EEG Microstates and Its Relationship With Clinical Symptoms in Patients With Schizophrenia

Schizophrenia is a complex and devastating disorder with unclear pathogenesis. Electroencephalogram (EEG) microstates have been suggested as a potential endophenotype for this disorder. However, no clear dynamic pattern of microstates has been found. This study aims to identify the dynamics of EEG microstates in schizophrenia and to test whether schizophrenia patients with altered clinical symptoms severity showed different microstates abnormalities compared with healthy controls. Resting-state EEG data in 46 individuals who met the ICD-10 diagnostic criteria for schizophrenia and 39 healthy controls was recorded. The patients with schizophrenia were divided into subgroups based on the level of their negative or positive symptoms assessed using the Positive and Negative Syndrome Scale. Microstate parameters (contribution, occurrence, and duration) of four prototypical microstate classes (A–D) were investigated. Compared with healthy controls, individuals with schizophrenia showed increased duration and contribution of microstate class C, decreased contribution and occurrence of microstate class B. Different microstate patterns were found between subgroups and healthy controls. Results in this study support the consistent observation of abnormal EEG microstates patterns in patients with schizophrenia and highlight the necessity to divide subjects into subgroups according to their clinical symptoms.

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Decision making under ambiguity and risk in adolescent-onset schizophrenia

BMC Psychiatry ◽

10.1186/s12888-021-03230-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dandan Li ◽

Fengyan Zhang ◽

Lu Wang ◽

Yifan Zhang ◽

Tingting Yang ◽

...

Keyword(s):

Decision Making ◽

Executive Function ◽

Iowa Gambling Task ◽

Clinical Symptoms ◽

Healthy Controls ◽

Syndrome Scale ◽

Significant Difference ◽

Abnormal Pattern ◽

Negative Syndrome ◽

The Relationship

Abstract Objective Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. Methods We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson’s correlation revealed the relationship among total score of DM and clinical and neuropsychological data. Results Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. Conclusions Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.

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Sex-dependent effect on the association of COMT Val158Met polymorphism with schizophrenia clinical symptoms and cognitive impairment

10.21203/rs.3.rs-817886/v1 ◽

2021 ◽

Author(s):

Hang Xu ◽

Yongjie Zhou ◽

Jiesi Wang ◽

Meihong Xiu ◽

Dachun Chen ◽

...

Keyword(s):

Cognitive Impairment ◽

Clinical Symptoms ◽

Chronic Schizophrenia ◽

Positive Symptoms ◽

Sexually Dimorphic ◽

Genotype Distribution ◽

Immediate Memory ◽

Neuropsychological Status ◽

Syndrome Scale ◽

Negative Syndrome

Abstract Catechol-O-methyltransferase (COMT) Val158Met (rs4680) polymorphism is thought to be involved in the pathogenesis of schizophrenia, which is related to the regulation of dopamine transmission in the prefrontal cortex. Recent studies have shown that the influence of COMT Val158Met variation is sexually dimorphic. This study aims to explore the possible effect of the interaction between COMT Val158Met polymorphism and sex on patients’ clinical characteristics and cognitive function. 367 inpatients with chronic schizophrenia (246 males and 121 females) and 419 healthy controls (172 males and 247 females) are recruited. The cognitive performances are assessed by Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and the COMT Val158Met polymorphism is genotyped. The psychopathological symptoms of the patients are assessed by the Positive and Negative Syndrome Scale (PANSS). We find that: 1) sex difference in the allele frequency and genotype distribution of COMT Val158Met are found only in schizophrenia patients; 2) there is sex × COMT genotype interaction in positive symptoms, immediate memory, attention, and RBANS total score indexes in patients with schizophrenia; 3) mainly in the male patients’ sample, Val/Val carriers exhibit more positive symptoms and more severe cognitive impairment than Met carriers. These findings suggest that COMT Val158Met polymorphism is associated with the risk and severity of schizophrenia in a sexually dimorphic way, which is helpful to understand the factors that may lead to different manifestations of male and female patients with schizophrenia.

