scholarly journals T18. EFFECTS OF COGNITIVE REMEDIATION ON WHITE MATTER IN INDIVIDUALS AT ULTRA-HIGH RISK FOR PSYCHOSIS – A RANDOMIZED, CONTROLLED CLINICAL TRIAL

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S237-S238
Author(s):  
Tina Kristensen ◽  
Bjørn H Ebdrup ◽  
Carsten Hjorthøj ◽  
Rene C W Mandl ◽  
Jayachandra Mitta Raghava ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Negative Symptoms ◽  
Cognitive Remediation ◽  
Attrition Rate ◽  
Healthy Controls ◽  
Whole Brain ◽  
Ultra High Risk ◽  
Secondary Outcomes ◽  
Post Hoc

Abstract Background Individuals at ultra-high risk for psychosis (UHR) present with subtle white matter alterations, which have been associated with clinical and functional outcome. The effect of cognitive remediation on white matter (WM) in UHR-individuals has not been investigated. Methods In a randomized, clinical intervention-trial (FOCUS), UHR-individuals aged 18–40 years were assigned to treatment as usual (TAU) or TAU plus cognitive remediation (CR) for 20 weeks. CR comprised 20 x 2-hour sessions of neurocognitive and social-cognitive training (SCIT). Primary outcome was whole brain fractional anisotropy (FA) derived from diffusion weighted imaging. Secondary outcomes pertained to regions of interest analyses. Planned post-hoc analyses explored dose-response effects of CR on WM. Main analyses of treatment effect of CR on primary and secondary outcomes were conducted using linear mixed models, assessing the interaction of timepoint by group (CR and TAU). Analyses were conducted according to the intention-to-treat principle. Results 111 UHR-individuals and 59 healthy controls were included. Attrition-rate was 30% at 6 months post-treatment follow-up. The CR group completed a mean of 12 hours of neurocognitive training. We found no effect of CR on whole-brain or regional FA. Planned post-hoc analyses revealed significant time*group (high- and low-attendance to CR) interactions in left superior corona radiata (p<0.01), left cingulum cingulate gyrus (P=0.03), and right superior longitudinal fasciculus (P<0,01), corrected. Specifically, when compared to UHR-individuals with high attendance (UHR-high >12 hours), those with low attendance (UHR-low <12 hours) had more co-morbid diagnoses, larger recreational smoking (nicotine and cannabis), more depressive and negative symptoms, and had significantly lower global FA at baseline, and showed a significant increase in FA after treatment. Furthermore, UHR-low displayed large effect-size (ES) improvements on depressive and negative symptoms, and moderate to large ES improvements in several cognitive functions (verbal fluency, verbal working memory, and processing speed). In contrast, UHR-high displayed large ES improvements in UHR-symptoms, and moderate ES improvement on social and occupational functioning. Discussion Contradicting our main hypothesis, we found no effect of CR on whole-brain or regional FA after six months. This may be explained by both the low number of neurocognitive training sessions and the attrition rate. The average of 12 hours of neurocognitive training is considerably lower than the recommended dosage of 25–30 hours necessary for cognitive improvements. The continuous need to develop feasible interventions and enhance adherence is stressed. Nevertheless, non-specific treatment may improve WM-integrity in UHR-individuals with lower global baseline FA in those with more severe psychopathology. The UHR-low subgroup exhibited improvements with large ES in levels of depressive and negative symptoms, as well as cognitive functions. We speculate, whether our results reflect that UHR-individuals with higher baseline FA (approaching the healthy controls), present with a preserved structural capacity for increased demands and new learning, while UHR-individuals characterized by lower FA at baseline may be more amendable to neuroplastic treatment-effects. The results support the value of subgrouping in a clinically heterogenous UHR-population, which also applies to examining WM integrity.

scholarly journals No Effects of Cognitive Remediation on Cerebral White Matter in Individuals at Ultra-High Risk for Psychosis—A Randomized Clinical Trial

