scholarly journals Neurodevelopmental origin of cognitive impairment in schizophrenia

2014 ◽  
Vol 45 (1) ◽  
pp. 1-9 ◽  
Author(s):  
E. Bora
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Functional Decline ◽  
Current Evidence ◽  
Neurodevelopmental Abnormalities ◽  
The Individual

Cognitive impairment is a common feature of schizophrenia; however, its origin remains controversial. Neurodevelopmental abnormalities clearly play a role in pre-morbid cognitive dysfunction in schizophrenia, yet many authors believe that schizophrenia is characterized by illness-related cognitive decline before and after onset of the psychosis that can be the result of neurodegenerative changes. The main reasons behinds such arguments include, first, the evidence showing that effect sizes of the cognitive deficits in subjects who develop adult schizophrenia gradually increase in the first two decades of life and, second, the fact that there is functional decline in many patients with schizophrenia over the years. In this Editorial, I argue that current evidence suggests that illness-related cognitive impairment is neurodevelopmental in origin and characterized by slower gain (developmental lag) but not cognitive decline continuing throughout the first two decades of life. I introduce a model suggesting that neurodevelopmental abnormality can in fact explain the course of cognitive dysfunction and variations in the trajectory of functional decline throughout the life in individuals with schizophrenia. In this model, the severity of underlying neurodevelopmental abnormality determines the age that cognitive deficits first become apparent and contributes to the cognitive reserve of the individual. Interaction of neurodevelopmental abnormality with clinical symptoms, especially negative symptoms and aging, vascular changes, psychological and iatrogenic factors contributes to the heterogeneity of the functional trajectory observed in this disorder.

scholarly journals The Role of High Triglycerides Level in Predicting Cognitive Impairment: A Review of Current Evidence

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2118
Author(s):  
Alina Mihaela Dimache ◽  
Delia Lidia Șalaru ◽  
Radu Sascău ◽  
Cristian Stătescu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Lifestyle Modification ◽  
Cognitive Disorders ◽  
Current Evidence ◽  
Barrier Dysfunction ◽  
Serum Triglycerides ◽  
Cerebral Amyloidosis ◽  
The Relationship

The burden of cognitive disorders is huge and still growing, however the etiology and the degree of cognitive impairment vary considerably. Neurodegenerative and vascular mechanisms were most frequently assessed in patients with dementia. Recent studies have shown the possible involvement of triglycerides levels in cognitive function through putative mechanisms such as brain blood barrier dysfunction or amyloid metabolism imbalance, but not all research in the field found this association. Several clinical studies evaluated the relationship between different forms of cognitive decline and levels of serum triglycerides, independent of other cardiovascular risk factors. This review focuses on the role of triglycerides in cognitive decline, cerebral amyloidosis and vascular impairment. Considering that the management of hypertriglyceridemia benefits from lifestyle modification, diet, and specific drug therapy, future studies are requested to appraise the triglycerides–cognitive impairment relationship.

Combination Treatments for Schizophrenia

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S9) ◽  
pp. 19-23 ◽  
Author(s):  
Alexander L. Miller
Keyword(s):  
Electroconvulsive Therapy ◽  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Current Evidence ◽  
Positive Symptoms ◽  
Combination Therapies ◽  
Safety And Efficacy ◽  
Combination Treatments ◽  
Improved Outcomes ◽  
Expert Recommendations

ABSTRACTCombination treatments, especially combinations of antipsychotics, are used frequently for schizophrenia, despite a paucity of evidence regarding their safety and efficacy. Because the literature basis is weak and expert recommendations are largely lacking, providers should be vigilant in documenting improved outcomes for patients thought to benefit from combination treatments. Target symptoms that have been studied include psychosis, cognitive deficits, and negative symptoms. The strongest evidence is for augmentation of clozapine with another antipsychotic or with electroconvulsive therapy for persistent positive symptoms. Combination treatments for cognitive deficits and negative symptoms are being actively investigated, but current evidence is insufficient to recommend available agents for these components of schizophrenia. It is important that appropriate monotherapies be given adequate trials before resorting to combination therapies.