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Modification of the Effort Expenditure for Rewards Task (EEfRT) for Motivation Studies in Schizophrenia Patients

Clinical Psychology and Special Education ◽

10.17759/cpse.2019080409 ◽

2019 ◽

Vol 8 (4) ◽

pp. 138-155

Author(s):

V. Plakunova ◽

A.S. Tkhostov ◽

M. Alfimova

Keyword(s):

Young People ◽

Reward Magnitude ◽

Clinical Symptoms ◽

Psychiatric Patients ◽

Young Patients ◽

Demographic Characteristics ◽

Healthy Controls ◽

Moderating Effects ◽

Syndrome Scale ◽

Negative Syndrome

Recent evidence indicates a decrease in willingness to exert effort for rewards in patients with schizophrenia. The exact mechanism of this deficit is unknown, which necessitates further research of the issue using adequate experimental procedures to measure willingness to exert efforts. Among the latter, the most widely used paradigm is the Effort Expenditure for Rewards Task (EEfRT). However, the original version of the task cannot be used in all populations because of socio-economic differences between countries. The present study was aimed to adapt the EEfRT for use in the Russian population. We shortened the task and selected levels of rewards enabling the assessment of patterns of effort expenditure in patients and healthy people. To test the psychodiagnostic properties of the modified version, it was administered to 20 young people (including 15 women) with schizophrenia and 20 healthy controls matched to the patients on demographic characteristics. In addition, we assessed clinical symptoms with the Positive and Negative Syndrome Scale (PANSS) in patients and evaluated schizotypal traits with SPQ-74 in healthy controls. The modified version of EEfRT successfully revealed the normal patterns of effort expenditure for a monetary reward. A decrease in willingness to exert effort and an attenuation of moderating effects of reward magnitude and probability in young patients with schizophrenia were demonstrated. The task therefore allows study those motivational deficits in psychiatric patients, which cannot be assessed with clinical psychometric tools.

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Abnormalities of EEG Microstates In Drug-Naïve, First-Episode Schizophrenia

10.21203/rs.3.rs-1042706/v1 ◽

2021 ◽

Author(s):

Qiaoling Sun ◽

Linlin Zhao ◽

Liwen Tan

Keyword(s):

Clinical Symptoms ◽

Early Stage ◽

First Episode ◽

Healthy Controls ◽

Brain Functions ◽

Class D ◽

Syndrome Scale ◽

Drug Naïve ◽

Microstate Analysis ◽

First Episode Schizophrenia

Abstract Objective: Microstate analysis is a powerful tool to probe the brain functions, and changes in microstates under electroencephalography (EEG) have been repeatedly reported in patients with schizophrenia. This study aimed to investigate the dynamics of EEG microstates in drug-naïve, first-episode schizophrenia (FE-SCH) and to test the relationship between EEG microstates and clinical symptoms.Methods: Resting-state EEG were recorded for 23 patients with FE-SCH and 23 healthy controls using a 64-channel cap. Three parameters, i.e., contribution, duration, and occurrence, of the four microstate classes were calculated. Group differences in EEG microstates and their clinical symptoms (assessed using the Positive and Negative Syndrome Scale) were analyzed.Results: Compared with healthy controls, patients with FE-SCH showed increased duration, occurrence and contribution of microstate class C and decreased contribution and occurrence of microstate class D. In addition, the score of positive symptoms in PANSS was negatively correlated with the occurrence of microstate D.Conclusions: Our findings showed abnormal patterns of EEG microstates in drug-naïve, first-episode schizophrenia, which might help distinguish individuals with schizophrenia in the early stage and develop early intervention strategies.

