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Chu AOK, Chang WC, Chan SKW, Lee EHM, Hui CLM, Chen EYH. Comparison of cognitive functions between first-episode schizophrenia patients, their unaffected siblings and individuals at clinical high-risk for psychosis. Psychol Med 2019; 49:1929-1936. [PMID: 30226125 DOI: 10.1017/s0033291718002726] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cognitive impairment is a core feature of schizophrenia and has been observed in both familial (FHR) and clinical high-risk (CHR) samples. Nonetheless, there is a paucity of research directly contrasting cognitive profiles in these two high-risk states and first-episode schizophrenia. This study aimed to compare cognitive functions in patients with first-episode schizophrenia-spectrum disorder (FES), their unaffected siblings (FHR), CHR individuals and healthy controls. METHOD A standardized battery of cognitive assessments was administered to 69 FES patients, 71 help-seeking CHR individuals without family history of psychotic disorder, 50 FHR participants and 68 controls. FES and CHR participants were recruited from territory-wide early intervention service for psychosis in Hong Kong. CHR status was ascertained using Comprehensive Assessment of At-Risk Mental State. RESULTS Among four groups, FES patients displayed the largest global cognitive impairment and had medium-to-large deficits across all cognitive tests relative to controls. CHR and FHR participants significantly underperformed in most cognitive tests than controls. Among various cognitive tests, digit symbol coding demonstrated the greatest magnitude of impairment in FES and CHR groups compared with controls. No significant difference between two high-risk groups was observed in global cognition and all individual cognitive tests except digit symbol coding which showed greater deficits in CHR than in FHR participants. CONCLUSION Clinical and familial risk groups experienced largely comparable cognitive impairment that was intermediate between FES and controls. Digit symbol coding may have the greatest discriminant capacity in distinguishing FES and CHR from healthy controls, and between two high-risk samples.
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Miettunen J, Haapea M, Björnholm L, Huhtaniska S, Juola T, Kinnunen L, Lehtiniemi H, Lieslehto J, Rautio N, Nordström T. Psychiatric research in the Northern Finland Birth Cohort 1986 - a systematic review. Int J Circumpolar Health 2019; 78:1571382. [PMID: 30744507 PMCID: PMC6374936 DOI: 10.1080/22423982.2019.1571382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The Northern Finland Birth Cohort 1986 is a large population-based birth cohort, which aims to promote health and wellbeing of the population. In this paper, we systematically review the psychiatric research performed in the cohort until today, i.e. at the age of 32 years of the cohort (2018). We conducted a systematic literature search using the databases of PubMed and Scopus and complemented it with a manual search. We found a total of 94 articles, which were classified as examining ADHD, emotional and behavioural problems, psychosis risk or other studies relating to psychiatric subjects. The articles are mainly based on two large comprehensive follow-up studies of the cohort and several substudies. The studies have often used also nationwide register data. The studies have found several early predictors for the aforementioned psychiatric outcomes, such as problems at pregnancy and birth, family factors in childhood, physical inactivity and substance use in adolescence. There are also novel findings relating to brain imaging and cognition, for instance regarding familial risk of psychosis in relation to resting state functional MRI. The Northern Finland Birth Cohort 1986 has been utilised frequently in psychiatric research and future data collections are likely to lead to new scientifically important findings. Abbreviations: attention deficit hyperactivity disorder (ADHD); magnetic resonance imaging (MRI)
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Affiliation(s)
- Jouko Miettunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Marianne Haapea
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,c Department of Psychiatry , Oulu University Hospital , Oulu , Finland
| | - Lassi Björnholm
- c Department of Psychiatry , Oulu University Hospital , Oulu , Finland.,d Department of Psychiatry , Research Unit of Clinical Neuroscience, University of Oulu , Oulu , Finland
| | - Sanna Huhtaniska
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Teija Juola
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland
| | - Lotta Kinnunen
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Heli Lehtiniemi
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
| | - Johannes Lieslehto
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Nina Rautio
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland
| | - Tanja Nordström
- a Center for Life Course Health Research , University of Oulu , Oulu , Finland.,b Medical Research Center Oulu , Oulu University Hospital and University of Oulu , Oulu , Finland.,e Northern Finland Birth Cohorts, Faculty of Medicine , University of Oulu , Oulu , Finland
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Koivukangas J, Björnholm L, Tervonen O, Miettunen J, Nordström T, Kiviniemi V, Mäki P, Mukkala S, Moilanen I, Barnett JH, Jones PB, Nikkinen J, Veijola J. Body mass index and brain white matter structure in young adults at risk for psychosis - The Oulu Brain and Mind Study. Psychiatry Res Neuroimaging 2016; 254:169-176. [PMID: 27474847 DOI: 10.1016/j.pscychresns.2016.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/09/2016] [Accepted: 06/30/2016] [Indexed: 11/28/2022]
Abstract
Antipsychotic medications and psychotic illness related factors may affect both weight and brain structure in people with psychosis. Genetically high-risk individuals offer an opportunity to study the relationship between body mass index (BMI) and brain structure free from these potential confounds. We examined the effect of BMI on white matter (WM) microstructure in subjects with familial risk for psychosis (FR). We used diffusion tensor imaging and tract-based spatial statistics to explore the effect of BMI on whole brain FA in 42 (13 males) participants with FR and 46 (16 males) control participants aged 20-25 years drawn from general population-based Northern Finland Birth Cohort 1986. We also measured axial, radial and mean diffusivities. Most of the participants were normal weight rather than obese. In the FR group, decrease in fractional anisotropy and increase in radial diffusivity were associated with an increase in BMI in several brain areas. In controls the opposite pattern was seen in participants with higher BMI. There was a statistically significant interaction between group and BMI on FA and radial and mean diffusivities. Our results suggest that the effect of BMI on WM differs between individuals with FR for psychosis and controls.
