Cognitive impairment in schizophrenia: relationships with cortical thickness in fronto-temporal regions, and dissociability from symptom severity

AbstractCognitive impairments are a core and persistent characteristic of schizophrenia with implications for daily functioning. These show only limited response to antipsychotic treatment and their neural basis is not well characterised. Previous studies point to relationships between cortical thickness and cognitive performance in fronto-temporal brain regions in schizophrenia patients (SZH). There is also evidence that these relationships might be independent of symptom severity, suggesting dissociable disease processes. We set out to explore these possibilities in a sample of 70 SZH and 72 age and gender-matched healthy controls (provided by the Center of Biomedical Research Excellence (COBRE)). Cortical thickness within fronto-temporal regions implicated by previous work was considered in relation to performance across various cognitive domains (from the MATRICS Cognitive Battery). Compared to controls, SZH had thinner cortices across most fronto-temporal regions and significantly lower performance on all cognitive domains. Robust relationships with cortical thickness were found: visual learning and attention performance correlated with bilateral superior and middle frontal thickness in SZH only. Correlations between attention performance and right transverse temporal thickness were also specific to SZH. Findings point to the importance of these regions for cognitive performance in SZH, possibly reflecting compensatory processes and/or aberrant connectivity. No links to symptom severity were observed in these regions, suggesting these relationships are dissociable from underlying psychotic symptomology. Findings enhance understanding of the brain structural underpinnings and possible aetiology of cognitive impairment in SZH.

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Association Between Cerebral Cortical Microinfarcts and Perilesional Cortical Atrophy on 3T MRI

Neurology ◽

10.1212/wnl.0000000000013140 ◽

2021 ◽

pp. 10.1212/WNL.0000000000013140

Author(s):

Doeschka A. Ferro ◽

Hugo J. Kuijf ◽

Saima Hilal ◽

Susanne J. van Veluw ◽

Daniëlle van Veldhuizen ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Performance ◽

Sex Education ◽

Cortical Thickness ◽

Brain Regions ◽

Primary Objective ◽

Cognitive Testing ◽

Cortical Atrophy ◽

Intracranial Volume ◽

3T Mri

Background and objectives:Cerebral cortical microinfarcts (CMIs) are a novel MRI-marker of cerebrovascular disease (CeVD) that predicts accelerated cognitive decline. Presence of CMIs is known to be associated with global cortical atrophy, although the mechanism linking the two is unclear. Our primary objective was to examine the relation between CMIs and cortical atrophy and establish possible perilesional atrophy surrounding CMIs. Our secondary objective was to examine the role of cortical atrophy in CMI-associated cognitive impairment.Methods:Patients were recruited from two Singapore memory clinics between December 2010 and September 2013 and included if they received the diagnosis no objective cognitive impairment, cognitive impairment (with or without a history of stroke) or Alzheimer’s or vascular dementia. Cortical thickness, chronic cortical microinfarcts and MRI-markers of CeVD were assessed on 3T MRI. Patients underwent cognitive testing. Cortical thickness was compared globally between patients with and without CMIs, regionally within individual patients with CMIs comparing brain regions with CMIs to the corresponding contralateral region without CMIs and locally within individuals patients in a 50 mm radius of CMIs. Global cortical thickness was analyzed as mediator in the relation between CMI and cognitive performance.Results:Of the 238 patients (mean age 72.5 SD 9.1 years) enrolled, 75 had ≥1 CMIs. Patient with CMIs had a 2.1% lower global cortical thickness (B=-.049 mm, 95% CI [.091; -.007] p=.022) compared to patients without CMIs, after correction for age, sex, education and intracranial volume. In patients with CMIs, cortical thickness in brain regions with CMIs was 2.2 % lower than in contralateral regions without CMIs (B=-.048 mm [-.071; -.026] p<.001). In a 20 mm radius area surrounding the CMI-core, cortical thickness was lower than in the area 20-50 mm from the CMI-core (Mean difference -.06 mm 95% CI [-.10; -.02] p=.002). Global cortical thickness was a significant mediator in the relationship between CMI presence and cognitive performance as measure with the Mini-Mental State Examination (B=-.12 [-.22; -.01] p=.025).Discussion:We found cortical atrophy surrounding CMIs, suggesting a perilesional effect in a cortical area many times larger than the CMI-core. Our findings support the notion that CMIs affect brain structure beyond the actual lesion site.

