scholarly journals Neuropsychological outcomes of subtemporal selective amygdalohippocampectomy via a small craniotomy

2016 ◽  
Vol 125 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Peng-Fan Yang ◽  
Hui-Jian Zhang ◽  
Jia-Sheng Pei ◽  
Qiao Lin ◽  
Zhen Mei ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Brain Surgery ◽  
Mesial Temporal Sclerosis ◽  
Semantic Fluency ◽  
Verbal Comprehension ◽  
Subtemporal Approach ◽  
Selective Amygdalohippocampectomy

OBJECT The objectives of this study were to describe a novel minimal-access subtemporal approach for selective resection of the amygdala and hippocampus in patients with medically refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis, and to analyze the related outcomes. METHODS The authors analyzed data from all cases involving patients with unilateral MTLE due to hippocampal sclerosis who were treated with selective amygdalohippocampectomy via the posterior subtemporal approach through a relatively small craniotomy, without a neuronavigation system, at their institution during the period from September 2010 to September 2012. Data were obtained on baseline characteristics, preoperative evaluations of unilateral mesial temporal sclerosis, surgical complications, and Engel class seizure outcomes. All patients underwent memory testing, IQ testing, and language testing. RESULTS The mean duration of follow-up was 33.6 months (range 24–48 months). There were no deaths and no cases of significant postoperative morbidity. One patient had a mild complication. At 2-year follow-up, 19 patients were seizure free (Engel Class I outcome). Verbal memory scores obtained at 3 months and at 2 years after surgery were significantly lower than preoperative scores for patients who underwent surgery on the left side of the brain (p < 0.05). Pictorial memory scores were higher following surgery compared with before surgery regardless of whether patients underwent left- or right-sided brain surgery. There was also improvement in performance IQ and total IQ following surgery in both groups. For patients who underwent right-sided brain surgery, verbal comprehension and semantic fluency testing scores were significantly higher at both 3 months and 2 years after surgery than before surgery. For patients who underwent left-sided brain surgery, scores on all language tests were significantly lower at 3 months after surgery than before surgery. Verbal comprehension testing scores returned to the preoperative level at 2 years after surgery. CONCLUSIONS The posterior subtemporal approach through a relatively small craniotomy allows adequate exposure and safe resection of mesial temporal structures and effectively reduces medically intractable MTLE. It preserves IQ but may have a detrimental effect on verbal memory and language ability.

Seizure and memory outcome following temporal lobe surgery: selective compared with nonselective approaches for hippocampal sclerosis

2006 ◽  
Vol 104 (1) ◽  
pp. 70-78 ◽  
Author(s):  
Eliseu Paglioli ◽  
André Palmini ◽  
Mirna Portuguez ◽  
Eduardo Paglioli ◽  
Ney Azambuja ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Seizure Control ◽  
Hippocampal Sclerosis ◽  
Surgical Techniques ◽  
Mesial Temporal Lobe Epilepsy ◽  
Outcome Data ◽  
Temporal Lobectomy ◽  
Selective Amygdalohippocampectomy

Object The aim of this study was to compare seizure and memory outcome in patients with medically refractory mesial temporal lobe epilepsy due to hippocampal sclerosis (MTLE/HS) treated using an anterior temporal lobectomy (ATL) or a selective amygdalohippocampectomy (SA). Methods Surgical outcome data were prospectively collected for 2 to 11 years in 161 consecutive patients with MTLE/HS. Eighty patients underwent an ATL and 81 an SA. Seizure control achieved with each technique was compared using the Engel classification scheme. Postoperative memory testing was performed in 86 patients (53%). At the last follow up, 72% of the patients who had undergone an ATL (mean follow up 6.7 years) and 71% of those who had undergone an SA (mean follow up 4.5 years) were seizure free (Engle Class IA). Estimated survival in patients in Engel Classes I, IA, and I and II combined did not differ between the two surgical techniques. Preoperatively, 58% of the patients had verbal memory scores one standard deviation (SD) below the normal mean. One third of the patients with preoperative scores in the normal range worsened after surgery, although this outcome was not related to the surgical technique. In contrast, one third of those whose preoperative scores were less than −1 SD experienced improvement after surgery. Nine (18%) of the 50 patients whose left side had been surgically treated improved their verbal memory scores by more than one SD. Seven (78%) of these nine underwent an SA (p = 0.05). Conclusions Both ATL and SA can lead to similar favorable seizure control in patients with MTLE/HS. Preliminary data suggest that postoperative verbal memory scores may improve in patients who undergo selective resection of a sclerotic hippocampus in the dominant temporal lobe.