scholarly journals Resting State fMRI: A Valuable Tool for Studying Cognitive Dysfunction in PD

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Kai Li ◽  
Wen Su ◽  
Shu-Hua Li ◽  
Ying Jin ◽  
Hai-Bo Chen
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Resting State ◽  
Lewy Bodies ◽  
Resting State Fmri ◽  
Underlying Mechanism ◽  
Research Field ◽  
Functional Magnetic Resonance ◽  
Positron Emission

Cognitive impairment is a common disabling symptom in PD. Unlike motor symptoms, the mechanism underlying cognitive dysfunction in Parkinson’s disease (PD) remains unclear and may involve multiple pathophysiological processes. Resting state functional magnetic resonance imaging (rs-fMRI) is a fast-developing research field, and its application in cognitive impairments in PD is rapidly growing. In this review, we summarize rs-fMRI studies on cognitive function in PD and discuss the strong potential of rs-fMRI in this area. rs-fMRI can help reveal the pathophysiology of cognitive symptoms in PD, facilitate early identification of PD patients with cognitive impairment, distinguish PD dementia from dementia with Lewy bodies, and monitor and guide treatment for cognitive impairment in PD. In particular, ongoing and future longitudinal studies would enhance the ability of rs-fMRI in predicting PD dementia. In combination with other modalities such as positron emission tomography, rs-fMRI could give us more information on the underlying mechanism of cognitive deficits in PD.

scholarly journals Region-Specific Neurovascular Decoupling Associated With Cognitive Decline in Parkinson’s Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Song’an Shang ◽  
Hongying Zhang ◽  
Yuan Feng ◽  
Jingtao Wu ◽  
Weiqiang Dou ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Deficits ◽  
Inferior Frontal Gyrus ◽  
Neurovascular Coupling ◽  
Angular Gyrus ◽  
Visual Spatial ◽  
The Right

Background: Cognitive deficits are prominent non-motor symptoms in Parkinson’s disease (PD) and have been shown to involve the neurovascular unit (NVU). However, there is a lack of sufficient neuroimaging research on the associated modulating mechanisms. The objective of this study was to identify the contribution of neurovascular decoupling to the pathogenesis of cognitive decline in PD.Methods: Regional homogeneity (ReHo), a measure of neuronal activity, and cerebral blood flow (CBF), a measure of vascular responses, were obtained from patients with PD with mild cognitive impairment (MCI) and normal cognition (NC) as well as matched healthy controls (HCs). Imaging metrics of neurovascular coupling (global and regional CBF-ReHo correlation coefficients and CBF-ReHo ratios) were compared among the groups.Results: Neurovascular coupling was impaired in patients with PD-MCI with a decreased global CBF-ReHo correlation coefficient relative to HC subjects (P < 0.05). Regional dysregulation was specific to the PD-MCI group and localized to the right middle frontal gyrus, right middle cingulate cortex, right middle occipital gyrus, right inferior parietal gyrus, right supramarginal gyrus, and right angular gyrus (P < 0.05). Compared with HC subjects, patients with PD-MCI showed higher CBF-ReHo ratios in the bilateral lingual gyri (LG), bilateral putamen, and left postcentral gyrus and lower CBF-ReHo ratios in the right superior temporal gyrus, bilateral middle temporal gyri, bilateral parahippocampal gyri, and right inferior frontal gyrus. Relative to the HC and PD-NC groups, the PD-MCI group showed an increased CBF-ReHo ratio in the left LG, which was correlated with poor visual–spatial performance (r = −0.36 and P = 0.014).Conclusion: The involvement of neurovascular decoupling in cognitive impairment in PD is regionally specific and most prominent in the visual–spatial cortices, which could potentially provide a complementary understanding of the pathophysiological mechanisms underlying cognitive deficits in PD.

