizophrenia. METHOD A total of 278 subjects including patients with schizophrenia and their non-psychotic full siblings, healthy controls, and their full siblings were recruited. Heritability was estimated for working memory, episodic memory, executive function and attention, as well as clinical features, such as positive, negative and disorganization symptoms. RESULTS Many clinical and cognitive domains were impaired in subjects with schizophrenia and their non psychotic siblings. Negative symptoms, working memory, episodic memory and executive function, but not positive, disorganization symptoms and attention, were found to be significantly heritable in all sibling pairs. However, the heritability of working memory function was significantly (chi(2)((d.f.=6))=13.9, p=.031) decreased in proband sibling pairs (h(2)=.38) as compared to control sibling pairs (h(2)=.95). Significant genetic correlations were observed between negative symptoms and the cluster of working memory, episodic memory and executive function. CONCLUSIONS Several neurocognitive measures were heritable in sibling pairs with and without schizophrenia. However, schizophrenia reduced the heritability of working memory, perhaps due to disease-related environmental or genetic factors. Evidence for potential pleiotropy will inform future phenotypic studies.
Collapse
|
21
|
Bhatia T, Garg K, Pogue-Geile M, Nimgaonkar VL, Deshpande SN. Executive functions and cognitive deficits in schizophrenia: comparisons between probands, parents and controls in India. J Postgrad Med 2009; 55:3-7. [PMID: 19242070 DOI: 10.4103/0022-3859.43546] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cognitive impairment is said to be a core feature of schizophrenia. Executive function is an important cognitive domain. AIM This study was undertaken to assess cognitive impairment among Indian patients with schizophrenia (Sz) or schizoaffective disorder (SzA), compared with their parents and unaffected individuals (controls). SETTINGS AND DESIGN Executive functions as measured by Trail-making Test (TMT), of patients and their parents were compared with controls. The patients were recruited from the Outpatients' Department (OPD) of a government hospital. MATERIALS AND METHODS Patients diagnosed as Sz or SzA (n=172) and their parents (n=196: families n=132, 119 fathers and 77 mothers) participated. We also included 120 persons with no history of psychiatric illness. Cognitive function was assessed with the TMT. The Information Score of the Post Graduate Institute Battery of Brain Dysfunction test, developed in India for Indian subjects was used as a proxy for general fixed knowledge. STATISTICAL ANALYSIS Logistic and linear regression was used to compare cognitive deficits of cases, parents and controls. RESULTS Cases and their parents took significantly more time than controls on Part B of the TMT. There were no statistically significant differences between cases and parents on any of the TMT parameters. Using regression analysis, the most significant correlates of all TMT parameters among cases were with occurrence of auditory hallucinations and current age. CONCLUSION Cases, as well as their parents showed more cognitive impairment than controls on the TMT.
Collapse
Affiliation(s)
- T Bhatia
- Department of Psychiatry, Dr. RML Hospital, New Delhi -110 001, India.
| | | | | | | | | |
Collapse
|
22
|
Pietrzak RH, Snyder PJ, Jackson CE, Olver J, Norman T, Piskulic D, Maruff P. Stability of cognitive impairment in chronic schizophrenia over brief and intermediate re-test intervals. Hum Psychopharmacol 2009; 24:113-21. [PMID: 19090506 DOI: 10.1002/hup.998] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study examined between- and within-subject stability of cognitive performance in individuals with chronic schizophrenia. METHODS Thirty individuals with schizophrenia and 20 healthy controls matched by age, sex, education, and estimated IQ underwent repeated cognitive assessments at baseline and 30 days using computerized tests of psychomotor function, visual attention/information processing, non-verbal learning, and executive function. RESULTS Compared to healthy controls, individuals with schizophrenia scored lower on all cognitive measures and demonstrated greater variability in cognitive performance. Within-subject variability in cognitive performance in both the schizophrenia and healthy control groups remained stable at brief (i.e., hours) and intermediate (i.e., one month) assessments. CONCLUSIONS These results demonstrate the stability of between- and within-subject variability in cognitive performance in schizophrenia, and suggest that variability in cognitive performance may reflect an inherent characteristic of the disorder, rather than differences in test-retest reliability/error of cognitive measures.