Memory outcome after temporal lobe epilepsy surgery: corticoamygdalohippocampectomy versus selective amygdalohippocampectomy

2010 ◽  
Vol 113 (6) ◽  
pp. 1164-1175 ◽  
Author(s):  
Taner Tanriverdi ◽  
Roy William Roland Dudley ◽  
Alya Hasan ◽  
Ahmed Al Jishi ◽  
Qasim Al Hinai ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Hippocampal Sclerosis ◽  
Surgical Approaches ◽  
Seizure Outcome ◽  
Nonverbal Memory ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference

Object The aim of this study was to compare IQ and memory outcomes at the 1-year follow-up in patients with medically refractory mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis. All patients were treated using a corticoamygdalohippocampectomy (CAH) or a selective amygdalohippocampectomy (SelAH). Methods The data of 256 patients who underwent surgery for MTLE were retrospectively evaluated. One hundred twenty-three patients underwent a CAH (63 [right side] and 60 [left side]), and 133 underwent an SelAH (61 [right side] and 72 [left side]). A comprehensive neuropsychological test battery was assessed before and 1 year after surgery, and the results were compared between the surgical procedures. Furthermore, seizure outcome was compared using the Engel classification scheme. Results At 1-year follow-up, there was no statistically significant difference between the surgical approaches with respect to seizure outcome. Overall, IQ scores showed improvement, but verbal IQ decreased after left SelAH. Verbal memory impairment was seen after left-sided resections especially in cases of SelAH, and nonverbal memory decreased after right-sided resection, especially for CAH. Left-sided resections produced some improvement in nonverbal memory. Older age at surgery, longer duration of seizures, greater seizure frequency before surgery, and poor seizure control after surgery were associated with poorer memory. Conclusions Both CAH and SelAH can lead to several cognitive impairments depending on the side of the surgery. The authors suggest that the optimal type of surgical approach should be decided on a case-by-case basis.

Neuropsychological outcome after subtemporal versus transsylvian approach for selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy: a randomised prospective clinical trial

2017 ◽  
Vol 89 (10) ◽  
pp. 1057-1063 ◽  
Author(s):  
Viola Lara Vogt ◽  
Daniel Delev ◽  
Alexander Grote ◽  
Johannes Schramm ◽  
Marec von Lehe ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Verbal Learning ◽  
Mesial Temporal Lobe Epilepsy ◽  
Neuropsychological Outcome ◽  
Semantic Fluency ◽  
Subtemporal Approach ◽  
Selective Amygdalohippocampectomy ◽  
Mesial Temporal Lobe ◽  
Post Hoc

ObjectiveTo compare the effects of different surgical approaches for selective amygdalohippocampectomy in patients with pharmacoresistant mesial temporal lobe epilepsy with regard to the neuropsychological outcome and to replicate an earlier study employing a matched-pair design.Method47 patients were randomised to subtemporal versus transsylvian approaches. Memory, language, attentional and executive functions were assessed before and 1 year after surgery. Multivariate analyses of variance (MANOVAs) with presurgical and postsurgical assessments as within-subject variables and approach and side of surgery as between-subject factors were calculated. Additionally, the frequencies of individual performance changes based on reliable change indices were analysed.ResultsSeizure freedom International League Against Epilepsy (ILAE) 1a, was achieved in 62% of all patients without group difference. MANOVAs revealed no significant effects of approach on cognition. Tested separately for each parameter, verbal recognition memory declined irrespective of approach. Post hoc tests revealed that on group level, the subtemporal approach was associated with a worse outcome for verbal learning and delayed free recall as well as for semantic fluency. Accordingly, on individual level, more patients in the subtemporal group declined in verbal learning. Left side of surgery was associated with decline in naming regardless of approach.ConclusionThe main analysis did not confirm the effects of approach on memory outcome seen in our previous study. Post hoc testing, however, showed greater memory losses with the subtemporal approach. Previous findings were replicated for semantic fluency. The discrepant results are discussed on the background of the different study designs.