Cognitive Impairment in Children with Arachnoid Cyst of Sylvian Fissure: Does it Justify the Neurosurgical Treatment?

2020 ◽  
Vol 81 (04) ◽  
pp. 362-367 ◽  
Author(s):  
Karolina Kwiatkowska ◽  
Magdalena Dębicka ◽  
Agnieszka Maryniak ◽  
Stanisław Kwiatkowski
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Intracranial Hypertension ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Clinical Symptoms ◽  
Cognitive Impairments ◽  
Neurological Deficits ◽  
Neurosurgical Treatment ◽  
The Relationship

AbstractThis report discusses the relationship between arachnoid cysts (ACs) and cognitive deficits, and we ask if cognitive impairments could justify neurosurgical treatment. In clinical practice, only AC patients with symptoms of intracranial hypertension or focal neurological deficits are referred to surgery. Occasionally, one might assume that nonspecific problems such as impairment of learning, speech, or cognitive functions are caused by an AC and can be improved by surgery. We describe three patients, in which surgery was indicated on the basis of clinical symptoms such as headaches and the size of the cysts. A neuropsychological examination before AC surgery revealed reduced cognitive potential, and the same examination repeated after surgery showed improvement. We have not found any other reason for this change, except for the decompression of the AC.

scholarly journals Role of nurses in addressing modifiable risk factors for early Alzheimer's disease and mild cognitive impairment

2020 ◽  
Vol 29 (8) ◽  
pp. 460-469 ◽  
Author(s):  
Kevin Hope
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Health Professionals ◽  
Current Evidence ◽  
Modifiable Risk Factors ◽  
Early Alzheimer’S Disease

A multidisciplinary advisory group of health professionals involved in dementia care assessed the current evidence base regarding modifiable risk factors (MRFs) for early Alzheimer's disease and mild cognitive impairment. Based on evidence from the published literature and clinical experience, MRFs in four areas were identified where there is evidence to support interventions that may help delay cognitive decline or reduce the risk of developing Alzheimer's disease: medical (eg cardiovascular risk factors), psychosocial (eg depression, anxiety, social isolation), lifestyle (eg lack of physical activity, smoking) and nutrition (eg poor diet, lack of micronutrients). Practical guidance on how health professionals, but in particular nurses, may actively seek to address these MRFs in clinical practice was also developed. Nurses are at the forefront of patient care and, as such, are ideally placed to offer advice to patients that may proactively help mitigate the risks of cognitive decline and the development of Alzheimer's disease.

Managing Cognitive Dysfunction in Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S15-S16
Author(s):  
K. Miskowiak
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Functional Recovery ◽  
Cognitive Deficits ◽  
Clinical Treatment ◽  
Screening Tools ◽  
Treatment Target ◽  
Concentration Difficulty

Cognitive dysfunction, including memory and concentration difficulty, is an emerging treatment target in bipolar disorder. However, a key challenge in the management of these cognitive deficits is the lack of treatments with robust effects on cognition. Further, it is unclear how cognitive dysfunction should be assessed and addressed in the clinical treatment of the disorder. This talk will review the evidence for cognitive impairment in bipolar disorder, including its severity, persistence and impact on patients’ functional recovery. It will then discuss when and how to assess cognition and present some new feasible screening tools for cognitive dysfunction. Finally, it will highlight some novel candidate cognition treatments.Disclosure of interestI have acted as a consultant and received honoraria from Lundbeck and Allergan.