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Correlation between vaspin and PANSS scores in schizophrenia patients with obesity

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217420905463 ◽

2020 ◽

Vol 55 (4) ◽

pp. 264-280

Author(s):

Hülya Ertekin ◽

Sema Uysal ◽

Memduha Aydın ◽

Bilge İlhan ◽

Yusuf Haydar Ertekin

Keyword(s):

Metabolic Syndrome ◽

Plasma Levels ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Metabolic Parameters ◽

Healthy Controls ◽

Positive Correlation ◽

Syndrome Scale ◽

Positive Correlations ◽

Negative Syndrome

Objective Metabolic abnormalities such as diabetes, dyslipidemia, abdominal obesity, metabolic syndrome, and abnormal levels of plasma adipokines have been observed in patients with schizophrenia. This study aimed to investigate the differences and correlations of plasma vaspin levels with metabolic parameters in patients with schizophrenia and to compare with healthy controls. Method We measured plasma levels of vaspin and metabolic parameters of 100 patients with schizophrenia and 95 healthy controls. Patients with schizophrenia were evaluated with the Positive and Negative Syndrome Scale (PANSS) and The Global Assessment of Functioning. Results Mean levels of body mass index, waist circumference, triglyceride, and low-density lipoprotein cholesterol of the patients were statistically higher than those of the healthy controls (p = 0.002, p < 0.001, p = 0.03, and p = 0.002, respectively). Plasma levels of vaspin were 0.96 ± 0.73 ng/ml in patients with schizophrenia and 0.29 ± 0.15 ng/ml in the healthy controls (p < 0.001). Plasma vaspin levels were statistically higher in patients with schizophrenia than healthy controls both in groups with and without metabolic syndrome and obesity (p < 0.001). Plasma vaspin levels showed a positive correlation with triglyceride in patients with schizophrenia (r = 0.26, p = 0.007). There were positive correlations between vaspin and PANSS scores in schizophrenia patients with obesity (PANSS Positive: r = 0.42, p = 0.01; PANSS Negative: r = 0.42, p = 0.01; PANSS General: r = 0.43, p = 0.01; PANSS Total: r = 0.47, p = 0.006). Conclusions Our study showed a significant relationship and positive correlation between vaspin and PANSS scores in schizophrenia patients with obesity. Vaspin may play an important role in the metabolic processes of patients with schizophrenia.

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Influence ofNRGNrs12807809 polymorphism on symptom severity in individuals with schizophrenia in the Han population but not the Zhuang population of south China

Acta Neuropsychiatrica ◽

10.1017/neu.2015.13 ◽

2015 ◽

Vol 27 (4) ◽

pp. 221-227 ◽

Cited By ~ 7

Author(s):

Li Su ◽

Jianxiong Long ◽

Runde Pan ◽

Xinfeng Xie ◽

Xixiang Mao ◽

...

Keyword(s):

South China ◽

Clinical Symptoms ◽

Subscale Score ◽

Assay Method ◽

Psychotic Symptoms ◽

Han Population ◽

Syndrome Scale ◽

General Activation ◽

Negative Syndrome ◽

Pooled Samples

BackgroundNRGNis one of the most promising candidate genes for schizophrenia based on function and position. Therefore, this study aimed to examine the genetic association of this polymorphism with schizophrenia in the Zhuang and Han populations of south China.Subjects and methodsA total of 282 patients (188 Han and 94 Zhuang) and 282 healthy subjects (188 Han and 94 Zhuang) were recruited. Of these, 246 schizophrenia patients underwent an assessment of psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS). A TaqMan genotyping assay method was used to determine the genotypes.ResultsWe did not find a significant association of rs12807809 polymorphism with schizophrenia in the total pooled samples, or in the separate ethnic groups. However, in Han schizophrenia patients, quantitative data analyses showed that the CC genotype of the rs12807809 polymorphism was associated with PANSS aggression subscale score and activation subscale score. Furthermore, carriers of the C allele of rs12807809 polymorphism among Han schizophrenia patients had higher scores of general, activation, depression, aggression, and global symptoms than the T allele carriers.ConclusionIn conclusion rs12807809 polymorphism may not contribute to the risk of schizophrenia but influence the clinical symptoms of schizophrenia in the Han population.