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Affiliation(s)
- Jenni Koivukangas
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Aurora Doctoral Program, University of Oulu, Oulu, Finland.
| | - Lassi Björnholm
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Osmo Tervonen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Tanja Nordström
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Department of Psychiatry, Länsi-Pohja Healthcare District, Finland; Department of Psychiatry, Middle Ostrobothnia Central Hospital, Kiuru, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland; Mental Health Services, Basic Health Care District of Kallio, Finland; Visala Hospital, Northern Ostrobothnia Hospital District, Finland
| | - Sari Mukkala
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Irma Moilanen
- Aurora Doctoral Program, University of Oulu, Oulu, Finland; Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland; PEDEGO Research Center, and Medical Research Center Oulu, University of Oulu, Finland
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge Cognition, Cambridge, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Juha Nikkinen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Oncology and Radiotherapy, Oulu University Hospital, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Aurora Doctoral Program, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Hou CL, Xiang YT, Wang ZL, Everall I, Tang Y, Yang C, Xu MZ, Correll CU, Jia FJ. Cognitive functioning in individuals at ultra-high risk for psychosis, first-degree relatives of patients with psychosis and patients with first-episode schizophrenia. Schizophr Res 2016; 174:71-76. [PMID: 27197904 DOI: 10.1016/j.schres.2016.04.034] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 04/20/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate and compare cognitive functioning of first-degree relatives of people with schizophrenia who were also at ultra-high risk (UHR) for psychosis with patients with first-episode (FE) schizophrenia, first degree relatives of patients not fulfilling UHR criteria (FDR), and healthy control (HC) subjects. METHOD Forty subjects in each group were included, underwent a face-to-face interview and completed a neurocognitive test battery, including the Trail Making Test-A (TMT-A, psychomotor functions), Stroop Color Word Test (attention), Digit Symbol Coding Test (DST, processing speed and working memory) and Hopkins Verbal Leaning Test-Revised (HVLT-R, verbal memory). RESULTS Functioning in all the cognitive test domains displayed a gradual decrease from the HC, FDR, UHR to FE groups. After controlling for covariates, there were still significant differences in TMT-A (F(7160)=35.4, P<0.001), DST (F(7160)=38.9, P<0.001), Stroop Color Word Test (F(7160)=35.0, P<0.001), Stroop Word Test (F(7160)=36.2, P<0.001), Stroop Color Test (F(7160)=40.9, P<0.001) and HVLT-R (F(7160)=62.5, P<0.001) between the four groups, indicating that the cognitive functioning in the UHR group was intermediate between the FE and FDR groups, while the FDR group had poorer performance than the HC group, and the FE group had the poorest cognitive functioning across all four examined domains. CONCLUSION The results indicate that impairments in processing speed, attention, working memory and verbal memory exist in both UHR and FDR subjects. In order to clarify the associations between cognitive functioning and UHR and schizophrenia, longitudinal studies are warranted.
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Affiliation(s)
- Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China.
| | - Zhong-Lei Wang
- Shenzhen Key Laboratory for Psychological Healthcare, Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Ian Everall
- Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Yi Tang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Chengjia Yang
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Ming-Zhi Xu
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China
| | - Christoph U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Province, China.