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Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

International Journal of Social Psychiatry ◽

10.1177/0020764019897697 ◽

2020 ◽

Vol 66 (3) ◽

pp. 240-248 ◽

Cited By ~ 1

Author(s):

Afaf Hamed Khalil ◽

Marwa Abd el-Meguid ◽

Mostafa Bastawy ◽

Samah Rabei ◽

Ramy Ali ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Problem Solving ◽

Cognitive Functions ◽

Visual Learning ◽

Verbal Learning ◽

General Psychopathology ◽

Cognitive Domains ◽

Reasoning Problem ◽

Egyptian Patients

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

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Cortical Microstructural Alterations in Mild Cognitive Impairment and Alzheimer’s Disease Dementia

Cerebral Cortex ◽

10.1093/cercor/bhz286 ◽

2020 ◽

Vol 30 (5) ◽

pp. 2948-2960 ◽

Cited By ~ 6

Author(s):

Nicholas M Vogt ◽

Jack F Hunt ◽

Nagesh Adluru ◽

Douglas C Dean ◽

Sterling C Johnson ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cortical Thickness ◽

Gray Matter ◽

Brain Regions ◽

Cortical Atrophy ◽

Microstructural Alterations ◽

Additional Information

Abstract In Alzheimer’s disease (AD), neurodegenerative processes are ongoing for years prior to the time that cortical atrophy can be reliably detected using conventional neuroimaging techniques. Recent advances in diffusion-weighted imaging have provided new techniques to study neural microstructure, which may provide additional information regarding neurodegeneration. In this study, we used neurite orientation dispersion and density imaging (NODDI), a multi-compartment diffusion model, in order to investigate cortical microstructure along the clinical continuum of mild cognitive impairment (MCI) and AD dementia. Using gray matter-based spatial statistics (GBSS), we demonstrated that neurite density index (NDI) was significantly lower throughout temporal and parietal cortical regions in MCI, while both NDI and orientation dispersion index (ODI) were lower throughout parietal, temporal, and frontal regions in AD dementia. In follow-up ROI analyses comparing microstructure and cortical thickness (derived from T1-weighted MRI) within the same brain regions, differences in NODDI metrics remained, even after controlling for cortical thickness. Moreover, for participants with MCI, gray matter NDI—but not cortical thickness—was lower in temporal, parietal, and posterior cingulate regions. Taken together, our results highlight the utility of NODDI metrics in detecting cortical microstructural degeneration that occurs prior to measurable macrostructural changes and overt clinical dementia.

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Association Between Reduced Brain Glucose Metabolism and Cortical Thickness in Alcoholics: Evidence of Neurotoxicity

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyz036 ◽

2019 ◽

Vol 22 (9) ◽

pp. 548-559 ◽

Cited By ~ 2

Author(s):

Dardo G Tomasi ◽

Corinde E Wiers ◽

Ehsan Shokri-Kojori ◽

Amna Zehra ◽

Veronica Ramirez ◽

...

Keyword(s):

Cortical Thickness ◽

Brain Regions ◽

Excessive Alcohol Consumption ◽

Mediation Effects ◽

Cognitive Domains ◽

Performance Accuracy ◽

Positron Emission ◽

Superior Parietal Cortex ◽

Excessive Alcohol ◽

Causal Mediation Analysis

Abstract Background Excessive alcohol consumption is associated with reduced cortical thickness (CT) and lower cerebral metabolic rate of glucose (CMRGlu), but the correlation between these 2 measures has not been investigated. Methods We tested the association between CT and cerebral CMRGlu in 19 participants with alcohol use disorder (AUD) and 20 healthy controls. Participants underwent 2-Deoxy-2-[18F]fluoroglucose positron emission tomography to map CMRGlu and magnetic resonance imaging to assess CT. Results Although performance accuracy on a broad range of cognitive domains did not differ significantly between AUD and HC, AUD had widespread decreases in CT and CMRGlu. CMRGlu, normalized to cerebellum (rCMRGlu), showed significant correlation with CT across participants. Although there were large group differences in CMRGlu (>17%) and CT (>6%) in medial orbitofrontal and BA 47, the superior parietal cortex showed large reductions in CMRGlu (~17%) and minimal CT differences (~2.2%). Though total lifetime alcohol (TLA) was associated with CT and rCMRGlu, the causal mediation analysis revealed significant direct effects of TLA on rCMRGlu but not on CT, and there were no significant mediation effects of TLA, CT, and rCMRGlu. Conclusions The significant correlation between decrements in CT and CMRGlu across AUD participants is suggestive of alcohol-induced neurotoxicity, whereas the findings that the most metabolically affected regions in AUD had minimal atrophy and vice versa indicates that changes in CT and CMRGlu reflect distinct responses to alcohol across brain regions.