Collapse
Affiliation(s)
- Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | | | | | | | | |
Collapse
|
23
|
Dane S, Yildirim S, Ozan E, Aydin N, Oral E, Ustaoglu N, Kirpinar I. Handedness, eyedness, and hand–eye crossed dominance in patients with schizophrenia: Sex-related lateralisation abnormalities. Laterality 2009; 14:55-65. [DOI: 10.1080/13576500802061883] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
24
|
Fis NP, Cetin FC, Erturk M, Erdogan E, Dedeoglu C, Yazgan Y. Executive dysfunction in Turkish children at high risk for schizophrenia. Eur Child Adolesc Psychiatry 2008; 17:424-31. [PMID: 18427864 DOI: 10.1007/s00787-008-0684-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To explore different aspects of executive function (i.e. sequencing, set shifting and mental flexibility) in children who are at high risk for schizophrenia by comparing them with normal controls. METHOD The high risk (HR) group consisted of 30 children whose parents were diagnosed as schizophrenia. As the control group (CG) 30 children, whose parents did not meet any DSM IV diagnostic criteria for any psychiatric disorder, participated. They were age and sex matched with the HR group. For the evaluation of different domains of cognitive functions Wechsler intelligence scale for children-revised (WISC-R), and a group of neuropsychological tests, including Trail Making A-B Tests, Color Form Test, and Progressive Figures Test were administered. Behavioral problems were assessed using Hacettepe Adjustment Scale. RESULTS The subjects in the high risk group had significantly lower scores on Trail Making A-B, Color Form, Progressive Figures Tests, as well as subtests and scores of WISC-R (Information, Comprehension, Similarities, Picture Completion, Block Design, Object Assembly and Coding subtests, Verbal, Performance and Full Scale IQ scores). There is no significant difference between the two groups in the frequency and severity of behavioral problems. CONCLUSION Children of parents with schizophrenia displayed significantly greater number of difficulties in several areas of executive function, such as sequencing, set shifting, and mental flexibility, when compared to their controls.
Collapse
Affiliation(s)
- Nese Perdahli Fis
- Deptartment of Child Psychiatry, Marmara Universitesi Hastanesi Cocuk, Psikiyatrisi Anabilim Dali, Tophanelioglu Cad. No: 13-15 Altunizade, 34660, Uskudar, Istanbul, Turkey.
| | | | | | | | | | | |
Collapse
|
25
|
Schürhoff F, Laguerre A, Roy I, Beaumont JL, Leboyer M. Handedness and schizotypal features in healthy subjects. World J Biol Psychiatry 2008; 9:121-5. [PMID: 17853301 DOI: 10.1080/15622970701218679] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND An excess of mixed-handedness has been repeatedly reported in schizophrenia and schizotypy. Handedness is a measure of atypical cerebral lateralization, which is considered as a risk factor for schizophrenia. Several studies have attempted to identify correlations between handedness and dimensions of psychosis but the results obtained so far remain inconclusive. OBJECTIVE To explore a possible link between mixed-handedness and the three classical dimensions of psychosis. As speech and language disorders may be associated with cerebral lateralization, we predicted a correlation between mixed-handedness and disorganized dimension. METHODS We used the Schizotypal Personality Questionnaire (SPQ) and the Edinburgh Handedness Inventory (EHI) to study the correlation between mixed-handedness scores and positive, negative or disorganized dimensions in a sample of 62 healthy subjects. RESULTS We found a negative correlation between mixed-handedness and the disorganized dimension of schizotypy, as individuals with prominent mixed-handedness showed more severe disorganization. CONCLUSION We have identified a link between mixed-handedness and the disorganized dimension that may help to identify genetic vulnerability factors involved in psychosis.