2020 ◽  
Vol 11 ◽  
Author(s):  
Tina D. Kristensen ◽  
Bjørn H. Ebdrup ◽  
Carsten Hjorthøj ◽  
René C. W. Mandl ◽  
Jayachandra M. Raghava ◽  
...  
Keyword(s):  
Clinical Trial ◽  
White Matter ◽  
High Risk ◽  
Randomized Clinical Trial ◽  
Cognitive Remediation ◽  
Cerebral White Matter ◽  
Ultra High Risk

Frontal slow wave resting EEG power is higher in individuals at Ultra High Risk for psychosis than in healthy controls but is not associated with negative symptoms or functioning

2019 ◽  
Vol 208 ◽  
pp. 293-299
Author(s):  
Miranda Sollychin ◽  
Bradley N. Jack ◽  
Andrea Polari ◽  
Ayaka Ando ◽  
G. Paul Amminger ◽  
...  
Keyword(s):  
High Risk ◽  
Slow Wave ◽  
Negative Symptoms ◽  
Healthy Controls ◽  
Ultra High Risk ◽  
Eeg Power

White-matter markers for psychosis in a prospective ultra-high-risk cohort

2009 ◽  
Vol 40 (8) ◽  
pp. 1297-1304 ◽  
Author(s):  
O. J. N. Bloemen ◽  
M. B. de Koning ◽  
N. Schmitz ◽  
D. H. Nieman ◽  
H. E. Becker ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Healthy Controls ◽  
Syndrome Scale ◽  
Ultra High Risk ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

BackgroundSubjects at ‘ultra high risk’ (UHR) for developing psychosis have differences in white matter (WM) compared with healthy controls. WM integrity has not yet been investigated in UHR subjects in relation to the development of subsequent psychosis. Hence, we investigated a prospective cohort of UHR subjects comparing whole brain fractional anisotropy (FA) of those later developing psychosis (UHR-P) to those who did not (UHR-NP).MethodWe recruited 37 subjects fulfilling UHR criteria and 10 healthy controls. Baseline 3 Tesla magnetic resonance imaging (MRI) scans and Positive and Negative Syndrome Scale (PANSS) ratings were obtained. UHR subjects were assessed at 9, 18 and 24 months for development of frank psychosis. We compared baseline FA of UHR-P to controls and UHR-NP subjects. Furthermore, we related clinical data to MRI outcome in the patient population.ResultsOf the 37 UHR subjects, 10 had transition to psychosis. UHR-P subjects showed significantly lower FA values than control subjects in medial frontal lobes bilaterally. UHR-P subjects had lower FA values than UHR-NP subjects, lateral to the right putamen and in the left superior temporal lobe. UHR-P subjects showed higher FA values, compared with UHR-NP, in the left medial temporal lobe. In UHR-P, positive PANSS negatively correlated to FA in the left middle temporal lobe. In the total UHR group positive PANSS negatively correlated to FA in the right superior temporal lobe.ConclusionsUHR subjects who later develop psychosis have differences in WM integrity, compared with UHR subjects who do not develop psychosis and to healthy controls, in brain areas associated with schizophrenia.

Spatial working memory ability is a marker of risk-for-psychosis

2003 ◽  
Vol 33 (7) ◽  
pp. 1239-1247 ◽  
Author(s):  
S. J. WOOD ◽  
C. PANTELIS ◽  
T. PROFFITT ◽  
L. J. PHILLIPS ◽  
G. W. STUART ◽  
...  
Keyword(s):  
Working Memory ◽  
High Risk ◽  
Negative Symptoms ◽  
Cognitive Deficit ◽  
Spatial Working Memory ◽  
Matching To Sample ◽  
Healthy Controls ◽  
Predictive Tool ◽  
Ultra High Risk ◽  
The Relationship

Background. Working memory has been identified as a core cognitive deficit in schizophrenia that is associated with negative symptoms, but it is unclear whether it is impaired prior to onset of psychosis in symptomatic patients.Method. Thirty-eight young people at ultra high-risk (UHR) of developing psychosis (of whom nine later became psychotic) were compared with 49 healthy controls on tests of spatial working memory (SWM) and delayed matching-to-sample (DMTS).Results. Both SWM and DMTS performance was significantly poorer in the UHR groups. Those who later became psychotic generally performed more poorly than those who did not, although this did not reach significance for any measure. A significant association between SWM errors and negative symptoms was seen in the later-psychotic group only (P=0·02).Conclusions. Spatial working memory abilities are impaired in those at high-risk for psychosis. The relationship between working memory and negative symptoms may be useful as a predictive tool.

