scholarly journals S59. LINKING VERBAL MEMORY DEFICITS, HIPPOCAMPAL VOLUME, AND FUNCTIONING: SEX DIFFERENCES ARE CRUCIAL

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S55-S56
Author(s):  
Gabriella Buck ◽  
Katie Lavigne ◽  
Carolina Makowski ◽  
Ridha Joober ◽  
Ashok Malla ◽  
...  
Keyword(s):  
Sex Differences ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Functional Outcomes ◽  
Negative Symptoms ◽  
Brain Regions ◽  
Control Group ◽  
Neurocognitive Deficits ◽  
Male Patients

Abstract Background Verbal memory (VM) is one of the most affected cognitive domains in individuals with a first episode of psychosis (FEP). In the general population, there are well-documented sex differences in VM such that males perform worse than females. This has implications for understanding cognitive deficits in psychosis given that male patients present with more severe negative symptoms and poorer functional outcomes, both of which are associated with cognitive deficits. There lacks, however, a clear understanding of how VM deficits might contribute to males’ poorer functioning. From a neuroanatomical perspective, VM relies on a network of brain regions, including the hippocampus (HC) as an important hub in the acquisition of new information. Interestingly, many of the brain regions that differ between males and females, including the HC, show structural abnormalities in psychosis. Thus, consideration of sex differences may be essential for better characterizing and understanding brain alterations in psychosis and their effects on cognition. The aims of the current research were to: (1) evaluate whether the propensity for poorer functional outcomes among FEP males is mediated by sex differences in VM; and (2) investigate whether HC volume mediates the effect of sex on VM. Methods 137 FEP (90 males, 47 females) and 81 controls (55 males, 26 females) completed a VM task (Wechsler Memory Scale or CogState Research Battery) and a structural MRI scan (1.5 Tesla). Patients were additionally assessed for negative symptoms (Scale for the Assessment of Negative Symptoms) at baseline and functioning (Social and Occupational Functioning Assessment Scale) at 1-year follow-up. Performance of the matched control group was used as normative data to derive VM z-scores. HC volumes were computed for each subject and hemisphere using the MAGeT brain algorithm. Mediation analyses were conducted using the PROCESS macro with SPSS. The behavioral model (‘sex VM negative symptoms functioning’) was performed in patients only, controlling for education; the imaging model (‘sex HC volume VM’) was performed in both groups and additionally controlled for age and total brain volume. Significance was assessed at 95% confidence intervals. Results The effect of sex on functioning at 1-year follow-up was fully mediated by verbal memory capacity and negative symptoms (β=0.54, CI=[0.12, 1.12]. Importantly, neither VM nor negative symptoms alone mediated the relationship between sex and functioning at 1-year follow-up. Left and right HC volumes, which were larger in males than in females in both groups, demonstrated a suppression effect on the relation between sex and verbal memory in patients (left HC: β=-0.21, CI=[-0.39, -0.07]; right HC: β=-0.24, CI=[-0.45,-0.09]), but not in controls (left HC: β=0.04, CI=[-0.14, 0.24]; right HC: β=0.06, CI=[-0.13,0.25]). Discussion This study reveals that sex differences in VM are robust and influence functioning through negative symptoms in FEP. Given that males are typically overrepresented in psychosis samples, it is possible that male patients chiefly contribute to associations between negative symptoms and neurocognitive impairments observed in previous studies in which sex was not explicitly examined. Further, our results suggest that the role of the HC in memory may be differentially affected by sex. This second model was specific to FEP, indicating that certain structure-function relationships are not consistent between patients and controls. Overall, such findings highlight the need to consider sex differences when developing personalized treatment plans and highlight neurocognitive deficits as a promising avenue for treatment.

scholarly journals The Clinical Course and Prognostic Problems of Youth Depressions with Attenuated Schizophrenic Symptoms

2021 ◽  
pp. 42-52
Author(s):  
V. G. Kaleda ◽  
M. A. Omelchenko
Keyword(s):  
Depressive Episode ◽  
Functional Outcomes ◽  
Negative Symptoms ◽  
Clinical Course ◽  
Control Group ◽  
Youth Depression ◽  
Early Markers ◽  
Spectrum Disorders