Collapse
Affiliation(s)
- Franck Schürhoff
- AP-HP Groupe Henri Mondor-Albert Chenevier, Pôle de Psychiatrie, Créteil, France.
| | | | | | | | | |
Collapse
|
26
|
Bora E, Gökçen S, Veznedaroglu B. Empathic abilities in people with schizophrenia. Psychiatry Res 2008; 160:23-9. [PMID: 18514324 DOI: 10.1016/j.psychres.2007.05.017] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2007] [Revised: 05/31/2007] [Accepted: 05/31/2007] [Indexed: 12/20/2022]
Abstract
Although the existence of empathy deficits in schizophrenia is generally accepted, very few studies have directly investigated the issue. The nature of empathy deficits in healthy subjects and psychiatric patients is an understudied subject. The performances of the 30 outpatients with schizophrenia on a psychometric measure, the Empathy Quotient (EQ), were compared with those of 30 control subjects matched for age, duration of education and gender. The relatives or spouses of the patients also filled out the EQ. A neuropsychological battery, including emotion recognition, emotional reasoning and theory of mind tasks, was also administered. Schizophrenia patients had severe empathy dysfunction based on their relative EQ ratings. There was a serious discrepancy between the self and relative/spouse assessments of the empathic skills of schizophrenia patients. Consistent with the previous findings schizophrenia patients were impaired in nearly all cognitive tasks. The empathy deficits of schizophrenia patients were associated with their impairments in other social cognitive tasks. Studies focusing on dysfunctional brain networks underlying empathy deficits and studies using more experimental measures of empathy should be helpful to unravel the true nature of the empathic failure in patients with schizophrenia.
Collapse
Affiliation(s)
- Emre Bora
- Melbourne Neuropsychiatry Centre, Psychiatry Department of Melbourne University, Victoria, Australia.
| | | | | |
Collapse
|
27
|
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.
Collapse
|
28
|
Jabben N, van Os J, Janssen I, Versmissen D, Krabbendam L. Cognitive alterations in groups at risk for psychosis: neutral markers of genetic risk or indicators of social disability? Acta Psychiatr Scand 2007; 116:253-62. [PMID: 17803755 DOI: 10.1111/j.1600-0447.2006.00990.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate whether cognitive alterations associated with vulnerability to psychosis, are associated with expression of psychopathology and functional outcome in groups at different levels of risk for psychotic illness. METHOD Neurocognition, psychopathology and functional outcome were measured in subjects with variable risk for psychosis: i) 29 patients with psychotic disorder, ii) 46 subjects at familial risk, iii) 41 subjects at psychometric risk and iv) 54 control subjects. RESULTS Dose-response relationships between cognitive dysfunction and increasing risk for psychosis were found. Cognitive alterations were predicted by negative symptoms in patients and by positive psychotic experiences in the familial risk group. In both at risk groups, cognitive speed was associated with functional outcome. CONCLUSION Some cognitive impairments serve as neutral endophenotypic marker across the psychosis continuum. However, other cognitive alterations associated with transmission of psychosis may have a direct impact on the pathway from risk to psychopathology and alterations in functioning.
Collapse
Affiliation(s)
- N Jabben
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands
| | | | | | | | | |
Collapse
|
29
|
Abstract
Cognitive dysfunction is a major component of schizophrenia, with deficits in executive function particularly pertinent to successful daily living and outcome. Executive deficits and negative/disorganised symptoms remain relatively resistant to amelioration by antipsychotic medication in comparison to positive symptoms. While there is a relative paucity of data on the effects of antipsychotics on specific executive deficits, atypical antipsychotics would appear to be more beneficial than typical antipsychotics at improving these functions, with muscarinic, glutamatergic and cholinergic systems variously implicated. Recent research focusing on the relationships between specific symptoms and specific executive deficits holds important implications for future psychopharmacological interventions in the area by elucidating the neural substrates and pathways which underpin schizophrenic symptomatology. This review attempts to evaluate the research thus far for the specific executive components of spatial working memory (SWM), inhibition, sustained attention and set shifting. Issues significant to future psychopharmacology in the area are discussed, with particular emphasis on the need for a greater consensus in methodology and definition executive function research in schizophrenia.
