scholarly journals M68. COGNITIVE IMPAIRMENT IN NEVER-TREATED SCHIZOPHRENIA SPECTRUM INDIVIDUALS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rodolfo Solis-Vivanco ◽  
Felipe Rangel-Hassey ◽  
Pablo León-Ortiz ◽  
Alejandra Mondragón-Maya ◽  
Francisco Reyes-Madrigal ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Cognitive Domain ◽  
First Episode ◽  
Control Group ◽  
Duration Of Untreated Psychosis ◽  
Schizophrenia Spectrum ◽  
Main Effect ◽  
Patient Groups

Abstract Background Cognitive impairment is a key feature of schizophrenia. While one recent study suggested that individuals with psychosis experience a progressive decline in certain cognitive domains during the first 10 years of their illness, other clinical and functional MRI-based studies have proposed that most cognitive deficits are present during the first episode and remain stable over time, possibly as a result of medication response. To examine the temporal nature of cognitive deficits in the schizophrenia spectrum, we examined cognition in never-medicated individuals at different stages of the illness. Methods We recruited three groups of patients: 1) individuals at clinical high-risk (CHR) for psychosis (n=87), 2) individuals experiencing their first-episode of a non-affective psychosis (FEP) (n=64) (defined by a duration of untreated psychosis < 74 weeks), and 3) individuals with chronic schizophrenia (n=40) (CSz – duration of untreated psychosis > 74 weeks). All three groups were antipsychotic-naïve. Patients with any comorbid disorders or current substance abuse disorders were excluded from this study. We also recruited matched healthy control subjects (n=102). All subjects were recruited at the Instituto Nacional de Neurología y Neurocirugía in Mexico City. The study was approved by the institutional review board. Adults provided written informed consent and minors provided assent with written consent provided by both parents. Cognition was assessed with the MATRICS Consensus Cognitive Battery. Differences between groups were analyzed using a repeated measures analysis of variance (RM-ANOVA) with cognitive domain as inter-subject factor and Bonferroni correction for post hoc pairwise comparisons. Statistical significance was set at p ≤ .05. Results Since age, gender, and parental education were significantly different between the groups, they were included as covariates in the RM-ANOVA. In this revised model, there was no main effect of age (p = 0.69) nor any interaction between age and any cognitive domain. Therefore, age was removed from the final model. We observed a significant main effect of group (p <.001); All patient groups were significantly impaired compared to the control group (CHR mean difference (MD) = 6.12; FEP MD = 16.46; CSz MD = 16.37; p <.001 in all cases), individuals with both FEP and CSz had significantly more cognitive impairment than the CHR group (FEP MD = 10.34; CSz MD = 10.25; p <.001 in both cases). No significant differences were observed between FEP and CSz groups (MD = .09, p >.99). We also found a significant group by cognitive domain interaction (p <.001). Namely, all patient groups were cognitively impaired compared to the control group, except in the Verbal and Visual Learning domains in which there were no significant differences between the control and CHR groups. No significant differences were found between the FEP and CSz groups in any domain. Moreover, the CHR group was not significantly different from the other clinical groups in the Social Cognition domain. Within the FEP and CSz groups, no significant correlations were observed between duration of untreated psychosis and any cognitive domain. Discussion We observed significant cognitive deficits since at-risk stages of the schizophrenia spectrum. Patients with FEP were as impaired as those with CSz, while cognitive functioning observed in CHR individuals was intermediate between controls and patients with syndromal psychosis. These results emphasize the importance of pre-syndromal detection and prediction of burgeoning psychotic illness. Future research on strategies to mitigate the decline in cognitive function between presyndromal and first-episode psychosis is warranted.