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Nicotine dependence and illness severity in schizophrenia

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.107953 ◽

2012 ◽

Vol 201 (4) ◽

pp. 306-312 ◽

Cited By ~ 53

Author(s):

Rajeev Krishnadas ◽

Sameer Jauhar ◽

Susan Telfer ◽

Somashekara Shivashankar ◽

Robin G. McCreadie

Keyword(s):

Nicotine Dependence ◽

Social Adjustment ◽

Symptom Severity ◽

Clinical Symptoms ◽

Cross Sectional ◽

Syndrome Scale ◽

Never Smokers ◽

Negative Syndrome ◽

The Relationship ◽

Higher Doses

BackgroundReasons for the increased prevalence of cigarette smoking in schizophrenia are unclear. Studies assessing clinical symptoms have sampled heterogeneous populations, with discrepant findings.AimsTo examine the relationship between clinical features, social adjustment and nicotine dependence in a geographically defined population of people with schizophrenia.MethodCross-sectional clinical study of 131 people with schizophrenia in Nithsdale, Scotland.ResultsSmokers were younger, mostly males and three times more likely to be unemployed. Those with severe nicotine dependence had greater scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS), and were prescribed higher doses of antipsychotic. Those with mild–moderate dependence had greater scores on the PANSS negative subscale. Greater symptom severity was associated with poorer social adjustment. Psychopathology and social adjustment were similar in quitters and never-smokers.ConclusionsOur findings indicate an association between nicotine dependence, clinical symptoms and social adjustment in schizophrenia. Although causal links cannot be inferred, identifying the relationship between nicotine dependence and psychopathology may have some value in the management of smoking in schizophrenia. Further longitudinal studies are required to explore this relationship.

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Duration Mismatch Negativity Predicts Remission in First-Episode Schizophrenia Patients

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.777378 ◽

2021 ◽

Vol 12 ◽

Author(s):

Suguru Nakajima ◽

Yuko Higuchi ◽

Takahiro Tateno ◽

Daiki Sasabayashi ◽

Yuko Mizukami ◽

...

Keyword(s):

Social Functioning ◽

Mismatch Negativity ◽

Rating Scale ◽

Clinical Symptoms ◽

First Episode ◽

Healthy Controls ◽

Brief Assessment ◽

Syndrome Scale ◽

Symptomatic Remission ◽

First Episode Schizophrenia

Objective: Remission in schizophrenia patients is associated with neurocognitive, social, and role functioning during both the early and chronic stages of schizophrenia. It is well-established that the amplitudes of duration mismatch negativity (dMMN) and frequency MMN (fMMN) are reduced in schizophrenia patients. However, the potential link between MMN and remission has not been established. In this study, we investigated the relationship between MMNs and remission in first-episode schizophrenia (FES) and their association with neurocognitive and social functioning.Method: dMMN and fMMN were measured in 30 patients with FES and 22 healthy controls at baseline and after a mean of 3 years. Clinical symptoms and cognitive and social functioning in the patients were assessed at the time of MMN measurements by using the Positive and Negative Syndrome Scale (PANSS), modified Global Assessment of Functioning (mGAF), Schizophrenia Cognition Rating Scale (SCoRS), and the Brief Assessment of Cognition in Schizophrenia (BACS). Remission of the patients was defined using the criteria by the Remission in Schizophrenia Working Group; of the 30 patients with FES, 14 achieved remission and 16 did not.Results: Baseline dMMN amplitude was reduced in FES compared to healthy controls. Further, baseline dMMN in the non-remitters had decreased amplitude and prolonged latency compared to the remitters. MMN did not change during follow-up period regardless of parameters, diagnosis, or remission status. Baseline dMMN amplitude in FES was correlated with future SCoRS and PANSS total scores. Logistic regression analysis revealed that dMMN amplitude at baseline was a significant predictor of remission.Conclusions: Our findings suggest that dMMN amplitude may be a useful biomarker for predicting symptomatic remission and improvement of cognitive and social functions in FES.