Collapse
Affiliation(s)
- Cara O'Grada
- Department of Psychiatry and Alimentary Pharmabiotic Centre, University College Cork, Ireland.
| | | |
Collapse
|
30
|
Abstract
The idea that some phenotypes bear a closer relationship to the biological processes that give rise to psychiatric illness than diagnostic categories has attracted considerable interest. Much effort has been devoted to finding such endophenotypes, partly because it is believed that the genetic basis of endophenotypes will be easier to analyse than that of psychiatric disease. This belief depends in part on the assumption that the effect sizes of genetic loci contributing to endophenotypes are larger than those contributing to disease susceptibility, hence increasing the chance that genetic linkage and association tests will detect them. We examine this assumption by applying meta-analytical techniques to genetic association studies of endophenotypes. We find that the genetic effect sizes of the loci examined to date are no larger than those reported for other phenotypes. A review of the genetic architecture of traits in model organisms also provides no support for the view that the effect sizes of loci contributing to phenotypes closer to the biological basis of disease is any larger than those contributing to disease itself. While endophenotype measures may afford greater reliability, it should not be assumed that they will also demonstrate simpler genetic architecture.
Collapse
Affiliation(s)
- JONATHAN FLINT
- Wellcome Trust Centre for Human Genetics, University of
Oxford, Oxford, UK
| | - MARCUS R. MUNAFÒ
- Department of Experimental Psychology, University of
Bristol, Bristol, UK
| |
Collapse
|
31
|
Binder PE. At the verge of unthinkable anxiety: On the relevance of a neurophysiologically informed relational perspective on meaning-making in psychosis. INTERNATIONAL FORUM OF PSYCHOANALYSIS 2006. [DOI: 10.1080/08037060500526433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
32
|
Klemm S, Schmidt B, Knappe S, Blanz B. Impaired working speed and executive functions as frontal lobe dysfunctions in young first-degree relatives of schizophrenic patients. Eur Child Adolesc Psychiatry 2006; 15:400-8. [PMID: 16721500 PMCID: PMC1705537 DOI: 10.1007/s00787-006-0547-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2006] [Indexed: 11/28/2022]
Abstract
The aim of the investigation was to detect neuropsychological markers, such as sustained and selective attention and executive functions, which contribute to the vulnerability to schizophrenia especially in young persons. Performance was assessed in 32 siblings and children of schizophrenic patients and 32 matched controls using Wisconsin Card Sorting Test, Colour-Word-Interference-Test, Trail Making Test, and d2-Concentration-Test. The first-degree relatives showed certain impairments on all four tests, in particular, slower times on all time-limited tests. These results suggest the need for more time when completing neuropsychological tasks involving selected and focused attention, as well as cognitive flexibility, as a possible indicator of genetic vulnerability to schizophrenia.
Collapse
Affiliation(s)
- Silke Klemm
- Dept. of Child and Adolescent Psychiatry, University of Jena, Philosophenweg 3-5, 07740 Jena, Germany.
| | | | | | | |
Collapse
|
33
|
Heinze S, Sartory G, Müller BW, de Greiff A, Forsting M, Jüptner M. Neural activation during successful and unsuccessful verbal learning in schizophrenia. Schizophr Res 2006; 83:121-30. [PMID: 16497485 DOI: 10.1016/j.schres.2005.12.852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Revised: 12/10/2005] [Accepted: 12/20/2005] [Indexed: 11/29/2022]
Abstract
Successful and unsuccessful intention to learn words was assessed by means of event-related functional MRI. Eighteen patients with schizophrenia and 15 healthy control participants were scanned while being given two word lists to read and another seven to learn with immediate recall. Neural activation patterns were segregated according to whether words were subsequently recalled or forgotten and these conditions were contrasted with each other and reading. Compared to controls, patients with schizophrenia showed deficits with regard to neural recruitment of right hippocampus and of cerebellar structures during successful verbal learning. Furthermore, a reversal of activated structures was evident in the two groups: Controls showed activation of right frontal and left middle temporal structures during the unsuccessful intention to learn. During successful learning, there was additional activation of right superior parietal lobule. In contrast, patients showed activation of right superior parietal lobule during unsuccessful and successful intention to learn. There were additional frontal and left middle temporal lobe activations during successful learning. We conclude that increased parietal activity may reflect a mechanism which compensates for the lack of hippocampal and cerebellar contributions to verbal learning in schizophrenia.
