Visual shape completion deficits arise in first-episode and chronic schizophrenia, but are less severe in bipolar disorder: Evidence for a novel behavioral biomarker

Aims:Affective deficits (flat affect, a diminished expression of emotion, anhedonia, and lowered ability to experience pleasure) are very common in schizophrenia. In emotion feeling, the crucial role of the insula, rather than of the primary somatosensory cortices, strongly suggests that the neural substrate for emotions is not merely sensorial. It is more likely that the activation of the insula representation of the viscero-motor activity is responsible for feeling of disgust. A recent MRI study demonstrated specific left anterior insular volume reduction in chronic schizophrenia patients: sustainable is the suggestion that emotion of disgust or of taste may be related to the experience of pleasure, which probably is compromise in schizophrenics.We investigated fMRI brain activations in first episode schizophrenic subjects with negative symptoms and in healthy subjects elicited by pleasant and unpleasant visual stimuli.Method:Ten first-episode schizophrenic subjects with normal IQ were recruited from the psychiatric service “SMILE” of San Salvatore Hospital and 10 healthy volunteers matched for age and education were scanned during observation of pleasant and unpleasant visual stimuli. Functional images were acquired with a 1.5T MRI scanner. Blood oxygenation level dependent (BOLD) contrast was obtained using EPI T2* weighted images.Results:The most important result of the study was the demonstration that anterior insula was activated by the exposure to disgusting stimula in normal subjects but not in schizophrenic subjects.Conclusion:This failure of the neural systems used to support emotional attribution is consistent with pervasive problems in experiencing emotions by schizophrenics.

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Cognitive heterogeneity in first-episode schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.187.6.516 ◽

2005 ◽

Vol 187 (6) ◽

pp. 516-522 ◽

Cited By ~ 79

Author(s):

Eileen M. Joyce ◽

Sam B. Hutton ◽

Stanley H. Mutsatsa ◽

Thomas R. E. Barnes

Keyword(s):

Working Memory ◽

Cognitive Decline ◽

Spatial Working Memory ◽

Age At Onset ◽

Chronic Schizophrenia ◽

First Episode ◽

Entire Group ◽

Illness Onset ◽

Cognitive Heterogeneity ◽

First Episode Schizophrenia

BackgroundStudies of chronic schizophrenia suggest that there are subgroups with different profiles of cognitive impairment.AimsTo determine whether such heterogeneity is present at illness onset and any relationship to clinical variables.MethodNinety-three community patients with first-episode schizophrenia and 50 healthy volunteers were assessed for premorbid (Revised National Adult Reading Test) and current IQ, memory and executive function.ResultsHalf of those with schizophrenia had preserved IQ in the normal range but there was evidence of a specific impairment in spatial working memory even in those with high/average IQ; 37 out of 93 (40%) had generalised cognitive decline. Those with low premorbid IQ were significantly younger at illness onset. For the entire group, age at onset correlated positively with premorbid but not current IQ.ConclusionsAt illness onset, cognitive heterogeneity is present in people with schizophrenia, with a high proportion having undergone general cognitive decline. However, working memory impairment may be a common feature. Lower premorbid IQ is a risk factor for an earlier onset.

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Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

European Psychiatry ◽

10.1016/j.eurpsy.2010.11.001 ◽

2011 ◽

Vol 27 (8) ◽

pp. 557-562 ◽

Cited By ~ 8

Author(s):

J.-M. Azorin ◽

A. Kaladjian ◽

M. Adida ◽

E. Fakra ◽

E. Hantouche ◽

...

Keyword(s):

Bipolar Disorder ◽

Suicide Attempts ◽

Correct Diagnosis ◽

Manic Episode ◽

Psychotic Symptoms ◽

First Episode ◽

Prodromal Phase ◽

Multiple Episode ◽

Patients At Risk ◽

Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

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An fMRI study of face encoding and recognition in first-episode schizophrenia

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2008.00280.x ◽

2008 ◽

Vol 20 (3) ◽

pp. 129-138 ◽

Cited By ~ 10

Author(s):

Anantha P. P. Anilkumar ◽

Veena Kumari ◽

Ravi Mehrotra ◽

Ingrid Aasen ◽

Martina T. Mitterschiffthaler ◽

...

