scholarly journals M48. IS METABOLIC SYNDROME RELATED TO COGNITIVE PERFORMANCE IN PATIENTS WITH SCHIZOPHRENIA? RESULTS FROM A DOUBLE-BLIND, ACTIVE-CONTROLLED, LURASIDONE STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S152-S152
Author(s):  
Katsuhiko Hagi ◽  
Tadashi Nosaka ◽  
Andrei Pikalov
Keyword(s):  
Metabolic Syndrome ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
General Population ◽  
Cognitive Performance ◽  
Composite Score ◽  
Double Blind ◽  
Reasoning Problem ◽  
Quetiapine Xr ◽  
Post Hoc

Abstract Background Schizophrenia is associated with cognitive dysfunction as well as cardiovascular disease (CVD). A central risk factor for CVD is the metabolic syndrome (MetS), which is of special concern in schizophrenia. The prevalence of MetS in U.S. patients with schizophrenia is higher versus general population (32.5% versus 23%). The prevalence of MetS and diabetes mellitus (DM) in those with schizophrenia double that of the general population. Adverse events of some antipsychotics used to treat schizophrenia include weight gain, obesity and other MetS complications, particularly abnormal glucose and lipid metabolism. Patients with schizophrenia have low rates of treatment for MetS and its components. Furthermore, components of MetS are risk factors for cognitive impairment and dementia in the general population. Cognitive impairment is a hallmark feature of schizophrenia, and the level of community functioning is strongly correlated with the degree of cognitive impairment. Given the importance of cognitive impairment in schizophrenia, the potential role of MetS in contributing to cognitive dysfunction is important. The objective of this post-hoc analysis was to examine cross-sectional relationships between metabolic syndrome and cognitive performance in patients with schizophrenia treated with lurasidone or quetiapine XR for 6-weeks. Methods This post hoc analysis utilized data from 6-week, double-blind, placebo-controlled trial of patients with an acute exacerbation of schizophrenia who were randomized to fixed, once-daily oral doses of lurasidone 80 mg (LUR 80 n=125), lurasidone 160 mg (LUR 160, n=121), quetiapine XR 600 mg (QXR, n=120) and placebo (PBO, n=122). Patients with metabolic syndrome (MetS) at baseline were identified based on the National Cholesterol Education Program – Adult Treatment Panel III criteria (NCEP-ATP-III). Cognitive performance and functional capacity were assessed by the CogState computerized cognitive battery at baseline and 6 weeks. Results In the acute 6-week period, LUR160 was significantly superior on the cognitive composite score to PBO (p<0.05, d=0.37), while LUR 80 and QXR did not separate from PBO in the evaluable analysis sample (excluding subjects with non-evaluable composite Z-scores; n=267). A total of 45/267 (16.9%) patients met criteria for MetS. Treatment of patients with MetS group with LUR 160 (vs placebo) was associated with significantly greater week 6 improvement in the cognitive composite score (p<0.05, d=1.15), while LUR 80 and QXR did not separate from PBO. In the group without MetS, LUR dose groups and QXR did not differ from PBO in the CogState composite score. In the analysis of cognitive domain scores, LUR 80 was significantly superior to PBO on working memory in the group with MetS (p<0.05, d=1.01) and reasoning/problem solving in the group without MetS (p<0.05, d=0.46). LUR 160 was significantly superior to PBO on processing speed in the group with MetS (p<0.05, d=1.20), reasoning/problem solving (p<0.05, d=0.45) and social cognition (p<0.05, d=0.46) in the group without MetS. QXR was significantly superior to PBO on verbal learning and reasoning/problem solving in the group without MetS (p<0.05, d=0.38 and p<0.05, d=0.37, respectively). Discussion Patients with MetS responded to treatment with lurasidone with significantly improved CogState composite and domain scores. No improvement on cognition was seen in patients with MetS treated with QXR. Evaluation of potential for MetS and improvements in cognition should be important elements in the algorithm of optimization of treatment in patients with schizophrenia.

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

2020 ◽  
Vol 66 (3) ◽  
pp. 240-248 ◽  
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.