Collapse
Affiliation(s)
- Sibylle Heinze
- Department of Clinical Psychology, University of Wuppertal, Max-Horkheimer-Strasse 20, D-42119 Wuppertal, Germany
| | | | | | | | | | | |
Collapse
|
34
|
El Hamaoui Y, Elyazaji M, Yaalaoui S, Rachidi L, Saoud M, d'Amato T, Moussaoui D, Dalery J, Battas O. [Wiscosin card sorting task in patients with schizophrenia and thier siblings]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2006; 51:48-54. [PMID: 16491984 DOI: 10.1177/070674370605100109] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study's first objective was to confirm that patients with schizophrenia and their nonmentally ill siblings share the same impaired executive function when compared to healthy control subjects. The second objective was to study the relation between Wisconsin card sorting task (WCST) performance and the persistence and severity of clinical symptoms, as well as different clinical dimensions. METHOD Ninety subjects were involved in this study, divided in 3 groups of 30 each: one group of patients with schizophrenia, one group of their siblings, and a control group. Symptom severity was assessed with the Positive and Negative Syndrome Scale (PANSS), and social functioning was measured by the Global functioning scale (GFS). The WCST was administered to all 3 groups. RESULTS Patients with schizophrenia and their siblings had a significantly lower WCST performance than control subjects. Statistical analysis showed that the patient group had a significantly greater impaired WCST performance than the 2 other groups. Siblings also had a significantly lower performance than the control subjects. Furthermore, no significant relation was found between WCST performance and other variables, including age, gender, education, illness duration, treatment, and different PANSS and GFS scores. CONCLUSION Patients with schizophrenia and their nonmentally ill siblings share the same impaired executive function. These findings suggest that WCST performance can be considered a schizophrenia vulnerability marker in siblings of patients with schizophrenia.
Collapse
|
35
|
Whyte MC, McIntosh AM, Johnstone EC, Lawrie SM. Declarative memory in unaffected adult relatives of patients with schizophrenia: a systematic review and meta-analysis. Schizophr Res 2005; 78:13-26. [PMID: 16006102 DOI: 10.1016/j.schres.2005.05.018] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2005] [Revised: 05/16/2005] [Accepted: 05/24/2005] [Indexed: 11/22/2022]
Abstract
Despite evidence for diverse neuropsychological impairment in schizophrenia, verbal declarative memory has emerged as a core deficit in the disorder. Similar but less marked impairments have been demonstrated in unaffected biological relatives of patients with schizophrenia, but the nature and extent of the memory impairment in relatives compared to controls is unclear. We have conducted a systematic review and meta-analysis of the literature investigating declarative memory in unaffected biological relatives of schizophrenics and controls, with the aim of quantifying memory deficits in relatives. The standardised mean difference between groups was calculated for nine measures of declarative memory and two measures of intellectual ability, based on 21 studies of several hundred relatives of schizophrenics and controls. Unaffected relatives showed poorer performance relative to controls on all tests of memory examined. Small to moderate effect sizes, with overlapping 95% confidence intervals, were greatest on immediate (trial 1) list recall (0.65), followed by immediate (0.53) and delayed story recall (0.52). Verbal and general IQ showed smaller standardised mean differences as the latter tests, while the smallest standardised mean difference was shown on delayed visual recall (0.32). Results suggest greater deficits on tests of increasing memory load or which place demands on effective encoding processes but more studies with these tasks are needed. Investigation of sub-groups within these cohorts (e.g. age groups within or beyond the maximum age of risk) is recommended in order to identify deficits specific to the disease process.
Collapse
Affiliation(s)
- Marie-Claire Whyte
- Division of Psychiatry, University of Edinburgh, Kennedy Tower, Royal Edinburgh Hospital, Morningside Park, Edinburgh, EH10 5HF, UK
| | | | | | | |
Collapse
|
36
|
Sartory G, Zorn C, Groetzinger G, Windgassen K. Computerized cognitive remediation improves verbal learning and processing speed in schizophrenia. Schizophr Res 2005; 75:219-23. [PMID: 15885513 DOI: 10.1016/j.schres.2004.10.004] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Revised: 10/05/2004] [Accepted: 10/07/2004] [Indexed: 11/25/2022]
Abstract
Computerized cognitive remediation has resulted in improved executive function in schizophrenia, whereas results with regard to verbal memory were inconsistent. In the present study, 42 inpatients with schizophrenia were randomly assigned to a computerized cognitive remediation group or to a treatment-as-usual (TAU) control group. The remediation group received 15 sessions of computerized cognitive training (Cogpack) over a 3-week period. Neurocognitive functions were assessed at the beginning and end of this period. Compared to the control condition, remediation training resulted in improvements in verbal learning, processing speed and executive function (verbal fluency). The results indicate that cognitive remediation may lead to improvements beyond those of executive function.
