Sensory gating, neurocognition, social cognition and real-life functioning: a 2-year follow-up of early psychosis

2021 ◽  
pp. 1-13
Author(s):  
Shen Li ◽  
Shi Yu Chan ◽  
Amy Higgins ◽  
Mei-Hua Hall
Keyword(s):  
Psychotic Disorders ◽  
Mixed Model ◽  
Real Life ◽  
Sensory Gating ◽  
Early Psychosis ◽  
Global Functioning ◽  
Chi Square ◽  
Life Functioning ◽  
Inference Test

Abstract Background Diminished sensory gating (SG) is a robust finding in psychotic disorders, but studies of early psychosis (EP) are rare. It is unknown whether SG deficit leads to poor neurocognitive, social, and/or real-world functioning. This study aimed to explore the longitudinal relationships between SG and these variables. Methods Seventy-nine EP patients and 88 healthy controls (HCs) were recruited at baseline. Thirty-three and 20 EP patients completed 12-month and 24-month follow-up, respectively. SG was measured using the auditory dual-click (S1 & S2) paradigm and quantified as P50 ratio (S2/S1) and difference (S1-S2). Cognition, real-life functioning, and symptoms were assessed using the MATRICS Consensus Cognitive Battery, Global Functioning: Social (GFS) and Role (GFR), Multnomah Community Ability Scale (MCAS), Awareness of Social Inference Test (TASIT), and the Positive and Negative Syndrome Scale (PANSS). Analysis of variance (ANOVA), chi-square, mixed model, correlation and regression analyses were used for group comparisons and relationships among variables controlling for potential confounding variables. Results In EP patients, P50 ratio (p < 0.05) and difference (p < 0.001) at 24-month showed significant differences compared with that at baseline. At baseline, P50 indices (ratio, S1-S2 difference, S1) were independently associated with GFR in HCs (all p < 0.05); in EP patients, S2 amplitude was independently associated with GFS (p = 0.037). At 12-month and 24-month, P50 indices (ratio, S1, S2) was independently associated with MCAS (all p < 0.05). S1-S2 difference was a trending predictor of future function (GFS or MCAS). Conclusions SG showed progressive reduction in EP patients. P50 indices were related to real-life functioning.

Course of cannabis use and clinical outcome in patients with non-affective psychosis: a 3-year follow-up study

2015 ◽  
Vol 45 (9) ◽  
pp. 1977-1988 ◽  
Author(s):  
F. J. van der Meer ◽  
E. Velthorst ◽  
Keyword(s):  
Clinical Outcome ◽  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Mixed Model ◽  
Cannabis Use ◽  
Global Functioning ◽  
Follow Up Study ◽  
Multi Center Study ◽  
Illness Outcome

BackgroundProspective studies on the relationship between course of cannabis use and clinical outcome in patients with non-affective psychotic disorders are inconclusive. The current study examined whether (1) persistent, recently started, discontinued and non-cannabis-using patients with a psychotic disorder differed with regard to illness outcome at 3-year follow-up, and (2) whether timing of cannabis discontinuation was associated with course of clinical outcome.MethodThis 3-year follow-up study was part of a multi-center study in the Netherlands and Belgium (Genetic Risk and Outcome of Psychosis; GROUP). We used mixed-model analyses to investigate the association between pattern of cannabis use and symptoms, global functioning and psychotic relapse.ResultsIn our sample of 678 patients, we found persistent users to have more positive and general symptoms, worse global functioning and more psychotic relapses compared with non-users and discontinued users [Positive and Negative Syndrome Scale (PANSS) positive, p < 0.001; PANSS general, p < 0.001; Global Assessment of Functioning (GAF) symptoms, p = 0.017; GAF disability, p < 0.001; relapses, p = 0.038]. Patients who started using cannabis after study onset were characterized by worse functioning at baseline and showed an increase in general symptoms (including depression and anxiety) at the 3-year follow-up (p = 0.005). Timing of cannabis discontinuation was not associated with clinical outcome.ConclusionsThese findings suggest that cannabis use in patients with a psychotic disorder has a long-lasting negative effect on illness outcome, particularly when persistent. Treatment should focus on discouraging cannabis use.