Efficacy and tolerability of quetiapine XR 400/600/800mg/day in acute schizophrenia: a post-hoc analysis of data from two pooled randomised studies

2011 ◽  
Vol 26 (S2) ◽  
pp. 1411-1411
Author(s):  
R. Kahn ◽  
A. Kalali ◽  
U. Gustafsson ◽  
S. Nyberg
Keyword(s):  
Dose Response ◽  
Extended Release ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Once Daily ◽  
Quetiapine Fumarate ◽  
Post Hoc Analysis ◽  
Response Efficacy ◽  
Quetiapine Xr ◽  
Post Hoc

IntroductionData from two, identically designed, placebo-controlled, randomised, double-blind clinical trials (D1444C00132+D1444C00133) for once-daily extended-release quetiapine fumarate (QTP-XR) were pooled and analysed.ObjectiveEvaluate dose response, efficacy and safety for QTP-XR in schizophrenia.MethodsPost-hoc analysis of data from patients receiving QTP-XR 400, 600, 800 mg/day or placebo. Endpoints: least squares means (LSM) change from baseline to Day 42 in PANSS total and positive and negative subscale scores. No corrections for multiplicity were performed. Adverse events (AEs) were recorded.Results914 patients were included; PANSS scores were assessed in the MITT population (n = 889). LSM change from baseline in PANSS total score diverged significantly from placebo at: Day 14 for QTP-XR 800 mg/day (-15.3 vs -12.1 for placebo; p = 0.018); Day 21 for 600 mg/day (-17.3 vs -14.2; p = 0.039); Day 42 for 400 mg/day (-19.2 vs -15.4; p = 0.033).Jonckheere-Terpstra analysis of change in PANSS total score at Day 42 showed a significant QTP-XR dose response (p = 0.0196; p < 0.001 with placebo). PANSS positive scores diverged by Day 21 for both QTP-XR 800 (-5.7 vs -4.8; p = 0.049) and 600 mg/day (-5.8 vs -4.8; p = 0.046). PANSS negative scores diverged by Day 21 (-4.0 vs -3.2; p = 0.040) and 42 (-4.8 vs -3.6; p = 0.009) for QTP-XR 800 and 600 mg/day, respectively. AEs occurred in 59.4%, 66.5%, 62.1% and 56.2% of patients in the QTP-XR 800, 600, 400 mg/day and placebo groups, respectively. Most common AEs were somnolence, dry mouth, sedation, insomnia, dizziness, headache, constipation and nausea.ConclusionsQTP-XR was generally well tolerated and demonstrated efficacy that increased with dose in schizophrenia.Financial support: AstraZeneca.

scholarly journals Safety profile of sedative endoscopy including cognitive performance in liver cirrhosis: A double-blind randomized controlled trial

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Jeong-Ju Yoo ◽  
Hyeon Jeong Goong ◽  
Ji Eun Moon ◽  
Sang Gyune Kim ◽  
Young Seok Kim
Keyword(s):  
Liver Cirrhosis ◽  
Cognitive Impairment ◽  
Combination Therapy ◽  
Cognitive Performance ◽  
Combination Group ◽  
Double Blind ◽  
Randomized Controlled ◽  
Subjective Satisfaction ◽  
Cirrhotic Patients ◽  
Sedative Drugs

AbstractThe indiscriminate use of sedative drugs during endoscopy can pose multiple risks including cognitive impairment in advanced liver cirrhosis. However, the data are scarce regarding which sedative drugs are safest in these populations. The aim of this study was to evaluate the safety profiles including cognitive performance among midazolam, propofol, and combination therapy in advanced cirrhotic patients. This double-blind randomized controlled study included 60 consecutive advanced cirrhotic patients who underwent upper gastrointestinal endoscopy. The Stroop application was used to screen for cognitive impairment. Patients were randomly assigned to one of 3 groups, midazolam, propofol, or the combination group, and underwent Stroop test before and two hours after the completion of endoscopy. Hemodynamic safety and the subjective satisfaction score were also evaluated. Patients did not show significant changes in on-time or off-time on the Stroop test before and two hours after sedatives, and there was no significant difference among the 3 treatment groups. Also, there were no significant vital sign changes after sedatives. Time-to-recovery was longest in midazolam group, and patient awakening and patient memory were highest in propofol group. However, all 3 groups showed no difference in patient satisfaction, but the combination group was more preferred in terms of subjective satisfaction by physicians. Factors affecting worsened Stroop speed after sedatives were older age, low education level and high MELD score. All sedative methods using midazolam, propofol, or combination therapy showed similar safety profile in advanced cirrhosis, and were not associated with increased risk of cognitive impairment.