Collapse
Affiliation(s)
- Gudrun Sartory
- Dept. Psychology, University of Wuppertal, Max-Horkheimer-Strasse 20, D-42119 Wuppertal, Germany.
| | | | | | | |
Collapse
|
37
|
Hoff AL, Svetina C, Maurizio AM, Crow TJ, Spokes K, DeLisi LE. Familial cognitive deficits in schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2005; 133B:43-9. [PMID: 15635688 DOI: 10.1002/ajmg.b.30120] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Susceptibility to schizophrenia is considered familial, but the mechanism for transmission has not been found. Since widespread cognitive deficits have been found in patients with schizophrenia, several of these have been proposed as candidate familial endophenotypes that may or may not be predictive of who develops the illness. The current study examines these candidates in individuals from 32 families with at least 2 members having the diagnosis of chronic schizophrenia and normal comparison subjects using an extensive neuropsychological battery. Consistent with previous literature, family members with schizophrenia were significantly impaired on all measures compared with controls. Well relatives demonstrated significantly worse performance on a measure of verbal learning, delayed visual recall, perceptual-motor, and pure motor speed. Expressive and receptive language, but not other functions, were highly correlated within both concordant for schizophrenia and discordant sibling pairs, suggesting that they are familial vulnerability endophenotypes, but not predictive of whom becomes ill. On the other hand, some measures of perceptual-motor, pure motor speed, and frontal/executive functioning were significantly correlated in concordant, but not discordant pairs. These latter correlations suggest that some cognitive measures may be genetically related to the illness.
Collapse
Affiliation(s)
- Anne L Hoff
- Napa State Hospital, Napa, California and Department of Psychiatry, UC Davis, USA
| | | | | | | | | | | |
Collapse
|
38
|
Sitskoorn MM, Aleman A, Ebisch SJH, Appels MCM, Kahn RS. Cognitive deficits in relatives of patients with schizophrenia: a meta-analysis. Schizophr Res 2004; 71:285-95. [PMID: 15474899 DOI: 10.1016/j.schres.2004.03.007] [Citation(s) in RCA: 286] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2004] [Revised: 03/19/2004] [Accepted: 03/20/2004] [Indexed: 11/21/2022]
Abstract
BACKGROUND Schizophrenia is characterized by a generalized cognitive impairment with pronounced deficits in the domains of verbal memory, executive functioning and attention. AIM To investigate whether cognitive deficits found in patients with schizophrenia are also found in non-affected relatives. METHOD A meta-analytic review of the published literature on cognitive performance between relatives of schizophrenic patients and healthy controls. RESULTS The meta-analyses yielded nine weighted effect sizes from 37 studies comprising 1639 relatives of schizophrenia patients and 1380 control subjects. The largest differences were found on verbal memory recall (d=0.54, 95% CI=0.43-0.66) and executive functioning (d=0.51, 0.36-0.67). Attentional functioning showed smaller effect sizes (d=0.28, 0.06-0.50). These effect sizes are in the moderate range. CONCLUSION Cognitive deficits found in patients with schizophrenia are also found in non-affected relatives. This finding is consistent with the idea that certain cognitive deficiencies in relatives are caused by familial predisposition to schizophrenia and that these deficiencies might be putative endophenotypes for schizophrenia. However, our results do not address genetic causes directly. Further work is needed to determine whether certain cognitive traits are familial and whether there is co-inheritance of these traits with schizophrenia within families.
Collapse
Affiliation(s)
- Margriet M Sitskoorn
- Rudolf Magnus Institute of Neuroscience, Department of Psychiatry (B01.206), University Medical Center Utrecht, PO Box 85500, Utrecht 3508 GA, The Netherlands.
| | | | | | | | | |
Collapse
|
39
|
Abstract
Working memory has been successively considered as a mnesic or executive process. The cognitive processes involved in working memory and the executive functions are closely linked. Most authors currently agree that executive functions include planning, attentional maintenance, mental flexibility and attentional inhibition. Considering that the role of the central administrator, the main module of the working memory model, is to manage new situations, inhibit old non-pertinent schemes, or carry out attentional control, it is clear that it involves the different executive processes mentioned above. Therefore, even though the working memory model has its origins in the classic concept of short-term memory, it is now situated at the interface between memory and executive functions. The identification of the neuroanatomical support of these processes has been widely explored for many years. The involvement of monoaminergic neurotransmitter systems, and in particular of the dopaminergic system, in these complex cognitive functions has been suggested by numerous studies, both in humans and in non-human primates.