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Jukuri T, Kiviniemi V, Nikkinen J, Miettunen J, Mäki P, Mukkala S, Koivukangas J, Nordström T, Moilanen I, Barnett JH, Jones PB, Murray GK, Veijola J. Cerebellar activity in young people with familial risk for psychosis--The Oulu Brain and Mind Study. Schizophr Res 2015; 169:46-53. [PMID: 26527249 DOI: 10.1016/j.schres.2015.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 09/30/2015] [Accepted: 10/06/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The cerebellum plays a critical role in cognition and behavior. Altered function of the cerebellum has been related to schizophrenia and psychosis but it is not known how this applies to spontaneous resting state activity in young people with familial risk for psychosis. METHODS We conducted resting-state functional MRI (R-fMRI) in 72 (29 male) young adults with a history of psychosis in one or both parents (FR) but without their own psychosis, and 72 (29 male) similarly healthy control subjects without parental psychosis. Both groups in the Oulu Brain and Mind Study were drawn from the Northern Finland Birth Cohort 1986. Participants were 20-25 years old. Parental psychosis was established using the Care Register for Health Care. R-fMRI data pre-processing was conducted using independent component analysis with 30 and 70 components. A dual regression technique was used to detect between-group differences in the cerebellum with p<0.05 threshold corrected for multiple comparisons. RESULTS FR participants demonstrated statistically significantly increased activity compared to control subjects in the anterior lobe of the right cerebellum in the analysis with 70 components. The volume of the increased activity was 73 mm(3). There was no difference between the groups in the analysis with 30 components. CONCLUSION The finding suggests that increased activity of the anterior lobe of the right cerebellum may be associated with increased vulnerability to psychosis. The finding is novel, and needs replication to be confirmed.
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Affiliation(s)
- Tuomas Jukuri
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Thule Doctoral Programme, University of Oulu, Finland.
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, MIPT, Oulu University Hospital, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Juha Nikkinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Oncology and Radiotherapy, Oulu University Hospital, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Psychiatry, Länsi-Pohja Healthcare District, Finland; Department of Psychiatry, The Middle Ostrobothnia Central Hospital, Kiuru, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland; Mental Health Services, Basic Health Care District of Kallio, Finland; Visala Hospital, The Northern Ostrobothnia Hospital District, Finland
| | - Sari Mukkala
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| | - Jenni Koivukangas
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Thule Doctoral Programme, University of Oulu, Finland
| | - Tanja Nordström
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Finland
| | - Irma Moilanen
- Thule Doctoral Programme, University of Oulu, Finland; Department of Child Psychiatry, Oulu University Hospital and University of Oulu, Finland
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK; Cambridge Cognition, Cambridge, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Thule Doctoral Programme, University of Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
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White matter structure in young adults with familial risk for psychosis - The Oulu Brain and Mind Study. Psychiatry Res 2015; 233:388-93. [PMID: 26231121 DOI: 10.1016/j.pscychresns.2015.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/21/2015] [Accepted: 06/27/2015] [Indexed: 01/05/2023]
Abstract
According to the disconnectivity model, disruptions in neural connectivity play an essential role in the pathology of schizophrenia. The aim of this study was to determine whether these abnormalities are present in young adults with familial risk (FR) for psychosis in the general population based sample. We used diffusion tensor imaging (DTI) and tract-based spatial statistics to compare whole-brain fractional anisotropy, mean diffusivity, and axial and radial diffusion in 47 (17 males) FR subjects to 51 controls (17 males). All the participants were aged between 20 and 25 years and were members of the Northern Finland Birth Cohort 1986 (Oulu Brain and Mind Study). Region of interest analyses were conducted for 12 tracts. Separately, we analysed whole-brain FA for the subgroup with FR for schizophrenia (n=13) compared with 13 gender-matched controls. Contrary to our expectations there were no differences in any of the DTI measures between FR and control groups. This suggests that white matter abnormalities may not be a genetic feature for risk of psychosis and preceding the onset of a psychotic disorder. Our findings do not support the theory of disconnectivity as a primary sign of psychosis in young adults with FR for the illness.
