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Malykhin N, Pietrasik W, Hoang KN, Huang Y. Contributions of hippocampal subfields and subregions to episodic memory performance in healthy cognitive aging. Neurobiol Aging 2024; 133:51-66. [PMID: 37913626 DOI: 10.1016/j.neurobiolaging.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/01/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
In the present study we investigated whether hippocampal subfield (cornu ammonis 1-3, dentate gyrus, and subiculum) and anteroposterior hippocampal subregion (head,body, and tail) volumes can predict episodic memory function using high-field high resolution structural magnetic resonance imaging (MRI). We recruited 126 healthy participants (18-85 years). MRI datasets were collected on a 4.7 T system. Participants were administered the Wechsler Memory Scale (WMS-IV) to evaluate episodic memory function. Structural equation modeling was used to test the relationship between studied variables. We found that the volume of the dentate gyrus subfield and posterior hippocampus (body) showed a significant direct effect on visuospatial memory performance; additionally, an indirect effect of age on visuospatial memory mediated through these hippocampal subfield/subregion was significant. Logical and verbal memory were not significantly associated with hippocampal subfield or subregion volumes.
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Affiliation(s)
- Nikolai Malykhin
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.
| | - Wojciech Pietrasik
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kim Ngan Hoang
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Yushan Huang
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
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2
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Gills JL, Campitelli A, Jones M, Paulson S, Myers JR, Madero EN, Glenn JM, Komorowski J, Gray M. Acute Inositol-Stabilized Arginine Silicate Improves Cognitive Outcomes in Healthy Adults. Nutrients 2021; 13:4272. [PMID: 34959823 PMCID: PMC8703995 DOI: 10.3390/nu13124272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 12/05/2022] Open
Abstract
Inositol-stabilized arginine silicate (ASI) is an ergogenic aid that upregulates nitric oxide. Acute ASI supplementation improves working memory and processing speed in young adults but there is a lack of data examining other cognitive tasks. Therefore, the purpose of this study was to examine acute ASI effects on young healthy adults by assessing multiple cognitive domains. Nineteen young adults (20.9 ± 3.2 years) completed this randomized, double-blind, crossover study consuming ASI (1.5 g ASI + 12 g dextrose) and placebo (12 g dextrose). The participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and two digital cognitive assessments before consuming the supplement and then completed the same battery of tests 60 min post-supplementation. Repeated measures ANOVA demonstrated that ASI consumption significantly improved total RBANS and immediate memory scores compared to the placebo (p < 0.05). However, no significant differences were displayed between trials for other cognitive domains (p > 0.05). Acute ASI ingestion increased overall RBANS scores and immediate memory scores in young adults. More research is needed to examine the acute effects of ASI on other domains of cognition, in older populations, and its long-term effects on cognition.
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Affiliation(s)
- Joshua L. Gills
- Department of Health, Human Performance and Recreation, Exercise Science Research Center, University of Arkansas, Fayetteville, AR 72701, USA; (J.L.G.); (A.C.); (M.J.)
| | - Anthony Campitelli
- Department of Health, Human Performance and Recreation, Exercise Science Research Center, University of Arkansas, Fayetteville, AR 72701, USA; (J.L.G.); (A.C.); (M.J.)
| | - Megan Jones
- Department of Health, Human Performance and Recreation, Exercise Science Research Center, University of Arkansas, Fayetteville, AR 72701, USA; (J.L.G.); (A.C.); (M.J.)
| | | | - Jennifer Rae Myers
- Neurotrack Technologies, Inc., Redwood City, CA 94063, USA; (J.R.M.); (E.N.M.); (J.M.G.)
| | - Erica N. Madero
- Neurotrack Technologies, Inc., Redwood City, CA 94063, USA; (J.R.M.); (E.N.M.); (J.M.G.)
| | - Jordan M. Glenn
- Neurotrack Technologies, Inc., Redwood City, CA 94063, USA; (J.R.M.); (E.N.M.); (J.M.G.)
| | | | - Michelle Gray
- Department of Health, Human Performance and Recreation, Exercise Science Research Center, University of Arkansas, Fayetteville, AR 72701, USA; (J.L.G.); (A.C.); (M.J.)
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Eskridge CLM, Hochberger WC, Kaseda ET, Lencer R, Reilly JL, Keedy SK, Keefe RSE, Pearlson GD, Keshavan MS, Tamminga CA, Sweeney JA, Hill SK. Deficits in generalized cognitive ability, visual sensorimotor function, and inhibitory control represent discrete domains of neurobehavioral deficit in psychotic disorders. Schizophr Res 2021; 236:54-60. [PMID: 34392106 PMCID: PMC8464494 DOI: 10.1016/j.schres.2021.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/06/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
Psychotic disorders are characterized by impaired cognition, yet some reports indicate specific deficits extend beyond reduced general cognitive ability. This study utilized exploratory and confirmatory factor analytic methods to evaluate the latent structure of a broad neurocognitive battery used in the Bipolar-Schizophrenia Network of Intermediate Phenotypes (B-SNIP) study, which included neuropsychological and neurophysiological measures in psychotic disorder probands and their unaffected first-degree relatives. Findings indicate that the factor structure of data from this set of assessments is more complex than the unitary factor of global cognitive ability underlying the Brief Assessment of Cognition in Schizophrenia (BACS). In addition to assessing generalized cognitive ability, two other factors were identified: visual sensorimotor function and inhibitory behavioral control. This complex cognitive architecture, derived in controls, generalized to patients across the psychosis spectrum and to their unaffected relatives. These findings highlight the need for a more differentiated assessment of neurobehavioral functions in studies designed to test for diagnostically specific biomarkers, endophenotypes for gene discovery and beneficial effects of therapeutics on cognitive function.
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Affiliation(s)
- Courtney L M Eskridge
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States.
