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Watson MR, Traczewski N, Dunghana S, Boroujeni KB, Neumann A, Wen X, Womelsdorf T. A Multi-task Platform for Profiling Cognitive and Motivational Constructs in Humans and Nonhuman Primates. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.09.566422. [PMID: 38014107 PMCID: PMC10680597 DOI: 10.1101/2023.11.09.566422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Understanding the neurobiological substrates of psychiatric disorders requires comprehensive evaluations of cognitive and motivational functions in preclinical research settings. The translational validity of such evaluations will be supported by (1) tasks with high construct validity that are engaging and easy to teach to human and nonhuman participants, (2) software that enables efficient switching between multiple tasks in single sessions, (3) software that supports tasks across a broad range of physical experimental setups, and (4) by platform architectures that are easily extendable and customizable to encourage future optimization and development. New Method We describe the Multi-task Universal Suite for Experiments ( M-USE ), a software platform designed to meet these requirements. It leverages the Unity video game engine and C# programming language to (1) support immersive and engaging tasks for humans and nonhuman primates, (2) allow experimenters or participants to switch between multiple tasks within-session, (3) generate builds that function across computers, tablets, and websites, and (4) is freely available online with documentation and tutorials for users and developers. M-USE includes a task library with seven pre-existing tasks assessing cognitive and motivational constructs of perception, attention, working memory, cognitive flexibility, motivational and affective self-control, relational long-term memory, and visuo-spatial problem solving. Results M-USE was used to test NHPs on up to six tasks per session, all available as part of the Task Library, and to extract performance metrics for all major cognitive and motivational constructs spanning the Research Domain Criteria (RDoC) of the National Institutes of Mental Health. Comparison with Existing Methods Other experiment design and control systems exist, but do not provide the full range of features available in M-USE, including a pre-existing task library for cross-species assessments; the ability to switch seamlessly between tasks in individual sessions; cross-platform build capabilities; license-free availability; and its leveraging of video-engine capabilities used to gamify tasks. Conclusions The new multi-task platform facilitates cross-species translational research for understanding the neurobiological substrates of higher cognitive and motivational functions.
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Watson AJ, Giordano A, Suckling J, Barnes TRE, Husain N, Jones PB, Krynicki CR, Lawrie SM, Lewis S, Nikkheslat N, Pariante CM, Upthegrove R, Deakin B, Dazzan P, Joyce EM. Cognitive function in early-phase schizophrenia-spectrum disorder: IQ subtypes, brain volume and immune markers. Psychol Med 2023; 53:2842-2851. [PMID: 35177144 PMCID: PMC10244009 DOI: 10.1017/s0033291721004815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Evidence suggests that cognitive subtypes exist in schizophrenia that may reflect different neurobiological trajectories. We aimed to identify whether IQ-derived cognitive subtypes are present in early-phase schizophrenia-spectrum disorder and examine their relationship with brain structure and markers of neuroinflammation. METHOD 161 patients with recent-onset schizophrenia spectrum disorder (<5 years) were recruited. Estimated premorbid and current IQ were calculated using the Wechsler Test of Adult Reading and a 4-subtest WAIS-III. Cognitive subtypes were identified with k-means clustering. Freesurfer was used to analyse 3.0 T MRI. Blood samples were analysed for hs-CRP, IL-1RA, IL-6 and TNF-α. RESULTS Three subtypes were identified indicating preserved (PIQ), deteriorated (DIQ) and compromised (CIQ) IQ. Absolute total brain volume was significantly smaller in CIQ compared to PIQ and DIQ, and intracranial volume was smaller in CIQ than PIQ (F(2, 124) = 6.407, p = 0.002) indicative of premorbid smaller brain size in the CIQ group. CIQ had higher levels of hs-CRP than PIQ (F(2, 131) = 5.01, p = 0.008). PIQ showed differentially impaired processing speed and verbal learning compared to IQ-matched healthy controls. CONCLUSIONS The findings add validity of a neurodevelopmental subtype of schizophrenia identified by comparing estimated premorbid and current IQ and characterised by smaller premorbid brain volume and higher measures of low-grade inflammation (CRP).
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Affiliation(s)
- Andrew J. Watson
- The Department of Clinical and Motor Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Annalisa Giordano
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Suckling
- Brain Mapping Unit, Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge, UK
| | | | - Nusrat Husain
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- MAHSC, The University of Manchester, Manchester, UK
- Lancashire & South Cumbria NHS Foundation Trust, Accrington, UK
| | - Peter B. Jones
- Brain Mapping Unit, Department of Psychiatry, Herchel Smith Building for Brain and Mind Sciences, University of Cambridge, Cambridge, UK
- Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Carl R. Krynicki
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Stephen M. Lawrie
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Shôn Lewis
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- MAHSC, The University of Manchester, Manchester, UK
| | - Naghmeh Nikkheslat
- Stress, Psychiatry and Immunology Lab & Perinatal Psychiatry, The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Carmine M. Pariante
- Stress, Psychiatry and Immunology Lab & Perinatal Psychiatry, The Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK
- Forward thinking Birmingham, Birmingham Women's and Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Bill Deakin
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Eileen M. Joyce
- The Department of Clinical and Motor Neuroscience, UCL Queen Square Institute of Neurology, London, UK
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3
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Mawson ER, Morris BJ. A consideration of the increased risk of schizophrenia due to prenatal maternal stress, and the possible role of microglia. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110773. [PMID: 37116354 DOI: 10.1016/j.pnpbp.2023.110773] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/07/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023]
Abstract
Schizophrenia is caused by interaction of a combination of genetic and environmental factors. Of the latter, prenatal exposure to maternal stress is reportedly associated with elevated disease risk. The main orchestrators of inflammatory processes within the brain are microglia, and aberrant microglial activation/function has been proposed to contribute to the aetiology of schizophrenia. Here, we evaluate the epidemiological and preclinical evidence connecting prenatal stress to schizophrenia risk, and consider the possible mediating role of microglia in the prenatal stress-schizophrenia relationship. Epidemiological findings are rather consistent in supporting the association, albeit they are mitigated by effects of sex and gestational timing, while the evidence for microglial activation is more variable. Rodent models of prenatal stress generally report lasting effects on offspring neurobiology. However, many uncertainties remain as to the mechanisms underlying the influence of maternal stress on the developing foetal brain. Future studies should aim to characterise the exact processes mediating this aspect of schizophrenia risk, as well as focussing on how prenatal stress may interact with other risk factors.
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Affiliation(s)
- Eleanor R Mawson
- School of Psychology and Neuroscience, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Brian J Morris
- School of Psychology and Neuroscience, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK.
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4
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Ayesa-Arriola R, de la Foz VOG, Murillo-García N, Vázquez-Bourgon J, Juncal-Ruiz M, Gómez-Revuelta M, Suárez-Pinilla P, Setién-Suero E, Crespo-Facorro B. Cognitive reserve as a moderator of outcomes in five clusters of first episode psychosis patients: a 10-year follow-up study of the PAFIP cohort. Psychol Med 2023; 53:1891-1905. [PMID: 37310335 DOI: 10.1017/s0033291721003536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cognitive reserve (CR) has been associated with the development and prognosis of psychosis. Different proxies have been used to estimate CR among individuals. A composite score of these proxies could elucidate the role of CR at illness onset on the variability of clinical and neurocognitive outcomes. METHODS Premorbid intelligence quotient (IQ), years of education and premorbid adjustment were explored as proxies of CR in a large sample (N = 424) of first-episode psychosis (FEP) non-affective patients. Clusters of patients were identified and compared based on premorbid, clinical and neurocognitive variables at baseline. Additionally, the clusters were compared at 3-year (N = 362) and 10-year (N = 150) follow-ups. RESULTS The FEP patients were grouped into five CR clusters: C1 (low premorbid IQ, low education and poor premorbid) 14%; C2 (low premorbid IQ, low education and good premorbid adjustment) 29%; C3 (normal premorbid IQ, low education and poor premorbid adjustment) 17%; C4 (normal premorbid IQ, medium education and good premorbid adjustment) 25%; and C5 (normal premorbid IQ, higher education and good premorbid adjustment) 15%. In general, positive and negative symptoms were more severe in the FEP patients with the lowest CR at baseline and follow-up assessments, while those with high CR presented and maintained higher levels of cognitive functioning. CONCLUSIONS CR could be considered a key factor at illness onset and a moderator of outcomes in FEP patients. A high CR could function as a protective factor against cognitive impairment and severe symptomatology. Clinical interventions focused on increasing CR and documenting long-term benefits are interesting and desirable.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Victor Ortiz-García de la Foz
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Nancy Murillo-García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - María Juncal-Ruiz
- Department of Psychiatry, Sierrallana Hospital, IDIVAL, School of Medicine, University of Cantabria, Torrelavega, Spain
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Esther Setién-Suero
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Bilbao, Basque Country, Spain
| | - Benedicto Crespo-Facorro
- Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
- Instituto de Investigación Sanitaria de Sevilla, IBiS, Sevilla, Spain
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Modeling the interplay of age at onset and sex on cognition in Schizophrenia. Asian J Psychiatr 2022; 75:103202. [PMID: 35907340 DOI: 10.1016/j.ajp.2022.103202] [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: 03/23/2022] [Revised: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022]
Abstract
Cognition remains one of the most critical features of the schizophrenia. A wide range of factors has been associated to neurocognition and, among these, sex and age of onset are two of the most consistently reported to influence the functional and cognitive outcome. This work aims to evaluate the effects of sex and age of onset and their interaction on cognition in 419 subjects with schizophrenia. Analyses of variance and analyses of covariance were performed to evaluate the effect of sex and age at onset on cognition. To model the possible interaction sex-onset on cognition, a separate slope regression analysis was performed. Analyses of variance showed significant differences between sexes for age and age at onset, both significantly higher among females, as well as for Executive Functions, with higher performance among males. When compared according to age at onset, late-onset patients performed better than both early- and intermediate-onset ones in Verbal Memory subtest, with a significant effect of length of illness. Moreover, early-onset patients showed a significantly lower IQ compared to both intermediate and late-onset ones, with no significant effect of length of illness. Finally, the separate slope regression revealed a significant interaction between sex and age at onset, with early-onset being associated to a worse global cognition only among male patients. Our finding of a significant sex-onset interaction effect on neurocognition sheds new light on the complex issue of cognitive heterogeneity in schizophrenia. Our data may help towards the development of personalized programs for preventive and rehabilitative purposes.
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Romanowska S, Best MW, Bowie CR, Depp CA, Patterson TL, Penn DL, Pinkham AE, Harvey PD. Examining the association of life course neurocognitive ability with real-world functioning in schizophrenia-spectrum disorders. Schizophr Res Cogn 2022; 29:100254. [PMID: 35521291 PMCID: PMC9062312 DOI: 10.1016/j.scog.2022.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022] Open
Abstract
There is considerable variability in neurocognitive functioning within schizophrenia-spectrum disorders, and neurocognitive performance ranges from severe global impairment to normative performance. Few investigations of neurocognitive clusters have considered the degree to which deterioration relative to premorbid neurocognitive abilities is related to key illness characteristics. Moreover, while neurocognition and community functioning are strongly related, understanding of the sources of variability in the association between these two domains is also limited; it is unknown what proportion of participants would over-perform or under-perform the level of functioning expected based on current neurocognitive performance vs. lifelong attainment. This study examined data from 954 outpatients with schizophrenia-spectrum disorders across three previous studies. Neurocognition, community functioning, and symptoms were assessed. Neurocognitive subgroups were created based on current neurocognition, estimated premorbid IQ, and degree of deterioration from premorbid using z-score cut-offs; functional subgroups were created with cluster analysis based on the Specific Level of Functioning Scale and current neurocognition. The sample was neurocognitively heterogeneous; 65% displayed current neurocognitive impairment and 84% experienced some level of deterioration. Thirty percent of our sample was relatively higher functioning despite significant neurocognitive impairment. Individuals with better community functioning, regardless of neurocognitive performance, had lower symptom severity compared to those with worse functioning. These results highlight the variability in neurocognition and its role in functioning. Understanding individual differences in neurocognitive and functional profiles and the interaction between prior and current cognitive functioning can guide individualized treatment and selection of participants for clinical treatment studies.