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Ramsay H, Barnett JH, Miettunen J, Mukkala S, Mäki P, Liuhanen J, Murray GK, Jarvelin MR, Ollila H, Paunio T, Veijola J. Association between Dopamine Receptor D2 (DRD2) Variations rs6277 and rs1800497 and Cognitive Performance According to Risk Type for Psychosis: A Nested Case Control Study in a Finnish Population Sample. PLoS One 2015; 10:e0127602. [PMID: 26114663 PMCID: PMC4482687 DOI: 10.1371/journal.pone.0127602] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 04/16/2015] [Indexed: 01/21/2023] Open
Abstract
Background There is limited research regarding the association between genes and cognitive intermediate phenotypes in those at risk for psychotic disorders. Methods We measured the association between established psychosis risk variants in dopamine D2 receptor (DRD2) and cognitive performance in individuals at age 23 years and explored if associations between cognition and these variants differed according to the presence of familial or clinical risk for psychosis. The subjects of the Oulu Brain and Mind Study were drawn from the general population-based Northern Finland 1986 Birth Cohort (NFBC 1986). Using linear regression, we compared the associations between cognitive performance and two candidate DRD2 polymorphisms (rs6277 and rs1800497) between subjects having familial (n=61) and clinical (n=45) risk for psychosis and a random sample of participating NFBC 1986 controls (n=74). Cognitive performance was evaluated using a comprehensive battery of tests at follow-up. Results Principal components factor analysis supported a three-factor model for cognitive measures. The minor allele of rs6277 was associated with poorer performance on a verbal factor (p=0.003) but this did not significantly interact with familial or clinical risk for psychosis. The minor allele of rs1800497 was associated with poorer performance on a psychomotor factor (p=0.038), though only in those at familial risk for psychotic disorders (interaction p=0.049). Conclusion The effect of two DRD2 SNPs on cognitive performance may differ according to risk type for psychosis, suggesting that cognitive intermediate phenotypes differ according to the type (familial or clinical) risk for psychosis.
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Affiliation(s)
- Hugh Ramsay
- Department of Psychiatry, Centre for Clinical Neuroscience, University of Oulu, Oulu, Finland
- Health Service Executive, Dublin, Ireland
- * E-mail:
| | - Jennifer H. Barnett
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Cambridge Cognition Ltd., Bottisham, Cambridge, United Kingdom
| | - Jouko Miettunen
- Department of Psychiatry, Centre for Clinical Neuroscience, University of Oulu, Oulu, Finland
- Institute of Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Sari Mukkala
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Centre for Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
- Department of Psychiatry, Länsi-Pohja healthcare district, Finland
- Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Kiuru, Finland
- Mental health services, Joint Municipal Authority of Wellbeing in Raahe District, Finland
- Mental health services, Basic Health Care District of Kallio, Finland
- Visala Hospital, the Northern Ostrobothnia Hospital District, Finland
| | - Johanna Liuhanen
- Public Health Genomics Unit, National Institute for Health and Welfare and Institute for Molecular Medicine, Helsinki, Finland
| | - Graham K. Murray
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Marjo-Riitta Jarvelin
- Department of Public Health Science and General Practice, Institute of Health Sciences, University of Oulu, Oulu, Finland
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Hanna Ollila
- Public Health Genomics Unit, National Institute for Health and Welfare and Institute for Molecular Medicine, Helsinki, Finland
| | - Tiina Paunio
- Public Health Genomics Unit, National Institute for Health and Welfare and Institute for Molecular Medicine, Helsinki, Finland
- Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Veijola
- Department of Psychiatry, Centre for Clinical Neuroscience, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Pulkkinen J, Nikkinen J, Kiviniemi V, Mäki P, Miettunen J, Koivukangas J, Mukkala S, Nordström T, Barnett JH, Jones PB, Moilanen I, Murray GK, Veijola J. Functional mapping of dynamic happy and fearful facial expressions in young adults with familial risk for psychosis - Oulu Brain and Mind Study. Schizophr Res 2015; 164:242-9. [PMID: 25703807 DOI: 10.1016/j.schres.2015.01.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 01/26/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Social interaction requires mirroring to other people's mental state. Psychotic disorders have been connected to social interaction and emotion recognition impairment. We compared the brain activity between young adults with familial risk for psychosis (FR) and matched controls during visual exposure to emotional facial expression. We also investigated the role of the amygdala, the key region for social interaction and emotion recognition. METHODS 51 FR and 52 control subjects were drawn from the Northern Finland 1986 Birth Cohort (Oulu Brain and Mind Study). None of the included participants had developed psychosis. The FR group was defined as having a parent with psychotic disorder according to the Finnish Hospital Discharge Register. Participants underwent functional MRI (fMRI) using visual presentation of dynamic happy and fearful facial expressions. FMRI data were processed to produce