| | - William C Hochberger
- Advanced Neurobehavioral Health of Southern California, San Diego, CA, United States
| | - Erin T Kaseda
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States
| | - Rebekka Lencer
- University of Muenster, Department of Psychiatry and Psychotherapy, Munster, Germany
| | - James L Reilly
- Northwestern University, Department of Psychiatry and Behavioral Sciences, Chicago, IL, United States
| | - Sarah K Keedy
- University of Chicago, Department of Psychiatry, Chicago, IL, United States
| | - Richard S E Keefe
- Duke University, Departments of Psychiatry, Neuroscience, and Psychology, Durham, NC, United States
| | - Godfrey D Pearlson
- Yale University School of Medicine, Departments of Psychiatry and Neurobiology, New Haven, CT, United States
| | - Matcheri S Keshavan
- Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Psychiatry, Boston, MA, United States
| | - Carol A Tamminga
- University of Texas-Southwestern University Hospital, Department of Psychiatry, Dallas, TX, United States
| | - John A Sweeney
- University of Cincinnati, Department of Psychiatry and Behavioral Neuroscience, Cincinnati, OH, United States
| | - S Kristian Hill
- Rosalind Franklin University of Medicine and Science, Department of Psychology, North Chicago, IL, United States
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Lu L, Kong W, Zhou K, Chen J, Hou Y, Dou H, Liang J. Association of lipoproteins and thyroid hormones with cognitive dysfunction in patients with systemic lupus erythematosus. BMC Rheumatol 2021; 5:18. [PMID: 34103098 PMCID: PMC8188676 DOI: 10.1186/s41927-021-00190-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/11/2021] [Indexed: 12/19/2022] Open
Abstract
Background Neuropsychiatric manifestations occur in up to 75% of adult systemic lupus erythematosus (SLE) patients and are one of the major causes of death in SLE patients. Cognitive dysfunction is a typical clinical feature of neuropsychiatric SLE (NPSLE), which seriously affects the quality of life of patients. Dyslipidaemia and thyroid symptoms, which are prevalent in SLE patients, have both been related to neuropsychiatric disturbances, including significant psychiatric and cognitive disturbances. This study aimed to investigate whether cognitive dysfunction in patients with SLE was related to the expression of serum thyroid hormone and lipoprotein levels. Methods A total of 121 patients with SLE and 65 healthy controls (HCs) at Nanjing Drum Tower Hospital completed a cognitive function test, and 81 SLE patients were divided into a high-cognition (n = 33) group and a low-cognition group (n = 48). The clinical and laboratory characteristics of the patients were compared; moreover, correlations between serum HDL-C, LDL-C, F-T3 and F-T4 levels and cognitive function were analysed. Serum levels of APOE, APOA1, IGF-1, and IGFBP7 in 81 patients were detected by ELISA, and the correlation between these four proteins and cognition was analysed separately. Results The patients with SLE with abnormal cognitive function were less educated than the HCs. For low-cognition patients, the levels of albumin, F-T3 (P < 0.05) and F-T4 decreased, while D-dimer, anti-dsDNA antibody, and IgM levels increased. Serum F-T3 and F-T4 levels positively correlated with cognition. Furthermore, serum protein levels of APOE and APOA1 showed no difference between the high- and low-cognition groups. However, the serum APOE levels were negatively correlated with line orientation scores, and APOA1 levels were positively correlated with coding scores. Conclusions Serum F-T3 and F-T4 levels were both positively correlated with four indexes of cognition (language was the exception), while serum APOE levels were negatively correlated with line orientation scores, APOA1 levels were positively correlated with coding scores, and IGFBP7 levels were negatively correlated with figure copy scores. These results demonstrated that F-T3 and F-T4 might be clinical biomarkers of cognitive dysfunction in SLE. Supplementary Information The online version contains supplementary material available at 10.1186/s41927-021-00190-7.
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Affiliation(s)
- Li Lu
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China.,Jiangsu Key Laboratory of Molecular Medicine, Nanjing, 210093, PR China
| | - Wei Kong
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China
| | - Kangxing Zhou
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China
| | - Jinglei Chen
- The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China.,Jiangsu Key Laboratory of Molecular Medicine, Nanjing, 210093, PR China
| | - Yayi Hou
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China. .,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China. .,Jiangsu Key Laboratory of Molecular Medicine, Nanjing, 210093, PR China.
| | - Huan Dou
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China. .,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China. .,Jiangsu Key Laboratory of Molecular Medicine, Nanjing, 210093, PR China.
| | - Jun Liang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, PR China. .,The State Key Laboratory of Pharmaceutical Biotechnology, Division of Immunology, Medical School, Nanjing University, Nanjing, 210093, PR China.
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Liu Y, Bi T, Zhang B, Kuang Q, Li H, Zong K, Zhao J, Ning Y, She S, Zheng Y. Face and object visual working memory deficits in first-episode schizophrenia correlate with multiple neurocognitive performances. Gen Psychiatr 2021; 34:e100338. [PMID: 33728399 PMCID: PMC7896562 DOI: 10.1136/gpsych-2020-100338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/17/2022] Open
Abstract
Background Working memory (WM) deficit is considered a core feature and cognitive biomarker in patients with schizophrenia. Several studies have reported prominent object WM deficits in patients with schizophrenia, suggesting that visual WM in these patients extends to non-spatial domains. However, whether non-spatial WM is similarly affected remains unclear. Aim This study primarily aimed to identify the processing of visual object WM in patients with first-episode schizophrenia. Methods The study included 36 patients with first-episode schizophrenia and 35 healthy controls. Visual object WM capacity, including face and house WM capacity, was assessed by means of delayed matching-to-sample visual WM tasks, in which participants must distribute memory so that they can discriminate a target sample. We specifically examined their anhedonia experience by the Temporal Experience of Pleasure Scale and the Snaith-Hamilton Pleasure Scale. Cognitive performance was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results Both face and house WM capacity was significantly impaired in patients with schizophrenia. For both tasks, the performance of all the subjects was worse under the high-load condition than under the low-load condition. We found that WM capacity was highly positively correlated with the performance on RBANS total scores (r=−0.528, p=0.005), RBANS delayed memory scores (r=−0.470, p=0.013), RBANS attention scores (r=−0.584, p=0.001), RBANS language scores (r=−0.448, p=0.019), Trail-Making Test: Part A raw scores (r=0.465, p=0.015) and simple IQ total scores (r=−0.538, p=0.005), and correlated with scores of the vocabulary test (r=−0.490, p=0.011) and scores of the Block Diagram Test (r=−0.426, p=0.027) in schizophrenia. No significant correlations were observed between WM capacity and Positive and Negative Syndrome Scale symptoms. Conclusions Our research found that visual object WM capacity is dramatically impaired in patients with schizophrenia and is strongly correlated with other measures of cognition, suggesting a mechanism that is critical in explaining a portion of the broad cognitive deficits observed in schizophrenia.
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Affiliation(s)
- Yi Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Taiyong Bi
- Centre for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, Guizhou, China
| | - Bei Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Psychology, General and Experimental Psychology, LMU Munich, Germany
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Haijing Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kunlun Zong
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University; Chinese National Clinical Research Center on Mental Disorders; Chinese National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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Xiu MH, Man LJ, Wang D, Du X, Yin G, Zhang Y, Tan YL, Chen N, Chen S, Teixeira AL, Cassidy RM, Soares JC, Zhang XY. Tumor necrosis factor-alpha -1031T/C polymorphism is associated with cognitive deficits in chronic schizophrenia patients versus healthy controls. Am J Med Genet B Neuropsychiatr Genet 2018; 177:379-387. [PMID: 29633506 DOI: 10.1002/ajmg.b.32622] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/03/2018] [Accepted: 02/16/2018] [Indexed: 11/07/2022]
Abstract
Recent compelling research has demonstrated a pathophysiologic role for proinflammatory cytokines of microglial origin in decreasing neurocognitive function. Psychiatric diseases are already known to have reduced cognitive function and are also associated with increased inflammation. To elaborate on these data, our study aims to investigate how a particular polymorphism of the tumor necrosis factor gene, TNF-α -1031T/C, affects neurocognitive performance in patients with schizophrenia. We recruited 905 patients with schizophrenia and 571 healthy control subjects. We employed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to test for neurocognitive function and the positive and negative syndrome scale to evaluate schizophrenia severity. The -1031T/C polymorphism was genotyped in both healthy controls and schizophrenic patients. Our results demonstrate that patients with the C allele (either T/C or C/C) possessed increased immediate memory index, visuospatial/constructional index, and RBANS total scores as compared to patients without it (p < .05). In healthy controls, there was no significant difference across genotypes (p > .05). Our findings demonstrate that the TNF-α -1031T/C polymorphism may not play a role in the susceptibility of schizophrenia itself, but may be involved in the cognitive deficits of schizophrenia. This suggests an important role for cytokine signaling in mediating the severity of cognitive dysfunction in schizophrenia.