scholarly journals Effects of caffeine on visual evoked potencial (P300) and neuromotor performance

2004 ◽  
Vol 62 (2b) ◽  
pp. 385-390 ◽  
Author(s):  
Andréa Camaz Deslandes ◽  
Heloisa Veiga ◽  
Maurício Cagy ◽  
Roberto Piedade ◽  
Fernando Pompeu ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
P300 Latency ◽  
Double Blind ◽  
Positive Tendency ◽  
Dependent Variables ◽  
Double Blind Design ◽  
Post Hoc ◽  
Visual Evoked

The stimulant effects of caffeine on cognitive performance have been widely investigated. The visual evoked potential, specially the P300 component, has been used in studies that explain the stimulant mechanisms of caffeine through neurophysiological methods. In this context, the present study aimed to investigate electrophysiological changes (P300 latency) and modification of cognitive and motor performance produced by caffeine. Fifteen healthy volunteers, 9 women and 6 men (26 ± 5 years, 67 ± 12.5kg) were submitted three times to the following procedure: electroencefalographic recording, Word Color Stroop Test, and visual discrimination task. Subjects took a gelatin caffeine capsule (400 mg) or a placebo (P1 and P2), in a randomized, crossover, double-blind design. A one-factor ANOVA and Tukey’ post hoc test were used to compare dependent variables on the C, P1 and P2 moments. The statistical analyses indicated a non-significant decrease in reaction time, Stroop execution time and latency at Cz on the caffeine moment when compared to the others. Moreover, a non-significant increase in Stroop raw score and latency at Pz could be observed. The only significant result was found at Fz. These findings suggest that the positive tendency of caffeine to improve cognitive performance is probably associated with changes in the frontal cortex, a widely recognized attention area.

scholarly journals Memory enhancement by multidomain group cognitive training in patients with Parkinson’s disease and mild cognitive impairment: long-term effects of a multicenter randomized controlled trial

2021 ◽  
Author(s):  
Nele Schmidt ◽  
Inken Tödt ◽  
Daniela Berg ◽  
Christian Schlenstedt ◽  
Ann-Kristin Folkerts ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Executive Functioning ◽  
Cognitive Training ◽  
Composite Score ◽  
Randomized Controlled ◽  
Post Hoc

Abstract Background Meta-analyses indicate positive effects of cognitive training (CT) in patients with Parkinson’s disease (PD), however, most previous studies had small sample sizes and did not evaluate long-term follow-up. Therefore, a multicenter randomized controlled, single-blinded trial (Train-ParC study) was conducted to examine CT effects in PD patients with mild cognitive impairment (PD-MCI). Immediately after CT, an enhancement of executive functions was demonstrated. Here, we present the long-term results 6 and 12 months after CT. Methods At baseline, 64 PD-MCI patients were randomized to a multidomain CT group (n = 33) or to a low-intensity physical activity training control group (PT) (n = 31). Both interventions included 90 min training sessions twice a week for 6 weeks. 54 patients completed the 6 months (CT: n = 28, PT: n = 26) and 49 patients the 12 months follow-up assessment (CT: n = 25, PT: n = 24). Primary study outcomes were memory and executive functioning composite scores. Mixed repeated measures ANOVAs, post-hoc t tests and multiple regression analyses were conducted. Results We found a significant time x group interaction effect for the memory composite score (p = 0.006, η2 = 0.214), but not for the executive composite score (p = 0.967, η2 = 0.002). Post-hoc t tests revealed significant verbal and nonverbal memory improvements from pre-intervention to 6 months, but not to 12 months follow-up assessment in the CT group. No significant predictors were found for predicting memory improvement after CT. Conclusions This study provides Class 1 evidence that multidomain CT enhances memory functioning in PD-MCI after 6 months but not after 12 months, whereas executive functioning did not change in the long-term. Clinical trial registration German Clinical Trials Register (ID: DRKS00010186), 21.3.2016 (The study registration is outlined as retrospective due to an administrative delay. The first patient was enrolled three months after the registration process was started. A formal confirmation of this process from the German Clinical Trials Register can be obtained from the authors.)