maps of activation for happy and fearful facial expression, which were then compared between groups. Two spherical regions of interest (ROIs) in the amygdala were set to extract BOLD responses during happy and fearful facial expression. BOLD responses were then compared with subjects' emotion recognition, which was assessed after fMRI. Psychophysiological interaction (PPI) for the left and right amygdala during happy and fearful facial expression was conducted using the amygdala as seed regions. RESULTS FR subjects had increased activity in the left premotor cortex and reduced deactivation of medial prefrontal cortex structures during happy facial expression. There were no between-group differences during fearful facial expression. The FR group also showed a statistically significant linear correlation between mean amygdala BOLD response and facial expression recognition. PPI showed that there was a significant negative interaction between the amygdala and the dorsolateral prefrontal cortex (dlPFC) and superior temporal gyrus in FR subjects. CONCLUSIONS Increased activations by positive valence in FR were in brain regions crucial to emotion recognition and social interaction. Increased activation of the premotor cortex may serve as a compensatory mechanism as FR subjects may have to exert more effort on processing the stimuli, as has been found earlier in schizophrenia. Failure to deactivate PFC structures may imply error in the default mode network. Abnormal PFC function in FR was also suggested by PPI, as the dlPFC showed decreased functional connectivity with the amygdala in the FR group. This may indicate that in FR subjects the amygdala have to take a greater role in emotion recognition and social functioning. This inference was supported by our discovery of statistically significant correlations between the amygdala BOLD response and emotion recognition in the FR group but not in controls.
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Affiliation(s)
- Johannes Pulkkinen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - Juha Nikkinen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland; Department of Oncology and Radiotherapy, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Department of Psychiatry, Länsi-Pohja Healthcare District, Finland; Department of Psychiatry, The Middle Ostrobothnia Central Hospital, Kiuru, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland; Mental Health Services, Basic Health Care District of Kallio, Finland; Visala Hospital, The Northern Ostrobothnia Hospital District, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland; Department of Child Psychiatry, Institute of Clinical Medicine, University and University Hospital of Oulu, Oulu, Finland
| | - Jenni Koivukangas
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland
| | - Sari Mukkala
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Child Psychiatry, Institute of Clinical Medicine, University and University Hospital of Oulu, Oulu, Finland
| | - Tanja Nordström
- Institute of Health Sciences, University of Oulu, Oulu, Finland
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge Cognition, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Irma Moilanen
- Department of Child Psychiatry, Institute of Clinical Medicine, University and University Hospital of Oulu, Oulu, Finland
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Juha Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
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9
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Jukuri T, Kiviniemi V, Nikkinen J, Miettunen J, Mäki P, Mukkala S, Koivukangas J, Nordström T, Parkkisenniemi J, Moilanen I, Barnett JH, Jones PB, Murray GK, Veijola J. Central executive network in young people with familial risk for psychosis--the Oulu Brain and Mind Study. Schizophr Res 2015; 161:177-83. [PMID: 25468181 DOI: 10.1016/j.schres.2014.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The central executive network controls and manages high-level cognitive functions. Abnormal activation in the central executive network has been related to psychosis and schizophrenia but it is not established how this applies to people with familial risk for psychosis (FR). METHODS We conducted a resting-state functional MRI (R-fMRI) in 72 (29 males) young adults with a history of psychosis in one or both parents (FR) but without psychosis themselves, and 72 (29 males) similarly healthy control subjects without parental psychosis. Both groups in the Oulu Brain and Mind Study were drawn from the Northern Finland Birth Cohort 1986. Participants were 20-25years old. Parental psychosis was established using the Care Register for Health Care. R-fMRI data pre-processing was conducted using independent component analysis with 30 and 70 components. A dual regression technique was used to detect between-group differences in the central executive network with p<0.05 threshold corrected for multiple comparisons. RESULTS FR participants demonstrated statistically significantly lower activity compared to control subjects in the right inferior frontal gyrus, a key area of central executive network corresponding to Brodmann areas 44 and 45, known as Broca's area. The volume of the lower activation area with 30 components was 896mm(3) and with 70 components was 1151mm(3). CONCLUSION The activity of the central executive network differed in the right inferior frontal gyrus between FR and control groups. This suggests that abnormality of the right inferior frontal gyrus may be a central part of vulnerability for psychosis.