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Affiliation(s)
- Mei Hong Xiu
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Li-Juan Man
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Dong Wang
- Department of Psychiatry, Weihai Mental Health Center, Weihai, China
| | - Xiangdong Du
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Guangzhou Yin
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yingyang Zhang
- Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Yun Long Tan
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Nan Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Song Chen
- Beijing HuiLongGuan Hospital, Peking University, Beijing, China
| | - Antonio L Teixeira
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Ryan M Cassidy
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Xiang Yang Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas
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Interleukin-3, symptoms and cognitive deficits in first-episode drug-naïve and chronic medicated schizophrenia. Psychiatry Res 2018; 263:147-153. [PMID: 29554544 DOI: 10.1016/j.psychres.2018.02.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/30/2017] [Accepted: 02/27/2018] [Indexed: 12/31/2022]
Abstract
Previous studies consistently showed that IL-3 signaling may be involved in the pathophysiology of schizophrenia. However, investigations of associations between IL-3 and the neurocognitive impairments are lacking, including the study of how this may vary with stage of illness. We recruited 45 first-episode drug-naïve (FE-Sz), 35 chronic medicated schizophrenia (Ch-Sz) and 40 healthy controls (HC) and examined the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and serum IL-3. Altered serum IL-3 levels were found in both patient groups compared with HC group (both p < 0.001). There were significantly lower neurocognitive scores on the RBANS and nearly all of its five subscales, except for Visuospatial/Constructional index in both FE-Sz and Ch-Sz patients vs healthy controls. Moreover, a significant reduction in Immediate memory index (p = 0.021) and a trend-level reduction in RBANS total score (p = 0.094) in Ch-Sz than FE-Sz patients. Interestingly, there was a significant negative correlation between IL-3 and the Immediate memory index only in Ch-Sz patients (p = 0.03). Our findings showed that neurocognitive impairments present in schizophrenia emerge during the first episode with further diminished functioning with disease progression, and IL-3 may be involved in the immediate memory deficits in the chronic phase of schizophrenia.
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Locked in and Growing Old: The Psychiatric, Forensic, and Cognitive Correlates of 30 Years of Psychiatric Hospitalization. Am J Geriatr Psychiatry 2018; 26:188-197. [PMID: 29122420 DOI: 10.1016/j.jagp.2017.10.003] [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: 07/02/2017] [Revised: 10/02/2017] [Accepted: 10/03/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVE As the number of older adults in the United States continues to grow, the population of older adults with severe mental illness in institutional settings (OASIS) is expected to place a significant demand on healthcare resources. This study presents an update to research regarding the clinical characteristics of OASIS inpatients with histories of extensive hospitalization through the use of a newly developed psychiatric measure: the Clinician-Rated Dimension of Psychosis Symptom Severity. METHODS We investigated an OASIS sample (N = 55) with an average of nearly 30 continuous years of hospitalization at a forensic state psychiatric hospital. RESULTS The average OASIS patient exhibited the most prominent psychiatric symptoms via delusions and negative symptoms, received psychotropic medications at substantially higher doses than recommended therapeutic levels, rarely committed acts of institutional violence (IV), and performed more than two standard deviations below the normative mean on cognitive testing. More severe hallucination symptoms were associated with higher psychotropic medication dosage, and more severe depressive symptoms were associated with more IV incidents. OASIS inpatients performed moderately worse than general psychiatric inpatients in the areas of overall cognition, immediate memory, and delayed memory; older age was associated with poorer language and attention. No psychiatric or cognitive factors predicted IV incidents. CONCLUSION These results highlight the continued importance of understanding the psychiatric, forensic, and cognitive factors associated with aging in an institutional setting and how these factors among OASIS inpatients may vary from general psychiatric inpatients.
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Stramecki F, Kotowicz KD, Piotrowski P, Frydecka D, Rymaszewska J, Beszłej JA, Samochowiec J, Jabłoński M, Wroński M, Moustafa AA, Misiak B. Assessment of the Association Between Cigarette Smoking and Cognitive Performance in Patients With Schizophrenia-Spectrum Disorders: A Case-Control Study. Front Psychiatry 2018; 9:642. [PMID: 30559684 PMCID: PMC6287108 DOI: 10.3389/fpsyt.2018.00642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/15/2018] [Indexed: 12/21/2022] Open
Abstract
The prevalence of cigarette smoking is significantly higher in patients with schizophrenia compared to the general population. Schizophrenia is also characterized by cognitive impairments that can be detected in the premorbid phase of illness. However, studies addressing the association between cigarette smoking and cognition in patients with psychosis have provided mixed findings. Therefore, the aim of this study was to assess the relationship between tobacco smoking and cognitive performance in patients with schizophrenia. In this case-control study, we recruited 67 inpatients with schizophrenia (34 cigarette smokers) and 62 healthy controls (30 cigarette smokers) at two clinical sites (Wroclaw and Szczecin, Poland). Cognitive performance was examined using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Smoking dependence was determined using the Fagerström Test for Nicotine Dependence (FTND) and the pack-year index. Results show that, after adjustment for potential confounders, smokers with schizophrenia presented significantly lower scores on delayed memory tests compared to non-smokers with schizophrenia (F = 11.07, p = 0.002). In healthy controls, after adjustment for age, sex, and education level, smokers had significantly lower scores in immediate memory (47.1 ± 6.4 vs. 52.0 ± 4.0, F = 11.64, p = 0.001), visuospatial/constructional functions (34.8 ± 3.8 vs. 37.7 ± 1.8, F = 12.86, p = 0.001) and global cognition (177.0 ± 15.7 vs. 191.2 ± 14.0, F = 12.63, p = 0.001) compared to non-smokers. There were no significant correlations between FTND scores or pack-year index and cognitive performance neither in patient nor control group. Our results show that cigarette smoking is related to worse delayed memory performance in schizophrenia patients as well as deficits of immediate memory, visuospatial/constructional functions, and global cognition in controls. Longitudinal studies are required to establish causal interference between smoking and cognition in patients with schizophrenia.
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Affiliation(s)
- Filip Stramecki
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Kamila D Kotowicz
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Patryk Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | | | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Marcin Jabłoński
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Michał Wroński
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Marcs Institute of Brain and Behaviour, Western Sydney University, Penrith, NSW, Australia.,Department of Social Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Błazej Misiak
- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
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Hall JR, Balldin VH, Gamboa A, Edwards ML, Johnson LA, O'Bryant SE. Texas Mexican American adult normative studies: Normative data for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Dev Neuropsychol 2017; 43:27-35. [PMID: 29185823 DOI: 10.1080/87565641.2017.1401629] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is an assessment of neuropsychological functioning commonly used in clinical and research settings. To our knowledge, normative data for the RBANS is not available for Hispanic, Mexican Americans, which the current study sought to establish. Data from 136 Hispanic, Mexican Americans from Project FRONTIER were analyzed. Approximately half of the sample was administered testing in Spanish. Normative tables were created for English and Spanish speaking Mexican Americans. Generated RBANS normative references are provided for unadjusted raw scores as well as output adjusted by education level.
