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Mohn-Haugen CR, Mohn C, Larøi F, Teigset CM, Øie MG, Rund BR. A systematic review of premorbid cognitive functioning and its timing of onset in schizophrenia spectrum disorders. Schizophr Res Cogn 2022; 28:100246. [PMID: 35251943 PMCID: PMC8892142 DOI: 10.1016/j.scog.2022.100246] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/24/2022]
Abstract
Cognitive impairments are core features of established schizophrenia spectrum disorders (SSD). However, it remains unclear whether specific cognitive functions are differentially impaired pre-onset and at what age these impairments can be detected. The purpose of this review was to elucidate these issues through a systematic summary of results from longitudinal studies investigating impairment in specific cognitive domains as antecedents of SSD. Relevant studies were identified by electronic and manual literature searches and included any original study of cognitive domains any time pre-onset of SSDs that included a control group. Effect sizes were calculated by domain for studies comparing high-risk participants who developed SSD with those who did not. The strongest evidence for impairment pre-onset was for mental processing speed, verbal learning and memory, executive function, and social cognition. Some verbal impairments, like language abilities at age 3 and verbal learning and memory at age 7, may develop as static deficits. Conversely, some non-verbal impairments, like mental processing speed, visuospatial abilities, and visual working memory manifest as developmental lag and become significant later in life. Most effect sizes were small to moderate, except for verbal fluency (d' = 0,85), implying this impairment as central in high-risk participants who develop SSD. The present review documents extensive cognitive impairments pre-onset of SSD, and that these impairments start early in life, in line with the neurodevelopmental hypothesis of schizophrenia. Increased knowledge about cognitive impairments preonset can provide a better basis for understanding the complex pathogenesis of SSD as well as informing cognitive remediation programs.
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Affiliation(s)
- Caroline Ranem Mohn-Haugen
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
| | - Christine Mohn
- Norment Centre, Institute of Clinical Medicine, University of Oslo, P.O. box 4956, Nydalen, 0424 Oslo, Norway
| | - Frank Larøi
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, B-4000, Belgium
| | | | - Merete Glenne Øie
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
| | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway
- Department of Psychology, P. O. box 1094, Blindern, University of Oslo, 0317 Oslo, Norway
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Makowski C, Lewis JD, Lepage C, Malla AK, Joober R, Evans AC, Lepage M. Intersection of verbal memory and expressivity on cortical contrast and thickness in first episode psychosis. Psychol Med 2020; 50:1923-1936. [PMID: 31456533 DOI: 10.1017/s0033291719002071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Longitudinal studies of first episode of psychosis (FEP) patients are critical to understanding the dynamic clinical factors influencing functional outcomes; negative symptoms and verbal memory (VM) deficits are two such factors that remain a therapeutic challenge. This study uses white-gray matter contrast at the inner edge of the cortex, in addition to cortical thickness, to probe changes in microstructure and their relation with negative symptoms and possible intersections with verbal memory. METHODS T1-weighted images and clinical data were collected longitudinally for patients (N = 88) over a two-year period. Cognitive data were also collected at baseline. Relationships between baseline VM (immediate/delayed recall) and rate of change in two negative symptom dimensions, amotivation and expressivity, were assessed at the behavioral level, as well as at the level of brain structure. RESULTS VM, particularly immediate recall, was significantly and positively associated with a steeper rate of expressivity symptom decline (r = 0.32, q = 0.012). Significant interaction effects between baseline delayed recall and change in expressivity were uncovered in somatomotor regions bilaterally for both white-gray matter contrast and cortical thickness. Furthermore, interaction effects between immediate recall and change in expressivity on cortical thickness rates were uncovered across higher-order regions of the language processing network. CONCLUSIONS This study shows common neural correlates of language-related brain areas underlying expressivity and VM in FEP, suggesting deficits in these domains may be more linked to speech production rather than general cognitive capacity. Together, white-gray matter contrast and cortical thickness may optimally inform clinical investigations aiming to capture peri-cortical microstructural changes.
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Affiliation(s)
- Carolina Makowski
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
- Department of Psychiatry, McGill University, Verdun, Canada
| | - John D Lewis
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Claude Lepage
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Ashok K Malla
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
| | - Ridha Joober
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
| | - Alan C Evans
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Verdun, Canada
- Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Verdun, Canada
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Siddi S, Petretto DR, Burrai C, Scanu R, Baita A, Trincas P, Trogu E, Campus L, Contu A, Preti A. The role of set-shifting in auditory verbal hallucinations. Compr Psychiatry 2017; 74:162-172. [PMID: 28167329 DOI: 10.1016/j.comppsych.2017.01.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/05/2016] [Accepted: 01/16/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are a cardinal characteristic of psychosis. Recent research on the neuropsychological mechanism of AVHs has focused on source monitoring failure, but a few studies have suggested the involvement of attention, working memory, processing speed, verbal learning, memory, and executive functions. In this study we examined the neuropsychological profile of patients with AVHs, assuming that the mechanism underlying this symptom could be a dysfunction of specific cognitive domains. METHODS A large neuropsychological battery including set-shifting, working memory, processing speed, attention, fluency, verbal learning and memory, and executive functions was administered to 90 patients with psychotic disorders and 44 healthy controls. The group of patients was divided into two groups: 46 patients with AVHs in the current episode and 44 who denied auditory hallucinations or other modalities in the current episode. AVHs were assessed with the Psychotic Symptom Rating Scales (PSYRATS); the Launay-Slade Hallucination Scale was used to measure long-term propensity to auditory verbal hallucination-like experiences (HLEs) in the sample. RESULTS Patients showed poorer performances on all neuropsychological measures compared to the healthy controls' group. In the original dataset without missing data (n=58), patients with AVHs (n=29) presented poorer set shifting and verbal learning, higher levels of visual attention, and marginally significant poorer semantic fluency compared to patients without AVHs (n=29). In the logistic model on the multiple imputed dataset (n=90, 100 imputed datasets), lower capacity of set shifting and semantic fluency distinguished patients with AVHs from those without them. CONCLUSIONS Patients experiencing persistent AVHs might fail to shift their attention away from the voices; poorer semantic fluency could be a secondary deficit of set-shifting failure.
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Affiliation(s)
- Sara Siddi
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Research and Development Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Faculty of Medicine, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Donatella Rita Petretto
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Caterina Burrai
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Rosanna Scanu
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy
| | - Antonella Baita
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Pierfranco Trincas
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Emanuela Trogu
- Psychiatric Diagnosis and Treatment Service II, Department of Mental Health, ASL Cagliari, Cagliary, Italy
| | - Liliana Campus
- Psychiatric Diagnosis and Treatment Service I, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Augusto Contu
- Head, Department of Mental Health, ASL Cagliari, Cagliari, Italy
| | - Antonio Preti
- Section of Clinical Psychology, Department of Education, Psychology, and Philosophy, University of Cagliari, Italy; Genneruxi Medical Center, Cagliari, Italy
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