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Affiliation(s)
- Tuomas Jukuri
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Thule Doctoral Programme, University of Oulu, Finland.
| | - Vesa Kiviniemi
- Department of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Juha Nikkinen
- Department of Oncology and Radiotherapy, Oulu University Hospital, Finland
| | - Jouko Miettunen
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Institute of Health Sciences, University of Oulu, Finland
| | - Pirjo Mäki
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Department of Psychiatry, Länsi-Pohja Healthcare District, Finland; Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Kiuru, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland; Mental Health Services, Basic Health Care District of Kallio, Finland; Visala Hospital, the Northern Ostrobothnia Hospital District, Finland
| | - Sari Mukkala
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland
| | - Jenni Koivukangas
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Thule Doctoral Programme, University of Oulu, Finland
| | - Tanja Nordström
- Thule Doctoral Programme, University of Oulu, Finland; Institute of Health Sciences, University of Oulu, Finland
| | - Juha Parkkisenniemi
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland
| | - Irma Moilanen
- Thule Doctoral Programme, University of Oulu, Finland; Clinic of Child Psychiatry, University of Oulu and Oulu University Hospital, Finland
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK; Cambridge Cognition, Cambridge, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridgeshire, UK
| | - Juha Veijola
- Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Finland; Thule Doctoral Programme, University of Oulu, Finland
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10
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Bora E, Lin A, Wood SJ, Yung AR, McGorry PD, Pantelis C. Cognitive deficits in youth with familial and clinical high risk to psychosis: a systematic review and meta-analysis. Acta Psychiatr Scand 2014; 130:1-15. [PMID: 24611632 DOI: 10.1111/acps.12261] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It is likely that cognitive deficits are vulnerability markers for developing schizophrenia, as these deficits are already well-established findings in first-episode psychosis. Studies at-risk adolescents and young adults are likely to provide information about cognitive deficits that predate the onset of the illness. METHOD We conducted meta-analyses of studies comparing familial-high risk (FHR) or ultra-high risk (UHR; n = 2113) and healthy controls (n = 1748) in youth studies in which the mean age was between 15 and 29. RESULTS Compared with controls, high risk subjects were impaired in each domain in both UHR (d = 0.34-0.71) and FHR (d = 0.24-0.81). Heterogeneity of effect sizes across studies was modest, increasing confidence to the findings of the current meta-analysis (I(2) = 0-0.18%). In both risk paradigms, co-occurrence of genetic risk with attenuated symptoms was associated with more severe cognitive dysfunction. In UHR, later transition to psychosis was associated with more severe cognitive deficits in all domains (d = 0.31-0.49) except sustained attention. However, cognitive impairment has a limited capacity to predict the outcome of high-risk patients. CONCLUSION Cognitive deficits are already evident in adolescents and young adults who have familial or clinical risk for psychosis. Longitudinal developmental studies are important to reveal timing and trajectory of emergence of such deficits.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, Melbourne, Vic., Australia
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11
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Mukkala S, Ilonen T, Koskela J, Nordström T, Loukkola J, Miettunen J, Barnett JH, Murray GK, Jones PB, Heinimaa M, Jääskeläinen E, Mäki P, Moilanen I, Veijola J. Response initiation in young adults at risk for psychosis in the Northern Finland 1986 Birth Cohort. Cogn Neuropsychiatry 2014; 19:226-40. [PMID: 24131203 DOI: 10.1080/13546805.2013.840569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION This is one of the very few studies to investigate the specific executive function/processing speed component of response initiation in subjects at familial risk (FR) for psychosis, and the first such study in subjects at clinical risk (CR) for psychosis. METHODS Participants (N = 177) were members of the general population-based Northern Finland 1986 Birth Cohort in the following four groups: FR for psychosis (n = 62), CR for psychosis (n = 21), psychosis (n = 25) and control subjects (n = 69). The response initiation of these groups was compared in three different tests: Semantic fluency, Stockings of Cambridge and Spatial working memory. RESULTS The two risk groups did not differ significantly from control group, but differed from, and outperformed the psychosis group in semantic fluency response initiation. CONCLUSIONS Response initiation deficits were not evident in a non-help seeking psychosis high-risk sample.