Patterns of white matter microstructure in individuals at ultra-high-risk for psychosis: associations to level of functioning and clinical symptoms

2017 ◽  
Vol 47 (15) ◽  
pp. 2689-2707 ◽  
Author(s):  
K. Krakauer ◽  
B. H. Ebdrup ◽  
B. Y. Glenthøj ◽  
J. M. Raghava ◽  
D. Nordholm ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Diffusion Tensor ◽  
Mental States ◽  
Brain Regions ◽  
Level Of Functioning ◽  
Ultra High Risk ◽  
The Cross

BackgroundIndividuals at ultra-high-risk (UHR) for psychosis present with emerging symptoms and decline in functioning. Previous univariate analyses have indicated widespread white matter (WM) aberrations in multiple brain regions in UHR individuals and patients with schizophrenia. Using multivariate statistics, we investigated whole brain WM microstructure and associations between WM, clinical symptoms, and level of functioning in UHR individuals.MethodsForty-five UHR individuals and 45 matched healthy controls (HCs) underwent magnetic resonance diffusion tensor imaging (DTI) at 3 Tesla. UHR individuals were assessed with the Comprehensive Assessment of At-Risk Mental States, Scale for the Assessment of Negative Symptoms, and Social and Occupational Functioning Assessment Scale. Partial least-squares correlation analysis (PLSC) was used as statistical method.ResultsPLSC group comparisons revealed one significant latent variable (LV) accounting for 52% of the cross-block covariance. This LV indicated a pattern of lower fractional anisotropy (FA), axial diffusivity (AD), and mode of anisotropy (MO) concomitant with higher radial diffusivity (RD) in widespread brain regions in UHR individuals compared with HCs. Within UHR individuals, PLSC revealed five significant LVs associated with symptoms and level of functioning. The first LV accounted for 31% of the cross-block covariance and indicated a pattern where higher symptom score and lower level of functioning correlated to lower FA, AD, MO, and higher RD.ConclusionsUHR individuals demonstrate complex brain patterns of WM abnormalities. Despite the subtle psychopathology of UHR individuals, aberrations in WM appear associated with positive and negative symptoms as well as level of functioning.

scholarly journals Changes in negative symptoms are linked to white matter changes in superior longitudinal fasciculus in individuals at ultra-high risk for psychosis

2021 ◽  
Vol 237 ◽  
pp. 192-201
Author(s):  
Tina D. Kristensen ◽  
Louise B. Glenthøj ◽  
Jayachandra M. Ragahava ◽  
Warda Syeda ◽  
Rene C.W. Mandl ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Negative Symptoms ◽  
Superior Longitudinal Fasciculus ◽  
White Matter Changes ◽  
Ultra High Risk

White matter microstructure in ultra-high risk and first episode schizophrenia: A prospective study

2016 ◽  
Vol 247 ◽  
pp. 42-48 ◽  
Author(s):  
Silvia Rigucci ◽  
Giulia Santi ◽  
Valentina Corigliano ◽  
Annamaria Imola ◽  
Camilla Rossi-Espagnet ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Prospective Study ◽  
First Episode ◽  
White Matter Microstructure ◽  
Ultra High Risk ◽  
A Prospective Study ◽  
First Episode Schizophrenia

Effects of cannabis use on event related potentials in subjects at ultra high risk for psychosis and healthy controls