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Affiliation(s)
- James R Hall
- a Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas
| | - Valerie Hobson Balldin
- b Department of Neurology , University of Texas at San Antonio Health Sciences Center , San Antonio , Texas
| | - Adriana Gamboa
- a Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas
| | - Melissa L Edwards
- c Department of Psychology , University of North Texas , Denton , Texas
| | - Leigh A Johnson
- a Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas
| | - Sid E O'Bryant
- a Institute for Healthy Aging , University of North Texas Health Science Center , Fort Worth , Texas
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Térémetz M, Carment L, Brénugat-Herne L, Croca M, Bleton JP, Krebs MO, Maier MA, Amado I, Lindberg PG. Manual Dexterity in Schizophrenia-A Neglected Clinical Marker? Front Psychiatry 2017; 8:120. [PMID: 28740470 PMCID: PMC5502278 DOI: 10.3389/fpsyt.2017.00120] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 06/23/2017] [Indexed: 01/30/2023] Open
Abstract
Impaired manual dexterity is commonly observed in schizophrenia. However, a quantitative description of key sensorimotor components contributing to impaired dexterity is lacking. Whether the key components of dexterity are differentially affected and how they relate to clinical characteristics also remains unclear. We quantified the degree of dexterity in 35 stabilized patients with schizophrenia and in 20 age-matched control subjects using four visuomotor tasks: (i) force tracking to quantify visuomotor precision, (ii) sequential finger tapping to measure motor sequence recall, (iii) single-finger tapping to assess temporal regularity, and (iv) multi-finger tapping to measure independence of finger movements. Diverse clinical and neuropsychological tests were also applied. A patient subgroup (N = 15) participated in a 14-week cognitive remediation protocol and was assessed before and after remediation. Compared to control subjects, patients with schizophrenia showed greater error in force tracking, poorer recall of tapping sequences, decreased tapping regularity, and reduced degree of finger individuation. A composite performance measure discriminated patients from controls with sensitivity = 0.79 and specificity = 0.9. Aside from force-tracking error, no other dexterity components correlated with antipsychotic medication. In patients, some dexterity components correlated with neurological soft signs, Positive and Negative Syndrome Scale (PANSS), or neuropsychological scores. This suggests differential cognitive contributions to these components. Cognitive remediation lead to significant improvement in PANSS, tracking error, and sequence recall (without change in medication). These findings show that multiple aspects of sensorimotor control contribute to impaired manual dexterity in schizophrenia. Only visuomotor precision was related to antipsychotic medication. Good diagnostic accuracy and responsiveness to treatment suggest that manual dexterity may represent a useful clinical marker in schizophrenia.
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Affiliation(s)
- Maxime Térémetz
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Loïc Carment
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Lindsay Brénugat-Herne
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marta Croca
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - Marie-Odile Krebs
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marc A Maier
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Isabelle Amado
- SHU, Resource Center for Cognitive Remediation and Psychosocial Rehabilitation, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Påvel G Lindberg
- FR3636, CNRS, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM U894, GDR3557 Psychiatrie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
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12
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Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness. Community Ment Health J 2016; 52:851-8. [PMID: 25895854 DOI: 10.1007/s10597-015-9874-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
Abstract
We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises, and working in an OC or not. There were two variables with significant adjusted odds ratios for having a job: "attention" and "Educational level". There were five variables with significant odds ratios for having a job in an OC: "Sex", "Educational level", "Attention", "Communication", and "Independence-competence". The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models.
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13
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Unitary construct of generalized cognitive ability underlying BACS performance across psychotic disorders and in their first-degree relatives. Schizophr Res 2016; 170:156-61. [PMID: 26645510 PMCID: PMC5226655 DOI: 10.1016/j.schres.2015.11.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 11/18/2015] [Accepted: 11/21/2015] [Indexed: 01/10/2023]
Abstract
Despite robust evidence of neurocognitive dysfunction in psychotic patients, the degree of similarity in cognitive architecture across psychotic disorders and among their respective first-degree relatives is not well delineated. The present study examined the latent factor structure of the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Analyses were conducted on 783 psychosis spectrum probands (schizophrenia, schizoaffective, psychotic bipolar), 887 of their first-degree relatives, and 396 non-psychiatric controls from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium. Exploratory factor analysis of BACS subtest scores indicated a single-factor solution that was similar across all groups and provided the best overall data fit in confirmatory analyses. Correlations between the standard BACS composite score and the sum of subscale scores weighted by their loadings on this unitary factor were very high in all groups (r≥.99). Thus, the BACS assesses a similar unitary cognitive construct in probands with different psychotic disorders, in their first-degree relatives, and in healthy controls, and this factor is well measured by the test's standard composite score.
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14
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Moore RC, Harmell AL, Harvey PD, Bowie CR, Depp CA, Pulver AE, McGrath JA, Patterson TL, Cardenas V, Wolyniec P, Thornquist MH, Luke JR, Palmer BW, Jeste DV, Mausbach BT. Improving the understanding of the link between cognition and functional capacity in schizophrenia and bipolar disorder. Schizophr Res 2015; 169:121-127. [PMID: 26427917 PMCID: PMC4681671 DOI: 10.1016/j.schres.2015.09.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/10/2015] [Accepted: 09/15/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. METHOD Two independent samples were studied. Study 1: participants with schizophrenia (n=435) and bipolar disorder (n=390) aged 18-83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range=39-72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. RESULTS Significant linear and quadratic trends were observed for both studies. Study 1: in both the schizophrenia and bipolar participants, when cognitive composite z-scores were >0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: when neuropsychological screening battery z-scores were >-1 (indicating low average to average performance), cognition was not related to functional capacity. CONCLUSIONS These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States.
| | - Alexandrea L Harmell
- Department of Psychiatry, University of California, San Diego, United States; San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States.
| | - Philip D Harvey
- University of Miami Miller School of Medicine, United States.
| | | | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States; VA San Diego Healthcare System, San Diego, CA, United States.
| | - Ann E Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States.
| | - John A McGrath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States.
| | - Thomas L Patterson
- Department of Psychiatry, University of California, San Diego, United States.
| | - Veronica Cardenas
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States.
| | - Paula Wolyniec
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States.
| | - Mary H Thornquist
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States.
| | - James R Luke
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, United States.
| | - Barton W Palmer
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States.
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States.
| | - Brent T Mausbach
- Department of Psychiatry, University of California, San Diego, United States; Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, United States.
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15
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Voineskos AN, Winterburn JL, Felsky D, Pipitone J, Rajji TK, Mulsant BH, Chakravarty MM. Hippocampal (subfield) volume and shape in relation to cognitive performance across the adult lifespan. Hum Brain Mapp 2015; 36:3020-37. [PMID: 25959503 PMCID: PMC6869683 DOI: 10.1002/hbm.22825] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/13/2015] [Accepted: 04/15/2015] [Indexed: 01/18/2023] Open
Abstract
Newer approaches to characterizing hippocampal morphology can provide novel insights regarding cognitive function across the lifespan. We comprehensively assessed the relationships among age, hippocampal morphology, and hippocampal-dependent cognitive function in 137 healthy individuals across the adult lifespan (18-86 years of age). They underwent MRI, cognitive assessments and genotyping for Apolipoprotein E status. We measured hippocampal subfield volumes using a new multiatlas segmentation tool (MAGeT-Brain) and assessed vertex-wise (inward and outward displacements) and global surface-based descriptions of hippocampus morphology. We examined the effects of age on hippocampal morphology, as well as the relationship among age, hippocampal morphology, and episodic and working memory performance. Age and volume were modestly correlated across hippocampal subfields. Significant patterns of inward and outward displacement in hippocampal head and tail were associated with age. The first principal shape component of the left hippocampus, characterized by a lengthening of the antero-posterior axis was prominently associated with working memory performance across the adult lifespan. In contrast, no significant relationships were found among subfield volumes and cognitive performance. Our findings demonstrate that hippocampal shape plays a unique and important role in hippocampal-dependent cognitive aging across the adult lifespan, meriting consideration as a biomarker in strategies targeting the delay of cognitive aging.