Keyword(s):

Face Recognition ◽

Brain Activity ◽

Chronic Schizophrenia ◽

First Episode ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Social Situations ◽

Fmri Study ◽

On Line ◽

First Episode Schizophrenia

Background:Schizophrenia has been associated with limited abilities to interact effectively in social situations. Face perception and ability to recognise familiar faces are critical for social interaction. Patients with chronic schizophrenia are known to show impaired face recognition. Studying first-episode (FE) patients allows the exclusion of confounding effects of chronicity, medication and institutionalisation in this deficit.Objective:To determine brain (dys)functions during a face encoding and recognition paradigm in FE schizophrenia.Methods:Thirteen antipsychotic-naïve FE schizophrenia patients and 13 age- and sex-matched healthy controls underwent functional magnetic resonance imaging during a face encoding and recognition paradigm. Behavioural responses were recorded on line.Results:Patients recognised significantly fewer of previously presented faces than the controls (p = 0.008). At the neural level, both groups activated a network of regions including the fusiform area, occipital, temporal and frontal regions. In brain activity, the two groups did not differ in any region during encoding or recognition conditions (p > 0.05, corrected or uncorrected).Conclusions:Our findings show impaired face recognition without a significant alteration of related brain activity in FE schizophrenia patients. It is possible that neural changes become more strongly evident with progression of the illness, and manifest themselves as behavioural impairments during the early course.

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BDNF as a Biomarker of Cognition in Schizophrenia/Psychosis: An Updated Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.662407 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rodrigo R. Nieto ◽

Andrea Carrasco ◽

Sebastian Corral ◽

Rolando Castillo ◽

Pablo A. Gaspar ◽

...

Keyword(s):

Cognitive Function ◽

High Risk ◽

Human Subjects ◽

Chronic Schizophrenia ◽

Review Article ◽

First Episode ◽

Cognitive Symptoms ◽

Research Gaps ◽

Future Developments ◽

The Relationship

Brain Derived Neurotrophic Factor (BDNF) has been linked to cognitive symptoms of schizophrenia, which has been documented in previous reviews by several authors. However, a trend has recently emerged in this field moving from studying schizophrenia as a disease to studying psychosis as a group. This review article focuses on recent BDNF studies in relation to cognition in human subjects during different stages of the psychotic process, including subjects at high risk of developing psychosis, patients at their first episode of psychosis, and patients with chronic schizophrenia. We aim to provide an update of BDNF as a biomarker of cognitive function on human subjects with schizophrenia or earlier stages of psychosis, covering new trends, controversies, current research gaps, and suggest potential future developments in the field. We found that most of current research regarding BDNF and cognitive symptoms in psychosis is done around schizophrenia as a disease. Therefore, it is necessary to expand the study of the relationship between BDNF and cognitive symptoms to psychotic illnesses of different stages and origins.

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Decreased levels of plasma BDNF in first-episode schizophrenia and bipolar disorder patients

Schizophrenia Research ◽

10.1016/j.schres.2006.05.028 ◽

2006 ◽

Vol 86 (1-3) ◽

pp. 321-322 ◽

Cited By ~ 116

Author(s):

Aitor Palomino ◽

Ainara Vallejo-Illarramendi ◽

Ana González-Pinto ◽

Ana Aldama ◽

Cristina González-Gómez ◽

...

Keyword(s):

Bipolar Disorder ◽

First Episode ◽

First Episode Schizophrenia

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Bipolar Disorder and Suicide: 10 Years Follow-up/retrospective Survey/

European Psychiatry ◽

10.1016/s0924-9338(09)70596-6 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

D. Breznoscakova ◽

E. Palova ◽

J. Dragasek ◽

K. Losonciova ◽

J. Uhrin

Keyword(s):

Bipolar Disorder ◽

Depressive Episode ◽

Suicide Risk ◽

First Episode ◽

Retrospective Case ◽

Suicidal Thoughts ◽

Adequate Treatment ◽

Retrospective Survey ◽

Naturalistic Condition

Introduction:Bipolar disorder (BD) is chronic psychiatric disorder by mood swings, symptoms of BD are serious and life-threating. Suicide risk in patients with BD is 25-50%, more frequent during depressive episode (Compton,2000) but with adequate treatment suicide risk can be presented in nearby 50% of patients only (Goodwin, Jamison,2006). Despite these facts data about the changes of treatment habits over the longer period of time under naturalistic condition are lacking.The aim of study:To assess presence of suicidal thoughts and attempts in inpatients with BD and follow-up changes of treatment with lithium over the period of time.Patients and methods:It was retrospective survey of in-patient's files hospitalized at the 1st Dept. of Psychiatry, UPJS, Kosice (1997-2007) with typical limitations for retrospective case survey. All patients had diagnosis of BD (DSM-IV), n=125 (67% of women and 33% of men). We discovered changes in suicidal behaviour with/without treatment of lithium.Results:The first episode was depressive in 62% of patients, average number of episodes: 8,2. There was trend of decrease in use of lithium over the time (68% vs 84% in men, 29% vs 60% in women). The suicidal thoughts were more frequent during depressive episode (in 50% of women and 18% of men). Suicidal thoughts and attempts were 3 times more frequent in women vs men with BD. Suicidal attempts were 4 times more frequent in women with treatment with lithium vs without lithium.

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