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Affiliation(s)
- S Mukkala
- a Department of Psychiatry , Institute of Clinical Medicine, University of Oulu , Oulu , Finland
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12
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Dickson H, Cullen AE, Reichenberg A, Hodgins S, Campbell DD, Morris RG, Laurens KR. Cognitive impairment among children at-risk for schizophrenia. J Psychiatr Res 2014; 50:92-9. [PMID: 24373930 DOI: 10.1016/j.jpsychires.2013.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 09/13/2013] [Accepted: 12/03/2013] [Indexed: 11/17/2022]
Abstract
Adults with schizophrenia present cognitive impairments, as do individuals at ultra-high risk for the disorder, youth with relatives with schizophrenia spectrum disorders, and children with antecedents of schizophrenia. The present study aimed to determine if impairments in childhood differed depending on the definition of risk and/or on the degree of relatedness to an affected individual, and if impairments were explained by IQ. Four groups of children aged 9-12 years were studied: (1) 13 children with ≥1 first-degree or ≥2 second-degree affected relatives (high familial loading: FHx(H)); (2) 14 with ≥1 affected second-degree relative (lower familial loading: FHx(L)); (3) 32 with well-replicated antecedents of schizophrenia (ASz); and (4) 45 typically-developing (TD) children with neither a positive family history nor antecedents. Compared to TD children, both FHx(H) and ASz children exhibited significantly poorer verbal comprehension, scholastic achievement, and verbal working memory, while FHx(H) children additionally displayed significantly lower full-scale IQ, and verbal memory and executive function impairments. After adjusting statistical analyses for IQ, group differences were attenuated. Relative to TD children, FHx(L) children showed no significant differences in performance. The results imply that impairments in verbal comprehension, scholastic achievement, and verbal working memory may index vulnerability for schizophrenia among children with affected relatives with the disorder and among those with multiple antecedents of the disorder who have no affected relatives. More accurate identification of children at-risk for schizophrenia and the specific deficits that they present provides opportunities for interventions such as cognitive remediation that may impact the development of the illness.
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Affiliation(s)
- Hannah Dickson
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom.
| | - Alexis E Cullen
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, United Kingdom; Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, NY, USA; Department of Preventive Medicine, Ichan School of Medicine at Mount Sinai, New York, NY, USA; Freidman Brain Institute, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheilagh Hodgins
- Département de Psychiatrie, Université de Montréal, Montréal, Canada
| | | | - Robin G Morris
- Department of Psychology, Institute of Psychiatry, Kings College London, United Kingdom
| | - Kristin R Laurens
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, United Kingdom; Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia; Schizophrenia Research Institute, Sydney, Australia.
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13
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Roman-Urrestarazu A, Murray GK, Barnes A, Miettunen J, Jääskeläinen E, Mäki P, Nikkinen J, Remes J, Mukkala S, Koivukangas J, Heinimaa M, Moilanen I, Suckling J, Kiviniemi V, Jones PB, Veijola J. Brain structure in different psychosis risk groups in the Northern Finland 1986 birth cohort. Schizophr Res 2014; 153:143-9. [PMID: 24462264 DOI: 10.1016/j.schres.2013.12.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 12/01/2013] [Accepted: 12/27/2013] [Indexed: 10/25/2022]
Abstract
We tested the hypothesis that family risk for psychosis (FR) and clinical risk for psychosis (CR) are associated with structural brain abnormalities, with increased deficits in those at both family risk and clinical risk for psychosis (FRCR). The study setting was the Oulu Brain and Mind Study, with subjects drawn from the Northern Finland 1986 Birth Cohort (n=9479) using register and questionnaire based screening, and interviews using the Structured Interview for Prodromal Symptoms. After this procedure, 172 subjects were included in the study, classified as controls (n=73) and three risk groups: FR excluding CR (FR, n=60), CR without FR (CR, n=26), and individuals at both FR and CR (FRCR, n=13). T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. In the comparison between FRCR versus controls, we found lower grey matter volume (GMV) in a cluster (1689 voxels at -4.00, -72.00, -18.00mm) covering both cerebellar hemispheres and the vermis. This cluster was subsequently used as a mask to extract mean GMV in all four groups: FR had a volume intermediate between controls and FRCR. Within FRCR there was an association between cerebellar cluster brain volume and motor function. These findings are consistent with an evolving pattern of cerebellar deficits in psychosis risk with the most pronounced deficits in those at highest risk of psychosis.
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Affiliation(s)
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.