Endoscopic Transcortical Selective Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Takehiro Uda ◽  
Toshiyuki Kawashima ◽  
Masato Hattori ◽  
Yuichiro Kojima ◽  
Yuki Mito ◽  
...  
Keyword(s):  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Skin Incision ◽  
Cognitive Outcomes ◽  
Parahippocampal Gyrus ◽  
Middle Temporal Gyrus ◽  
Surgical Video ◽  
Selective Amygdalohippocampectomy ◽  
Depth Electrodes ◽  
The Right

Abstract This surgical video shows a 19-yr-old woman with focal impaired awareness seizures. Seizure semiology showed no lateralizing signs. Ictal electroencephalography (EEG) failed to determine the seizure origin. Interictal EEG showed bilateral spike-and-waves at the temporal electrodes. Magnetic resonance imaging (MRI) showed suspected hippocampal sclerosis on the right side. To determine the side of the focus, depth electrodes were implanted in both hippocampi. Invasive video EEG identified the seizure origin on the right. The decision was made to perform selective amygdalohippocampectomy (SelAH) via the middle temporal gyrus (MTG). An endoscope was used to minimize the craniotomy and shorten the skin incision.  A 5-cm linear skin incision and 2.5-cm craniotomy were made. A thin tube was inserted to the inferior horn of the lateral ventricle (Inf-H) under neuronavigation to guide the route to the Inf-H. The endoscope was introduced. A 1.5-cm corticotomy was made at the MTG, and white matter was aspirated until opening the Inf-H. The hippocampus and parahippocampal gyrus were removed with the usual steps in microsurgical SelAH. The surgical time was 4 h 20 min. The patient was discharged without complications and has remained seizure free.  In addition to the preoperative objectives, using an endoscope widens the surgical view in the Inf-H compared with microsurgical procedures. Although seizure and cognitive outcomes are expected to be comparable to those from other methods of SelAH, invasiveness might be reduced. This appears to represent the first video report of endoscopic SelAH. The patient consented to the procedure and publication of her images and surgical video.

scholarly journals Anterior temporal lobectomy versus selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy

2015 ◽  
Vol 74 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Fábio A. Nascimento ◽  
Luana Antunes Maranha Gatto ◽  
Carlos Silvado ◽  
Maria Joana Mäder-Joaquim ◽  
Marlus Sidney Moro ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Mesial Temporal Sclerosis ◽  
Anterior Temporal Lobectomy ◽  
Selective Amygdalohippocampectomy ◽  
Significant Difference ◽  
Mesial Temporal Lobe ◽  
Neuropsychological Outcomes

ABSTRACT Objective To contribute our experience with surgical treatment of patients with mesial temporal lobe epilepsy (mTLE) undergoing anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SelAH). Method This is a retrospective observational study. The sample included patients with medically refractory mTLE due to unilateral mesial temporal sclerosis who underwent either ATL or SelAH, at Hospital de Clinicas – UFPR, from 2005 to 2012. We report seizure outcomes, using Engel classification, cognitive outcomes, using measurements of verbal and visuospatial memories, as well as operative complications. Result Sixty-seven patients (33 ATL, 34 SelAH) were studied; median follow-up was 64 months. There was no statistically significant difference in seizure or neuropsychological outcomes, although verbal memory was more negatively affected in ATL operations on patients’ dominant hemispheres. Higher number of major complications was observed in the ATL group (p = 0.004). Conclusion Seizure and neuropsychological outcomes did not differ. ATL appeared to be associated with higher risk of complications.