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Affiliation(s)
- Aristotle N Voineskos
- Kimel Family Translational Imaging Genetics Laboratory, Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Geriatric Mental Health Service, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Julie L Winterburn
- Kimel Family Translational Imaging Genetics Laboratory, Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Daniel Felsky
- Kimel Family Translational Imaging Genetics Laboratory, Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Jon Pipitone
- Kimel Family Translational Imaging Genetics Laboratory, Research Imaging Centre, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Tarek K Rajji
- Geriatric Mental Health Service, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Benoit H Mulsant
- Geriatric Mental Health Service, Campbell Family Mental Health Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - M Mallar Chakravarty
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada
- Departments of Psychiatry and Biomedical Engineering, McGill University, Montreal, QC, Canada
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16
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Beinat C, Banister SD, Herrera M, Law V, Kassiou M. The therapeutic potential of α7 nicotinic acetylcholine receptor (α7 nAChR) agonists for the treatment of the cognitive deficits associated with schizophrenia. CNS Drugs 2015; 29:529-42. [PMID: 26242477 DOI: 10.1007/s40263-015-0260-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Homomeric α7 nicotinic acetylcholine receptors (α7 nAChRs) have implications in the regulation of cognitive processes such as memory and attention, and have shown promise as a therapeutic target for the treatment of the cognitive deficits associated with schizophrenia. Multiple α7 nAChR agonists have entered human trials; however, unfavorable side effects and pharmacokinetic issues have hindered the development of a clinical α7 nAChR agonist. Currently, EVP-6124 is in phase III clinical trials, and several other α7 nAChR agonists (GTS-21 and AQW051) are in earlier stages of development. This review will summarize the recent advances and failures of α7 nAChR agonists in clinical trials for the treatment of the aforementioned pathology.
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Affiliation(s)
- Corinne Beinat
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, 94305, USA
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17
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Lippa SM, Agbayani KA, Hawes S, Jokic E, Caroselli JS. Effort in acute traumatic brain injury: considering more than pass/fail. Rehabil Psychol 2015; 59:306-12. [PMID: 25133905 DOI: 10.1037/a0037217] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE Performance validity is often conceptualized as a dichotomous process. Effort likely lies on a continuum, however, and psychologists' tendency to rely on pass/fail descriptors of one's effort may not be the only approach. The current study aims to show that when performance validity is considered on a continuum, it may provide clinical information related to cognitive functioning. RESEARCH METHOD/DESIGN Forty-four patients with moderate or severe traumatic brain injury were evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status upon their emergence from posttraumatic amnesia. From this data, previously developed effort index scores and "other cognitive functions" index scores were calculated. RESULTS Performance on the effort index significantly accounted for the patients' performance on a cognitive composite score after considering education and severity of injury. CONCLUSIONS/IMPLICATIONS Findings suggest that more in-depth analysis of validity test performance is beneficial to gauge a patient's level of effort and is important to consider when interpreting results and in treatment planning.
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Affiliation(s)
- Sara M Lippa
- Department of Psychology/Neuropsychology, TIRR Memorial Hermann Hospital
| | | | - Samuel Hawes
- Department of Psychology/Neuropsychology, TIRR Memorial Hermann Hospital
| | - Emily Jokic
- Department of Psychology/Neuropsychology, TIRR Memorial Hermann Hospital
| | - Jerome S Caroselli
- Department of Psychology/Neuropsychology, TIRR Memorial Hermann Hospital
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18
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Zhang T, Li H, Stone WS, Woodberry KA, Seidman LJ, Tang Y, Guo Q, Zhuo K, Qian Z, Cui H, Zhu Y, Jiang L, Chow A, Tang Y, Li C, Jiang K, Yi Z, Xiao Z, Wang J. Neuropsychological Impairment in Prodromal, First-Episode, and Chronic Psychosis: Assessing RBANS Performance. PLoS One 2015; 10:e0125784. [PMID: 25973925 PMCID: PMC4431726 DOI: 10.1371/journal.pone.0125784] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/25/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cognitive deficits are observed throughout all developmental phases of psychosis. However, prior studies have usually focused on a limited illness period and used a wide variety of cognitive instruments. Therefore, it has been difficult to characterize or highlight cognitive functioning in different stages of psychosis. METHOD We administered the RBANS (Repeatable Battery for the Assessment of Neuropsychological Status) tests to 4 participant subgroups, including healthy volunteers (controls, HC, n = 28), subjects at high risk for clinical psychosis (prodrome, CHR, n = 27), first-episode schizophrenia patients (FE-Sz, n = 26), and mid-term and long-term chronic schizophrenia patients (Ch-Sz, n =147). Comparison, correlation, and regression analyses of RBANS index scores were assessed among groups. We examined clinical outcomes over 2 years between the CHR and HC subjects, and RBANS domains were used as possible predictors for conversion to psychosis. RESULTS Performance on all RBANS domains was significantly impaired during a post-onset stage of psychosis (FE-Sz and Ch-Sz), and RBANS scores declined along with disease progression. Regression analyses showed that for CHR and HC subjects, baseline impairment in delayed memory (DM) significantly predicted conversion to psychosis. Additionally, partial correlations showed that for FE-Sz and Ch-Sz subjects, DM was the only correlate with a later stage of psychosis. CONCLUSIONS Cognitive deficits broadly emerged, and diminished functioning followed along with disease progression. Impairment in DM is perhaps one domain that helps us understand the development of psychosis. A critical need is to monitor and treat memory functioning for psychotic patients throughout all phases of the disease.
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Affiliation(s)
- TianHong Zhang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - HuiJun Li
- Florida A & M University, Department of Psychology, Tallahassee, Florida 32307, United States of America
- Harvard Medical School Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, United States of America
| | - William S. Stone
- Harvard Medical School Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, United States of America
| | - Kristen A. Woodberry
- Harvard Medical School Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, United States of America
| | - Larry J. Seidman
- Harvard Medical School Department of Psychiatry, Beth Israel Deaconess Medical Center, 75 Fenwood Rd, Boston, MA 02115, United States of America
| | - YingYing Tang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - Qian Guo
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - KaiMing Zhuo
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - ZhenYing Qian
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - HuiRu Cui
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - YiKang Zhu
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - LiJuan Jiang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - Annabelle Chow
- Changi General Hospital, Department of psychological medicine, Singapore, Singapore
| | - YunXiang Tang
- Department of medical psychology, Faculty of Mental Health, Second Military Medical University, Shanghai 200433, China
| | - ChunBo Li
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - KaiDa Jiang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
| | - ZhengHui Yi
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
- * E-mail: (JJW); (ZPX); (ZHY)
| | - ZePing Xiao
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
- * E-mail: (JJW); (ZPX); (ZHY)
| | - JiJun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China
- * E-mail: (JJW); (ZPX); (ZHY)
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD. METHODS Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis. CONCLUSION The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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20
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Ho JS, Moore RC, Davine T, Cardenas V, Bowie CR, Patterson TL, Mausbach BT. Direct and mediated effects of cognitive function with multidimensional outcome measures in schizophrenia: the role of functional capacity. J Clin Exp Neuropsychol 2013; 35:882-95. [PMID: 23984631 PMCID: PMC3789849 DOI: 10.1080/13803395.2013.828021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although cognitive ability is a known predictor of real-world functioning in schizophrenia, there has been an expanded interest in understanding the mechanisms by which it explains real-world functioning in this population. We examined the extent to which functional capacity (i.e., skills necessary to live independently) mediated the relationship between cognitive ability and both observer and self-reported real-world functioning in 138 outpatients with schizophrenia. Functional capacity significantly mediated the relations between cognitive ability and observer-rated real-world functioning, but not self-reported real-world functioning, with small to medium effect sizes observed for all outcomes. The role of cognitive ability in observer versus self-reported real-world functioning may be explained by different mechanisms.