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Abnormally low prolactin levels in schizophrenia patients after switching to aripiprazole in a randomized trial: a biomarker for rebound in psychotic symptoms?

BMC Psychiatry ◽

10.1186/s12888-020-02957-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Ya-Wen Jen ◽

Tzung-Jeng Hwang ◽

Hung-Yu Chan ◽

Ming H. Hsieh ◽

Chen-Chung Liu ◽

...

Keyword(s):

Prolactin Level ◽

Age At Onset ◽

Psychotic Symptoms ◽

Warning Sign ◽

Multivariable Logistic Regression Analysis ◽

Early Age ◽

Positive Symptoms ◽

Cumulative Proportion ◽

Syndrome Scale ◽

Negative Syndrome

Abstract Background Switching to aripiprazole from other antipsychotics can avoid antipsychotic-induced hyperprolactinemia but may result in an abnormally low prolactin level. This study aimed to assess whether the aripiprazole-induced abnormally low prolactin level was a biomarker for subsequent rebound of positive symptoms in schizophrenia patients. Methods Participants were 63 patients in an 8-week trial of switching to aripiprazole, in which preswitching antipsychotics were maintained for the first 2 weeks and aripiprazole was fixed at 15 mg orally throughout the trial. A prolactin level of < 3.7 ng/ml was defined as abnormally low, and an increase of two or more points in the positive subscore of the Positive and Negative Syndrome Scale at two adjacent ratings was defined as a psychotic rebound. Results Among 63 patients, 25 (39.7%) had an abnormally low prolactin level and 21 (33.3%) had a psychotic rebound after switching to aripiprazole. In patients with abnormally low prolactin levels, 48.0% of them had a rebound in psychotic symptoms, whereas in those without abnormally low prolactin levels 23.7% did so. Multivariable logistic regression analysis with adjustment for sex, early age at onset, and preswitching medications revealed that abnormally low prolactin levels were associated with psychotic rebound (adjusted odds ratio = 3.55, 95% confidence interval = 1.02, 12.5). Furthermore, there was concurrency between the trend of the cumulative proportion of patients having an abnormally low prolactin level and that of the cumulative proportion of patients having a rebound in psychotic symptoms. Conclusions An abnormally low prolactin level after switching to aripiprazole in schizophrenia patients was a potential warning sign of a psychotic rebound. Hence, monitoring of prolactin levels after switching to aripiprazole may help avoid such rebound in schizophrenia. Trial registration NCT00545467; Date of registration: 17/10/2007.

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Cognitive Group Therapy for Paranoid Schizophrenics: Applying Cognitive Dissonance

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.12.1.3 ◽

1998 ◽

Vol 12 (1) ◽

pp. 3-12 ◽

Cited By ~ 25

Author(s):

Joseph Levine ◽

Yoram Barak ◽

Ilana Granek

Keyword(s):

Group Therapy ◽

Cognitive Dissonance ◽

Control Group ◽

Positive Symptoms ◽

Wide Acceptance ◽

Syndrome Scale ◽

Schizophrenic Patients ◽

Supportive Group ◽

Negative Syndrome

Psychotherapy with paranoid schizophrenics is a hard and often unrewarding task. Individual and group therapies are usually supportive only and are not aimed at changing the paranoid mode of thinking. Although cognitive therapy has been applied in schizophrenic patients, it has not gained wide acceptance. Cognitive dissonance postulates that individuals experience discomfort and tension when holding two dissonant beliefs simultaneously. We here present the group therapy of six schizophrenic paranoids treated by modified cognitive group therapy implementing cognitive dissonance as the vector of change. A control group of six age- and sex-matched paranoid schizophrenics was treated by supportive group therapy. Analysis of the results, using the Positive and Negative Syndrome Scale (PANSS), during therapy and at follow-up of 4 weeks demonstrates statistically significant improvement in total PANSS score as well as in the positive symptoms subscale.

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