Long-term seizure outcomes following amygdalohippocampectomy

2003 ◽  
Vol 98 (4) ◽  
pp. 751-763 ◽  
Author(s):  
H. Gregor Wieser ◽  
Marcos Ortega ◽  
Alon Friedman ◽  
Yasuhiro Yonekawa
Keyword(s):  
Mesial Temporal Lobe Epilepsy ◽  
Outcome Data ◽  
University Hospital ◽  
Seizure Outcome ◽  
Content Type ◽  
Selective Amygdalohippocampectomy ◽  
Class 1 ◽  
Fine Print

Object. Analyses of the results of surgery for epilepsy are hindered by inconsistent classifications of seizure outcome, small numbers of patients, and short postoperative follow-up periods. The authors conducted a retrospective study with a reassessment of the long-term seizure outcomes in patients who underwent selective amygdalohippocampectomy (SelAH) for pharmacotherapy—resistant mesial temporal lobe epilepsy (MTLE) at the Zurich University Hospital from 1975 to 1999. Methods. Year-by-year data and the last available data on seizure outcomes were retrospectively assessed for 369 consecutively surgically treated patients who had participated in a follow-up period longer than 1 year as of 1999 and whose outcomes were classified according to the Engel scale and the proposed new International League Against Epilepsy (ILAE) scale. Patients were grouped into nonlesional and lesional MTLE groups depending on whether they harbored a gross anatomical lesion that caused the MTLE. Differentiation was made between curative and palliative operations. Complications related to surgery are reported for 453 patients who underwent SelAH and participated in more than 3 months of follow-up review. The last available outcome data according to the Engel scale were found to be generally similar to those of the new ILAE classification, with 66.9% of patients free from disabling seizures (Engel Class I) compared with 57.1% who were completely seizure and aura free (ILAE Class 1). The last available data on seizure outcome were not significantly different between patients in the lesional and nonlesional MTLE groups. In the lesional group, seizure outcomes were significantly better when patients underwent surgery early in the course of the disease. Overall, 70% of the patients received reductions in their antiepileptic drug treatment at the time of the last available follow-up review. Complications related to the surgical procedures were rare. Conclusions. The authors conclude that SelAH is a safe and effective surgical procedure for MTLE.

scholarly journals Stereotactic-EEG Guided Radiofrequency Thermocoagulation Versus Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis: Study protocol for a randomized controlled trial

2021 ◽  
Author(s):  
Yi-He Wang ◽  
Si-Chang Chen ◽  
Peng-Hu Wei ◽  
Kun Yang ◽  
Xiao-Tong Fan ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Controlled Trial ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Anterior Temporal Lobectomy ◽  
Radiofrequency Thermocoagulation ◽  
Mesial Temporal Lobe

Abstract Introduction: In this report, we aim to describe the design for the randomized controlled trial of Stereotactic-electroencephalogram (EEG) guided Radiofrequency Thermocoagulation versus Anterior Temporal Lobectomy for Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis (STARTS). Mesial temporal lobe epilepsy (mTLE) is a classical subtype of temporal lobe epilepsy that often requires surgical intervention. Although anterior temporal lobectomy (ATL) remains the most popular treatment for mTLE, accumulating evidence has indicated that ATL can cause tetartanopia and memory impairments. Stereotactic EEG (SEEG)-guided radiofrequency thermocoagulation (RF-TC) is a non-invasive alternative associated with lower seizure freedom but greater preservation of neurological function. In the present study, we aim to compare the safety and efficacy of SEEG-guided RF-TC and classical ATL in the treatment of mTLE. Methods and analysis: STARTS is a single-centre, two-arm, randomised controlled, parallel-group clinical trial. The study includes patients with typical mTLE over the age of 14 who have drug-resistant seizures for at least 2 years and have been determined via detailed evaluation to be surgical candidates prior to randomisation. The primary outcome measure is cognitive function at the 1-year follow-up after treatment. Seizure outcomes, visual field abnormalities after surgery, quality of life, ancillary outcomes, and adverse events will also be evaluated at 1-year follow-up as secondary outcomes. Disscussion: SEEG-guided RF-TC for mTLE remains a controversial seizure outcome but has the advantage for cognitive and visual filed protection. This is the first RCT studying cognitive outcomes and treatment results between SEEG-guided RF-TC and standard ATL for mTLE with hippocampal sclerosis. This study may provide a higher levels of clinical evidence for the treatment for mTLE. Trial registration: The STARTS protocol has been registered on the US National Institutes of Health (ClinicalTrials.gov): NCT03941613. The status of the STARTS was recruiting and the estimated study completion date was December 31, 2021.