Cognitive Dysfunctions in the Psychoses and their Impact on Patients’ Social Functioning

2017 ◽  
Vol 41 (S1) ◽  
pp. S48-S48
Author(s):  
A. Mucci ◽  
S. Galderisi
Keyword(s):  
Quality Of Life ◽  
Social Cognition ◽  
Theory Of Mind ◽  
Cognitive Deficits ◽  
Psychotic Disorders ◽  
Real Life ◽  
Advisory Board ◽  
Affect Recognition ◽  
Life Functioning

IntroductionImpairment of neurocognitive functions, such as attention, memory or executive functions, as well as of social cognition, particularly of affect recognition and theory of mind, are frequently observed in people with Schizophrenia or other psychotic disorders. These dysfunctions are associated with poor real-life functioning. Social cognition deficits mediate in part the impact of neurocognitive dysfunction on functional outcome.AimsTo review literature findings on prevalence, severity and association with functional outcome of neurocognitive and social cognitive deficits in schizophrenia and other psychotic disorders.MethodsWe searched PubMed for English/Italian or French full-text publications with the keywords.schizophr*/psychosis/psychot*/AND neurocognitive/cognitive/neuropsychological/memory/attention/”executive function”/learning/”social cognition”/”theory of mind”/”affect recognition”/”acial emotion recognition”/”emotional intelligence”/”emot* recognition”. Furthermore, we manually searched the reference lists of relevant papers, systematic reviews and meta-analyses.ResultsIn people with schizophrenia, schizoaffective disorder or bipolar disorder with psychotic features, neurocognitive and social cognition deficits were observed in all phases of the disorders, even after symptom remission. Some of these deficits were observed in subjects at high-risk to develop schizophrenia before psychotic onset. In all these subjects, cognitive deficits are associated with worse psychosocial functioning and poor quality of life. Pharmacological treatments do not alleviate cognitive deficits, which can also limit the benefit of other psychological or psychosocial interventions.ConclusionsNeurocognitive and social cognition deficits need to be targeted by specific interventions to improve real-life functioning and quality of life of people with schizophrenia or psychotic disorders.Disclosure of interestAM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre.SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter.

scholarly journals Stable habituation deficits in the early stage of psychosis: a 2-year follow-up study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Suzanne N. Avery ◽  
Maureen McHugo ◽  
Kristan Armstrong ◽  
Jennifer Urbano Blackford ◽  
Neil D. Woodward ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Early Stage ◽  
Occipital Cortex ◽  
Brain Regions ◽  
Early Psychosis ◽  
Brain Response ◽  
Face Area ◽  
Healthy Control

AbstractNeural habituation, the decrease in brain response to repeated stimuli, is a fundamental, highly conserved mechanism that acts as an essential filter for our complex sensory environment. Convergent evidence indicates neural habituation is disrupted in both early and chronic stages of schizophrenia, with deficits co-occurring in brain regions that show inhibitory dysfunction. As inhibitory deficits have been proposed to contribute to the onset and progression of illness, habituation may be an important treatment target. However, a crucial first step is clarifying whether habituation deficits progress with illness. In the present study, we measured neural habituation in 138 participants (70 early psychosis patients (<2 years of illness), 68 healthy controls), with 108 participants assessed longitudinally at both baseline and 2-year follow-up. At follow-up, all early psychosis patients met criteria for a schizophrenia spectrum disorder (i.e., schizophreniform disorder, schizophrenia, schizoaffective disorder). Habituation slopes (i.e., rate of fMRI signal change) to repeated images were computed for the anterior hippocampus, occipital cortex, and the fusiform face area. Habituation slopes were entered into a linear mixed model to test for effects of group and time by region. We found that early psychosis patients showed habituation deficits relative to healthy control participants across brain regions, and that these deficits were maintained, but did not worsen, over two years. These results suggest a stable period of habituation deficits in the early stage of schizophrenia.