Metabolic syndrome in patients with schizophrenia receiving long-term treatment with lurasidone, quetiapine XR, or risperidone

2016 ◽  
Vol 33 (S1) ◽  
pp. S105-S105
Author(s):  
J. Newcomer ◽  
M. Tocco ◽  
A. Pikalov ◽  
H. Zheng ◽  
J. Cucchiaro ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Antipsychotic Agents ◽  
Term Treatment ◽  
Adult Patients ◽  
Fixed Dose ◽  
Controlled Study ◽  
Double Blind ◽  
Quetiapine Xr ◽  
Long Term Treatment

IntroductionLurasidone has demonstrated low propensity for metabolic disturbance in adult patients with schizophrenia in short-term studies.ObjectivesTo evaluate metabolic syndrome occurrence during long-term lurasidone treatment in patients with schizophrenia.AimsTo compare metabolic syndrome rates with lurasidone versus other antipsychotic agents.MethodsMetabolic syndrome rates (as defined by the US National Cholesterol Education Program-Adult Treatment Panel III) were evaluated in adult patients with schizophrenia treated with lurasidone in 2 long-term, active-controlled studies (quetiapine XR or risperidone). In the quetiapine XR-controlled study, patients completing a 6-week, double-blind, placebo-controlled, fixed-dose trial of lurasidone (74 mg/d or 148 mg/d) or quetiapine XR (600 mg/d) continued on double-blind, flexibly dosed lurasidone (37–148 mg/d) or quetiapine XR (200–800 mg/d) for up to 12 months. In the risperidone-controlled study, patients received double-blind, flexibly dosed lurasidone (37–111 mg/d) or risperidone (2–6 mg/d) for up to 12 months.ResultsAmong patients without metabolic syndrome at baseline in the quetiapine XR-controlled study, 2.4% (2/84) of lurasidone-treated patients and 7.4% (2/27) of quetiapine XR-treated patients developed metabolic syndrome at month 12 (P = NS). Of patients without metabolic syndrome at baseline in the risperidone-controlled study, 10.3% (12/117) and 23.2% (16/69) of lurasidone- and risperidone-treated patients, respectively, developed metabolic syndrome at month 12 (P = 0.02).ConclusionsLong-term treatment with lurasidone was associated with lower rates of metabolic syndrome in patients with schizophrenia compared to treatment with quetiapine XR or risperidone.SupportSunovion Pharmaceuticals Inc.ClinicalTrials.gov identifiersNCT00789698, NCT00641745.Disclosure of interestThe authors have not supplied their declaration of competing interest.

An association study between epicardial fat thickness and cognitive impairment in the elderly

2014 ◽  
Vol 307 (9) ◽  
pp. H1269-H1276 ◽  
Author(s):  
Gianluigi Mazzoccoli ◽  
Mariangela Pia Dagostino ◽  
Manlio Vinciguerra ◽  
Filomena Ciccone ◽  
Giulia Paroni ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Transthoracic Echocardiography ◽  
The Elderly ◽  
Elderly Subjects ◽  
Increased Risk ◽  
Visceral Adipose

The amount of fat surrounding the heart, called epicardial adipose tissue (EAT), is a marker of cardiometabolic risk and correlates with the quantity of visceral adipose tissue (VAT). The amount of VAT is associated with an increased risk of cardiovascular and cerebrovascular disease and with cognitive impairment. We aimed to evaluate the association between EAT thickness as a measure of VAT and cognitive function. In 71 elderly subjects (mean age 72.7 ± 7.1 yr) we measured EAT thickness through transthoracic echocardiography, assessed the metabolic profile through evaluation of biochemical parameters, and estimated the cognitive function via the Mini Mental State Examination (MMSE). We found that greater EAT thickness was associated with lower cognitive performance evaluated by MMSE ( P < 0.01) independently of the presence or absence of metabolic syndrome or obesity. Lower MMSE results were also associated with the presence of metabolic syndrome ( P < 0.01), elevated HOMA index ( P < 0.01), and high BMI values ( P < 0.01). The results of mediation analysis confirmed that the total effect of metabolic syndrome, HOMA, and BMI on MMSE is mainly explained by an indirect effect through EAT thickness. In conclusion, increased EAT thickness assessed by transthoracic echocardiography is associated with deficient results of psychometric tests assessing cognitive performance and may consistently foresee impairment of cognition in the elderly.

Sign in / Sign up

Export Citation Format

Share Document