Cognitive Deficits in First Episode Schizophrenia

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Galderisi
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Abilities ◽  
Psychotic Disorders ◽  
Treatment Strategies ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Baseline Evaluation ◽  
Z Scores ◽  
First Episode Schizophrenia

Cognitive deficits are increasingly recognized as key features of schizophrenia, important determinants of poor psychosocial outcome and targets for treatment strategies. The huge literature on the topic made it clear that cognitive impairment is present in the majority of subjects with schizophrenia, is not an epiphenomenon of symptoms, is a risk factor for psychotic disorders and seems to contribute to poor functional outcome more than symptoms. However, relationships of cognitive impairment with symptoms, drug treatment and duration of untreated psychosis remain controversial and studies involving large cohorts of first episode schizophrenia patients are highly needed to address these topics adequately. The European First Episode Schizophrenia Trial collected demographic, clinical, psychosocial and cognitive baseline data in 498 first episode patients with schizophrenia, schizophreniform or schizoaffective disorder, with minimal or no prior exposure to antipsychotics, and in 220 healthy subjects, comparable with patients for age, sex, race and education level of parents. Z scores of the examined cognitive abilities (number of standard deviations below the comparison group means) ranged from -0.88 to -1.73. No association was found between the duration of untreated psychosis and cognitive impairment. Psychopathological dimensions were weakly correlated with cognitive impairment both at baseline evaluation and after six months of treatment.According to EUFEST findings, cognitive impairment in patients with first-episode schizophrenia is moderate/severe, has no association with the duration of untreated psychosis, involves several domains of cognition, and is largely independent from psychopathology.

scholarly journals Cognitive deficits and white matter abnormalities in never-treated first-episode schizophrenia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mi Yang ◽  
Shan Gao ◽  
Xiangyang Zhang
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
First Episode ◽  
Control Group ◽  
Pathophysiological Mechanism ◽  
Healthy Controls ◽  
Healthy Control ◽  
First Episode Schizophrenia

Abstract Cognitive impairment is viewed as a core symptom of schizophrenia (SCZ), but its pathophysiological mechanism remains unclear. White matter (WM) disruption is considered to be a central abnormality that may contribute to cognitive impairment in SCZ patients. However, few studies have addressed the association between cognition and WM integrity in never-treated first-episode (NTFE) patients with SCZ. In this study, we used the MATRICS Consensus Cognitive Battery (MCCB) to evaluate cognitive function in NTFE patients (n = 39) and healthy controls (n = 30), and associated it with whole-brain fractional anisotropy (FA) values obtained via voxel-based diffusion tensor imaging. We found that FA was lower in five brain areas of SCZ patients, including the cingulate gyrus, internal capsule, corpus callosum, cerebellum, and brainstem. Compared with the healthy control group, the MCCB’s total score and 8 out of 10 subscores were significantly lower in NTFE patients (all p < 0.001). Moreover, in patients but not healthy controls, the performance in the Trail Making Test was negatively correlated with the FA value in the left cingulate. Our findings provide evidence that WM disconnection is involved in some cognitive impairment in the early course of SCZ.

Impaired glucose tolerance in first-episode drug-naïve patients with schizophrenia: relationships with clinical phenotypes and cognitive deficits

2016 ◽  
Vol 46 (15) ◽  
pp. 3219-3230 ◽  
Author(s):  
D. C. Chen ◽  
X. D. Du ◽  
G. Z. Yin ◽  
K. B. Yang ◽  
Y. Nie ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Cognitive Impairment ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Cognitive Deficits ◽  
First Episode ◽  
Oral Glucose ◽  
Model Assessment ◽  
Clinical Phenotypes ◽  
Drug Naïve

BackgroundSchizophrenia patients have a higher prevalence of type 2 diabetes mellitus with impaired glucose tolerance (IGT) than normals. We examined the relationship between IGT and clinical phenotypes or cognitive deficits in first-episode, drug-naïve (FEDN) Han Chinese patients with schizophrenia.MethodA total of 175 in-patients were compared with 31 healthy controls on anthropometric measures and fasting plasma levels of glucose, insulin and lipids. They were also compared using a 75 g oral glucose tolerance test and the homeostasis model assessment of insulin resistance (HOMA-IR). Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Patient psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).ResultsOf the patients, 24.5% had IGT compared with none of the controls, and they also had significantly higher levels of fasting blood glucose and 2-h glucose after an oral glucose load, and were more insulin resistant. Compared with those patients with normal glucose tolerance, the IGT patients were older, had a later age of onset, higher waist or hip circumference and body mass index, higher levels of low-density lipoprotein and triglycerides and higher insulin resistance. Furthermore, IGT patients had higher PANSS total and negative symptom subscale scores, but no greater cognitive impairment except on the emotional intelligence index of the MCCB.ConclusionsIGT occurs with greater frequency in FEDN schizophrenia, and shows association with demographic and anthropometric parameters, as well as with clinical symptoms but minimally with cognitive impairment during the early course of the disorder.