Abstract W P382: Cognitive Outcome in SAMMPRIS: Medical Therapy vs. Stenting

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Alison P Smock ◽  
Tanya N Turan ◽  
George A Cotsonis ◽  
Michael J Lynn ◽  
Colin P Derdeyn ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Repeated Measures ◽  
Mixed Model ◽  
Cerebral Arteries ◽  
Cognitive Outcome ◽  
Chi Square ◽  
Treatment Groups ◽  
Angioplasty And Stenting ◽  
Time Point

Background: It has been hypothesized that revascularization of stenotic cerebral arteries may improve cognitive outcome by increasing cerebral perfusion. We sought to compare cognitive outcome in patients treated with percutaneous angioplasty and stenting (PTAS) and aggressive medical management (AMM) vs. AMM alone in the SAMMPRIS Trial. Methods: In SAMMPRIS, 451 patients with recent TIA or stroke attributed to 70%-99% intracranial stenosis were randomized to PTAS plus AMM or AMM alone. Patients with stroke as the qualifying event who had a NIHSS indicating aphasia or neglect were excluded from these analyses. Patients with any ischemic stroke, cerebral infarct with temporary signs (CITS), or ICH during follow-up were excluded from subsequent follow-up visit analyses. The Montreal Cognitive Assessment (MoCA) score was used to assess cognition at baseline, 4 months, 12 months, and closeout (mean 3.05 years in AMM group and 3.12 years in PTAS group). Cognitive impairment was defined as MoCA <26. Mean MoCA scores and the percentage of patients with cognitive impairment were compared between treatment groups at each time point using t-tests and Chi-square tests. Differences in MoCA means from baseline to follow-up time points were compared using mixed model repeated measures ANOVA and Tukey-Kramer tests. Results: As shown in the Figure, there were no significant differences between the treatment groups for mean MoCA at any time point. There were significant improvements in mean MoCA from baseline to 4 months, 12 months, and closeout in both groups. The percentage of patients with cognitive impairment in the AMM vs. PTAS groups were not significantly different at baseline (53 vs. 56%), 4 months (38 vs. 44%), 12 months (42 vs. 40%), and closeout (43 vs. 39%). Conclusions: Revascularization did not provide any additional cognitive benefit over AMM alone in SAMMPRIS even after excluding patients who had cerebral infarction or ICH during follow-up.

scholarly journals M233. EXPERIENTIAL NEGATIVE SYMPTOMS ARE MORE PREDICTIVE OF REAL-LIFE FUNCTIONAL OUTCOME THAN EXPRESSIVE NEGATIVE SYMPTOMS IN CLINICAL HIGH-RISK STATES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S225-S225
Author(s):  
Louise Birkedal Glenthoej ◽  
Tina Dam Kristensen ◽  
Christina Wenneberg ◽  
Carsten Hjorthøj ◽  
Merete Nordentoft
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Functional Outcome ◽  
Negative Symptoms ◽  
Real Life ◽  
Self Report ◽  
Functional Impairments ◽  
Life Functioning

Abstract Background Negative symptoms are key features of schizophrenia spectrum disorders that are linked to psychosis development and functional impairments. This study investigated the predictive power of negative symptoms domains on multiple aspects of real-life functional outcome in individuals at Ultra High-Risk (UHR) for psychosis. Methods A total of 146 UHR individuals were enrolled in a randomised, clinical trial. This study reports on analyses secondary to the RCT. The UHR individuals were assessed at baseline with the Scale for the Assessment of Negative Symptoms (SANS) encompassing the four domains of affect, alogia, avolition, and anhedonia. Functioning measures, comprising overall-, social-, and role functioning, self-report social functioning, and quality of life, were obtained at 12-month follow-up. Regression analyses elucidated on the relationship between the four negative symptom domains and functional outcomes. Results The aspects of negative symptoms most predictive of real-life functioning at 12-month follow-up were anhedonia and avolition explaining 6–19% of the variance on the functional outcome measures. The finding was maintained when controlling for the effect of neurocognition, antipsychotic medication, and depressive symptoms. Discussion Our study finds experiential negative symptoms to predict multiple areas of real-life functioning and quality of life, while expressive negative symptoms exert a modest influence on the functional prognosis of UHR individuals. Hence, experiential negative symptoms (such as motivational deficits and asociality) may constitute an important treatment target in intervention approaches aimed at enhancing the functional outcome of UHR individuals.

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