Collapse
|
40
|
Zalla T, Joyce C, Szöke A, Schürhoff F, Pillon B, Komano O, Perez-Diaz F, Bellivier F, Alter C, Dubois B, Rouillon F, Houde O, Leboyer M. Executive dysfunctions as potential markers of familial vulnerability to bipolar disorder and schizophrenia. Psychiatry Res 2004; 121:207-17. [PMID: 14675740 DOI: 10.1016/s0165-1781(03)00252-x] [Citation(s) in RCA: 155] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Attentional and executive impairments have been found both in patients with schizophrenia and in their unaffected first-degree relatives, suggesting that they might be considered as familial vulnerability markers. Several studies have shown that the performance of bipolar patients does not significantly differ from that of schizophrenic patients, so that executive and attentional deficits might not be specific to schizophrenia. In the present study, we aimed to identify executive dysfunctions in schizophrenia and bipolar disorder that might be vulnerability trait markers specific to one or common to both of these diseases. We assessed cognitive performance of euthymic bipolar and schizophrenic patients, their unaffected first-degree relatives and a healthy control group, using neuropsychological tasks to test different components of executive function: the Verbal Fluency Test, the Stroop Word Colour Test, the Wisconsin Card Sorting Test and the Trail Making Test. The two groups of patients and their unaffected relatives demonstrated disproportionately increased slowness on the Stroop test in comparison to the normal healthy group. Patients with schizophrenia performed poorly on all the tests in comparison to the normal healthy subjects, while no other impairment was observed in the bipolar patients and in the relatives of schizophrenic and bipolar patients. Enhanced susceptibility to interference and reduced inhibition could be transnosographical markers for a shared familial vulnerability common to schizophrenia and bipolar disorders.
Collapse
|
41
|
Müller BW, Sartory G, Bender S. Neuropsychological Deficits and Concomitant Clinical Symptoms in Schizophrenia. EUROPEAN PSYCHOLOGIST 2004. [DOI: 10.1027/1016-9040.9.2.96] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The most frequently reported neuropsychological deficits in schizophrenia are those of attention, executive function, and verbal memory. Whereas the former appear to be related to negative symptoms of schizophrenia, there is little agreement about which clinical symptoms are related to the verbal memory deficit. The aim of the present study was to delineate further the pattern of neuropsychological deficits in schizophrenia—especially those of verbal memory—and their relationship to clinical symptoms. One hundred patients with chronic schizophrenia and 62 healthy control subjects took part in the study. Assessments of patients took place within the first 3 weeks after admission to hospital. Nine neuropsychological tests, mainly measuring executive and memory function and attention, were administered to all subjects, and clinical symptoms, such as psychotic and negative symptoms and conceptual disorganization, were assessed in patients by means of the Positive and Negative Syndrome Scale (PANSS). Patients showed widespread cognitive deficits with verbal memory impairment best discriminating patients and controls. Conceptual disorganization was partly accounted for by poor verbal memory and a low IQ estimate, and negative symptoms by deficient word fluency; positive symptoms were not significantly related to cognitive deficits. The results indicate that there is a specific relationship between neuropsychological deficits and the more chronic of the clinical symptoms.