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Affiliation(s)
- Jennifer S. Ho
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Raeanne C. Moore
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | - Taylor Davine
- Department of Psychology, San Diego State University, San Diego, CA
| | - Veronica Cardenas
- Department of Psychiatry, University of California San Diego, La Jolla, CA
| | | | | | - Brent T. Mausbach
- Department of Psychiatry, University of California San Diego, La Jolla, CA
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21
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Moore RC, Davine T, Harmell AL, Cardenas V, Palmer BW, Mausbach BT. Using the repeatable battery for the assessment of neuropsychological status (RBANS) effort index to predict treatment group attendance in patients with schizophrenia. J Int Neuropsychol Soc 2013; 19:198-205. [PMID: 23234753 PMCID: PMC3568222 DOI: 10.1017/s1355617712001221] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In a psychosocial treatment study, knowing which participants are likely to put forth adequate effort to maximize their treatment, such as attending group sessions and completing homework assignments, and knowing which participants need additional motivation before engagement in treatment is a crucial component to treatment success. This study examined the ability of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) Effort Index (EI), a newly developed measure of suboptimal effort that is embedded within the RBANS, to predict group attendance in a sample of 128 middle-aged and older adults with schizophrenia. This study was the first to evaluate the EI with a schizophrenia sample. While the EI literature recommends a cutoff score of >3 to be considered indicative of poor effort, a cutoff of >4 was identified as the optimal cutoff for this sample. Receiver Operating Characteristics curve analyses were conducted to determine if the EI could predict participants who had high versus low attendance. Results indicated that the EI was successfully able to discriminate between group attendance, and this measure of effort appears to be most valuable as a tool to identify participants who will have high attendance. Of interest, overall cognitive functioning and symptoms of psychopathology were not predictive of group attendance.
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Affiliation(s)
- Raeanne C. Moore
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Taylor Davine
- Department of Psychology, San Diego State University, San Diego, California
| | - Alexandrea L. Harmell
- Department of Psychiatry, University of California, San Diego, La Jolla, California
- Joint Doctoral Program in Clinical Psychology, University of California, San Diego/San Diego State University, San Diego, California
| | - Veronica Cardenas
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Barton W. Palmer
- Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - Brent T. Mausbach
- Department of Psychiatry, University of California, San Diego, La Jolla, California
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Boggs DL, Kelly DL, McMahon RP, Gold JM, Gorelick DA, Linthicum J, Conley RR, Liu F, Waltz J, Huestis MA, Buchanan RW. Rimonabant for neurocognition in schizophrenia: a 16-week double blind randomized placebo controlled trial. Schizophr Res 2012; 134:207-10. [PMID: 22137462 PMCID: PMC3268840 DOI: 10.1016/j.schres.2011.11.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Revised: 11/07/2011] [Accepted: 11/09/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To examine the effect of rimonabant on neurocognitive impairments in people with schizophrenia. METHODS Participants entered a 16-week double-blind, placebo-controlled, randomized clinical trial. A neurocognitive battery was administered at baseline and end of study. RESULTS In comparison to rimonabant (20mg/day), placebo-treated participants exhibited a significant improvement on the Repeatable Battery for the Assessment of Neuropsychological Status total score. In contrast, rimonabant was associated with significant improvement on a probabilistic learning task. There were no other significant treatment effects. CONCLUSIONS Rimonabant did not improve global cognitive functioning, but did improve a specific learning deficit based on response to positive feedback.
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Affiliation(s)
| | - Deanna L. Kelly
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert P. McMahon
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James M. Gold
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David A. Gorelick
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
| | - Jared Linthicum
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Fang Liu
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James Waltz
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore, MD
| | - Robert W. Buchanan
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
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Bolding MS, Lahti AC, Gawne TJ, Hopkins KB, Gurler D, Gamlin PD. Ocular convergence deficits in schizophrenia. Front Psychiatry 2012; 3:86. [PMID: 23087652 PMCID: PMC3474129 DOI: 10.3389/fpsyt.2012.00086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 09/19/2012] [Indexed: 12/12/2022] Open
Abstract
Individuals with schizophrenia (SZ) have been reported to exhibit a higher prevalence of convergence insufficiency (CI) than the "normal" adult population. The purpose of this study was to determine if individuals with SZ exhibit clinical signs of CI and to determine if the Convergence Insufficiency Symptom Survey (CISS) is an effective instrument for identifying CI in this population. Twenty participants with SZ and 20 healthy controls (HC) completed the study. The prevalence of CI (15%) in the SZ group was slightly higher than reported norms, but the difference was not significant. The SZ group had significantly higher scores on the CISS than the HC group, but the CISS scores did not correlate with clinical measures of CI in individuals with SZ. The only exception was that SZ patients had a significantly reduced fusional reserve as determined by Sheard's criteria. Further study is needed to determine why individuals with SZ reported symptoms associated with CI even though clinical measures did not support this diagnosis.
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Affiliation(s)
- Mark S Bolding
- Department of Vision Sciences, University of Alabama at Birmingham Birmingham, AL, USA
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Dickinson D, Goldberg TE, Gold JM, Elvevåg B, Weinberger DR. Cognitive factor structure and invariance in people with schizophrenia, their unaffected siblings, and controls. Schizophr Bull 2011; 37:1157-67. [PMID: 20351040 PMCID: PMC3196936 DOI: 10.1093/schbul/sbq018] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Separable, but positively correlated, factors emerge from analyses of cognitive test data in schizophrenia and control samples (eg, verbal memory and processing speed) and these factors guide data reduction. Additionally, data support a hierarchical model of cognitive performance, in which these correlations reflect the influence of a higher-order factor, referred to as "g." We tested these findings in large, carefully screened samples of people with schizophrenia (n = 496), their unaffected siblings (n = 504), and controls (n = 823). Furthermore, we tested the hypothesis that cognitive performance in schizophrenia is more generalized across domains than among siblings and controls. METHOD A combination of exploratory and confirmatory factor analyses (EFA and CFA) and multiple groups CFA (MCFA) was used. RESULTS EFA yielded factors for verbal memory, visual memory, processing speed, working memory span, nback performance, and card sorting. The solution was consistent across groups, in terms of the factor assignments of individual cognitive variables and the magnitude of loadings. Method variance may have contributed to the card sorting, visual memory, and nback factors. CFA indicated that the hierarchical model, incorporating a "g" factor, was a good fit for data from all groups. MCFA suggested that this hierarchical structure was fully invariant for controls and siblings. While the variable/factor loadings for the schizophrenia group also were invariant with comparison groups, factor/"g" loadings were higher in schizophrenia, as were correlations among factor-based composite scores. CONCLUSIONS Cognitive variables sort into domains consistently in schizophrenia, unaffected siblings, and controls. However, performance in schizophrenia is more generalized and less domain specific.
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Affiliation(s)
- Dwight Dickinson
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892, USA.
| | | | - James M. Gold
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD
| | - Brita Elvevåg
- Clinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Daniel R. Weinberger
- Clinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
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Kjelby E, Jørgensen HA, Kroken RA, Løberg EM, Johnsen E. Anti-depressive effectiveness of olanzapine, quetiapine, risperidone and ziprasidone: a pragmatic, randomized trial. BMC Psychiatry 2011; 11:145. [PMID: 21884578 PMCID: PMC3178484 DOI: 10.1186/1471-244x-11-145] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 08/31/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Efficacy studies indicate anti-depressive effects of at least some second generation antipsychotics (SGAs). The Bergen Psychosis Project (BPP) is a 24-month, pragmatic, industry-independent, randomized, head-to-head comparison of olanzapine, quetiapine, risperidone and ziprasidone in patients acutely admitted with psychosis. The aim of the study is to investigate whether differential anti-depressive effectiveness exists among SGAs in a clinically relevant sample of patients acutely admitted with psychosis. METHODS Adult patients acutely admitted to an emergency ward for psychosis were randomized to olanzapine, quetiapine, risperidone or ziprasidone and followed for up to 2 years. Participants were assessed repeatedly using the Positive and Negative Syndrome Scale-Depression factor (PANSS-D) and the Calgary Depression Scale for Schizophrenia (CDSS). RESULTS A total of 226 patients were included. A significant time-effect showing a steady decline in depressive symptoms in all medication groups was demonstrated. There were no substantial differences among the SGAs in reducing the PANSS-D score or the CDSS sum score. Separate analyses of groups with CDSS sum scores > 6 or ≤6, respectively, reflecting degree of depressive morbidity, revealed essentially identical results to the primary analyses. There was a high correlation between the PANSS-D and the CDSS sum score (r = 0.77; p < 0.01). CONCLUSIONS There was no substantial difference in anti-depressive effectiveness among olanzapine, quetiapine, risperidone or ziprasidone in this clinically relevant sample of patients acutely admitted to hospital for symptoms of psychosis. Based on our findings we can make no recommendations concerning choice of any particular SGA for targeting symptoms of depression in a patient acutely admitted with psychosis. TRIAL REGISTRATION ClinicalTrials.gov ID; URL: http://www.clinicaltrials.gov/: NCT00932529.