Emotional recognition during the course of schizophrenia

2016 ◽  
Vol 33 (S1) ◽  
pp. s243-s243
Author(s):  
D. Bošnjak ◽  
P. Makarić ◽  
M. Rojnić Kuzman
Keyword(s):  
Recognition Task ◽  
First Episode ◽  
Control Group ◽  
Emotion Identification ◽  
Emotional Recognition ◽  
Self Evaluation ◽  
Syndrome Scale ◽  
Significant Difference ◽  
Patient Groups ◽  
Competing Interest

IntroductionAdequate emotion identification ability facilitates forming emotional relationships and effective communication. Patients suffering from schizophrenia have deficits in emotional recognition (ER), which leads to impaired social and occupational functioning.ObjectivesTo compare the differences in ER between the healthy control group (HC) and two patient groups at different phases of illness: first episode psychosis (FEP) and chronic, multi-episode schizophrenia (MEP).AimsTo investigate the pattern of emotional recognition deficit during the course of schizophrenia.MethodsWe compared three groups of participants: MEP, FEP and HC, each containing 50 participants, based on their emotional recognition abilities using the Penn Emotion Recognition Task and The I FEEL Pictures. Patients were diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for schizophrenia (schizophreniform disorder) with their psychopathology rated with the Positive and Negative Syndrome Scale (PANSS) scale. Besides ER tasks, patients were administered self-evaluation scales for the assessment of quality of life, depression, suicidality, impulsivity, aggression, and relationship with their parents.ResultsOur findings showed deficits in emotional recognition ability of both patient groups in comparison with HC, especially in the identification of negative emotions: sadness, fear and anger. There was no statistically significant difference between groups in the identification of happiness. First episode patients showed better results than the MEP group.ConclusionsAlthough the FEP group was more successful than the ME group, our results showed that the emotional recognition impairment exists at a significant level even at the beginning of the illness.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Neurocognitive impairments in patients with schizophrenia and schizophrenia spectrum disorders: cluster analysis results

2020 ◽  
pp. 45-51 ◽  
Author(s):  
M. V. Karyakina ◽  
A. B. Shmukler
Keyword(s):  
Cluster Analysis ◽  
Sensitivity Analysis ◽  
Cognitive Impairment ◽  
Clinical Parameters ◽  
Schizophrenia Spectrum Disorders ◽  
Cognitive Differences ◽  
Neurocognitive Impairments ◽  
Schizophrenia Spectrum ◽  
Patient Groups ◽  
Spectrum Disorders

There are results of cluster analysis of neurocognitive impairments in 85 patients with schizophrenia spectrum disorders in the article. Three patient groups were discriminated based on the results. These groups differ from each other both by severity of general cognitive impairment and by severity of impairments of the specific cognitive functions. There are differences between groups by specific demographic and clinical parameters. However sensitivity analysis does not find influence of these clinical parameters on the cognitive differences between groups, which stay certain after symptoms are taken into account.

Ten-year course of cognition in first-episode non-affective psychosis patients: PAFIP cohort

2020 ◽  
pp. 1-10
Author(s):  
José Manuel Rodríguez-Sánchez ◽  
Esther Setién-Suero ◽  
Paula Suárez-Pinilla ◽  
Jaqueline Mayoral Van Son ◽  
Javier Vázquez-Bourgon ◽  
...  
Keyword(s):  
Cognitive Functions ◽  
Large Body ◽  
Control Sample ◽  
First Episode ◽  
Control Group ◽  
Entire Group ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Concomitant Factors