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Affiliation(s)
- Sylvia Romanowska
- Department of Psychological Science, University of Toronto Scarborough, Toronto, ON, Canada
| | - Michael W Best
- Department of Psychological Science, University of Toronto Scarborough, Toronto, ON, Canada
| | | | - Colin A Depp
- Department of Psychiatry, UCSD Medical Center, La Jolla, CA, United States.,San Diego VA Healthcare System, San Diego, CA, United States
| | - Thomas L Patterson
- Department of Psychiatry, UCSD Medical Center, La Jolla, CA, United States
| | - David L Penn
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Amy E Pinkham
- Department of Psychology, University of Texas at Dallas, Dallas, TX, United States.,Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami VA Healthcare System, United States
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7
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Fett AKJ, Reichenberg A, Velthorst E. Lifespan evolution of neurocognitive impairment in schizophrenia - A narrative review. Schizophr Res Cogn 2022; 28:100237. [PMID: 35242606 PMCID: PMC8861413 DOI: 10.1016/j.scog.2022.100237] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 01/28/2023]
Abstract
Cognitive impairment is a well-recognized key feature of schizophrenia. Here we review the evidence on (1) the onset and sensitive periods of change in cognitive impairment before and after the first psychotic episode, and (2) heterogeneity in neurocognitive presentations across cognitive domains between and within individuals. Overall, studies suggest that mild cognitive impairment in individuals who develop schizophrenia or related disorders is already present during early childhood. Cross-sectional studies further suggest increasing cognitive impairments from pre- to post-psychosis onset, with the greatest declines between adolescence, the prodrome, and the first psychotic episode and with some variability between domains. Longitudinal studies with more than 10 years of observation time are scarce but support mild cognitive declines after psychosis onset until late adulthood. Whether and how much this cognitive decline exceeds normal aging, proceeds further in older patients, and is specific to certain cognitive domains and subpopulations of patients remains to be investigated. Finally, studies show substantial heterogeneity in cognitive performance in schizophrenia and suggest a variety of impairment profiles. This review highlights a clear need for long-term studies that include a control group and individuals from adolescence to old age to better understand critical windows of cognitive change and their predictors. The available evidence stresses the importance of interventions that aim to counter cognitive decline during the prodromal years, as well as careful assessment of cognition in order to determine who will profit most from which cognitive training.
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Affiliation(s)
- Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY, USA.,Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, USA
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8
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Lemvigh CK, Brouwer RM, Pantelis C, Jensen MH, Hilker RW, Legind CS, Anhøj SJ, Robbins TW, Sahakian BJ, Glenthøj BY, Fagerlund B. Heritability of specific cognitive functions and associations with schizophrenia spectrum disorders using CANTAB: a nation-wide twin study. Psychol Med 2022; 52:1101-1114. [PMID: 32779562 DOI: 10.1017/s0033291720002858] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Many cognitive functions are under strong genetic control and twin studies have demonstrated genetic overlap between some aspects of cognition and schizophrenia. How the genetic relationship between specific cognitive functions and schizophrenia is influenced by IQ is currently unknown. METHODS We applied selected tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) to examine the heritability of specific cognitive functions and associations with schizophrenia liability. Verbal and performance IQ were estimated using The Wechsler Adult Intelligence Scale-III and the Danish Adult Reading Test. In total, 214 twins including monozygotic (MZ = 32) and dizygotic (DZ = 22) pairs concordant or discordant for a schizophrenia spectrum disorder, and healthy control pairs (MZ = 29, DZ = 20) were recruited through the Danish national registers. Additionally, eight twins from affected pairs participated without their sibling. RESULTS Significant heritability was observed for planning/spatial span (h2 = 25%), self-ordered spatial working memory (h2 = 64%), sustained attention (h2 = 56%), and movement time (h2 = 47%), whereas only unique environmental factors contributed to set-shifting, reflection impulsivity, and thinking time. Schizophrenia liability was associated with planning/spatial span (rph = -0.34), self-ordered spatial working memory (rph = -0.24), sustained attention (rph = -0.23), and set-shifting (rph = -0.21). The association with planning/spatial span was not driven by either performance or verbal IQ. The remaining associations were shared with performance, but not verbal IQ. CONCLUSIONS This study provides further evidence that some cognitive functions are heritable and associated with schizophrenia, suggesting a partially shared genetic etiology. These functions may constitute endophenotypes for the disorder and provide a basis to explore genes common to cognition and schizophrenia.
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Affiliation(s)
- Cecilie K Lemvigh
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rachel M Brouwer
- Department of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Christos Pantelis
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Maria H Jensen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark
| | - Rikke W Hilker
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian S Legind
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Mental Health Center North Zealand, Hilleroed, Denmark
| | - Simon J Anhøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychiatry Svendborg, Baagoes Alle 25, 5700 Svendborg, Denmark
| | - Trevor W Robbins
- Department of Psychology, University of Cambridge, Cambridge, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Birte Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Glostrup, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
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9
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Molina-García M, Fraguas D, del Rey-Mejías Á, Mezquida G, Sánchez-Torres AM, Amoretti S, Lobo A, González-Pinto A, Andreu-Bernabeu Á, Corripio I, Vieta E, Baeza I, Mané A, Cuesta M, de la Serna E, Payá B, Zorrilla I, Arango C, Bernardo M, Rapado-Castro M, Parellada M. The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis. J Clin Med 2021; 10:2474. [PMID: 34199653 PMCID: PMC8199787 DOI: 10.3390/jcm10112474] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. METHODS we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. RESULTS early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). CONCLUSIONS early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.
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Affiliation(s)
- Mariola Molina-García
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - David Fraguas
- Institute of Psychiatry and Mental Health, Hospital Clínico San Carlos (IdISSC), Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28040 Madrid, Spain;
| | - Ángel del Rey-Mejías
- Data Science Unit, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, School of Psychology, Complutense University of Madrid (UCM), 28223 Madrid, Spain;
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Ana M. Sánchez-Torres
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 50009 Zaragoza, Spain;
| | - Ana González-Pinto
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Álvaro Andreu-Bernabeu
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Iluminada Corripio
- Department of Psychiatry, Institut d’Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Research Networking Center for Mental Health Network (CIBERSAM), Universitat Autònoma de Barcelona (UAB), 08041 Barcelona, Spain;
| | - Eduard Vieta
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Institute of Neurosciences, Hospital Clinic, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain;
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, SGR-881, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clínic de Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Anna Mané
- Hospital del Mar Medical Research Institute, Research Networking Center for Mental Health Network (CIBERSAM), Autonomous University of Barcelona, 08003 Barcelona, Spain;
| | - Manuel Cuesta
- Department of Psychiatry, Navarra Institute for Health Research (IdiSNA), Complejo Hospitalario de Navarra, 31008 Pamplona, Spain; (A.M.S.-T.); (M.C.)
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), 08036 Barcelona, Spain;
| | - Beatriz Payá
- IDIVAL, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Iñaki Zorrilla
- Department of Psychiatry, Bioaraba Health Research Institute, Hospital Universitario de Álava, Research Networking Center for Mental Health Network (CIBERSAM), University of the Basque Country (UPV/EHU), 01009 Vitoria, Spain; (A.G.-P.); (I.Z.)
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic of Barcelona, Research Networking Center for Mental Health Network (CIBERSAM), University of Barcelona, 08036 Barcelona, Spain; (G.M.); (S.A.); (M.B.)
| | - Marta Rapado-Castro
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
- Melbourne Neuropsychiatry Centre, The University of Melbourne and Melbourne Health, 161 Barry Street, Carlton South, VIC 3053, Australia
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañón Health Research Institute (IiSGM), Hospital General Universitario Gregorio Marañón, Research Networking Center for Mental Health Network (CIBERSAM), School of Medicine, Complutense University of Madrid (UCM), 28007 Madrid, Spain; (Á.A.-B.); (C.A.); (M.R.-C.); (M.P.)
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10
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Subtypes of depression characterized by different cognitive decline and brain activity alterations. J Psychiatr Res 2021; 138:413-419. [PMID: 33962128 DOI: 10.1016/j.jpsychires.2021.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/15/2021] [Accepted: 04/25/2021] [Indexed: 02/05/2023]
Abstract
Depression is characterized by the heterogeneity in anti-depressant treatment response and clinical outcomes. Cognitive impairment may be one of the more practically important aspects of depression. A new approach was to identify neuropsychologically derived depression subtypes based on the trajectory of neuro-cognition such as intelligence quotient (IQ) change. We used a classical premorbid IQ prediction algorithm and then compared predicted premorbid IQ with current IQ. IQ change was used to delineate the patterns of neuropsychological heterogeneity within a large dataset consisting of 131 patients with major depressive disorder (MDD) and 165 healthy controls (HCs). Neurocognitive results from CANTAB and 3 T resting-state fMRI data were compared among the subgroups identified. IQ change heterogeneity identified two subgroups within the MDD group: preserved IQ (PIQ) and deteriorated IQ (DIQ) in MDD. The DIQ subgroup was marked by poorer functioning across multiple cognition domains, including increased impairments in motor speed, cognitive flexibility, and catastrophic thinking when compared to PIQ and HCs. Moreover, cognitive performance of patients with DIQ was correlated with IQ decline. Also, increased brain activity of anterior cingulate cortex and medial prefrontal cortex was found in DIQ but not in PIQ and HCs. IQ-based subgroups of depression may be differentially associated with the extent of neurocognitive impairment and brain activities, which suggests that classifying the cognitive heterogeneity associated with depression may provide a platform to better characterize the neurobiological underpinnings of the disease.
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11
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Matsuo J, Hori H, Ishida I, Hiraishi M, Ota M, Hidese S, Yomogida Y, Kunugi H. Performance on the Wechsler Adult Intelligence Scale (WAIS) in Japanese patients with bipolar and major depressive disorders in euthymic and depressed states. Psychiatry Clin Neurosci 2021; 75:128-137. [PMID: 33368739 PMCID: PMC8048446 DOI: 10.1111/pcn.13191] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/29/2020] [Accepted: 12/21/2020] [Indexed: 02/01/2023]
Abstract
AIM This study aimed to examine the cognitive performance of patients with bipolar disorder (BD) stratified by illness phase compared to that of patients with major depressive disorder (MDD) and healthy controls. METHODS Participants were 139 patients with BD (55 euthymic and 84 depressed), 311 patients with MDD (88 euthymic and 223 depressed), and 386 healthy controls who underwent the Wechsler Adult Intelligence Scale-Revised or the Third Edition. They were non-elderly Japanese individuals with normal estimated premorbid intelligence quotient (IQ; >90), group-matched for age, sex, and premorbid IQ. RESULTS The depressed BD group showed significantly lower scores on verbal IQ, performance IQ, full-scale IQ, and three group indexes of perceptual organization, working memory, and processing speed when compared with healthy controls (all P < 0.001). All IQs and working memory index were also significantly lower than those of the depressed MDD group. The depressed MDD group scored significantly lower than controls in performance IQ (P < 0.001), full-scale IQ, and only in the index of processing speed (P < 0.001). The euthymic BD group scored significantly lower than controls in performance IQ (P = 0.004), whereas the euthymic MDD group scored significantly lower than controls only in processing speed (P = 0.030). CONCLUSION Patients with BD appear to have global and more intense cognitive impairments in depressed states compared with those with MDD whose impairments seem to be apparent only in processing speed in the Wechsler Adult Intelligence Scale. Attenuated impairments appear to exist in euthymic states of both patients.