| | - Anna Barnes
- Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - Jouko Miettunen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland; Institute of Health Sciences, Department of Public Health Sciences and General Practice, University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Pirjo Mäki
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Juha Nikkinen
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jukka Remes
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Sari Mukkala
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jenni Koivukangas
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Heinimaa
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Irma Moilanen
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland; Institute of Clinical Medicine, Clinic of Child Psychiatry, University of Oulu, Oulu, Finland
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Vesa Kiviniemi
- Institute of Diagnostics, Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Juha Veijola
- Institute of Clinical Medicine, Department of Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
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Üçok A, Direk N, Koyuncu A, Keskin-Ergen Y, Yüksel Ç, Güler J, Karadayı G, Akturan E, Devrim-Üçok M. Cognitive deficits in clinical and familial high risk groups for psychosis are common as in first episode schizophrenia. Schizophr Res 2013; 151:265-9. [PMID: 24262680 DOI: 10.1016/j.schres.2013.10.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/23/2013] [Accepted: 10/25/2013] [Indexed: 01/03/2023]
Abstract
The aim of this study is to compare the neurocognitive functions in individuals with clinical or genetic risk for psychosis, in patients with first-episode schizophrenia (FES) and in healthy controls. We compared cognitive functions of 52 individuals at ultra high risk (UHR) for psychosis, 53 patients with FES, their 30 healthy siblings (familial high risk group, FHR) and controls. FES group had worse neuropsychological performance than controls in all of the domains. UHR group had worse performance in verbal learning, attention, and working memory than controls. Additionally, individuals at UHR with familial risk had worse performance on executive functions than the control group. FES group had lower global composite score than UHR group, and worse sustained attention than FHR group. FHR group had worse performance on executive functions and attention than controls. We found no difference in cognitive performances of UHR and FHR groups. Cognitive deficits in UHR and FHR groups were largely similar to those with FES. These findings support that cognitive deficits may arise before the first episode of schizophrenia.
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Affiliation(s)
- Alp Üçok
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul, Turkey.
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15
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Kelleher I, Murtagh A, Clarke MC, Murphy J, Rawdon C, Cannon M. Neurocognitive performance of a community-based sample of young people at putative ultra high risk for psychosis: support for the processing speed hypothesis. Cogn Neuropsychiatry 2013; 18:9-25. [PMID: 22991935 DOI: 10.1080/13546805.2012.682363] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION A wide variety of neurocognitive deficits have been reported for help-seeking individuals who are at clinical or ultra high risk for psychosis based on fulfilling set criteria for prodromal syndromes/at risk mental states. We wished to extend this research by conducting the first population-based assessment of prodromal syndromes and associated neurocognition. METHODS A sample of 212 school-based adolescents were assessed for prodromal syndromes using the criteria of prodromal syndromes from the Structured Interview for Prodromal Syndromes. The MATRICS consensus neurocognitive battery was used to assess cognitive functioning in this sample. RESULTS A total of 8% of the population sample of adolescents met criteria for a prodromal syndrome. These adolescents performed significantly more poorly than controls on two tests of processing speed-Trail-Making Test Part A, F=4.54, p < .01, and the Brief Assessment of Cognition in Schizophrenia Symbol Coding task, F=8.26, p < .0001-and on a test of nonverbal working memory-the Wechsler Memory Scale Spatial Span task, F=3.29, p < .05. CONCLUSIONS Adolescents in the community who fulfil criteria for prodromal syndromes demonstrate deficits on a number of neurocognitive tasks. Deficits are particularly pronounced in symbol coding performance, supporting processing speed as a central deficit associated with psychosis risk.
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Affiliation(s)
- Ian Kelleher
- Royal College of Surgeons in Ireland, Department of Psychiatry, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
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16
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Default mode network in young people with familial risk for psychosis--the Oulu Brain and Mind study. Schizophr Res 2013; 143:239-45. [PMID: 23245776 DOI: 10.1016/j.schres.2012.11.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 11/03/2012] [Accepted: 11/19/2012] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The default mode network (DMN) is active in the brain at rest and de-activated during cognitive tasks. Abnormal function in the DMN has been reported in people with schizophrenia but it is not known whether this applies also to people with a familial risk for psychosis (FR). We compared the activity of the DMN between FR participants and controls. METHODS We conducted a resting state functional MRI (R-fMRI) in 72 young adults without psychosis and with a history of psychosis in one or both parents (FR group) and 72 age matched controls without parental psychosis, and without current psychosis or a current prodromal syndrome. Both groups were drawn from the Northern Finland Birth Cohort 1986 (Oulu Brain and Mind study). Parental psychosis was established using the Finnish hospital discharge register. We pre-processed R-fMRI data using independent component analysis followed by a dual regression approach to assess differences between the groups. The FR vs. Control group differences were assessed using non-parametric permutation tests utilizing threshold-free cluster enhancement and correcting for multiple comparisons (p<0.05). RESULTS FR participants demonstrated significantly lower activity compared with controls in the posterior cingulate cortex, the central node of the DMN. The size of the region was 41 mm(3). CONCLUSION The activity of the DMN differed between FR and control groups. This suggests that familial risk for psychotic disorders may be mediated through genetic effects on connectivity in the posterior cingulate cortex.
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