2013 ◽  
Vol 88 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Mirjam J. van Tricht ◽  
Emma C. Harmsen ◽  
Johannes H.T.M. Koelman ◽  
Lo J. Bour ◽  
Thérèse A. van Amelsvoort ◽  
...  
Keyword(s):  
High Risk ◽  
Event Related Potentials ◽  
Cannabis Use ◽  
Healthy Controls ◽  
Ultra High Risk ◽  
Related Potentials

scholarly journals S150. EMOTIONAL BEHAVIOUR IN HIGH-RISK AND FIRST-EPISODE PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S93-S93
Author(s):  
Irina Falkenberg ◽  
Huai-Hsuan Tseng ◽  
Gemma Modinos ◽  
Barbara Wild ◽  
Philip McGuire ◽  
...  
Keyword(s):  
High Risk ◽  
Emotion Recognition ◽  
Psychotic Disorders ◽  
First Episode Psychosis ◽  
First Episode ◽  
Healthy Controls ◽  
Emotional Faces ◽  
Facial Movements ◽  
Episode Psychosis ◽  
Ultra High Risk

Abstract Background Studies indicate that people with schizophrenia and first-episode psychosis experience deficits in their ability to accurately detect and display emotions through facial expressions, and that functioning and symptoms are associated with these deficits. This study aims to examine how emotion recognition and facial emotion expression are related to functioning and symptoms in a sample of individuals at ultra-high risk, first-episode psychosis and healthy controls. Methods During fMRI, we combined the presentation of emotional faces with the instruction to react with facial movements predetermined and assigned. 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs) were examined while viewing happy, sad, or neutral faces and were instructed to simultaneously move the corners of their mouths either (a). upwards or (b). downwards, or (c). to refrain from movement. The subjects’ facial movements were recorded with an MR-compatible video camera. Results Neurofunctional and behavioral response to emotional faces were measured. Analyses have only recently commenced and are ongoing. Full results of the clinical and functional impact of behavioral and neuroimaging results will be presented at the meeting. Discussion Increased knowledge about abnormalities in emotion recognition and behaviour as well as their neural correlates and their impact on clinical measures and functional outcome can inform the development of novel treatment approaches to improve social skills early in the course of schizophrenia and psychotic disorders.

scholarly journals Neuroanatomy of Patients with Deficit Schizophrenia: An Exploratory Quantitative Meta-Analysis of Structural Neuroimaging Studies

2020 ◽  
Vol 17 (17) ◽  
pp. 6227 ◽  
Author(s):  
Tji Tjian Chee ◽  
Louis Chua ◽  
Hamilton Morrin ◽  
Mao Fong Lim ◽  
Johnson Fam ◽  
...  
Keyword(s):  
White Matter ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Regions Of Interest ◽  
Grey Matter Volume ◽  
Healthy Controls ◽  
White Matter Volume ◽  
Total Brain Volume ◽  
Matter Volume ◽  
Deficit Schizophrenia

Little is known regarding the neuroanatomical correlates of patients with deficit schizophrenia or persistent negative symptoms. In this meta-analysis, we aimed to determine whether patients with deficit schizophrenia have characteristic brain abnormalities. We searched PubMed, CINAHL and Ovid to identify studies that examined the various regions of interest amongst patients with deficit schizophrenia, patients with non-deficit schizophrenia and healthy controls. A total of 24 studies met our inclusion criteria. A random-effects model was used to calculate a combination of outcome measures, and heterogeneity was assessed by the I2 statistic and Cochran’s Q statistic. Our findings suggested that there was statistically significant reduction in grey matter volume (−0.433, 95% confidence interval (CI): −0.853 to −0.014, p = 0.043) and white matter volume (−0.319, 95% CI: −0.619 to −0.018, p = 0.038) in patients with deficit schizophrenia compared to healthy controls. There is also statistically significant reduction in total brain volume (−0.212, 95% CI: −0.384 to −0.041, p = 0.015) and white matter volume (−0.283, 95% CI: −0.546 to −0.021, p = 0.034) in patients with non-deficit schizophrenia compared to healthy controls. Between patients with deficit and non-deficit schizophrenia, there were no statistically significant differences in volumetric findings across the various regions of interest.

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