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Affiliation(s)
- Junko Matsuo
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroaki Hori
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ikki Ishida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Moeko Hiraishi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Miho Ota
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yukihito Yomogida
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
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12
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Levaux MN, Potvin S, Sepehry AA, Sablier J, Mendrek A, Stip E. Computerized assessment of cognition in schizophrenia: Promises and pitfalls of CANTAB. Eur Psychiatry 2020; 22:104-15. [PMID: 17227707 DOI: 10.1016/j.eurpsy.2006.11.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2006] [Revised: 11/10/2006] [Accepted: 11/17/2006] [Indexed: 10/23/2022] Open
Abstract
AbstractObjectiveOver the last decade, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which comprises visuo-spatial tasks, has been utilized in cognitive studies of schizophrenia. A clear approach concerning the usage of CANTAB for the appraisal of neurocognitive dysfunction in schizophrenia is currently lacking.MethodIn this paper, we have first reviewed the overall applications of CANTAB and then evaluated methodological strengths and weaknesses of CANTAB as a neurocognitive battery for schizophrenia. We carried out a systematic search and assessment of studies where CANTAB was utilized to measure cognitive function in schizophrenia. We have also attempted to quantify the available data and perform a meta-analysis, but this approach turned out to be still premature.ResultsCANTAB has enabled researchers to highlight significant deficits affecting broad cognitive domains in schizophrenia, such as working memory, decision-making, attention, executive functions and visual memory. So far, the most consistent deficit observed with CANTAB testing has been attentional set-shifting, suggestive of fronto-striatal dysfunctions. In addition, preliminary evidence points towards the potential use of CANTAB to identify cognitive predictors of psychosocial functioning, to describe the relationships between symptoms and cognition, and to measure the impact of pharmacological agents on cognitive functioning.ConclusionCANTAB has been used successfully to highlight the range of visuo-spatial cognitive deficits in schizophrenia, producing similar results to those obtained with some traditional neuropsychological tests. Further studies validating the use of CANTAB following the standard set by Measurement And Treatment Research to Improve Cognition in Schizophrenia (MATRICS) are warranted.
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Affiliation(s)
- Marie-Noëlle Levaux
- Centre de Recherche Fernand-Seguin, Hôpital Louis-H Lafontaine, Montreal, Quebec, Canada
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13
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Andersen R, Fagerlund B, Rasmussen H, Ebdrup B, Aggernaes B, Gade A, Oranje B, Glenthoj B. The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients. Eur Psychiatry 2020; 28:332-9. [DOI: 10.1016/j.eurpsy.2012.06.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 06/05/2012] [Accepted: 06/08/2012] [Indexed: 12/30/2022] Open
Abstract
AbstractBackground:Impaired cognition is a prominent feature of schizophrenia. To what extent the heterogeneous cognitive impairments can be accounted for by considering only a single underlying impairment or a small number of core impairments remains elusive. This study examined whether cognitive impairments in antipsychotic-naïve, first-episode schizophrenia patients may be determined by a relative slower speed of information processing.Method:Forty-eight antipsychotic-naïve patients with first-episode schizophrenia and 48 matched healthy controls were administered a comprehensive battery of neuropsychological tests to assess domains of cognitive impairments in schizophrenia. Composite scores were calculated, grouping tests into cognitive domains.Results:There were significant differences between patients and healthy controls on global cognition and all cognitive domains, including verbal intelligence, processing speed, sustained attention, working memory, reasoning and problem solving, verbal learning and memory, visual learning and memory, and reaction time. All these significant differences, except for verbal intelligence and global cognition, disappeared when processing speed was included as a covariate.Conclusion:At the first stage of illness, antipsychotic-naïve patients with schizophrenia display moderate/severe impairments in all the cognitive domains assessed. The results support the contention of a global cognitive dysfunction in schizophrenia that to some extent may be determined by impaired processing speed.
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14
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Dickinson D, Zaidman SR, Giangrande EJ, Eisenberg DP, Gregory MD, Berman KF. Distinct Polygenic Score Profiles in Schizophrenia Subgroups With Different Trajectories of Cognitive Development. Am J Psychiatry 2020; 177:298-307. [PMID: 31838871 PMCID: PMC9627722 DOI: 10.1176/appi.ajp.2019.19050527] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Different cognitive development histories in schizophrenia may reflect variation across dimensions of genetic influence. The authors derived and characterized cognitive development trajectory subgroups within a schizophrenia sample and profiled the subgroups across polygenic scores (PGSs) for schizophrenia, cognition, educational attainment, and attention deficit hyperactivity disorder (ADHD). METHODS Demographic, clinical, and genetic data were collected at the National Institute of Mental Health from 540 schizophrenia patients, 247 unaffected siblings, and 844 control subjects. Cognitive trajectory subgroups were derived through cluster analysis using estimates of premorbid and current IQ. PGSs were generated using standard methods. Associations were tested using general linear models and logistic regression. RESULTS Cluster analyses identified three cognitive trajectory subgroups in the schizophrenia group: preadolescent cognitive impairment (19%), adolescent disruption of cognitive development (44%), and cognitively stable adolescent development (37%). Together, the four PGSs significantly predicted 7.9% of the variance in subgroup membership. Subgroup characteristics converged with genetic patterns. Cognitively stable individuals had the best adult clinical outcomes and differed from control subjects only in schizophrenia PGSs. Those with adolescent disruption of cognitive development showed the most severe symptoms after diagnosis and were cognitively impaired. This subgroup had the highest schizophrenia PGSs and had disadvantageous cognitive PGSs relative to control subjects and cognitively stable individuals. Individuals showing preadolescent impairment in cognitive and academic performance and poor adult outcome exhibited a generalized PGS disadvantage relative to control subjects and were the only subgroup to differ significantly in education and ADHD PGSs. CONCLUSIONS Subgroups derived from patterns of premorbid and current IQ showed different premorbid and clinical characteristics, which converged with broad genetic profiles. Simultaneous analysis of multiple PGSs may contribute to useful clinical stratification in schizophrenia.
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Affiliation(s)
- Dwight Dickinson
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Sofia R. Zaidman
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Evan J. Giangrande
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Daniel P. Eisenberg
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Michael D. Gregory
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
| | - Karen F. Berman
- Clinical and Translational Neuroscience Branch, National Institute of Mental Health, NIH
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15
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Wells R, Jacomb I, Swaminathan V, Sundram S, Weinberg D, Bruggemann J, Cropley V, Lenroot RK, Pereira AM, Zalesky A, Bousman C, Pantelis C, Weickert CS, Weickert TW. The Impact of Childhood Adversity on Cognitive Development in Schizophrenia. Schizophr Bull 2020; 46:140-153. [PMID: 31050754 PMCID: PMC6942153 DOI: 10.1093/schbul/sbz033] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Childhood adversity, such as physical, sexual, and verbal abuse, as well as neglect and family conflict, is a risk factor for schizophrenia. Such adversity can lead to disruptions of cognitive function during development, undermining intellectual capabilities and academic achievement. Schizophrenia is a neurodevelopmental disorder that is associated with cognitive impairments that may become evident during childhood. The Australian Schizophrenia Research Bank database comprises a large community cohort (N = 1169) in which we previously identified 3 distinct cognitive groups among people with schizophrenia: (1) Compromised, current, and estimated premorbid cognitive impairment; (2) Deteriorated, substantial decline from estimated premorbid function; and (3) Preserved, performing in the normal cognitive range without decline. The compromised group displayed the worst functional and symptom outcomes. Here, we extend our previous work by assessing the relationship among these categories of cognitive abilities and reported childhood adversity in 836 patients and healthy controls. Exploratory factor analysis of the Childhood Adversity Questionnaire revealed 3 factors (lack of parental involvement; overt abuse; family breakdown and hardship). People with schizophrenia reported significantly more childhood adversity than healthy controls on all items and factors. People with schizophrenia in the compromised group reported significantly more lack of parental involvement and family breakdown and hardship and lower socioeconomic status than those in the deteriorated group. The cognitive groups were not related to family history of psychosis. These findings identify specific social and family factors that impact cognition, highlighting the important role of these factors in the development of cognitive and functional abilities in schizophrenia.
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Affiliation(s)
- Ruth Wells
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Isabella Jacomb
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Vaidy Swaminathan
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Mental Health Program, Monash Medical Centre, Monash Health, Clayton, Australia,Schizophrenia Research Institute, Sydney, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Suresh Sundram
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Mental Health Program, Monash Medical Centre, Monash Health, Clayton, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia,Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Danielle Weinberg
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Present address: Clinical Research Support Office, Childrens Hospital of Philadelphia, Philadelphia, PA
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia
| | - Vanessa Cropley
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Rhoshel K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,Present address: School of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM
| | - Avril M Pereira
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Andrew Zalesky
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Chad Bousman
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Present address: Department of Medical Genetics, Psychiatry, and Physiology & Pharmacology, University of Calgary, Alberta, Canada
| | - Christos Pantelis
- Department of Psychiatry, University of Melbourne, Parkville, Australia,Schizophrenia Research Institute, Sydney, Australia
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,Present address: Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, New York
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia,Neuroscience Research Australia, Randwick, Sydney, Australia,Schizophrenia Research Institute, Sydney, Australia,To whom correspondence should be addressed; tel: +61-02-9399-1730, fax: +61-02-9399-1034, e-mail:
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16
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Influence of cognitive reserve in schizophrenia: A systematic review. Neurosci Biobehav Rev 2020; 108:149-159. [DOI: 10.1016/j.neubiorev.2019.10.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 10/10/2019] [Accepted: 10/26/2019] [Indexed: 01/08/2023]
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17
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Tibber MS, Kirkbride JB, Mutsatsa S, Harrison I, Barnes TRE, Joyce EM, Huddy V. Are socioenvironmental factors associated with psychotic symptoms in people with first-episode psychosis? A cross-sectional study of a West London clinical sample. BMJ Open 2019; 9:e030448. [PMID: 31537571 PMCID: PMC6756588 DOI: 10.1136/bmjopen-2019-030448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/06/2019] [Accepted: 08/19/2019] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To determine whether neighbourhood-level socioenvironmental factors including deprivation and inequality predict variance in psychotic symptoms after controlling for individual-level demographics. DESIGN A cross-sectional design was employed. SETTING Data were originally collected from secondary care services within the UK boroughs of Ealing, Hammersmith and Fulham, Wandsworth, Kingston, Richmond, Merton, Sutton and Hounslow as part of the West London First-Episode Psychosis study. PARTICIPANTS Complete case analyses were undertaken on 319 participants who met the following inclusion criteria: aged 16 years or over, resident in the study's catchment area, experiencing a first psychotic episode, with fewer than 12 weeks' exposure to antipsychotic medication and sufficient command of English to facilitate assessment. OUTCOME MEASURES Symptom dimension scores, derived from principal component analyses of the Scale for the Assessment of Positive Symptoms and Scale for the Assessment of Negative Symptoms, were regressed on neighbourhood-level predictors, including population density, income deprivation, income inequality, social fragmentation, social cohesion, ethnic density and ethnic fragmentation, using multilevel regression. While age, gender and socioeconomic status were included as individual-level covariates, data on participant ethnicity were not available. RESULTS Higher income inequality was associated with lower negative symptom scores (coefficient=-1.66, 95% CI -2.86 to -0.46, p<0.01) and higher levels of ethnic segregation were associated with lower positive symptom scores (coefficient=-2.32, 95% CI -4.17 to -0.48, p=0.01) after adjustment for covariates. CONCLUSIONS These findings provide further evidence that particular characteristics of the environment may be linked to specific symptom clusters in psychosis. Longitudinal studies are required to begin to tease apart the underlying mechanisms involved as well as the causal direction of such associations.
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Affiliation(s)
- Marc S Tibber
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Stanley Mutsatsa
- School of Health Sciences, City, University of London, London, UK
| | - Isobel Harrison
- Division of Psychiatry, University College London, London, UK
| | | | - Eileen M Joyce
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Vyv Huddy
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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18
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Carruthers SP, Van Rheenen TE, Gurvich C, Sumner PJ, Rossell SL. Characterising the structure of cognitive heterogeneity in schizophrenia spectrum disorders. A systematic review and narrative synthesis. Neurosci Biobehav Rev 2019; 107:252-278. [PMID: 31505202 DOI: 10.1016/j.neubiorev.2019.09.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/19/2019] [Accepted: 09/02/2019] [Indexed: 12/13/2022]
Abstract
The aim of the present review was to systematically summarise our current understanding of the structure of the cognitive heterogeneity that exists within schizophrenia spectrum disorder (SSD). Fifty-two relevant studies were identified from January 1980 to March 2019 that investigated cognitive subgroups within SSD. Twenty-five studies employed classification criteria based on current neuropsychological function, 14 studies employed various data-driven subgrouping methodologies and 13 studies investigated putative cognitive symptom trajectories. Despite considerable methodological variability, three distinct cognitive subgroups reliability emerged; a relatively intact cognitive subgroup characterised by high cognitive performance, an intermediate cognitive subgroup defined by mixed or moderate levels of cognitive function/dysfunction and a globally impaired subgroup characterised by severe cognitive deficits. Whilst preliminary evidence suggests that these subgroups may have further investigative relevance in and of themselves, additional research is required and discussed. A set of reporting guidelines are also presented to overcome the methodological inconsistencies identified in the reviewed literature.