Objective Clinical and follow-up verification of Attenuated Schizophrenic Symptoms (ASS) in the first youth depressive episode as early markers of the schizophrenic process, establishing further variants of the course of the disorder and its outcomes.Materials and methods. 124 young inpatients (averaged age 19,6±2,3 years) with the first depressive episode with ASS were examined. The control group consisted of 27 patients with youth depression without ASS. All patients have been tracked for at least five years. The average follow-up period was 7,1±1,6 years. The HDRS, SOPS, SANS and PSP scales were used to assess the symptomatic and functional outcomes. Statistical analysis was carried out using STATISTICA 12.Results. The typological classification of youth depressions (ASD) with ASS has been developed with the identification of three main types: (1) with attenuated positive symptoms (APS), (2) with attenuated negative symptoms (ANS), and (3) with attenuated symptoms of disorganization. Youth depression with ASS, compared to the control group, is more likely to move into chronic forms, has reliably worse functional and symptomatic outcomes, and is more associated with the diagnosis of schizophrenic spectrum disorders at five years follow-up.Conclusion. Attenuated schizophrenic symptoms in the structure of youth depressions have high affinity to each other, indicating a common pathogenic mechanism of their formation, and also have predicate value as risk factors for schizophrenia.

Duration of untreated psychosis and its correlates in first episode psychosis: results of the prospective 5-year follow-up study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1534-1534
Author(s):  
Y. Zaytseva ◽  
I. Gurovich ◽  
A. Dorodnova ◽  
L. Movina ◽  
A. Shmukler
Keyword(s):  
Social Adjustment ◽  
Verbal Memory ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Brain Regions ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Duration Of Untreated Psychosis

IntroductionDuration of untreated psychosis (DUP) is a potentially changeable prognostic factor which can also indicate neurodegenerative process in schizophrenia.ObjectiveTo examine the association of DUP with various characteristics of the course of schizophrenia in first episode patients during 5-year follow-up.MethodsOne-hundred-fourteen patients with first psychotic episodes who have been treated in naturalistic setting within Early Intervention Centre (Moscow Research Institute of Psychiatry) were included. Clinical, social and neuropsychological parameters were assessed using standardized instruments.ResultsThe mean duration of untreated psychotic symptoms before admission was 298.66 ± 447.35 days. According to the analysis DUP was found to be significantly associated with the mode of onset (r = 0.51, p ≤ 0.001) level of remission (r = 0.21–0.30, p ≤ 0.05), severity of positive symptoms and negative symptoms in remission mostly at 2nd, 3d and 4th years of observation, poorer level of social adjustment at the 5th year (r = 0.19, p ≤ 0.05). The effect of DUP remained significant after controlling for age, gender and diagnostic variables.Moreover, DUP correlated with the parameters of verbal memory, visual memory and spatial functions during the follow-up (r = 0.29–0.36, p ≤ 0.05, r = 0.28–0.30, p ≤ 0.05, respectively). No correlations have been found between DUP and the age of onset, number of relapses and their duration during 5-year follow-up as well as with other neurocognitive parameters (executive functioning, gnosis, praxis, attention).ConclusionsThe results of the study underline the prognostic value of DUP for predicting clinical and functional outcomes. Association between DUP and poor memory domains supports the notion of neurotoxicity of DUP grasping specific brain regions in schizophrenia.

scholarly journals Sex Differences in Verbal Memory Predict Functioning Through Negative Symptoms in Early Psychosis

2020 ◽  
Vol 46 (6) ◽  
pp. 1587-1595 ◽  
Author(s):  
Gabriella Buck ◽  
Katie M Lavigne ◽  
Carolina Makowski ◽  
Ridha Joober ◽  
Ashok Malla ◽  
...  
Keyword(s):  
Sex Differences ◽  
Verbal Memory ◽  
Visual Memory ◽  
Parental Education ◽  
Negative Symptoms ◽  
Early Psychosis ◽  
First Episode ◽  
Severe Illness ◽  
Cognitive Domains

Abstract Verbal memory (VM) is one of the most affected cognitive domains in first-episode psychosis (FEP) and is a robust predictor of functioning. Given that healthy females demonstrate superior VM relative to males and that female patients show less-severe illness courses than male patients, this study examined whether normative sex differences in VM extend to FEP and influence functioning. Four hundred and thirty-five patients (299 males, 136 females) with affective or nonaffective psychosis were recruited from a catchment-based specialized FEP intervention service and 138 nonclinical controls (96 males, 42 females) were recruited from the same community. One of the two neurocognitive batteries comprising six cognitive domains (VM, visual memory, working memory, attention, executive function, processing speed) were administered at baseline. In patients, positive and negative symptoms were evaluated at baseline and functioning was assessed at 1-year follow-up. Patients were more impaired than controls on all cognitive domains, but only VM showed sex differences (both patient and control males performed worse than females), and these results were consistent across batteries. In patients, better baseline VM in females was related to better functioning after 1 year, mediated through fewer baseline negative symptoms. Supplemental analyses revealed these results were not driven by affective psychosis nor by age and parental education. Thus, normative sex differences in VM are preserved in FEP and mediate functioning at 1-year follow-up via negative symptoms. This study highlights the importance of investigating sex effects for understanding VM deficits in early psychosis and suggests that sex may be a disease-modifying variable with important treatment implications.