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Effect of Virtual Reality on Cognitive Impairment and Clinical Symptoms Among Patients with Schizophrenia in the Remission Stage: A Randomized Controlled Trial

10.21203/rs.3.rs-49234/v1 ◽

2020 ◽

Author(s):

Shangda Li ◽

Bin Sun ◽

Ning Wei ◽

Zhe Shen ◽

Kangyu Jin ◽

...

Keyword(s):

Virtual Reality ◽

Cognitive Impairment ◽

Cognitive Function ◽

Clinical Symptoms ◽

Visual Learning ◽

Training System ◽

Chinese Patients ◽

Antipsychotic Treatment ◽

Treatment As Usual ◽

General Psychopathology

Abstract Background: This is an intervention study which explores the effect of using virtual reality supermarket training system (VRSTS) to improve cognitive function deficiency and clinical symptoms in Han Chinese patients with schizophrenia in the remission stage. Methods:68 patients with schizophrenia in the remission stage were recruited for the interventional study and were randomly allocated to either virtual reality training (VRT) group or treatment-as-usual (TAU) group. For VRT group, patients received training with VRSTS for two weeks and antipsychotic treatment as usual while TAU group only received antipsychotic treatment as usual. Cognitive function and clinical symptoms before and after intervention were assessed by MATRICS Consensus Cognitive Battery (MCCB), Positive and Negative Syndrome Scale (PANSS), and the Personal and Social Performance Scale (PSP).Results:Results showed (1) VRSTS could improve MCCB composite scores and 4 out of 7 cognitive domains: speed of processing, working memory, visual learning, reasoning and problem solving, and (2) VRSTS could alleviate general psychopathology symptoms of PANSS but did not exert effects on positive and negative symptoms among patients with schizophrenia in the remission stageConclusion:A therapeutic effect of VRSTS was observed in patients with schizophrenia in the remission stage. It may improve cognitive impairment and general psychopathology symptoms.Trial registration: China Clinical Trial Registry, ChiVTR1800016121. Registered 13 May 2018, http://www.chictr.org.cn/showproj.aspx?proj=27233

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Effect of virtual reality on cognitive impairment and clinical symptoms among patients with schizophrenia in the remission stage ： a randomized controlled trial

10.21203/rs.3.rs-49234/v2 ◽

2020 ◽

Author(s):

Shangda Li ◽

Bin Sun ◽

Ning Wei ◽

Zhe Shen ◽

Kangyu Jin ◽

...

Keyword(s):

Virtual Reality ◽

Cognitive Impairment ◽

Cognitive Function ◽

Clinical Symptoms ◽

Visual Learning ◽

Chinese Patients ◽

Antipsychotic Treatment ◽

Treatment As Usual ◽

General Psychopathology ◽

Psychopathology Symptoms

Abstract Background: This is an intervention study which explores the effect of using virtual reality supermarket training system (VRSTS) to improve cognitive function deficiency and clinical symptoms in Han Chinese patients with schizophrenia in the remission stage. Methods: 68 patients with schizophrenia in the remission stage were recruited for the interventional study and were randomly allocated to either virtual reality training (VRT) group or treatment-as-usual (TAU) group. For VRT group, patients received training with VRSTS for two weeks and antipsychotic treatment as usual while TAU group only received antipsychotic treatment as usual. Cognitive function and clinical symptoms before and after intervention were assessed by MATRICS Consensus Cognitive Battery (MCCB), Positive and Negative Syndrome Scale (PANSS), and the Personal and Social Performance Scale (PSP). Results: Results showed (1) VRSTS could improve MCCB composite scores and 4 out of 7 cognitive domains: speed of processing, working memory, visual learning, reasoning and problem solving, and (2) VRSTS could alleviate general psychopathology symptoms of PANSS but did not exert effects on positive and negative symptoms among patients with schizophrenia in the remission stage Conclusion: A therapeutic effect of VRSTS was observed in patients with schizophrenia in the remission stage. It may improve cognitive impairment and general psychopathology symptoms.