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Affiliation(s)
- Sean P Carruthers
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia.
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, 3053, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred Hospital, Melbourne, 3004, Australia
| | - Philip J Sumner
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Victoria, 3122, Australia; St Vincent's Hospital, Melbourne, Victoria, 3065, Australia
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19
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Ospina LH, Shanahan M, Perez-Rodriguez MM, Chan CC, Clari R, Burdick KE. Alexithymia predicts poorer social and everyday functioning in schizophrenia and bipolar disorder. Psychiatry Res 2019; 273:218-226. [PMID: 30658205 PMCID: PMC6561815 DOI: 10.1016/j.psychres.2019.01.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/28/2022]
Abstract
Alexithymia, or the inability to identify and describe one's emotions, is significantly higher in bipolar disorder (BD) and schizophrenia (SZ), compared to healthy controls (HC). Alexithymia has also been observed to predict psychosocial functioning in SZ. We investigated whether alexithymia predicted social and everyday functioning in BD, as well as transdiagnostically in HC, BD, and SZ patients. 56 BD, 45 SZ, and 50 HC were administered and compared on tests measuring neurocognition, social cognition, functioning and alexithymia. We conducted linear regressions assessing whether alexithymia predicted functional outcomes in BD. Next, we conducted hierarchical stepwise linear regressions investigating the predictive ability of neurocognition, social cognition and alexithymia on everyday and social functioning in our overall sample. BD and SZ patients were comparable on most demographics and demonstrated higher alexithymia compared to HCs. In BD, alexithymia predicted social functioning only. In the overall sample, difficulty identifying and describing feelings predicted everyday functioning; difficulty describing feelings predicted social functioning. Results suggest that aspects of alexithymia significantly predict functioning among these psychiatric groups, above and beyond the contributions of previously identified factors such as neurocognition and social cognition. Results may aid in developing proper interventions aimed at improving patients' ability to articulate their feelings.
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Affiliation(s)
- L H Ospina
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States.
| | - M Shanahan
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States; Brigham and Women's Hospital, Department of Psychiatry, Boston MA, United States
| | - M M Perez-Rodriguez
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - C C Chan
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - R Clari
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States
| | - K E Burdick
- Icahn School of Medicine at Mount Sinai, Departments of Psychiatry and Neuroscience, New York NY, United States; Brigham and Women's Hospital, Department of Psychiatry, Boston MA, United States; James J. Peters VA Medical Center, Bronx NY, United States; Harvard Medical School, Department of Psychiatry, Boston, MA, United States
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20
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Islam MA, Habtewold TD, van Es FD, Quee PJ, van den Heuvel ER, Alizadeh BZ, Bruggeman R. Long-term cognitive trajectories and heterogeneity in patients with schizophrenia and their unaffected siblings. Acta Psychiatr Scand 2018; 138:591-604. [PMID: 30242827 PMCID: PMC6220939 DOI: 10.1111/acps.12961] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This study aimed to assess the heterogeneity and stability of cognition in patients with a non-affective psychotic disorder and their unaffected siblings. In addition, we aimed to predict the cognitive subtypes of siblings by their probands. METHOD Assessments were conducted at baseline, 3 and 6 years in 1119 patients, 1059 siblings and 586 controls from the Genetic Risk and Outcome of Psychosis (GROUP) study. Group-based trajectory modeling was applied to identify trajectories and clustered multinomial logistic regression analysis was used for prediction modeling. A composite score of eight neurocognitive tests was used to measure cognitive performance. RESULTS Five stable cognitive trajectories ranging from severely altered to high cognitive performance were identified in patients. Likewise, four stable trajectories ranging from moderately altered to high performance were found in siblings. Siblings had a higher risk of cognitive alteration when patients' alteration was mild (OR = 2.21), moderate (OR = 5.70), and severe (OR = 10.07) compared with patients with intact cognitive function. The familial correlation coefficient between pairs of index patients and their siblings was 0.27 (P = 0.003). CONCLUSIONS The cognitive profiles identified in the current study might be suitable as endophenotypes and could be used in future genetic studies and predicting functional and clinical outcomes.
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Affiliation(s)
- Md. A. Islam
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
- Department of StatisticsShahjalal University of Science and TechnologySylhetBangladesh
| | - T. D. Habtewold
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
| | - F. D. van Es
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
| | - P. J. Quee
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University Psychiatric Centre (UPC)KU LeuvenLeuvenBelgium
| | - E. R. van den Heuvel
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
- Department of Mathematics and Computer ScienceEindhoven University of TechnologyEindhovenThe Netherlands
| | - B. Z. Alizadeh
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- University of GroningenUniversity Medical Center GroningenDepartment of EpidemiologyGroningenThe Netherlands
| | - R. Bruggeman
- University of GroningenUniversity Medical Center GroningenUniversity Center for PsychiatryRob Giel Research CenterGroningenThe Netherlands
- Department of Clinical and Developmental NeuropsychologyUniversity of GroningenGroningenThe Netherlands
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21
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Tibber MS, Kirkbride JB, Joyce EM, Mutsatsa S, Harrison I, Barnes TRE, Huddy V. The component structure of the scales for the assessment of positive and negative symptoms in first-episode psychosis and its dependence on variations in analytic methods. Psychiatry Res 2018; 270:869-879. [PMID: 30551337 PMCID: PMC6299359 DOI: 10.1016/j.psychres.2018.10.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 12/20/2022]
Abstract
A secondary analysis was undertaken on Scales for the Assessment of Positive and Negative Symptoms (SAPS/SANS) data from 345 first-episode psychosis (FEP) patients gathered in the West London FEP study. The purpose of this study was to determine: (i) the component structure of these measures in FEP (primary analyses), and (ii) the dependence of any findings in these primary analyses on variations in analytic methods. Symptom ratings were exposed to data reduction methods and the effects of the following manipulations ascertained: (i) level of analysis (individual symptom vs. global symptom severity ratings), (ii) extraction method (principal component vs. exploratory factor analysis) and (iii) retention method (scree test vs. Kaiser criterion). Whilst global ratings level analysis rendered the classic triad of psychotic syndromes (positive, negative and disorganisation), symptom level analyses revealed a hierarchical structure, with 11 first-order components subsumed by three second-order components, which also mapped on to this syndrome triad. These results were robust across data reduction but not component retention methods, suggesting that discrepancies in the literature regarding the component structure of the SAPS/SANS partly reflect the level of analysis and component retention method used. Further, they support a hierarchical symptom model, the implications of which are discussed.
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Affiliation(s)
- Marc S Tibber
- Department of Clinical, Educational and Health Psychology, UCL, London, UK.
| | | | | | | | | | | | - Vyv Huddy
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, UK.
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22
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Zhou HY, Li Z, Xie DJ, Xu T, Cheung EEF, Li H, Chan RCK. Heritability estimates of spatial working memory and set-shifting in a healthy Chinese twin sample: A preliminary study. Psych J 2018; 7:144-151. [DOI: 10.1002/pchj.227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 06/06/2018] [Accepted: 07/02/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Han-yu Zhou
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Psychology; University of Chinese Academy of Sciences; Beijing China
- Department of Psychology; Renmin University of China; Beijing China
| | - Zhi Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Psychology; University of Chinese Academy of Sciences; Beijing China
| | - Dong-jie Xie
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Psychology; University of Chinese Academy of Sciences; Beijing China
| | - Ting Xu
- Key Laboratory of Behavioral Sciences and Magnetic Resonance Imaging Research Center; Institute of Psychology, Chinese Academy of Sciences; Beijing China
- Center for the Developing Brain; Child Mind Institute; New York New York USA
| | - Eric E. F. Cheung
- Castle Peak Hospital; Hong Kong Special Administrative Region; Tuen Mun China
| | - Huanhuan Li
- Department of Psychology; Renmin University of China; Beijing China
| | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology; Chinese Academy of Sciences; Beijing China
- Department of Psychology; University of Chinese Academy of Sciences; Beijing China
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23
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Sheikh TI, Harripaul R, Ayub M, Vincent JB. MeCP2 AT-Hook1 mutations in patients with intellectual disability and/or schizophrenia disrupt DNA binding and chromatin compaction in vitro. Hum Mutat 2018; 39:717-728. [DOI: 10.1002/humu.23409] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/10/2018] [Accepted: 02/07/2018] [Indexed: 01/29/2023]
Affiliation(s)
- Taimoor I. Sheikh
- Molecular Neuropsychiatry & Development (MiND) Lab; Campbell Family Mental Health Research Institute; Centre for Addiction and Mental Health; Toronto Ontario Canada
- Institute of Medical Science; University of Toronto; Toronto Ontario Canada
| | - Ricardo Harripaul
- Molecular Neuropsychiatry & Development (MiND) Lab; Campbell Family Mental Health Research Institute; Centre for Addiction and Mental Health; Toronto Ontario Canada
- Institute of Medical Science; University of Toronto; Toronto Ontario Canada
| | - Muhammad Ayub
- Lahore Institute of Research & Development; Lahore Pakistan
- Department of Psychiatry; Queen's University; Kingston Ontario Canada
| | - John B. Vincent
- Molecular Neuropsychiatry & Development (MiND) Lab; Campbell Family Mental Health Research Institute; Centre for Addiction and Mental Health; Toronto Ontario Canada
- Institute of Medical Science; University of Toronto; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Toronto Ontario Canada
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24
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Abstract
Intellectual and other more specific neurocognitive impairments in
schizophrenia are important for understanding the aetiology of the condition
and its likely outcome. However, these impairments are not usually
considered important for supporting a diagnosis in suspected early
schizophrenia. IQ testing is widely available and probably acceptable to
most people likely to be experiencing the early stages of psychosis and who
might be unable or unwilling to disclose details of their history and mental
state or to cooperate with more comprehensive neuropsychological assessment.
Although in general IQ tests have only limited diagnostic value in
schizophrenia, the finding of a substantial decline in IQ score from the
estimated premorbid level may be helpful in supporting a provisional
diagnosis of early schizophrenia in cases without organic signs in which the
clinical picture is unclear or incomplete. More important, the results of IQ
tests may contribute to a better understanding of patients' impairments and
assist clinical management in a number of ways, as illustrated here by three
fictional case studies.
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25
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Pentaraki A, Utoblo B, Kokkoli EM. Cognitive remediation therapy plus standard care versus standard care for people with schizophrenia. Hippokratia 2017. [DOI: 10.1002/14651858.cd012865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alexandra Pentaraki
- University of Liverpool Online Programs (in partnership with Laureate Online Education); Applied Psychology and Mental Health; Liverpool UK
- King's College London; Institute of Psychiatry, Psychology and Neuroscience; De Crespigny Park London UK SE5 8AF
- Brain Matters Institute; Thessaloniki Greece
| | - Bello Utoblo
- Leeds Beckett University; School of Health and Community Studies; Portland Way Leeds UK
| | - Eleni Maria Kokkoli
- City College, University of Sheffield; Department of Psychology; 24 Proxenou Koromila Street Kalamaria Thessaloniki Greece 546 22
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26
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Bak N, Mann J, Fagerlund B, Glenthøj BY, Jepsen JRM, Oranje B. Testing a decades' old assumption: Are individuals with lower sensory gating indeed more easily distracted? Psychiatry Res 2017; 255:387-393. [PMID: 28666245 DOI: 10.1016/j.psychres.2017.05.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/05/2017] [Accepted: 05/30/2017] [Indexed: 12/16/2022]
Abstract
The sensory gating deficits in schizophrenia have been theorized to associate with increased distractibility. We explore the potential associations between sensory and sensorimotor gating and subjective and objective indices of distraction in healthy subjects. Forty healthy males were assessed with the P50 suppression and pre-pulse inhibition of the startle reflex (PPI) paradigms. Additionally, a neurocognitive test battery was administered in a cross-over design: with/without auditory distraction. Significant effects of distraction were found in response inhibition, and verbal working memory and attention. Parameters from the PPI and P50 suppression paradigms were significantly associated with the distractor effects on strategy formation, cognitive inhibition and flexibility, visual short-term memory, and the level of subjective distraction. Subjectively reported distraction was significantly associated with verbal working memory and attention as well as executive and supervisory processes. Sensory and sensorimotor gating efficiency do not reflect the effect of distraction across executive and attention functions i.e. we did not observe a generalized distractor effect. Gating only related to the effect of distraction on strategy formation, cognitive inhibition and flexibility, as well as visual short term memory. Future studies should investigate if gating deficits affect the distractibility of the same specific cognitive functions in patients with schizophrenia.
