scholarly journals Neurocognitive effects of six ketamine infusions and the association with antidepressant effects in treatment-resistant bipolar depression: a preliminary study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10208
Author(s):  
Wei Zheng ◽  
Yan-Ling Zhou ◽  
Cheng-Yu Wang ◽  
Xiao-Feng Lan ◽  
Bin Zhang ◽  
...  
Keyword(s):  
Working Memory ◽  
Bipolar Depression ◽  
Visual Learning ◽  
Verbal Learning ◽  
Depression Symptoms ◽  
Speed Of Processing ◽  
Treatment Resistant ◽  
Observational Period ◽  
Preliminary Study ◽  
Over Time

Objective The N-methyl-D-aspartate subtype glutamate receptor antagonist ketamine has rapid antidepressant and antisuicidal effects in treating treatment-resistant bipolar depression (TRBD). The neurocognitive effects of repeated ketamine infusions in TRBD are not known. Methods Six intravenous infusions of ketamine (0.5 mg/kg over 40 min) were administered on a Monday–Wednesday–Friday schedule during a 12-day period on 16 patients with TRBD followed by a 2-week observational period. The assessment of neurocognitive function was conducted using the MATRICS Consensus Cognitive Battery at baseline, 13 and 26 days. Tasks were designed to test speed of processing, working memory, visual learning and verbal learning. Results A significant improvement was found only in scores of speed of processing (F = 9.9, p = 0.001) after a 2-week observational period, which was accounted for by the improvement of depression symptoms. There were no significant changes over time in terms of working memory, visual learning and verbal learning. Pearson correlation analysis showed that the improvement of depression symptoms through six ketamine infusions was greater among TRBD patients with lower working memory at baseline (r = 0.54, p = 0.03). In multiple regression analysis, the significant correlation was still maintained (beta = 0.67, t = 2.2, p = 0.04). Conclusion This preliminary study indicated that six ketamine infusions were not harmful but were slightly beneficial for speed of processing in TRBD. However, this change was mainly accounted for the improvement of depression symptoms over time. Lower baseline working memory appears to be associated with greater antidepressant response after completion of six ketamine infusions in patients with TRBD.

scholarly journals Latent structure of cognition in schizophrenia: a confirmatory factor analysis of the MATRICS Consensus Cognitive Battery (MCCB)

2015 ◽  
Vol 45 (12) ◽  
pp. 2657-2666 ◽  
Author(s):  
A. McCleery ◽  
M. F. Green ◽  
G. S. Hellemann ◽  
L. E. Baade ◽  
J. M. Gold ◽  
...  
Keyword(s):  
Working Memory ◽  
Factor Analysis ◽  
Confirmatory Factor Analysis ◽  
Factor Model ◽  
Visual Learning ◽  
Verbal Learning ◽  
Speed Of Processing ◽  
Confirmatory Factor ◽  
Correlated Factors ◽  
Cognitive Dimensions

BackgroundThe number of separable cognitive dimensions in schizophrenia has been debated. Guided by the extant factor analytic literature, the NIMH Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative selected seven cognitive domains relevant to treatment studies in schizophrenia: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. These domains are assessed in the MATRICS Consensus Cognitive Battery (MCCB). The aim of this study was to conduct a confirmatory factor analysis (CFA) of the beta battery of the MCCB to compare the fit of the MATRICS consensus seven-domain model to other models in the current literature on cognition in schizophrenia.MethodUsing data from 281 schizophrenia outpatients, we compared the seven correlated factors model with alternative models. Specifically, we compared the 7-factor model to (a) a single-factor model, (b) a three correlated factors model including speed of processing, working memory, and general cognition, and (c) a hierarchical model in which seven first-order factors loaded onto a second-order general cognitive factor.ResultsMultiple fit indices indicated the seven correlated factors model was the best fit for the data and provided significant improvement in model fit beyond the comparison models.ConclusionsThese results support the assessment of these seven cognitive dimensions in clinical trials of interventions to improve cognition in schizophrenia. Because these cognitive factors are separable to some degree, it is plausible that specific interventions may have differential effects on the domains.

scholarly journals Association between plasma homocysteine levels and cognitive deficits in Han Chinese patients with schizophrenia across age groups

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sumiao Zhou ◽  
Yuanyuan Huang ◽  
Yangdong Feng ◽  
Hehua Li ◽  
Kai Wu ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Function ◽  
Learning And Memory ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Verbal Learning ◽  
Age Groups ◽  
Speed Of Processing ◽  
Function Score ◽  
Cognitive Function Score