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Bipolar Disorder, Obesity and Cognitive Impairment

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2167 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S207-S207 ◽

Cited By ~ 2

Author(s):

M. La Montagna ◽

E. Stella ◽

F. Ricci ◽

L. Borraccino ◽

A.I. Triggiani ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Problem Solving ◽

Cognitive Deficits ◽

Cognitive Functions ◽

Visual Learning ◽

Verbal Learning ◽

Speed Of Processing ◽

Anthropometric Measures ◽

Cognitive Domains

IntroductionAccording to scientific literature, cognitive impairment is a disabling feature of the bipolar disorder (BD), present in all the phases of the disease. Obesity and metabolic disorders represent another risk factor for cognitive dysfunctions in BD, since the excess of weight could adversely influence several cognitive domains.ObjectiveTo highlight the presence of impairment of cognitive functions in a sample of subjects suffering from BD and obesity.AimsEvaluation of the cognitive performance in a sample of BD patients, considering their anthropometric measures (height and weight) and body mass index (BMI).MethodsThe neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained physicians for the evaluation of seven different cognitive domains in 46 patients (mean age: 43.17 years old; 39.13% male), affected by BD enrolled in the psychiatric unit of Azienda Sanitaria Locale and University of Foggia. In particular, cognitive functions assessed were speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. BMI was calculated, and patients were divided into a group of normal weight and another one of overweight or obese, on the base of BMI value (BMI cut-off = 25).ResultsThe obese patients amounted at 56.52%. We have found the presence of cognitive deficits in two of the seven domains assessed, that are speed of processing (P < 0.01) and reasoning and problem solving (P < 0.05) in the sample of overweight patients.ConclusionsCognitive deficits are clearly revealed in BD patients during the euthymic phase of the disorder. The obesity in BD could contribute to increase dysfunctions in cognitive domains.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Disrupted neural synchrony mediates the relationship between white matter integrity and cognitive performance in older adults

10.1101/2019.12.29.890228 ◽

2019 ◽

Author(s):

T. Hinault ◽

M. Kraut ◽

A. Bakker ◽

A. Dagher ◽

S.M. Courtney

Keyword(s):

Older Adults ◽

Individual Differences ◽

White Matter ◽

Cognitive Functioning ◽

Cognitive Performance ◽

Cognitive Aging ◽

Brain Regions ◽

Individual Variability ◽

White Matter Integrity ◽

Neural Basis

AbstractOur main goal was to determine the influence of white matter integrity on the dynamic coupling between brain regions and the individual variability of cognitive performance in older adults. EEG was recorded while participants performed a task specifically designed to engage working memory and inhibitory processes, and the associations among functional activity, structural integrity, and cognitive performance were assessed. We found that the association between white matter microstructural integrity and cognitive functioning with aging is mediated by time-varying alpha and gamma phase-locking value (PLV). Specifically, older individuals with better preservation of the inferior fronto-occipital fasciculus showed greater task-related modulations of alpha and gamma long-range PLV between the inferior frontal gyrus and occipital lobe, lower local phase-amplitude coupling in occipital lobes, and better cognitive control performance. Our results help delineate the role of individual variability of white matter microstructure in dynamic synchrony and cognitive performance during normal aging, and show that even small reductions in white matter integrity can lead to altered communications between brain regions, which in turn can result in reduced efficiency of cognitive functioning.Significance statementCognitive aging is associated with large individual differences, as some individuals maintain cognitive performance similar to that of young adults while others are significantly impaired. We hypothesized that individual differences in white matter integrity would influence the functional synchrony between frontal and posterior brain regions, and cognitive performance in older adults. We found that the association between reduced tract integrity and worse cognitive performance in older adults was mediated by task-related modulations of coupling synchrony in the alpha and gamma bands. Results offer a mechanistic explanation for the neural basis of the variability of cognitive performance in older adults who do not have any clinically diagnosable neuropathology, and for the association between structural network integrity and cognition in older adults.