Neurocognitive predictors of long-term clinical course in bipolar disorder

2020 ◽  
Vol 54 (11) ◽  
pp. 1101-1106 ◽  
Author(s):  
Marina P Valerio ◽  
Julieta Lomastro ◽  
Diego J Martino
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
Clinical Course ◽  
Manic Episode ◽  
Cognitive Domain ◽  
Neurocognitive Deficits ◽  
Manic Symptoms

Objective: The aim of this study was to estimate whether neurocognitive deficits are predictors of the long-term clinical course of patients with bipolar disorder. Methods: A total of 76 outpatients with bipolar disorder performed a neurocognitive assessment at baseline and were followed for a period of at least 48 months. The clinical course during the follow-up period was documented by two measures: (1) number of affective episodes and (2) time spent ill. Results: Patients had lower performance than controls in the domains of verbal memory and executive functions, and they were followed-up for a mean period of 70.73 months. Global cognitive deficits (performance 1.5 standard deviations below the mean in two or more cognitive domain) were independent predictors of both hypo/manic episode density and time spent with hypo/manic symptoms during follow-up. On the contrary, no neurocognitive measure showed a relationship with depressive morbidity during follow-up. Conclusion: Our findings suggest that cognitive deficits could be useful for predicting hypo/manic morbidity in the long-term clinical course. Theoretical and clinical implications of these findings are discussed.

scholarly journals Sex Differences in Cognitive Changes in De Novo Parkinson’s Disease

2019 ◽  
Vol 26 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Ece Bayram ◽  
Sarah J. Banks ◽  
Guogen Shan ◽  
Nikki Kaplan ◽  
Jessica Z.K. Caldwell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Sex Differences ◽  
Verbal Memory ◽  
Healthy Aging ◽  
De Novo ◽  
Cognitive Changes ◽  
Progression Markers ◽  
Cognitively Intact

AbstractObjective:To evaluate the sex differences in cognitive course over 4 years in Parkinson’s disease (PD) patients with and without mild cognitive impairment (MCI) compared to controls.Methods:Four-year longitudinal cognitive scores of 257 cognitively intact PD, 167 PD-MCI, and 140 controls from the Parkinson’s Progression Markers Initiative were included. Longitudinal scores of men and women, and PD with and without MCI were compared.Results:Women had better verbal memory, men had better visuospatial function. There was no interaction between sex, diagnostic group, and/or time (4-year follow-up period).Conclusions:Sex differences in cognitive course in de novo PD are similar to healthy aging. Cognitive decline rates in PD with and without MCI are similar for the first 4 years of PD.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

Cognitive disorders and negative symptoms as correlates of motivational deficits in psychotic patients

1994 ◽  
Vol 24 (4) ◽  
pp. 869-884 ◽  
Author(s):  
B. Schmand ◽  
T. Kuipers ◽  
M. Van Der Gaag ◽  
J. Bosveld ◽  
F. Bulthuis ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Negative Symptoms ◽  
Cognitive Disorders ◽  
Control Group ◽  
Positive Symptoms ◽  
Time On Task ◽  
Reaction Test ◽  
Motivational Deficit ◽  
Energetic Model ◽  
Positive Symptoms Of Psychosis

SynopsisThe problem of a possible lack of motivation to perform cognitive tasks, which is often encountered in psychotic patients, has been approached from the perspective of the ‘energetics’ of cognition (Hockey et al. 1986) and from the broader clinical context of psychosis as an ‘amotivational syndrome’ and its related negative symptoms.The presence of motivational deficits was investigated in a group of psychotic in-patients (N = 73, and 40 had schizophrenia) compared with a control group of non-psychotic psychiatric in-patients (N = 23). The motivational deficit was operationalized in terms of Sanders's (1983) cognitive–energetic model as a large effect of ‘time-on-task’ during a simple, monotonous reaction test. Significantly more psychotic patients than control patients showed evidence of this type of motivational deficit. The deficit appeared to be related with negative but not with positive symptoms of psychosis. Furthermore, the deficit was shown to be related to the cognitive disorders of psychosis, which have been amply documented in the literature, i.e. disorders of vigilance, verbal memory and distractibility. These results suggest that the cognitive disorders of psychosis are not of a ‘computational’ but of an ‘energetical’, i.e. motivational nature.