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Affiliation(s)
- N Bak
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, The Capital Region, Copenhagen, Denmark.
| | - J Mann
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark
| | - B Fagerlund
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, The Capital Region, Copenhagen, Denmark
| | - B Y Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, The Capital Region, Copenhagen, Denmark
| | - J R M Jepsen
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, The Capital Region, Copenhagen, Denmark; Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - B Oranje
- Centre for Neuropsychiatric Schizophrenia Research, Mental Health Services Glostrup, The Capital Region, Copenhagen, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, The Capital Region, Copenhagen, Denmark; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
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27
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Ben-Zeev D, Brian R, Wang R, Wang W, Campbell AT, Aung MSH, Merrill M, Tseng VWS, Choudhury T, Hauser M, Kane JM, Scherer EA. CrossCheck: Integrating self-report, behavioral sensing, and smartphone use to identify digital indicators of psychotic relapse. Psychiatr Rehabil J 2017; 40:266-275. [PMID: 28368138 PMCID: PMC5593755 DOI: 10.1037/prj0000243] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This purpose of this study was to describe and demonstrate CrossCheck, a multimodal data collection system designed to aid in continuous remote monitoring and identification of subjective and objective indicators of psychotic relapse. METHOD Individuals with schizophrenia-spectrum disorders received a smartphone with the monitoring system installed along with unlimited data plan for 12 months. Participants were instructed to carry the device with them and to complete brief self-reports multiple times a week. Multimodal behavioral sensing (i.e., physical activity, geospatials activity, speech frequency, and duration) and device use data (i.e., call and text activity, app use) were captured automatically. Five individuals who experienced psychiatric hospitalization were selected and described for instructive purposes. RESULTS Participants had unique digital indicators of their psychotic relapse. For some, self-reports provided clear and potentially actionable description of symptom exacerbation prior to hospitalization. Others had behavioral sensing data trends (e.g., shifts in geolocation patterns, declines in physical activity) or device use patterns (e.g., increased nighttime app use, discontinuation of all smartphone use) that reflected the changes they experienced more effectively. CONCLUSION Advancements in mobile technology are enabling collection of an abundance of information that until recently was largely inaccessible to clinical research and practice. However, remote monitoring and relapse detection is in its nascence. Development and evaluation of innovative data management, modeling, and signal-detection techniques that can identify changes within an individual over time (i.e., unique relapse signatures) will be essential if we are to capitalize on these data to improve treatment and prevention. (PsycINFO Database Record
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Affiliation(s)
| | | | - Rui Wang
- Department of Computer Science, Dartmouth College
| | - Weichen Wang
- Department of Computer Science, Dartmouth College
| | | | - Min S H Aung
- Department of Information Science, Cornell University
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28
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Fujino H, Sumiyoshi C, Yasuda Y, Yamamori H, Fujimoto M, Fukunaga M, Miura K, Takebayashi Y, Okada N, Isomura S, Kawano N, Toyomaki A, Kuga H, Isobe M, Oya K, Okahisa Y, Takaki M, Hashimoto N, Kato M, Onitsuka T, Ueno T, Ohnuma T, Kasai K, Ozaki N, Sumiyoshi T, Imura O, Hashimoto R. Estimated cognitive decline in patients with schizophrenia: A multicenter study. Psychiatry Clin Neurosci 2017; 71:294-300. [PMID: 27804186 DOI: 10.1111/pcn.12474] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/05/2016] [Accepted: 10/20/2016] [Indexed: 12/30/2022]
Abstract
AIM Studies have reported that cognitive decline occurs after the onset of schizophrenia despite heterogeneity in cognitive function among patients. The aim of this study was to investigate the degree of estimated cognitive decline in patients with schizophrenia by comparing estimated premorbid intellectual functioning and current intellectual functioning. METHODS A total of 446 patients with schizophrenia (228 male, 218 female), consisting of three sample sets obtained from 11 psychiatric facilities, and 686 healthy controls participated in this study. The Wechsler Adult Intelligence Scale-III (WAIS-III) was used to measure the participants' current full-scale IQ (FSIQ). The premorbid IQ was estimated using the Japanese Adult Reading Test-25. Estimated cognitive decline (difference score) was defined as the difference between the estimated premorbid IQ and the current FSIQ. RESULTS Patients with schizophrenia showed greater estimated cognitive decline, a lower FSIQ, and a lower premorbid IQ compared with the healthy controls. The mean difference score, FSIQ, and estimated premorbid IQ were -16.3, 84.2, and 100.5, respectively, in patients with schizophrenia. Furthermore, 39.7% of the patients had a difference score of 20 points or greater decline. A discriminant analysis showed that the difference score accurately predicted 81.6% of the patients and healthy controls. CONCLUSION These results show the distribution of difference score in patients with schizophrenia. These findings may contribute to assessing the severity of estimated cognitive decline and identifying patients with schizophrenia who suffer from cognitive decline.
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Affiliation(s)
- Haruo Fujino
- Graduate School of Human Sciences, Osaka University, Osaka, Japan.,Graduate School of Education, Oita University, Oita, Japan
| | - Chika Sumiyoshi
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
| | - Yuka Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hidenaga Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Fujimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaki Fukunaga
- Division of Cerebral Integration, National Institute for Physiological Sciences, Aichi, Japan
| | - Kenichiro Miura
- Graduate School of Medicine, Department of Integrative Brain Science, Kyoto University, Kyoto, Japan
| | - Yuto Takebayashi
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Naohiro Okada
- Graduate School of Medicine, Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Shuichi Isomura
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Naoko Kawano
- Green Mobility Research Institute, Institutes of Innovation for Future Society, Nagoya University, Aichi, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Atsuhito Toyomaki
- Graduate School of Medicine, Department of Psychiatry, Hokkaido University, Sapporo, Japan
| | - Hironori Kuga
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan
| | - Masanori Isobe
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazuto Oya
- Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan
| | - Yuko Okahisa
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Manabu Takaki
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naoki Hashimoto
- Graduate School of Medicine, Department of Psychiatry, Hokkaido University, Sapporo, Japan
| | - Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Toshiaki Onitsuka
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan
| | - Takefumi Ueno
- Graduate School of Medical Sciences, Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan.,Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, Saga, Japan
| | - Tohru Ohnuma
- Department of Psychiatry, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Kiyoto Kasai
- Graduate School of Medicine, Department of Neuropsychiatry, The University of Tokyo, Tokyo, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tomiki Sumiyoshi
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Osamu Imura
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
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29
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Haring L, Mõttus R, Kajalaid K, Koch K, Uppin K, Maron E, Vasar E. The course of cognitive functioning after first-episode of psychosis: A six month follow-up study. Schizophr Res 2017; 182:31-41. [PMID: 27746055 DOI: 10.1016/j.schres.2016.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 12/22/2022]
Abstract
Our aim with the present study was to evaluate rank-order and mean-level cognitive functioning stability among first-episode psychosis (FEP) patients, measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB), over a six month period. We also aimed to examine longitudinal measurement invariance and identify factors-such as age, gender, educational level, treatment and psychopathological change scores-potentially linked to cognitive change among patients. In addition, correlations between objectively measured and subjectively evaluated cognitive functioning were estimated. Neuropsychological assessments were administered to 85 patients after the initial stabilisation of their psychosis; 82 of the patients were retested. Subjectively perceived cognitive functioning was measured using a subscale derived from the Estonian version of the Subjective Well-Being Under Neuroleptic Scale (SWN-K-E). On average, executive functioning and processing speed improved significantly, while memory test scores decreased significantly, over time. Very high rank-order stability (r=0.80 to 0.94, p<0.001) was observed with all measured ability scores. Confirmatory factor analysis revealed the loadings of a single (broad ability) factor model were equal across both measurement occasions, but the lack of intercept invariance suggested that mean-level comparisons are more appropriately carried out at a subtest level. On average psychopathology scores and antipsychotics doses declined over time, with the latter also significantly correlating with better executive functioning. Gender was a significant moderator of some domains of cognitive performance, and decline tended to be somewhat more pronounced for women. The results also indicated the lack of any relationship between objective and subjective measurements of cognitive functioning.
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Affiliation(s)
- Liina Haring
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - René Mõttus
- Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Tartu, Tartu, Estonia.
| | | | - Kadri Koch
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Kärt Uppin
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Eduard Maron
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia; North Estonia Medical Centre, Department of Psychiatry, Tallinn, Estonia; Centre for Mental Health, Imperial College London, UK.
| | - Eero Vasar
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia.
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30
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Oikonomidis L, Santangelo AM, Shiba Y, Clarke FH, Robbins TW, Roberts AC. A dimensional approach to modeling symptoms of neuropsychiatric disorders in the marmoset monkey. Dev Neurobiol 2017; 77:328-353. [PMID: 27589556 PMCID: PMC5412688 DOI: 10.1002/dneu.22446] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/22/2016] [Accepted: 08/26/2016] [Indexed: 01/19/2023]
Abstract
Some patients suffering from the same neuropsychiatric disorder may have no overlapping symptoms whilst others may share symptoms common to other distinct disorders. Therefore, the Research Domain Criteria initiative recognises the need for better characterisation of the individual symptoms on which to focus symptom-based treatment strategies. Many of the disorders involve dysfunction within the prefrontal cortex (PFC) and so the marmoset, due to their highly developed PFC and small size, is an ideal species for studying the neurobiological basis of the behavioural dimensions that underlie these symptoms.Here we focus on a battery of tests that address dysfunction spanning the cognitive (cognitive inflexibility and working memory), negative valence (fear generalisation and negative bias) and positive valence (anhedonia) systems pertinent for understanding disorders such as ADHD, Schizophrenia, Anxiety, Depression and OCD. Parsing the separable prefrontal and striatal circuits and identifying the selective neurochemical modulation (serotonin vs dopamine) that underlie cognitive dysfunction have revealed counterparts in the clinical domain. Aspects of the negative valence system have been explored both at individual- (trait anxiety and genetic variation in serotonin transporter) and circuit-based levels enabling the understanding of generalisation processes, negative biases and differential responsiveness to SSRIs. Within the positive valence system, the combination of cardiovascular and behavioural measures provides a framework for understanding motivational, anticipatory and consummatory aspects of anhedonia and their neurobiological mechanisms. Together, the direct comparison of experimental findings in marmosets with clinical studies is proving an excellent translational model to address the behavioural dimensions and neurobiology of neuropsychiatric symptoms. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 328-353, 2017.
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Affiliation(s)
- Lydia Oikonomidis
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
| | - Andrea M Santangelo
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
| | - Yoshiro Shiba
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
| | - F Hannah Clarke
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
| | - Trevor W Robbins
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, United Kingdom
| | - Angela C Roberts
- Department of Physiology, Development and Neuroscience, University of Cambridge, Downing Street, Cambridge, CB2 3DY, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, CB2 3EB, United Kingdom
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31
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Adan A, Arredondo AY, Capella MDM, Prat G, Forero DA, Navarro JF. Neurobiological underpinnings and modulating factors in schizophrenia spectrum disorders with a comorbid substance use disorder: A systematic review. Neurosci Biobehav Rev 2017; 75:361-377. [PMID: 28188887 DOI: 10.1016/j.neubiorev.2017.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/01/2017] [Accepted: 01/27/2017] [Indexed: 12/13/2022]
Abstract
Recently there is a growing interest in the interaction of schizophrenia spectrum disorders (SSD) and substance use disorders (SUD), a condition named dual schizophrenia spectrum disorders (SSD+). While previous research has focused on clinical and cognitive aspects, little is known about the impact of comorbidity in the brain structure and functions. Evidence suggests that dual diagnosis patients, including SSD+, show a better neurocognitive functioning during the first years of illness, followed by a serious long-term decline. The initial search retrieved 94 articles, 12 were excluded for being redundant and 49 for not fulfilling the selection criteria. Thirty-three structural and functional neuroimaging studies that compare SSD and SSD+ patients were included. Both groups exhibited more brain alterations, in comparison to only SUD patients and healthy controls. SSD+ patients are less cognitively and emotionally impaired than non-dual SSD, but worse than healthy controls. The neurobiological alterations are prominent in SSD+ after five years of illness or longer. Moreover, SUD characteristics are important modulating factors, contrary to clinical severity or specific SSD diagnosis.