AbstractIt was still unclear how homocysteine (Hcy) levels and cognitive deficits change in patients with schizophrenia of various ages. The present article attempts to assess the relationship between Hcy levels and cognitive deficits in patients with schizophrenia across age groups, especially in young people. Totals of 103 patients and 122 healthy controls were included. All participants were stratified into four groups according to their age: 18–29 years, 30–39 years, 40–49 years, and 50–59 years. Clinical data, plasma Hcy levels, and cognitive function score were collected. Cognitive function was evaluated using the MATRICS Consensus Cognitive Battery of tests assessing speed of processing, verbal learning and memory, visual learning and memory, working memory, and attention/vigilance. Compared with the healthy group, Hcy levels increased significantly, and all the measured cognitive function score were significantly lower in all age groups of patients with schizophrenia (p < 0.001). Hcy levels were negatively associated with speed of processing (SoP), working memory (WM), and visual learning and memory (Vis Lrng) score in 18–29 years. Further multiple regression analysis showed that SoP were independently associated with Hcy levels in patients with schizophrenia aged 18–29 years (B = 0.74, t = 3.12, p = 0.008). Based on our results, patients with schizophrenia performed worse on cognitive assessments and Hcy levels were more closely related to cognition in young patients.

scholarly journals Association Between Plasma Homocysteine Levels and Cognitive Deficits in Han Chinese Patients with Schizophrenia across Age Groups

2021 ◽  
Author(s):  
Sumiao Zhou ◽  
Yuanyuan Huang ◽  
Yangdong Feng ◽  
Hehua Li ◽  
Kai Wu ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Function ◽  
Learning And Memory ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Verbal Learning ◽  
Age Groups ◽  
Speed Of Processing ◽  
Function Score ◽  
Cognitive Function Score

Abstract Background: It was still unclear how homocysteine (Hcy) levels and cognitive deficits change in patients with schizophrenia of various ages. The present article attempts to assess the relationship between Hcy levels and cognitive deficits in patients with schizophrenia across age groups, especially in young people.Methods: Totals of 103 patients and 122 healthy controls were included. All participants were stratified into four groups according to their age: 18-29 years, 30-39 years, 40-49 years, and 50-59 years. Clinical data, plasma Hcy levels, and cognitive function score were collected. Cognitive function was evaluated using the MATRICS Consensus Cognitive Battery of tests assessing speed of processing, verbal learning and memory, visual learning and memory, working memory, and attention/vigilance.Results: Compared with the healthy group, Hcy levels increased significantly, and all the measured cognitive function score were significantly lower in all age groups of patients with schizophrenia (p < 0.001). Hcy levels were negatively associated with speed of processing (SoP), working memory (WM), and visual learning and memory (Vis Lrng) score in 18-29 years. Further multiple regression analysis showed that SoP were independently associated with Hcy levels in patients with schizophrenia aged 18-29 years (B = 0.61, t = 3.17, p = 0.013).Conclusions: Based on our results, patients with schizophrenia performed worse on cognitive assessments and Hcy levels were more closely related to cognition in young patients.

scholarly journals M59. THE ASSOCIATIONS BETWEEN THEORY OF MIND AND NEUROCOGNITION IN RECENT ONSET PSYCHOSIS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S157-S157
Author(s):  
Élisabeth Thibaudeau ◽  
William Pothier ◽  
Andréanne Lavoie ◽  
Mélissa Turcotte ◽  
Amélie M Achim ◽  
...  
Keyword(s):  
Working Memory ◽  
Problem Solving ◽  
Theory Of Mind ◽  
Executive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
Mental States ◽  
Speed Of Processing ◽  
Recent Onset ◽  
Reasoning Problem