scholarly journals Gamma Knife radiosurgery for recurrent or residual seizures after anterior temporal lobectomy in mesial temporal lobe epilepsy patients with hippocampal sclerosis: long-term follow-up results of more than 4 years

2015 ◽  
Vol 123 (6) ◽  
pp. 1375-1382 ◽  
Author(s):  
Eun Mi Lee ◽  
Joong Koo Kang ◽  
Sang Joon Kim ◽  
Seok Ho Hong ◽  
Tae Sung Ko ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Gamma Knife Radiosurgery ◽  
Mesial Temporal Lobe Epilepsy ◽  
Temporal Lobectomy ◽  
Seizure Outcome ◽  
Anterior Temporal Lobectomy ◽  
Mesial Temporal Lobe ◽  
Signal Changes

OBJECTGamma Knife radiosurgery (GKRS) has proven efficacy in the treatment of drug-resistant mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and is comparable to conventional resective surgery. It may be effective as an alternative treatment to reoperation after failed temporal lobe surgery in patients with MTLE-HS. The purpose of this study was to investigate the efficacy of GKRS in patients with unilateral MTLE-HS who did not achieve seizure control or had recurrent seizures after anterior temporal lobectomy (ATL).METHODSTwelve patients (8 males; mean age 35.50 ± 9.90 years) with MTLE-HS who underwent GKRS after failed ATL (Engel Classes III–IV) were included. GKRS targets included the remnant tissue or adjacent regions of the previously performed ATL with a marginal dose of 24–25 Gy at the 50% isodose line in all patients. Final seizure outcome was assessed using Engel’s modified criteria during the final 2 years preceding data analysis. A comparison between signal changes on follow-up MRI and clinical outcome was performed.RESULTSAll patients were followed up for at least 4 years with a mean duration of 6.18 ± 1.77 years (range 4–8.8 years) after GKRS. At the final assessment, 6 of 12 patients were classified as seizure free (Engel Class Ia, n = 3; Ic, n = 2; and Id, n = 1) and 6 patients were classified as not seizure free (Engel Class II, n = 1; III, n = 2; and IV, n = 3). Neither initial nor late MRI signal changes after GKRS statistically correlated with surgical outcome. Clinical seizure outcome did not differ significantly with initial or late MRI changes after GKRS.CONCLUSIONSGKRS can be considered an alternative option when the patients with MTLE-HS who had recurrent or residual seizures after ATL refuse a second operation.

Electrical Stimulation of Subiculum for the Treatment of Refractory Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis: A 2-Year Follow-Up Study

2020 ◽  
pp. 1-8
Author(s):  
Daruni Vázquez-Barrón ◽  
Manola Cuéllar-Herrera ◽  
Francisco Velasco ◽  
Ana Luisa Velasco
Keyword(s):  
Electrical Stimulation ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Hippocampal Sclerosis ◽  
Mesial Temporal Lobe Epilepsy ◽  
Open Label ◽  
Anticonvulsive Effect ◽  
Mesial Temporal Lobe ◽  
Stimulation Of