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Affiliation(s)
- Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain.
| | - Arantxa Y Arredondo
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Maria Del Mar Capella
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d'Hebron, 171, 08035 Barcelona, Spain
| | - Diego A Forero
- Laboratory of NeuroPsychiatric Genetics, Biomedical Sciences Research Group, School of Medicine, Sede Circunvalar, Universidad Antonio Nariño, 110231 Bogotá, Colombia
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus Teatinos s/n, 29071 Málaga, Spain
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Ayesa-Arriola R, Rodríguez-Sánchez JM, Suero ES, Reeves LE, Tabarés-Seisdedos R, Crespo-Facorro B. Diagnosis and neurocognitive profiles in first-episode non-affective psychosis patients. Eur Arch Psychiatry Clin Neurosci 2016; 266:619-28. [PMID: 26769121 DOI: 10.1007/s00406-015-0667-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 12/17/2015] [Indexed: 11/28/2022]
Abstract
This study explored whether there are distinguishable neurocognitive profiles in diagnostic subgroups of first-episode non-affective psychosis (FEP) patients. Four hundred and eighty-seven individuals with diagnoses of non-affective psychosis disorders were evaluated 6 months after first contact with psychiatric services. Individuals with schizophrenia (n = 257), schizophreniform (n = 141), brief psychotic disorder (n = 54), and psychosis not otherwise specified (n = 35) were compared on baseline neuropsychological variables using analyses of variance and covariance with potential clinical, premorbid, and sociodemographic confounders. The brief psychotic disorder subgroup was the least impaired on global cognitive function, in particular when compared to the schizophrenia subgroup, and specifically on executive function, processing speed, and motor dexterity domains. However, with the exception of the processing speed domain, profile differences could be explained by sex, age, psychotic and negative symptoms, years of education, and premorbid IQ. These results suggest processing speed as a diagnostic marker for brief psychotic disorder in FEP patients. Further, there are quantitative and qualitative differences across the schizophrenia spectrum disorders subgroups, indicating different profiles with varying degrees of deficit.
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Affiliation(s)
- Rosa Ayesa-Arriola
- Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain. .,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.
| | - José Manuel Rodríguez-Sánchez
- Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Esther Setién Suero
- Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain
| | - Lauren E Reeves
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Rafael Tabarés-Seisdedos
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain.,Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, IDIVAL, School of Medicine, Marqués de Valdecilla University Hospital, University of Cantabria, Avda. Valdecilla s/n, 39008, Santander, Spain.,CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Madrid, Spain
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Weickert TW, Allen KM, Weickert CS. Potential Role of Oestrogen Modulation in the Treatment of Neurocognitive Deficits in Schizophrenia. CNS Drugs 2016; 30:125-33. [PMID: 26849054 PMCID: PMC4781892 DOI: 10.1007/s40263-016-0312-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cognitive deficits are prevalent in schizophrenia, and these deficits represent a disabling aspect of the illness for which there are no current effective treatments. Recent work has shown that sex hormone levels correlate with brain activity and cognitive abilities differentially in patients with schizophrenia relative to healthy control groups. There is emerging evidence suggesting that oestrogen-based therapies may be useful in reversing the cognitive deficits associated with schizophrenia. To date, the results from clinical trials using oestrogen-based therapies to reverse cognitive impairment in schizophrenia have shown that the selective oestrogen receptor modulator raloxifene may be useful to improve attention, memory, learning and the associated brain activity in chronically ill men and women with schizophrenia or schizoaffective disorder. While these findings of cognitive enhancement with a selective oestrogen receptor modulator in people with schizophrenia are encouraging, additional studies will be required to replicate the initial results, assess the time frame of treatment effects, identify biomarkers in subsets of patients who may be more likely to optimally respond to treatment, and identify a more precise mechanism of action, which may include anti-inflammatory effects of oestrogen-based treatments.
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Affiliation(s)
- Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW, 2031, Australia.
- Schizophrenia Research Institute, Sydney, NSW, Australia.
| | - Katherine M Allen
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW, 2031, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Cynthia S Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Barker Street, Randwick, Sydney, NSW, 2031, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
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Mella N, Fagot D, de Ribaupierre A. Dispersion in cognitive functioning: Age differences over the lifespan. J Clin Exp Neuropsychol 2015; 38:111-26. [DOI: 10.1080/13803395.2015.1089979] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wells R, Swaminathan V, Sundram S, Weinberg D, Bruggemann J, Jacomb I, Cropley V, Lenroot R, Pereira AM, Zalesky A, Bousman C, Pantelis C, Weickert CS, Weickert TW. The impact of premorbid and current intellect in schizophrenia: cognitive, symptom, and functional outcomes. NPJ SCHIZOPHRENIA 2015; 1:15043. [PMID: 27336046 PMCID: PMC4849463 DOI: 10.1038/npjschz.2015.43] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/15/2015] [Accepted: 10/06/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cognitive heterogeneity among people with schizophrenia has been defined on the basis of premorbid and current intelligence quotient (IQ) estimates. In a relatively large, community cohort, we aimed to independently replicate and extend cognitive subtyping work by determining the extent of symptom severity and functional deficits in each group. METHODS A total of 635 healthy controls and 534 patients with a diagnosis of schizophrenia or schizoaffective disorder were recruited through the Australian Schizophrenia Research Bank. Patients were classified into cognitive subgroups on the basis of the Wechsler Test of Adult Reading (a premorbid IQ estimate) and current overall cognitive abilities into preserved, deteriorated, and compromised groups using both clinical and empirical (k-means clustering) methods. Additional cognitive, functional, and symptom outcomes were compared among the resulting groups. RESULTS A total of 157 patients (29%) classified as 'preserved' performed within one s.d. of control means in all cognitive domains. Patients classified as 'deteriorated' (n=239, 44%) performed more than one s.d. below control means in all cognitive domains except estimated premorbid IQ and current visuospatial abilities. A separate 138 patients (26%), classified as 'compromised,' performed more than one s.d. below control means in all cognitive domains and displayed greater impairment than other groups on symptom and functional measures. CONCLUSIONS In the present study, we independently replicated our previous cognitive classifications of people with schizophrenia. In addition, we extended previous work by demonstrating worse functional outcomes and symptom severity in the compromised group.
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Affiliation(s)
- Ruth Wells
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Vaidy Swaminathan
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- Northern Psychiatry Research Centre, North Western Mental Health, Melbourne Health, Victoria, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
- Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Suresh Sundram
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- Northern Psychiatry Research Centre, North Western Mental Health, Melbourne Health, Victoria, Australia
- Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Danielle Weinberg
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Jason Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Isabella Jacomb
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Vanessa Cropley
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Rhoshel Lenroot
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Avril M Pereira
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- Molecular Psychopharmacology Laboratory, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Andrew Zalesky
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Chad Bousman
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Christos Pantelis
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
- Schizophrenia Research Institute, Sydney, NSW, Australia
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Hvoslef-Eide M, Mar AC, Nilsson SRO, Alsiö J, Heath CJ, Saksida LM, Robbins TW, Bussey TJ. The NEWMEDS rodent touchscreen test battery for cognition relevant to schizophrenia. Psychopharmacology (Berl) 2015. [PMID: 26202612 DOI: 10.1007/s00213-015-4007-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
RATIONALE The NEWMEDS initiative (Novel Methods leading to New Medications in Depression and Schizophrenia, http://www.newmeds-europe.com ) is a large industrial-academic collaborative project aimed at developing new methods for drug discovery for schizophrenia. As part of this project, Work package 2 (WP02) has developed and validated a comprehensive battery of novel touchscreen tasks for rats and mice for assessing cognitive domains relevant to schizophrenia. OBJECTIVES This article provides a review of the touchscreen battery of tasks for rats and mice for assessing cognitive domains relevant to schizophrenia and highlights validation data presented in several primary articles in this issue and elsewhere. METHODS The battery consists of the five-choice serial reaction time task and a novel rodent continuous performance task for measuring attention, a three-stimulus visual reversal and the serial visual reversal task for measuring cognitive flexibility, novel non-matching to sample-based tasks for measuring spatial working memory and paired-associates learning for measuring long-term memory. RESULTS The rodent (i.e. both rats and mice) touchscreen operant chamber and battery has high translational value across species due to its emphasis on construct as well as face validity. In addition, it offers cognitive profiling of models of diseases with cognitive symptoms (not limited to schizophrenia) through a battery approach, whereby multiple cognitive constructs can be measured using the same apparatus, enabling comparisons of performance across tasks. CONCLUSION This battery of tests constitutes an extensive tool package for both model characterisation and pre-clinical drug discovery.
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Affiliation(s)
- M Hvoslef-Eide
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK. .,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.
| | - A C Mar
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Department of Neuroscience and Physiology, New York University Medical Center, New York, NY, 10016, USA
| | - S R O Nilsson
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - J Alsiö
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK.,Department of Neuroscience, Unit of Functional Neurobiology, University of Uppsala, 75124, Uppsala, Sweden
| | - C J Heath
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - L M Saksida
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - T W Robbins
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
| | - T J Bussey
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,MRC and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, CB2 3EB, UK
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Woodward ND, Heckers S. Brain Structure in Neuropsychologically Defined Subgroups of Schizophrenia and Psychotic Bipolar Disorder. Schizophr Bull 2015; 41:1349-59. [PMID: 25904725 PMCID: PMC4601708 DOI: 10.1093/schbul/sbv048] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neuropsychological impairment is heterogeneous in psychosis. The association of intracranial volume (ICV) and total brain volume (TBV) with cognition suggests brain structure abnormalities in psychosis will covary with the severity of cognitive impairment. We tested the following hypotheses: (1) brain structure abnormalities will be more extensive in neuropsychologically impaired psychosis patients; (2) psychosis patients with premorbid cognitive limitations will show evidence of hypoplasia (ie, smaller ICV); and (3) psychosis patients with evidence of cognitive decline will demonstrate atrophy (ie, smaller TBV, but normal ICV). METHODS One hundred thirty-one individuals with psychosis and 97 healthy subjects underwent structural magnetic resonance imaging and neuropsychological testing. Patients were divided into neuropsychologically normal and impaired groups. Impaired patients were further subdivided into deteriorated and compromised groups if estimated premorbid intellect was average or below average, respectively. ICV and TBV were compared across groups. Localized brain volumes were qualitatively examined using voxel-based morphometry. RESULTS Compared to healthy subjects, neuropsychologically impaired patients exhibited smaller TBV, reduced grey matter volume in frontal, temporal, and subcortical brain regions, and widespread white matter volume loss. Neuropsychologically compromised patients had smaller ICV relative to healthy subjects, and neuropsychologically normal and deteriorated patient groups, but relatively normal TBV. Deteriorated patients exhibited smaller TBV compared to healthy subjects, but relatively normal ICV. Unexpectedly, TBV, adjusted for ICV, was reduced in neuropsychologically normal patients. CONCLUSIONS Patients with long-standing cognitive limitations exhibit evidence of early cerebral hypoplasia, whereas neuropsychologically normal and deteriorated patients show evidence of brain tissue loss consistent with progression or later cerebral dysmaturation.
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Affiliation(s)
- Neil D. Woodward
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN,*To whom correspondence should be addressed; Department of Psychiatry, Vanderbilt University School of Medicine, 1601 23rd Avenue South, Suite 3057, Nashville, TN 37212, US; tel: 615-322-8361, fax: 615-936-3563, e-mail:
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN
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Haring L, Mõttus R, Koch K, Trei M, Maron E. Factorial validity, measurement equivalence and cognitive performance of the Cambridge Neuropsychological Test Automated Battery (CANTAB) between patients with first-episode psychosis and healthy volunteers. Psychol Med 2015; 45:1919-1929. [PMID: 25544472 DOI: 10.1017/s0033291714003018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The purpose of this study was to use selected Cambridge Neuropsychological Test Automated Battery (CANTAB) tests to examine the dimensional structure of cognitive dysfunction in first episode of psychosis (FEP) patients compared with cognition in healthy subjects. METHOD A total of 109 FEP patients and 96 healthy volunteers were administered eight CANTAB tests of cognitive function. Principal components analysis (PCA) was used to estimate dimensionality within the test results. The dimensions identified by the PCA were assumed to reflect underlying cognitive traits. The plausibility of latent factor models was estimated using confirmatory factor analysis (CFA). Multi-group CFA (MGCFA) was used to test for measurement invariance of factors between groups. The nature and severity of cognitive deficits amongst patients as opposed to controls were evaluated using a general linear model. RESULTS Amongst subjects PCA identified two underlying cognitive traits: (i) a broad cognitive domain; (ii) attention/memory and executive function domains. Corresponding CFA models were built that fitted data well for both FEP patients and healthy volunteers. As in MGCFA latent variables appeared differently defined in patient and control groups, differences had to be ascribed using subtest scores rather than their aggregates. At subtest score level the patients performed significantly worse than healthy subjects in all comparisons (p < 0.001). CONCLUSIONS Results of this study demonstrate that the structure of underlying cognitive abilities as measured by a selection of CANTAB tests is not the same for healthy individuals and FEP patients, with patients displaying widespread cognitive impairment.