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Affiliation(s)
- Eirik Kjelby
- Division of Psychiatry, Haukeland University Hospital, Sandviken, Norway
| | - Hugo A Jørgensen
- Department of Clinical Medicine, Psychiatry, University of Bergen, Norway
| | - Rune A Kroken
- Division of Psychiatry, Haukeland University Hospital, Sandviken, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Sandviken, Norway
- University of Bergen, Inst. Biological and Medical Psychology, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Sandviken, Norway
- Department of Clinical Medicine, Psychiatry, University of Bergen, Norway
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Hurford IM, Marder SR, Keefe RSE, Reise SP, Bilder RM. A brief cognitive assessment tool for schizophrenia: construction of a tool for clinicians. Schizophr Bull 2011; 37:538-45. [PMID: 19776205 PMCID: PMC3080688 DOI: 10.1093/schbul/sbp095] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Cognitive impairment in schizophrenia is often severe, enduring, and contributes significantly to chronic disability. But clinicians have difficulty in assessing cognition due to a lack of brief instruments. We evaluated whether a brief battery of cognitive tests derived from larger batteries could generate a summary score representing global cognitive function. Using data from 3 previously published trials, we calculated the corrected item-total correlations (CITCs) or the correlation of each test with the battery total score. We computed the proportion of variance that each test shares with the global score excluding that test (R(t)(2)=CITC(2)) and the variance explained per minute of administration time for each test (R(t)(2)/min). The 3 tests with the highest R(t)(2)/min were selected for the brief battery. The composite score from the trail making test B, category fluency, and digit symbol correlated .86 with the global score of the larger battery in 2 of the studies and correlated between .73 and .82 with the total battery scores excluding these 3 tests. A Brief Cognitive Assessment Tool for Schizophrenia (B-CATS) using the above 3 tests can be administered in 10-11 min. The full batteries of the larger studies have administration times ranging from 90 to 210 min. Given prior research suggesting that a single factor of global cognition best explains the pattern of cognitive deficit in schizophrenia, an instrument like B-CATS can provide clinicians with meaningful data regarding their patients' cognitive function. It can also serve researchers who want an estimate of global cognitive function without requiring a full neuropsychological battery.
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Affiliation(s)
- Irene M. Hurford
- Department of Behavioral Health, Philadelphia VA Medical Center, Rm 7A-113 Mail Code 116, PA 19104,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA,To whom correspondence should be addressed; tel: 215-823-4055; fax: 215-823-4040, e-mail:
| | - Stephen R. Marder
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California at Los Angeles (UCLA), Los Angeles, CA,Department of Psychiatry, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Richard S. E. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - Robert M. Bilder
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California at Los Angeles (UCLA), Los Angeles, CA
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Reichenberg A. The assessment of neuropsychological functioning in schizophrenia. DIALOGUES IN CLINICAL NEUROSCIENCE 2010. [PMID: 20954432 PMCID: PMC3181984 DOI: 10.31887/dcns.2010.12.3/areichenberg] [Citation(s) in RCA: 150] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. The neuropsychological profile is typically characterized by prominent specific deficits in memory and learning, working memory, executive functions, attention, and processing speed, which are evident on a background of a generalized cognitive deficit This paper provides a review of studies of neuropsychological functioning in schizophrenia. The main cognitive ability areas affected in schizophrenia are described, and the degree of impairment in each ability area as found in studies of schizophrenia patients is summarized, based on meta-analytic findings. Recent studies that have compared neuropsychological functioning across psychotic disorders are presented, and finally, neuropsychological assessment batteries specifically developed for schizophrenia are introduced.
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Affiliation(s)
- Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College, London, UK.
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28
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Voineskos AN, Rajji TK, Lobaugh NJ, Miranda D, Shenton ME, Kennedy JL, Pollock BG, Mulsant BH. Age-related decline in white matter tract integrity and cognitive performance: a DTI tractography and structural equation modeling study. Neurobiol Aging 2010; 33:21-34. [PMID: 20363050 DOI: 10.1016/j.neurobiolaging.2010.02.009] [Citation(s) in RCA: 216] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 02/01/2010] [Accepted: 02/10/2010] [Indexed: 11/17/2022]
Abstract
Age-related decline in microstructural integrity of certain white matter tracts may explain cognitive decline associated with normal aging. Whole brain tractography and a clustering segmentation in 48 healthy individuals across the adult lifespan were used to examine: interhemispheric (corpus callosum), intrahemispheric association (cingulum, uncinate, arcuate, inferior longitudinal, inferior occipitofrontal), and projection (corticospinal) fibers. Principal components analysis reduced cognitive tests into 6 meaningful factors: (1) memory and executive function; (2) visuomotor dexterity; (3) motor speed; (4) attention and working memory; (5) set-shifting/flexibility; and (6) visuospatial construction. Using theory-based structural equation modeling, relationships among age, white matter tract integrity, and cognitive performance were investigated. Parsimonious model fit demonstrated relationships where decline in white matter integrity may explain age-related decline in cognitive performance: inferior longitudinal fasciculus (ILF) with visuomotor dexterity; the inferior occipitofrontal fasciculus with visuospatial construction; and posterior fibers (i.e., splenium) of the corpus callosum with memory and executive function. Our findings suggest that decline in the microstructural integrity of white matter fibers can account for cognitive decline in normal aging.
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Affiliation(s)
- Aristotle N Voineskos
- Geriatric Mental Health Program, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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29
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Christie J, Smith GR, Williamson GM, Lance CE, Shovali TE, Silva LC. Quality of informal care is multidimensional. Rehabil Psychol 2009; 54:173-81. [PMID: 19469607 DOI: 10.1037/a0015705] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are routinely satisfied. We investigated the extent to which potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are empirically distinct dimensions of quality of care. DESIGN 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of their own depression, life events, cognitive status, and perceptions of pre-illness relationship quality. RESULTS Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing additional evidence for the distinction between these measures of quality of care. CONCLUSIONS ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care.
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30
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Schmitter-Edgecombe M, Howard JT, Pavawalla SP, Howell L, Rueda A. Multidyad memory notebook intervention for very mild dementia: a pilot study. Am J Alzheimers Dis Other Demen 2008; 23:477-87. [PMID: 18955726 PMCID: PMC10846120 DOI: 10.1177/1533317508320794] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
This pilot study examines the efficacy of a group memory notebook intervention. Five individuals with very mild dementia and 4 spouses who served as coaches attended 14 group treatment sessions. Therapists use educational strategies and learning activities packets to teach memory notebook use. At posttreatment, coaches report fewer symptoms of depression, and participants with very mild dementia report greater confidence in ability to obtain support. Modified laboratory memory testing reveals that participants with dementia demonstrate improved posttreatment memory scores because of increased note-taking behavior and more frequent referencing of notes. Although more frequent everyday memory strategies use is reported at posttreatment, this does not translate into reports of fewer everyday memory failures or greater everyday independence for the participants with dementia. This study demonstrates that a multidyad group intervention can successfully be used to teach patients with very mild dementia to use a memory notebook, with beneficial effects for both members of the care dyad.