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Aerobic Capacity Is Not Associated with Most Cognitive Domains in Patients with Multiple Sclerosis—A Cross-Sectional Investigation

Journal of Clinical Medicine ◽

10.3390/jcm7090272 ◽

2018 ◽

Vol 7 (9) ◽

pp. 272 ◽

Cited By ~ 6

Author(s):

Martin Langeskov-Christensen ◽

Søren Eskildsen ◽

Egon Stenager ◽

Henrik Boye Jensen ◽

Helle Hvilsted Nielsen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Performance ◽

Aerobic Capacity ◽

Z Score ◽

Vo2 Max ◽

Cross Sectional ◽

Cognitive Domains ◽

Impaired Group ◽

Z Scores

(1) Background: Cognitive impairment is highly prevalent in multiple sclerosis (MS). Staying physically fit may be associated with preservation of cognitive performance in persons with MS (pwMS); (2) Objective: To investigate the association between aerobic capacity and the cognitive domains of information processing, learning and memory, and verbal fluency as well as single and composite z-scores of the Brief Repeatable Battery of Neuropsychological tests (BRBNT) in pwMS; (3) Methods: All subjects first performed the BRBNT and then a maximal oxygen consumption (VO2-max) test on a bicycle ergometer as a measure of aerobic capacity. Simple and multiple (adjusting for age, sex, and education level) regression analyses were performed to evaluate the relationship between aerobic capacity and cognitive performance in different domains. Published international norms were used to compute z-scores for each individual and composite BRBNT score. Furthermore, cognitive impairment was defined as one or more z-scores ≤−1.5 standard deviation (SD) of healthy controls; (4) Results: Eighty-four subjects were included (44.9 ± 9 years, 16.3 ± 2 education years, Expanded Disability Status Scale (EDSS): 2.6 ± 1.4, MS-type (relapsing-remitting, primary progressive, or secondary progressive): 73/6/5, disease duration: 9.9 ± 7 years, VO2-max: 28.4 ± 7.0 mL O2/min/kg). No significant associations between aerobic capacity and cognitive performance in the individual BRBNT tests were found, except that a weak relationship was found between aerobic capacity and the composite processing speed z-score (R2 = 0.06, p = 0.02). The average global BRBNT z-score (−0.2 ± 0.66) was not associated with aerobic capacity. Comparison of the cognitively impaired group (34.5%) with the nonimpaired group (65.5%) showed lower aerobic capacity in the impaired group (25.9 ± 1 vs. 29.7 ± 1 mLO2/min/kg, p = 0.02); (5) Conclusions: Limited support was found for an association between performance in most cognitive domains and aerobic capacity in the present MS group with a third of patients showing signs of cognitive impairments.

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Neurotropic effects of respiratory viral infections: mental and neuropsychological aspects

INTERNATIONAL JOURNAL OF ENDOCRINOLOGY ◽

10.22141/2224-0721.17.6.2021.243215 ◽

2021 ◽

Vol 17 (6) ◽

pp. 496-502

Author(s):

A.A. Shuprovich

Keyword(s):

Cognitive Impairment ◽

Cognitive Performance ◽

Viral Infections ◽

Psychiatric Symptoms ◽

Significant Proportion ◽

The Body ◽

Significant Heterogeneity ◽

Attention Performance ◽

Respiratory Viral Infections

The review is devoted to the problem of neurological complications that result from respiratory viral infections due to viral invasion to the central and peripheral nervous systems. Psychoneurological consequences after the disease of COVID-19 are considered separately. Viral pathogens can enter the central nervous system (CNS) in various ways, including through hematogenous infection of the endothelium (the “Trojan horse” mechanism) as well as through peripheral nerves or olfactory sensory neurons. The latter route is mostly used by respiratory viruses, such as coronaviruses (CoV), which enter the body intranasally because the olfactory nerve connects the nasal epithelium with the olfactory bulb — the way to the CNS. CoV in the human brain can cause long-term effects associated with the development or exacerbation of chronic neurological diseases, such as multiple sclerosis. Coronavirus COVID-19, which causes coronavirus disease, can provoke long-term outcomes after recovery, such as psychiatric symptoms and cognitive impairment, which are detected by cognitive screening. In the post-COVID period, patients demonstrated poor cognitive performance in the areas of attention, performance, and memory as well as increased levels of depression, anxiety, post-traumatic stress, fatigue, and sleep disturbances. These effects should be considered as possible post-viral disorders that require special diagnosis and appropriate treatment. Significant heterogeneity of applied approaches and methods hinders the comprehensive characterization of cognitive functions in specific areas since the studies often excluded people with previous cognitive impairment. Nevertheless, most studies indicate some degree of cognitive impairment in patients with COVID-19. Although the rates vary, a significant proportion of survivors show poor cognitive performance in the areas of attention, performance, and memory. These results have several important implications for further research, clinical management, and treatment of those who have experienced COVID-19.

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