Collapse
Affiliation(s)
| | - Gudrun Sartory
- Department of Psychology, University of Wuppertal, Germany
| | - Stefan Bender
- Department of Psychiatry, University Hospital Essen, Germany
| |
Collapse
|
42
|
Tabarés-Seisdedos R, Balanzá-Martinez V, Salazar-Fraile J, Selva-Vera G, Leal-Cercós C, Gómez-Beneyto M. Specific executive/attentional deficits in patients with schizophrenia or bipolar disorder who have a positive family history of psychosis. J Psychiatr Res 2003; 37:479-86. [PMID: 14563379 DOI: 10.1016/s0022-3956(03)00071-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neurocognitive impairments are well documented in patients with schizophrenia and their healthy first-degree biological relatives. Less is known about neuropsychological performance in bipolar disorders, but some studies indicate that, compared to schizophrenia, bipolar disorder displays a similar profile pattern with less severe deficits. The genetic and environmental contributions to the development of neurocognitive deficits are also unclear. This study explored the effect of a family history (FH) of psychotic disorders in first-degree relatives on a variety of cognitive domains (abstraction and flexibility, verbal fluency, verbal memory, motor activity and visual-motor processing/attention) in 30 patients with schizophrenia, and 24 type I bipolar patients. After adjusting the results for age, gender, education level and pre-morbid intelligence, patients with schizophrenia or bipolar disorder with positive FH (n=18) performed significantly worse than patients with negative FH (n=36) on the visual-motor processing/attention domain. These findings were independent of the specific diagnosis. Moreover, when logistic regression analysis was performed, poor Digit Symbol performance was the only predictor of belonging to the positive FH group. Our results are compatible with the existence of some common genetic factors between the illnesses, as well as the involvement of identical, or at least similar, disordered brain systems in both disorders. These findings are discussed within the context of the continuum model of psychosis.
Collapse
Affiliation(s)
- Rafael Tabarés-Seisdedos
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 15, 46010, Blasco Ibañez, Spain.
| | | | | | | | | | | |
Collapse
|
43
|
Appels MCM, Sitskoorn MM, Westers P, Lems E, Kahn RS. Cognitive dysfunctions in parents of schizophrenic patients parallel the deficits found in patients. Schizophr Res 2003; 63:285-93. [PMID: 12957707 DOI: 10.1016/s0920-9964(02)00342-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Schizophrenia is characterized by a global cognitive impairment, with varying degrees of deficit in all ability domains. Since genetic factors are important in the etiology of schizophrenia we investigated whether parents of schizophrenic patients also show cognitive deficits, particularly on those cognitive ability domains that are most severely affected in patients. Both biological parents of 37 patients with schizophrenia (N=74 subjects) and 28 comparable healthy married control couples (N=56 subjects) were included. A comprehensive and standardized cognitive battery was used including tests measuring verbal memory, executive functioning, language, attention, and psychomotor functioning. Parents of patients differed from control couples on those cognitive constructs that are generally considered to be most impaired in schizophrenic patients, i.e. global verbal memory, bilateral motor skill, continuous performance, and word fluency. In addition, parents differed significantly from control couples on some other cognitive constructs on which patients show a smaller but also significant difference compared to healthy controls, i.e. unilateral motor skill and digit span. Results suggest that the cognitive constructs on which patients show relatively most severe impairment may prove suitable as endophenotypic markers in schizophrenia.
Collapse
Affiliation(s)
- Melanie C M Appels
- Department of Psychiatry, University Medical Center, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | | | | | | | | |
Collapse
|
44
|
Sun Z, Wang F, Cui L, Breeze J, Du X, Wang X, Cong Z, Zhang H, Li B, Hong N, Zhang D. Abnormal anterior cingulum in patients with schizophrenia: a diffusion tensor imaging study. Neuroreport 2003; 14:1833-6. [PMID: 14534430 DOI: 10.1097/00001756-200310060-00015] [Citation(s) in RCA: 141] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Diffusion tensor imaging (DTI) can non-invasively examine the molecular diffusion of water in vivo and directly reflects the anatomical integrity of neural fibers in white matter. Fractional anisotropy (FA) can be calculated from DTI data, and utilized to evaluate white matter integrity. DTI was performed on 30 patients with schizophrenia and 19 healthy controls, and their FA values were subsequently measured in multiple brain regions. Statistical analyses revealed that FA values were decreased in the anterior cingulum of schizophrenia subjects. There were no significant differences between patients and controls in any other regions. This study supports the hypothesis that schizophrenia is associated with abnormal white matter integrity of the anterior cingulum.
Collapse
Affiliation(s)
- Zhiguo Sun
- Department of Radiology, 11 South Xizhimen St, People's Hospital, Peking University, Beijing 100044, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
|