scholarly journals Mid-term evaluation of clinical and functional outcomes after arthroscopic medial longitudinal and bucket-handle meniscus repair

2021 ◽  
Vol 32 (2) ◽  
pp. 363-370
Author(s):  
Raşit Özcafer ◽  
Ferdi Dırvar ◽  
Abdülhamit Mısır ◽  
Yaşar Maksut Dinçel ◽  
Mehmet Özbey Büyükkuşçu ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Meniscal Repair ◽  
Control Group ◽  
Meniscal Tears ◽  
Significant Difference ◽  
Ikdc Score ◽  
The Mean ◽  
Bucket Handle Tear ◽  
Bucket Handle

Objectives: The aim of this study was to evaluate clinical and functional outcomes following the arthroscopic medial meniscal repair. Patients and methods: A total of 50 patients (42 males, 8 females; mean age: 32.9±7.6 years; range, 17 to 48 years) who underwent arthroscopic repair for longitudinal and bucket-handle medial meniscal tears between March 2005 and October 2011 were retrospectively evaluated. The patients were divided into two groups as those having a longitudinal tear (patient group, n=31) and having a bucket-handle tear (control group, n=19). Preoperative and final follow-up functional outcomes were evaluated using the Lysholm Knee Score (LKS), International Knee Documentation Committee (IKDC) score, Tegner Activity Scale (TAS) score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: The mean follow-up was 61.7±22.8 (range, 36 to 110) months. The mean preoperative LKS, IKDC score, TAS, and KOOS scores were significantly improved at the final postoperative follow-up (p<0.05). There was no significant difference in functional outcome scores between longitudinal and bucket-handle repairs (p>0.05), and isolated repairs and concomitant meniscal repair and anterior cruciate ligament reconstruction (p>0.05). Conclusion: Arthroscopic meniscal repair provides similar mid-term functional and clinical outcomes for longitudinal and bucket-handle medial meniscal tears. Concomitant meniscal repair does not seem to affect meniscal healing.

scholarly journals Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bénédicte Thonon ◽  
Evelyne Van Aubel ◽  
Ginette Lafit ◽  
Clara Della Libera ◽  
Frank Larøi
Keyword(s):  
Quality Of Life ◽  
Functional Outcomes ◽  
Negative Symptoms ◽  
Single Case ◽  
Daily Functioning ◽  
Schizophrenia Spectrum Disorders ◽  
Vector Autoregressive ◽  
Registration Number

Abstract Background Motivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes in a naturalistic setting, and to explore the dynamics between the processes. Methods We used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time. Results The intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up). Conclusions This study used an innovative approach to look at the effectiveness of an intervention. The intervention seems to lead to meaningful improvements in motivational negative symptoms and functional outcomes. The mechanisms of change need to be further investigated. Trial registration number ClinicalTrials.gov, NCT04325100. Registered 27 March 27, 2020 -retrospectively registered. Reporting Guidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement were followed.

Neuropsychological Deficits and Concomitant Clinical Symptoms in Schizophrenia

2004 ◽  
Vol 9 (2) ◽  
pp. 96-106 ◽  
Author(s):  
Bernhard W. Müller ◽  
Gudrun Sartory ◽  
Stefan Bender
Keyword(s):  
Cognitive Deficits ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Clinical Symptoms ◽  
Memory Function ◽  
Chronic Schizophrenia ◽  
Neuropsychological Deficits ◽  
Word Fluency ◽  
Syndrome Scale ◽  
Healthy Control

The most frequently reported neuropsychological deficits in schizophrenia are those of attention, executive function, and verbal memory. Whereas the former appear to be related to negative symptoms of schizophrenia, there is little agreement about which clinical symptoms are related to the verbal memory deficit. The aim of the present study was to delineate further the pattern of neuropsychological deficits in schizophrenia—especially those of verbal memory—and their relationship to clinical symptoms. One hundred patients with chronic schizophrenia and 62 healthy control subjects took part in the study. Assessments of patients took place within the first 3 weeks after admission to hospital. Nine neuropsychological tests, mainly measuring executive and memory function and attention, were administered to all subjects, and clinical symptoms, such as psychotic and negative symptoms and conceptual disorganization, were assessed in patients by means of the Positive and Negative Syndrome Scale (PANSS). Patients showed widespread cognitive deficits with verbal memory impairment best discriminating patients and controls. Conceptual disorganization was partly accounted for by poor verbal memory and a low IQ estimate, and negative symptoms by deficient word fluency; positive symptoms were not significantly related to cognitive deficits. The results indicate that there is a specific relationship between neuropsychological deficits and the more chronic of the clinical symptoms.

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