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Efficiency of the CATIE and BACS neuropsychological batteries in assessing cognitive effects of antipsychotic treatments in schizophrenia. J Int Neuropsychol Soc 2008; 14:209-21. [PMID: 18282319 PMCID: PMC3138071 DOI: 10.1017/s1355617708080570] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Revised: 09/12/2007] [Accepted: 09/17/2007] [Indexed: 11/08/2022]
Abstract
Efficient and reliable assessments of cognitive treatment effects are essential for the comparative evaluation of procognitive effects of pharmacologic therapies. Yet, no studies have addressed the sensitivity and efficiency with which neurocognitive batteries evaluate cognitive abilities before and after treatment. Participants were primarily first episode schizophrenia patients who completed baseline (n = 367) and 12-week (n = 219) assessments with the BACS (Brief Assessment of Cognition in Schizophrenia) and CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) neuropsychological batteries in a clinical trial comparing olanzapine, quetiapine, and risperidone. Exploratory factor analysis revealed that performance on both batteries was characterized by a single factor of generalized cognitive deficit for both baseline performance and cognitive change after treatment. Both batteries estimated similar levels of change following treatment, although the BACS battery required half the administration time. Because a unitary factor characterized baseline cognitive abilities in early psychosis as well as cognitive change after treatment with atypical antipsychotic medications, short batteries such as the BACS may efficiently provide sufficient assessment of procognitive treatment effects with antipsychotic medications. Assessment of cognitive effects of adjunctive therapies targeting specific cognitive domains or impairments may require more extensive testing of the domains targeted to maximize sensitivity for detecting specific predicted cognitive outcomes.
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Salgado JV, Carvalhaes CFR, Pires ADM, Neves MDCLD, Cruz BF, Cardoso CS, Lauar H, Teixeira AL, Keefe RSE. Sensitivity and applicability of the Brazilian version of the Brief Assessment of Cognition in Schizophrenia (BACS). Dement Neuropsychol 2007; 1:260-265. [PMID: 29213399 PMCID: PMC5619004 DOI: 10.1590/s1980-57642008dn10300007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Cognitive assessment in schizophrenia has traditionally used batteries that are long and complex or differ widely in their content. The Brief Assessment of Cognition in Schizophrenia (BACS) has been developed to cover the main cognitive deficits of schizophrenia as well as to be easily and briefly administered, portable, sensitive and reliable. OBJECTIVES To investigate the applicability and sensitivity of the Brazilian Version of the BACS (Brazilian-BACS). METHODS Performance of 20 stable patients with schizophrenia on the Brazilian-BACS was compared to 20 matched healthy controls. RESULTS Applying the Brazilian-BACS required 43.4±8.4minutes for patients and 40.5±5.7 minutes for controls (p=0.17). All tests demonstrated significant differences between controls and patients (P<0.01). Pearson's correlation analysis and Cronbach's a evidenced a high internal consistency for patient performance. The cognitive deficit in the patients was approximately 1.5 standard deviations below controls. These results were consistent with those reported in the validation of the original version and in meta-analyses of similar studies. CONCLUSIONS The Brazilian-BACS displayed good applicability and sensitivity in assessing the major cognitive constructs that are impaired in schizophrenia. Thus, the Brazilian-BACS seems to be a promising tool for assessing cognition in patients with schizophrenia in Brazil.
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Affiliation(s)
- João Vinícius Salgado
- Department of Psychiatry, Raul Soares Institute, Belo Horizonte, MG, Brazil
- Neuropsychology and Education Department, Health Sciences School, FUMEC University, Belo Horizonte, MG, Brazil
| | | | - Annelise de Matos Pires
- Neuropsychology and Education Department, Health Sciences School, FUMEC University, Belo Horizonte, MG, Brazil
| | | | - Breno Fiúza Cruz
- Department of Psychiatry, Raul Soares Institute, Belo Horizonte, MG, Brazil
| | | | - Helio Lauar
- Department of Psychiatry, Raul Soares Institute, Belo Horizonte, MG, Brazil
| | - Antonio Lúcio Teixeira
- Neurology Unit, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Richard S E Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Abstract
Psychomotor slowing (PS) is a cluster of symptoms that was already recognized in schizophrenia by its earliest investigators. Nevertheless, few studies have been dedicated to the clarification of the nature and the role of the phenomenon in this illness. Moreover, slowed psychomotor functioning is often not clearly delineated from reduced processing speed. The current, first review of all existing literature on the subject discusses the key findings. Firstly, PS is a clinically observable feature that is most frequently established by neuropsychological measures assessing speed of fine movements such as writing or tasks that require rapid fingertip manipulations or the maintenance of maximal speed over brief periods of time in manual activities. Moreover, the slowed performance on the various psychomotor measures has been demonstrated independent of medication and has also been found to be associated with negative symptoms and, to a lesser extent, with positive and depressive symptoms. Importantly, performance on the psychomotor tasks proved related to the patients' social, clinical, and functional outcomes. Several imaging studies showed slowed performance to coincide with dopaminergic striatal activity. Finally, conventional neuroleptics do not improve the patients' PS symptoms, in contrast to the atypical agents that do seem to produce modestly improving effects.
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Affiliation(s)
- Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute, Building A, Campus Drie Eiken, Universiteitsplein 1, B-2610 Antwerp, Belgium.
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Wanebo JE, Amin-Hanjani S, Boyd C, Peery T. Assessing success after cerebral revascularization for ischemia. Skull Base 2005; 15:215-27. [PMID: 16175231 PMCID: PMC1214707 DOI: 10.1055/s-2005-872597] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cerebral revascularization continues to evolve as an option in the setting of ischemia. The potential to favorably influence stroke risk and the natural history of cerebrovascular occlusive disease is being evaluated by the ongoing Carotid Occlusion Surgery Study and the Japanese Extracranial-Intracranial Bypass Trial. For those patients who undergo bypass in the setting of ischemia, four key areas of follow-up include functional neurological status, neurocognitive status, bypass patency, and status of cerebral blood flow and perfusion. Several stroke scales that can be used to assess functional status include the National Institutes of Health Stroke Scale, Bathel Index, Modified Rankin Scale, and Stroke Specific Quality of Life. Neurocognition can be checked using the Repeatable Battery for the Assessment of Neuropsychological Status, among other tests. Bypass patency is checked intraoperatively using various flow probes and postoperatively using magnetic resonance angiography (MRA) or computed tomographic angiography (CTA). Cerebral blood flow and perfusion can be assessed using a host of modalities that include positron emission tomography (PET), xenon CT, single photon emission computed tomography (SPECT), transcranial Doppler (TCD), CT, and MR. Paired blood flow studies after a cerebral vasodilatory stimulus using one of these modalities can determine the state of autoregulatory vasodilation (Stage 1 hemodynamic compromise). However, only PET with oxygen extraction fraction measurements can reliably assess for Stage 2 compromise (misery perfusion). This article discusses the various clinical, neuropsychological, and radiographic techniques available to assess a patient's clinical state and cerebral blood flow before and after cerebral revascularization.
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Affiliation(s)
- John E Wanebo
- Department of Neurosciences, Division of Neurosurgery, Naval Medical Center San Diego, San Diego, California 92134-3201, USA.
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