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Affiliation(s)
- L Haring
- Psychiatry Clinic of Tartu University Hospital,Tartu,Estonia
| | - R Mõttus
- Department of Psychology,University of Edinburgh,Edinburgh,UK
| | - K Koch
- Psychiatry Clinic of Tartu University Hospital,Tartu,Estonia
| | - M Trei
- Department of Psychology,University of Tartu,Tartu,Estonia
| | - E Maron
- Psychiatry Clinic of Tartu University Hospital,Tartu,Estonia
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Cuesta MJ, Sánchez-Torres AM, Cabrera B, Bioque M, Merchán-Naranjo J, Corripio I, González-Pinto A, Lobo A, Bombín I, de la Serna E, Sanjuan J, Parellada M, Saiz-Ruiz J, Bernardo M. Premorbid adjustment and clinical correlates of cognitive impairment in first-episode psychosis. The PEPsCog Study. Schizophr Res 2015; 164:65-73. [PMID: 25819935 DOI: 10.1016/j.schres.2015.02.022] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 02/25/2015] [Accepted: 02/25/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND The extent to which socio-demographic, clinical, and premorbid adjustment variables contribute to cognitive deficits in first-episode schizophrenia spectrum disorders remains to be ascertained. AIMS To examine the pattern and magnitude of cognitive impairment in first-episode psychosis patients, the profile of impairment across psychosis subtypes and the associations with premorbid adjustment. METHODS 226 first-episode psychosis patients and 225 healthy controls were assessed in the PEPsCog study, as part of the PEPs study. RESULTS Patients showed slight to moderate cognitive impairment, verbal memory being the domain most impaired compared to controls. Broad affective spectrum patients had better premorbid IQ and outperformed the schizophrenia and other psychosis groups in executive function, and had better global cognitive function than the schizophrenia group. Adolescent premorbid adjustment together with age, gender, parental socio-economic status, and mean daily antipsychotic doses were the factors that best explained patients' cognitive performance. General and adolescent premorbid adjustment, age and parental socio-economic status were the best predictors of cognitive performance in controls. CONCLUSIONS Poorer premorbid adjustment together with socio-demographic factors and higher daily antipsychotic doses were related to a generalized cognitive impairment and to a lower premorbid intellectual reserve, suggesting that neurodevelopmental impairment was present before illness onset.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Bibiana Cabrera
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain
| | - Iluminada Corripio
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Psychiatry, Hospital Universitario de Álava, University of the Basque Country, Vitoria, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón). University of Zaragoza, Spain
| | - Igor Bombín
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Reintegra Foundation, Oviedo, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic de Neurociències. Hospital Clínic Universitari, Barcelona, Spain
| | - Julio Sanjuan
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Clinic Hospital (INCLIVA), Valencia, Spain
| | - Mara Parellada
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM. Madrid, Spain
| | - Jerónimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Psychiatry Department, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Spain; Department of Psychiatry and Clinical Psychobiology, University of Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Gutiérrez-Galve L, Chu EM, Leeson VC, Price G, Barnes TRE, Joyce EM, Ron MA. A longitudinal study of cortical changes and their cognitive correlates in patients followed up after first-episode psychosis. Psychol Med 2015; 45:205-216. [PMID: 24990283 DOI: 10.1017/s0033291714001433] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Loss of cortical volume in frontotemporal regions occurs in patients with first-episode psychosis (FEP) and longitudinal studies have reported progressive brain volume changes at different stages of the disease, even if cognitive deficits remain stable over time. We investigated cortical changes in patients over the 2 years following their FEP and their associations with clinical and cognitive measures. METHOD Twenty-seven patients after their FEP (20 with schizophrenia, seven with schizo-affective disorder) and 25 healthy controls matched for age and gender participated in this study. Magnetic resonance imaging (MRI) was performed on a 1.5-T scanner both at baseline and after 2 years. Area and thickness of the cortex were measured using surface-based morphometry (SBM). Patients also underwent neuropsychological testing at these two time points. RESULTS Progressive cortical thinning in the superior and inferior frontal and, to a lesser extent, superior temporal cortex was observed in patients. Cortical area remained constant. Cortical thinning was associated with duration of treatment at a trend level and was predicted by baseline measures of IQ and working memory. Cortical thinning occurred in the absence of clinical or cognitive deterioration. CONCLUSIONS The clinical implications of these cortical changes remain uncertain, but patients with less cognitive reserve may be more vulnerable to developing cortical abnormalities when exposed to medication or other disease-related biological factors.
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Affiliation(s)
| | - E M Chu
- University College London,Queen Square, London,UK
| | - V C Leeson
- Imperial College Faculty of Medicine,Charing Cross Campus, London,UK
| | - G Price
- University College London,Queen Square, London,UK
| | - T R E Barnes
- Imperial College Faculty of Medicine,Charing Cross Campus, London,UK
| | - E M Joyce
- University College London,Queen Square, London,UK
| | - M A Ron
- University College London,Queen Square, London,UK
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Ahmed AO, Bhat IA. Psychopharmacological treatment of neurocognitive deficits in people with schizophrenia: a review of old and new targets. CNS Drugs 2014; 28:301-18. [PMID: 24526625 DOI: 10.1007/s40263-014-0146-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurocognitive impairments significantly contribute to disability and the overall clinical picture in schizophrenia spectrum disorders. There has therefore been a concerted effort, guided by the discovery of neurotransmitter and synaptic systems in the central nervous system, to develop and test compounds that may ameliorate neurocognitive deficits. The current article summarizes the results of efforts to test neurocognitive-enhancing agents in schizophrenia. Overall, existing clinical trials provide little reason to be enthusiastic about the benefits of psychopharmacological agents at enhancing neurocognition in schizophrenia-a state of affairs that may reflect the inadequacy of single neurotransmitter or receptor models. The etiologic and phenomenological complexity of neurocognitive deficits in schizophrenia may be better served by psychopharmacological agents that (i) target neurotransmitter systems proximal in the causal chain to neurocognitive deficits; (ii) enhance distal survival processes in the central nervous system-neurogenesis, neuronal growth, synaptogenesis, and connectivity; and (iii) counteract the negative effects of aberrant neurodevelopment in schizophrenia, such as neuroinflammation and oxidative stress. Future efforts to develop psychopharmacological agents for neurocognitive impairment in schizophrenia should reflect the knowledge of its complex etiology by addressing aberrations along its causal chain. Clinical trials may benefit methodologically from (i) an appreciation of the phenomenological heterogeneity of neurocognitive deficits in schizophrenia; (ii) a characterization of the predictors of treatment response; and (iii) a recognition of issues of sample size, statistical power, treatment duration, and dosing.
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Affiliation(s)
- Anthony O Ahmed
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Georgia Regents University, 997 Saint Sebastian Way, Augusta, GA, 30912, USA,
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Lutgens D, Lepage M, Iyer S, Malla A. Predictors of cognition in first episode psychosis. Schizophr Res 2014; 152:164-9. [PMID: 24286943 DOI: 10.1016/j.schres.2013.10.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 01/20/2023]
Abstract
PURPOSE Cognitive deficits are common in the first episode of psychosis (FEP) and may begin much earlier. While some evidence suggests that the decline in cognition occurs over the untreated symptomatic period, including the prodromal phase, others point to these deficits being present even earlier. We aimed to investigate the differential effect of untreated symptomatic and pre-morbid phases on cognition in a large sample of FEP. METHODS Two hundred and sixty eight FEP patients, admitted into a specialized early intervention service, were administered neuro-cognitive tests. The Circumstances of Onset and Relapse Schedule (CORS) was administered for measurement of duration of untreated psychosis (DUP), the duration of untreated illness (DUI) and demographic factors. The Pre-morbid Adjustment Scale (PAS) was used to measure different domains of pre-morbid adjustment. Seventy three healthy controls were also recruited for neuro-cognitive comparison. RESULTS We observed no effect of DUP and a minimal effect of DUI on cognitive functioning in FEP. Instead, the early educational pre-morbid adjustment domain was most strongly associated with cognition and predicted both global cognitive and verbal memory outcome in FEP. CONCLUSION Our results suggest that symptoms associated with the symptomatic phase of a FEP do not influence cognitive functioning in FEP. Instead, cognitive deficits in FEP may predate illness onset and may indicate susceptibility to such illness.
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Affiliation(s)
- Danyael Lutgens
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Prevention and Early Intervention Program for the Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Prevention and Early Intervention Program for the Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Srividya Iyer
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Prevention and Early Intervention Program for the Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Prevention and Early Intervention Program for the Psychoses, Douglas Mental Health University Institute, Montreal, Quebec, Canada.
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Russo M, Levine SZ, Demjaha A, Di Forti M, Bonaccorso S, Fearon P, Dazzan P, Pariante CM, David AS, Morgan C, Murray RM, Reichenberg A. Association between symptom dimensions and categorical diagnoses of psychosis: a cross-sectional and longitudinal investigation. Schizophr Bull 2014; 40:111-9. [PMID: 23661632 PMCID: PMC3885297 DOI: 10.1093/schbul/sbt055] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT Cross-sectional studies of the signs and symptoms of psychosis yield dimensional phenotypes. However, the validity and clinical utility of such dimensions remain debated. This study investigated the structure of psychotic symptomatology, the stability of the structure over time, and the concordance between symptom dimensions and categorical diagnoses. METHODS Sample consisted of 500 first-episode psychotic patients. A cross-sectional study (N = 500) investigated the organizational structure of symptom dimensions at the onset of psychosis and its concordance with categorical diagnoses; next, a nested longitudinal study (N = 100) examined the stability of the symptom dimensions structure after 5-10 years of follow-up. RESULTS Factor analyses identified 6 first-order factors (mania, negative, disorganization, depression, hallucinations, and delusions) and 2 high-order factors (affective and nonaffective psychoses). Cumulative variance accounted for by the first and high-order factors was 63%: 31% by the first-order factors and 32% by the high-order factors. The factorial structure of psychotic symptoms during first episode remained stable after 5-10 years of follow-up. The overall concordance between 4 categorical diagnostic groups (schizophrenia, mania with psychosis, psychotic depression and schizoaffective disorder) and dimensional symptom ranged from 62.2% to 73.1% (when the schizoaffective group was excluded). CONCLUSIONS Symptoms of psychosis assume a multidimensional hierarchical structure. This hierarchical model was stable over time and showed good concordance with categorical diagnoses. The combined use of dimensional and categorical approach to psychotic disorders would be of clinical and research utility.