Abstract Background A large body of research states that cognitive impairment in schizophrenia is static. Nevertheless, most previous studies lack a control group or have small study samples or short follow-up periods. Method We aimed to address these limitations by studying a large epidemiological cohort of patients with first-episode schizophrenia spectrum disorders and a comparable control sample for a 10-year period. Results Our results support the generalized stability of cognitive functions in schizophrenia spectrum disorders considering the entire group. However, the existence of a subgroup of patients characterized by deteriorating cognition and worse long-term clinical outcomes must be noted. Nevertheless, it was not possible to identify concomitant factors or predictors of deterioration (all Ps > 0.05). Conclusions Cognitive functions in schizophrenia spectrum disorder are stable; however, a subgroup of subjects that deteriorate can be characterized.

Acupuncture Improves Cognitive Deficits and Increases Neuron Density of the Hippocampus in Middle-Aged Samp8 Mice

2012 ◽  
Vol 30 (4) ◽  
pp. 339-345 ◽  
Author(s):  
Guomin Li ◽  
Xuezhu Zhang ◽  
Haiyan Cheng ◽  
Xuemei Shang ◽  
Hui Xie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Morris Water Maze ◽  
Cognitive Deficits ◽  
Water Maze ◽  
Morris Water Maze Test ◽  
Control Group ◽  
Neuron Loss ◽  
Neuron Density ◽  
Maze Test ◽  
Samp8 Mice

Objectives To examine whether acupuncture could improve cognitive deficits and reduce the loss of neurons in mice models of ageing. Methods Male 7.5-month-old senescence-accelerated mouse prone 8 (SAMP8) and age-matched senescence-resistant inbred strains 1 (SAMR1) were divided into four groups (n=15 per group): SAMP8 acupuncture group (Pa), SAMP8 non-acupuncture point control group (Pn), SAMP8 control group (Pc) and SAMR1 normal control group (Rc). The behaviours were examined by the Morris water maze test and the neuron density in the hippocampus was estimated by the optical fractionator technique. Results The Morris water maze test demonstrated that the cognitive deficits of SAMP8 mice were improved by acupuncture treatment. Neuronal loss was found in hippocampal regions CA1 (−24%), CA3 (−18%) and DG (−28%) of Pc compared with Rc. The neuron number in hippocampal CA3 and DG of the Pa group was significantly increased by therapeutic acupuncture compared with the Pc group. Conclusions Acupuncture improved the cognitive impairment of middle-aged SAMP8 mice which could be attributed to the reduced neuron loss in hippocampal regions CA3 and DG. These results suggest that reducing neuron loss in the hippocampus by acupuncture is a potential therapeutic approach for the treatment of Alzheimer's disease and cognitive impairment diseases.

scholarly journals ACTUARIAL CRITERIA FOR MCI DIAGNOSIS IN ACTIVE: IMPLICATIONS OF ADJUSTMENT FOR RACE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S432-S432
Author(s):  
Kelsey Thomas ◽  
Sarah Cook ◽  
Fred Unverzagt ◽  
Mark W Bondi ◽  
Michael Marsiske
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Determinants ◽  
Test Scores ◽  
Healthcare Access ◽  
Normal Control Group ◽  
Education Quality ◽  
Cognitive Domain ◽  
Control Group ◽  
Future Work

Abstract This study examined the baseline prevalence of mild cognitive impairment (MCI) in the ACTIVE study using actuarial criteria for MCI. Participants (n=2763; 26% Black) were classified as probable MCI cases if they had two observed test scores within the same cognitive domain (memory, reasoning, speed) that were &gt;1SD below a demographically-adjusted expected score (based on the regression weights of a “robust” normal control group). Each score was adjusted using two approaches: Method 1 adjusted for age, sex, and education; Method 2 also adjusted for race. The estimated prevalence of MCI was 33.5% (n=925) in Method 1 and 32.1% (n=887) in Method 2. Adjusting for race reduced the proportion of Black participants classified as probable MCI from 42.3% to 34.9%. Future work will examine whether adjustment for social determinants of health (e.g., education quality, neighborhood/healthcare access) might further improve the utility of this classification method in diverse samples.

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