<b><i>Introduction:</i></b> Evidence has been provided that the subiculum may play an important role in the generation of seizures. Electrical stimulation at this target has been reported to have anticonvulsive effects in kindling and pilocarpine rat models, while in a clinical study of hippocampal deep brain stimulation (DBS), contacts closest to the subiculum were associated with a better anticonvulsive effect. <b><i>Objectives:</i></b> To evaluate the effect of electrical stimulation of the subiculum in patients with refractory mesial temporal lobe epilepsy (MTLE) who have hippocampal sclerosis (HS). <b><i>Methods:</i></b> Six patients with refractory MTLE and HS, who had focal impaired awareness seizures (FIAS) and focal to bilateral tonic-clonic seizures (FBTCS), had DBS electrodes implanted in the subiculum. During the first month after implantation, all patients were OFF stimulation, then they all completed an open-label follow-up of 24 months ON stimulation. DBS parameters were set at 3 V, 450 µs, 130 Hz, cycling stimulation 1 min ON, 4 min OFF. <b><i>Results:</i></b> There was a mean reduction of 49.16% (±SD 41.65) in total seizure number (FIAS + FBTCS) and a mean reduction of 67.93% (±SD 33.33) in FBTCS at 24 months. FBTCS decreased significantly with respect to baseline, starting from month 2 ON stimulation. <b><i>Conclusions:</i></b> Subiculum stimulation is effective for FBTCS reduction in patients with MTLE and HS, suggesting that the subiculum mediates the generalization rather than the genesis of mesial temporal lobe seizures. Better results are observed at longer follow-up times.

scholarly journals Schizophrenia polygenic risk predicts general cognitive deficit but not cognitive decline in healthy older adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Adrianna P. Kępińska ◽  
James H. MacCabe ◽  
Dorina Cadar ◽  
Andrew Steptoe ◽  
Robin M. Murray ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Genetic Susceptibility ◽  
Verbal Memory ◽  
Cognitive Deficit ◽  
Neurodegenerative Disorder ◽  
Later Life ◽  
Semantic Fluency ◽  
Healthy Older Adults ◽  
Rate Of Decline

AbstractThere has been a long argument over whether schizophrenia is a neurodegenerative disorder associated with progressive cognitive impairment. Given high heritability of schizophrenia, ascertaning if genetic susceptibility to schizophrenia is also associated with cognitive decline in healthy people would support the view that schizophrenia leads to an accelerated cognitive decline. Using the population representative sample of 6817 adults aged >50 years from the English Longitudinal Study of Ageing, we investigated associations between the biennial rate of decline in cognitive ability and the schizophrenia polygenic score (SZ-PGS) during the 10-year follow-up period. SZ-PGS was calculated based on summary statistics from the Schizophrenia Working Group of the Psychiatric Genomics Consortium. Cognition was measured sequentially across four time points using verbal memory and semantic fluency tests. The average baseline verbal memory was 10.4 (SD = 3.4) and semantic fluency was 20.7 (SD = 6.3). One standard deviation (1-SD) increase in SZ-PGS was associated with lower baseline semantic fluency (β = −0.25, 95%CI = −0.40 to −0.10, p = 0.002); this association was significant in men (β = −0.36, 95%CI = −0.59 to −0.12, p = 0.003) and in those who were aged 60–69 years old (β = −0.32, 95%CI = −0.58 to −0.05, p = 0.019). Similarly, 1-SD increase in SZ-PGS was associated with lower verbal memory score at baseline in men only (β = −0.12, 95%CI = −0.23 to −0.01, p = 0.040). However, SZ-PGS was not associated with a greater rate of decline in these cognitive domains during the 10-year follow-up. Our findings highlight that while genetic susceptibility to schizophrenia conveys developmental cognitive deficit, it is not associated with an ongoing cognitive decline, at least in later life. These results do not support the neo-Kraepelinian notion of schizophrenia as a genetically determined progressively deteriorating brain disease.

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