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Affiliation(s)
- Manuela Russo
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK;,Department of Psychiatry, Mount Sinai School of Medicine, New York, NY;,*To whom correspondence should be addressed; 1 Gustave L Levy Place, Box 1230, NY 10029, US; tel: +1 212-241-0755, fax: +1 212-996-8931, e-mail:
| | - Stephen Z. Levine
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Arsime Demjaha
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Stefania Bonaccorso
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Paul Fearon
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Carmine M. Pariante
- Department of Psychological Medicine, Institute of Psychiatry, King’s College London, London, UK
| | - Anthony S. David
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Craig Morgan
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Abraham Reichenberg
- Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK;,Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
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Roiser JP, Wigton R, Kilner JM, Mendez MA, Hon N, Friston KJ, Joyce EM. Dysconnectivity in the frontoparietal attention network in schizophrenia. Front Psychiatry 2013; 4:176. [PMID: 24399975 PMCID: PMC3871715 DOI: 10.3389/fpsyt.2013.00176] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 12/09/2013] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment is common in patients with schizophrenia, and even those with relatively preserved function perform worse than healthy volunteers (HVs) on attentional tasks. This is consistent with the hypothesis that connectivity - in the frontoparietal network (FPN) activated during attention - is disrupted in schizophrenia. We examined attentional effects on connectivity in the FPN, in schizophrenia, using magnetoencephalography (MEG). Twenty-three HVs and 19 first-episode schizophrenia patients were scanned during a simple visual change test, known to activate the FPN, in which attention was monitored and directed with an orthogonal flicker-detection task. Dynamic causal modeling (DCM) of evoked responses was used to assess effective connectivity - and its modulation by changes in the attended stimulus dimension - in the following network: higher visual area; temporoparietal junction (TPJ); intraparietal sulcus (IPS); dorsal anterior cingulate cortex; and ventrolateral prefrontal cortex. The final MEG analysis included 18 HVs and 14 schizophrenia patients. While all participants were able to maintain attention, HVs responded slightly, but non-significantly, more accurately than schizophrenia patients. HVs, but not schizophrenia patients, exhibited greater cortical responses to attended visual changes. Bayesian model comparison revealed that a DCM with attention dependent changes in both top-down and bottom-up connections best explained responses by patients with schizophrenia, while in HVs the best model required only bottom-up changes. Quantitative comparison of connectivity estimates revealed a significant group difference in changes in the right IPS-TPJ connection: schizophrenia patients showed relative reductions in connectivity during attended stimulus changes. Crucially, this reduction predicted lower intelligence. These data are consistent with the hypothesis that functional dysconnections in the FPN contribute to cognitive impairment in schizophrenia.
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Affiliation(s)
- Jonathan P. Roiser
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Rebekah Wigton
- Psychosis Studies, Cognition and Schizophrenia Imaging Lab, Institute of Psychiatry, King’s College London, London, UK
| | - James M. Kilner
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
- Institute of Neurology, University College London, London, UK
| | - Maria A. Mendez
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Nicholas Hon
- Department of Psychology, National University of Singapore, Singapore
| | - Karl J. Friston
- Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Eileen M. Joyce
- Institute of Neurology, University College London, London, UK
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Kuratomi G, Saito A, Ozeki Y, Watanabe T, Fujii K, Shimoda K, Inukai T, Mori H, Ohmori K, Akiyama K. Association of the Hermansky-Pudlak syndrome type 4 (HPS4) gene variants with cognitive function in patients with schizophrenia and healthy subjects. BMC Psychiatry 2013; 13:276. [PMID: 24168225 PMCID: PMC3819706 DOI: 10.1186/1471-244x-13-276] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/25/2013] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The Hermansky-Pudlak Syndrome Type 4 (HPS4) gene, which encodes a subunit protein of the biogenesis of lysosome-related organelles complex (BLOC)-3, which is involved in late endosomal trafficking, is associated with schizophrenia; however, its clinical relevance in schizophrenia remains unknown. The purpose of the present study was to investigate whether HPS4 is associated with cognitive functions in patients with schizophrenia and healthy controls and with the clinical profiles of patients with schizophrenia. METHODS We investigated the association of variants of HPS4 with clinical symptoms and cognitive function in Japanese patients with schizophrenia (n = 240) and age-matched healthy control subjects (n = 240) with single nucleotide polymorphisms (SNP)- or haplotype-based linear regression. We analyzed five tagging SNPs (rs4822724, rs61276843, rs9608491, rs713998, and rs2014410) of HPS4 and 2-5 locus haplotypes of these five SNPs. The cognitive functions of patients and healthy subjects were evaluated with the Brief Assessment of Cognition in Schizophrenia, Japanese-language version, and the patients were assessed for their symptomatology with the Positive and Negative Symptom Scale (PANSS). RESULTS In patients with schizophrenia, rs713998 was significantly associated with executive function under the dominant genetic model (P = 0.0073). In healthy subjects, there was a significant association between working memory and two individual SNPs under the recessive model (rs9608491: P = 0.001; rs713998: P = 0.0065) and two haplotypes (rs9608491-713998: P = 0.0025; rs61276843-9608491-713998: P = 0.0064). No significant association was found between HPS4 SNPs and PANSS scores or premorbid IQ, as measured by the Japanese version of the National Adult Reading Test. CONCLUSIONS These findings suggested the involvement of HPS4 in the working memory of healthy subjects and in the executive function deficits in schizophrenia.
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Affiliation(s)
- Go Kuratomi
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Atsushi Saito
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Yuji Ozeki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Kumiko Fujii
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan
| | - Toshihiko Inukai
- Department of Internal Medicine (Endocrinology, Metabolism, and Hematology), Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 3438555, Japan
| | - Harunobu Mori
- Mori Hospital, 419 Iidamachi, Utsunomiya, Tochigi 3210347, Japan
| | - Kenichi Ohmori
- Takizawa Hospital, 2-29 Hanabusahoncho Utsunomiya, Tochigi 3200828, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Tochigi 3210293, Japan.
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Nygård M, Løberg EM, Craven AR, Ersland L, Berle JØ, Kroken RA, Johnsen E, Hugdahl K. Dichotic listening, executive functions and grey matter cortical volume in patients with schizophrenia and healthy controls. Scand J Psychol 2013; 54:443-50. [PMID: 24117463 DOI: 10.1111/sjop.12080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 08/01/2013] [Indexed: 12/19/2022]
Abstract
Schizophrenia is characterized by cognitive impairment, especially in relation to executive functions. Brain structural abnormalities are also often seen in schizophrenia although little is known of the relationship between cognitive impairment and structural brain changes. Our aim was therefore to investigate this relationship further using MRI and a dichotic listening (DL) task with simple speech sounds and with instructions to focus attention and report only from the left or right ear stimulus. When instructed to focus attention on the left ear syllable a cognitive conflict is induced requiring the allocation of executive resources to be resolved. Grey matter (GM) volume was measured with MRI from four volumes of interests (VOIs), left and right frontal and temporal cortex, respectively, and correlated with DL performance. The results showed significant differences between the groups in their ability to focus attention on and report the left ear stimulus, which was accompanied by reduced GM volume in the left frontal and right temporal lobe VOIs. There was also a significant positive correlation between left frontal GM volume and performance on the DL task, for the groups combined. The results did not support a conclusion that an impairment in cognitive function in schizophrenia was driven by an corresponding impairment in brain structure, since there were no significant correlations when the groups were analyzed separately. It is however concluded that patients with schizophrenia are impaired in executive functions and that they also show reduced GM volumes in left frontal and right temporal lobe areas, compared to healthy controls.
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Affiliation(s)
- Merethe Nygård
- Department of Biological and Medical Psychology, University of Bergen, Norway
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Hur JW, Byun MS, Shin NY, Shin YS, Kim SN, Jang JH, Kwon JS. General intellectual functioning as a buffer against theory-of-mind deficits in individuals at ultra-high risk for psychosis. Schizophr Res 2013; 149:83-7. [PMID: 23810120 DOI: 10.1016/j.schres.2013.06.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 05/16/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
The influence of neurocognition, including general intelligence, on theory of mind (ToM) among patients with schizophrenia spectrum disorder is controversial. The purpose of the present study was to identify the influences of the non-ToM cognition and general intelligence on ToM performance in individuals at ultra-high risk (UHR) for psychosis. Fifty-five UHR subjects and 58 healthy controls (HCs) completed neurocognitive, verbal, and nonverbal ToM tasks. UHR individuals showed poorer performance in the two verbal ToM tasks, the false-belief task and the strange-story tasks. Moreover, the UHR subjects displayed poorer recall on the interference list of the verbal learning test. Linear regression analysis revealed that neurocognitive functioning, including executive functioning, working memory, and general intelligence, accounted for significant amounts of the variance in the results for UHR individuals: 20.4% in the false-belief task, 44.0% in the strange-story task, and 49.0% in the nonverbal cartoon task. Neurocognition, including general intelligence, was not a significant contributor to performance on ToM tasks in HCs. ToM deficits were not noted in UHR individuals with above-average IQ scores (≥ 110) compared with UHR subjects with IQ scores less than 110, who displayed significant differences on all ToM tasks compared with HCs. The present results suggest that ToM deficits in UHR individuals are complex and may be influenced by non-ToM cognition. Our findings are discussed in relation to the role of neurocognitive abilities in ToM-related impairments in UHR individuals.
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Affiliation(s)
- Ji-Won Hur
- Department of Brain and Cognitive Sciences, World Class University Program, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
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Rodriguez-Jimenez R, Bagney A, Mezquita L, Martinez-Gras I, Sanchez-Morla EM, Mesa N, Ibañez MI, Diez-Martin J, Jimenez-Arriero MA, Lobo A, Santos JL, Palomo T. Cognition and the five-factor model of the positive and negative syndrome scale in schizophrenia. Schizophr Res 2013. [PMID: 23201306 DOI: 10.1016/j.schres.2012.10.020] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Different exploratory and confirmatory factorial analyses of the Positive and Negative Syndrome Scale (PANSS) have found a number of factors other than the original positive, negative, and general psychopathology. Based on a review of previous studies and using confirmatory factor analyses (CFA), Wallwork et al. (Schizophr Res 2012; 137: 246-250) have recently proposed a consensus five-factor structure of the PANSS. This solution includes a cognitive factor which could be a useful measure of cognition in schizophrenia. Our objectives were 1) to study the psychometric properties (factorial structure and reliability) of this consensus five-factor model of the PANSS, and 2) to study the relationship between executive performance assessed using the Wisconsin Card Sorting Test (WCST) and the proposed PANSS consensus cognitive factor (composed by items P2-N5-G11). This cross-sectional study included a final sample of 201 Spanish outpatients diagnosed with schizophrenia. For our first objective, CFA was performed and Cronbach's alphas of the five factors were calculated; for the second objective, sequential linear regression analyses were used. The results of the CFA showed acceptable fit indices (NNFI=0.94, CFI=0.95, RMSEA=0.08). Cronbach's alphas of the five factors were adequate. Regression analyses showed that this five-factor model of the PANSS explained more of the WCST variance than the classical three-factor model. Moreover, higher cognitive factor scores were associated with worse WCST performance. These results supporting its factorial structure and reliability provide robustness to this consensus PANSS five-factor model, and indicate some usefulness of the cognitive factor in the clinical assessment of schizophrenic patients.
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Affiliation(s)
- Roberto Rodriguez-Jimenez
- Department of Psychiatry, Instituto de Investigación Hospital 12 de Octubre (i+12), Avda. de Córdoba s/n, 28041, Madrid, Spain.
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Braw Y, Benozio A, Levkovitz Y. Executive functioning during full and partial remission (positive and negative symptomatic remission) of schizophrenia. Schizophr Res 2012; 142:122-8. [PMID: 23127380 DOI: 10.1016/j.schres.2012.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 09/01/2012] [Accepted: 10/07/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the upsurge of research regarding cognitive impairment in schizophrenia we still lack adequate understanding of the executive functioning of patients in symptomatic remission. Moreover, the cognitive functioning of patients in partial remission has not been studied previously although they comprise a significant proportion of schizophrenia patients. The current study therefore examined the executive functioning of patients in full symptomatic remission and for the first time assessed two sub-groups of patients in partial remission. METHODS Executive functioning of five groups was compared; symptomatic patients, patients in positive symptomatic remission, negative symptomatic remission, full symptomatic remission (SP, PSR, NSR, and FSR; N=101) and healthy controls (N=37). RESULTS A graded cognitive profile was evident between the groups. SP patients exhibited widespread executive dysfunction while the performance of FSR patients was comparable to that of the healthy controls. Both PSR and NSR patients had working memory deficits, with PSR patients showing additional deficits in cognitive planning. CONCLUSIONS The findings are encouraging, tentatively suggesting intact executive functioning among patients in full symptomatic remission. The graded cognitive profile of the patient groups strengthens earlier findings indicating the significant role of negative symptoms in determining executive dysfunction in schizophrenia. The findings point toward potential targets for therapeutic efforts and emphasize the need for further research of sub-groups of schizophrenia patients in partial remission.
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Affiliation(s)
- Yoram Braw
- Shalvata Mental Health Center, Hod-Hasharon, Israel
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