Neuropsychological Deficits and Concomitant Clinical Symptoms in Schizophrenia

2004 ◽  
Vol 9 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Bernhard W. Müller ◽  
Gudrun Sartory ◽  
Stefan Bender
Keyword(s):  
Cognitive Deficits ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Memory Function ◽  
Chronic Schizophrenia ◽  
Neuropsychological Deficits ◽  
Word Fluency ◽  
Syndrome Scale ◽  
Healthy Control

The most frequently reported neuropsychological deficits in schizophrenia are those of attention, executive function, and verbal memory. Whereas the former appear to be related to negative symptoms of schizophrenia, there is little agreement about which clinical symptoms are related to the verbal memory deficit. The aim of the present study was to delineate further the pattern of neuropsychological deficits in schizophrenia—especially those of verbal memory—and their relationship to clinical symptoms. One hundred patients with chronic schizophrenia and 62 healthy control subjects took part in the study. Assessments of patients took place within the first 3 weeks after admission to hospital. Nine neuropsychological tests, mainly measuring executive and memory function and attention, were administered to all subjects, and clinical symptoms, such as psychotic and negative symptoms and conceptual disorganization, were assessed in patients by means of the Positive and Negative Syndrome Scale (PANSS). Patients showed widespread cognitive deficits with verbal memory impairment best discriminating patients and controls. Conceptual disorganization was partly accounted for by poor verbal memory and a low IQ estimate, and negative symptoms by deficient word fluency; positive symptoms were not significantly related to cognitive deficits. The results indicate that there is a specific relationship between neuropsychological deficits and the more chronic of the clinical symptoms.

The Association between Insomnia-like Sleep Pattern Changes and Cognitive Dysfunction: Possible Mechanism and Therapeutic Strategy

2021 ◽  
Vol 18 ◽  
Author(s):  
Kangzhi Chen ◽  
Yefan Lv ◽  
Xiaoyan Long ◽  
Weiping Liu ◽  
Jinxia Zhou
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Sleep Disorders ◽  
Cognitive Dysfunction ◽  
Therapeutic Strategy ◽  
Sleep Architecture ◽  
Sleep Pattern ◽  
Sleep Patterns ◽  
Preclinical Ad ◽  
The Relationship

: The prevalence of sleep disorders and cognitive dysfunction has overwhelmingly increased, with insomnia and Alzheimer’s disease (AD) being the most common form. A multitude of studies have linked the alterations in sleep continuity or sleep architecture with cognitive impairment bilaterally, but the management of disrupted sleep patterns in preclinical AD could be more beneficial since there is no cure for AD. This review mainly focuses on the altered sleep patterns in insomnia, and summarizes potential pathways underlying the relationship between insomnia and cognitive impairment, aiming to establish certain sleep pattern changes as biomarkers for cognitive decline and explore potential therapeutic targets based on evidence from research advances.

Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

2019 ◽  
Author(s):  
Tesfa Dejenie Habtewold ◽  
Lyan H. Rodijk ◽  
Edith J. Liemburg ◽  
Grigory Sidorenkov ◽  
H. Marike Boezen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Longitudinal Studies ◽  
Cognitive Deficits ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Data Driven ◽  
Schizophrenia Spectrum Disorders ◽  
Cross Sectional ◽  
Modelling Studies ◽  
Positive And Negative Symptoms

AbstractIntroductionTo tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its (sub)clinical symptoms though there is no systematic review.AimsTo summarize the evidence from cluster- and trajectory-based studies of positive, negative and cognitive symptoms in patients with schizophrenia spectrum disorders, their siblings and healthy people. Additionally, we aimed to highlight knowledge gaps and point out future directions to optimize the translatability of cluster- and trajectory-based studies.MethodsA systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE, and Web of Science electronic databases. Both cross-sectional and longitudinal studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data.ResultsOf 2,285 studies retrieved, 50 studies (17 longitudinal and 33 cross-sectional) conducted in 30 countries were selected for review. Longitudinal studies discovered two to five trajectories of positive and negative symptoms in patient, and four to five trajectories of cognitive deficits in patient and sibling. In cross-sectional studies, three clusters of positive and negative symptoms in patient, four clusters of positive and negative schizotypy in sibling, and three to five clusters of cognitive deficits in patient and sibling were identified. These studies also reported multidimensional predictors of clusters and trajectories.ConclusionsOur findings indicate that (sub)clinical symptoms of schizophrenia are more heterogeneous than currently recognized. Identified clusters and trajectories can be used as a basis for personalized psychiatry.

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