Abstract Background Deficits in theory of mind (ToM), the ability to infer the mental states of others, are common in psychotic disorders and are associated with functioning difficulties. While ToM is a social cognitive process, several neurocognitive processes are involved when inferring the mental states of others. A better understanding of the associations between ToM and neurocognitive domains could help better target treatment for ToM in schizophrenia. A recent meta-analysis has revealed that all neurocognitive domains are moderately associated with ToM in schizophrenia, but very few studies have looked at these associations in recent onset psychosis. These studies showed associations between ToM and speed of processing, episodic memory and executive functions although few neurocognitive domains have been assessed in each study. The aim of this study was to determine the associations between ToM and the key neurocognitive domains in recent onset psychosis. Methods These results are part of a larger study that aimed to determine the cognitive predictors of return to work or school in recent onset psychosis. Twenty-seven recent onset psychosis patients were recruited for this study, with a mean age of 24.9 years. The clinical assessment included the Combined Stories Test for ToM and the Matrics Consensus Cognitive Battery (MCCB) for neurocognition. The MCCB assesses the key cognitive domains relevant for schizophrenia, including attention/vigilance, speed of processing, working memory, verbal learning, visual learning, reasoning/problem solving and social cognition. Pearson correlations were conducted between the ToM scores of the Combined Stories Test and each neurocognitive domain of the MCCB. Results Correlations revealed a moderate to strong association between ToM and working memory (r = 0.443, p = 0.021), visual learning (r = 0.493, p = 0.009) and verbal learning (r = 0.443, p = 0.021). The correlations between ToM and attention/vigilance, speed of processing and reasoning/problem solving were not significant (p &gt; 0.05). Discussion This is the first study that has assessed the associations between ToM and the neurocognitive domains of the MCCB in recent onset psychosis. This study did not show association between ToM and speed of processing nor executive functions, but rather with working memory and learning. These contradictory results could be explained by the large heterogeneity of tasks used across studies, particularly ToM tasks that often present with psychometric limitations such as ceiling effect. Learning processes highlighted here should be considered in the understanding of the therapeutic response following a cognitive remediation therapy for ToM in recent onset psychosis.

Evaluation of Cognitive Dysfunction in a Sample of Patients Affected by Bipolar Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S212-S212
Author(s):  
E. Stella ◽  
M. La Montagna ◽  
L. Borraccino ◽  
F. Ricci ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Working Memory ◽  
Problem Solving ◽  
Verbal Memory ◽  
Visual Learning ◽  
Verbal Learning ◽  
Healthy Controls ◽  
Speed Of Processing ◽  
Cognitive Disturbances ◽  
Competing Interest

IntroductionCognitive dysfunctions concerning working memory, attention, psychomotor speed, and verbal memory are a disabling feature of the bipolar disorder (BD). According to scientific literature, cognitive disturbances are present not only in depressive and manic phases of BD, but also during the euthymic period, without regard to whether or not drugs are assumed.ObjectiveTo determine the presence of one or more dysfunctions in cognitive domains in a sample of subjects suffering from BD, in euthymic phase, compared with healthy controls.AimsEvaluation of the following cognitive performances in subjects affected by BD: speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition.MethodsForty-six patients affected by BD in the euthymic phase (mean age: 43.17 years old; 39.13% male), and 58 healthy controls (mean age: 39.21 years old; 51.72% male) were enrolled in the psychiatric unit of Azienda Sanitaria Locale, Foggia. The neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained psychiatrists.ResultsWe found the presence of cognitive impairment, affecting six out of seven of cognitive functions assessed (P < 0.001): speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving.ConclusionsThese preliminary results from our case-control study show that cognitive deficits are clearly present also during the euthymic phases of subjects with bipolar disorder (mainly pertaining attention/vigilance domain). These cognitive abnormalities may represent a biomarker of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neurocognitive effects of six ketamine infusions and the association with antidepressant response in patients with unipolar and bipolar depression

2018 ◽  
Vol 32 (10) ◽  
pp. 1118-1126 ◽  
Author(s):  
Yanling Zhou ◽  
Wei Zheng ◽  
Weijian Liu ◽  
Chengyu Wang ◽  
Yanni Zhan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Bipolar Depression ◽  
Visual Learning ◽  
Verbal Learning ◽  
Speed Of Processing ◽  
Antidepressant Response ◽  
Neurocognitive Impairments ◽  
Post Infusion

Background: Ketamine has proven to have rapid, robust antidepressant effects on treatment-resistant depression. However, whether repeated ketamine infusions would cause short-and long-term neurocognitive impairments was not clear. Our aims were to investigate the neurocognitive effects of six ketamine infusions and to examine the association between these infusions and the antidepressant response in patients with unipolar and bipolar depression. Methods: Six intravenous infusions of ketamine (0.5 mg/kg) over a 12-day period were administered to 84 patients with unipolar and bipolar depression. Severity of depressive symptoms and four domains of neurocognition, including speed of processing, working memory, visual learning and verbal learning, were assessed at baseline, one day following the last infusion and again two weeks post-infusion. Results: Significant improvements were found on speed of processing ( F=9.344, p<0.001) and verbal learning ( F=5.647, p=0.004) in a linear mixed model. The Sobel test showed significant indirect effects between time and improvement in speed of processing (Sobel test=3.573, p<0.001) as well as improvement in verbal learning (Sobel test=6.649, p<0.001), which were both significantly mediated by change in depressive symptoms. Logistic regression analysis showed ketamine responders had better visual learning at baseline than non-responders (B=0.118, p<0.001). Conclusions: Our findings suggest that neurocognitive function would not deteriorate after six ketamine infusions, while verbal learning and speed of processing improved over 13 days and 26 days of observation, respectively. However, this change was mainly accounted for by improvements in severity of depressive symptoms over time. Greater baseline visual learning predicted an antidepressant response over six ketamine infusions.

Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

2020 ◽  
Vol 66 (3) ◽  
pp. 240-248 ◽  
Author(s):  
Afaf Hamed Khalil ◽  
Marwa Abd el-Meguid ◽  
Mostafa Bastawy ◽  
Samah Rabei ◽  
Ramy Ali ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
Cognitive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
General Psychopathology ◽  
Cognitive Domains ◽  
Reasoning Problem ◽  
Egyptian Patients

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

Abnormal dynamic functional connectivity of hippocampal subregions associated with working memory impairment in melancholic depression

2021 ◽  
pp. 1-13
Author(s):  
Lai Shunkai ◽  
Ting Su ◽  
Shuming Zhong ◽  
Guangmao Chen ◽  
Yiliang Zhang ◽  
...  
Keyword(s):  
Working Memory ◽  
Functional Connectivity ◽  
Association Analysis ◽  
Memory Impairment ◽  
Visual Learning ◽  
Verbal Learning ◽  
Anterior Lobe ◽  
Healthy Controls ◽  
Dynamic Functional Connectivity ◽  
Whole Brain

Abstract Background Previous studies have demonstrated structural and functional changes of the hippocampus in patients with major depressive disorder (MDD). However, no studies have analyzed the dynamic functional connectivity (dFC) of hippocampal subregions in melancholic MDD. We aimed to reveal the patterns for dFC variability in hippocampus subregions – including the bilateral rostral and caudal areas and its associations with cognitive impairment in melancholic MDD. Methods Forty-two treatment-naive MDD patients with melancholic features and 55 demographically matched healthy controls were included. The sliding-window analysis was used to evaluate whole-brain dFC for each hippocampal subregions seed. We assessed between-group differences in the dFC variability values of each hippocampal subregion in the whole brain and cognitive performance on the MATRICS Consensus Cognitive Battery (MCCB). Finally, association analysis was conducted to investigate their relationships. Results Patients with melancholic MDD showed decreased dFC variability between the left rostral hippocampus and left anterior lobe of cerebellum compared with healthy controls (voxel p < 0.005, cluster p < 0.0125, GRF corrected), and poorer cognitive scores in working memory, verbal learning, visual learning, and social cognition (all p < 0.05). Association analysis showed that working memory was positively correlated with the dFC variability values of the left rostral hippocampus-left anterior lobe of the cerebellum (r = 0.338, p = 0.029) in melancholic MDD. Conclusions These findings confirmed the distinct dynamic functional pathway of hippocampal subregions in patients with melancholic MDD, and suggested that the dysfunction of hippocampus-cerebellum connectivity may be underlying the neural substrate of working memory impairment in melancholic MDD.

scholarly journals Neurocognitive functioning in bipolar depression: a component structure analysis

2013 ◽  
Vol 44 (5) ◽  
pp. 961-974 ◽  
Author(s):  
P. Gallagher ◽  
J. M. Gray ◽  
S. Watson ◽  
A. H. Young ◽  
I. N. Ferrier
Keyword(s):  
Working Memory ◽  
Learning And Memory ◽  
Test Performance ◽  
Bipolar Depression ◽  
Statistical Significance ◽  
Verbal Learning ◽  
Future Research ◽  
Control Group ◽  
Healthy Controls ◽  
Component Structure

BackgroundPrevious studies of neurocognitive performance in bipolar disorder (BD) have focused predominantly on euthymia. In this study we aimed to compare the neurocognitive profile of BD patients when depressed with healthy controls and explore the component structure of neurocognitive processes in these populations.MethodCognitive tests of attention and executive function, immediate memory, verbal and visuospatial learning and memory and psychomotor speed were administered to 53 patients with a SCID-verified diagnosis of BD depression and 47 healthy controls. Test performance was assessed in terms of statistical significance, effect size and percentile standing. Principal component analysis (PCA) was used to explore underlying cognitive factor structure.ResultsMultivariate analysis revealed an overall group effect, depressed BD patients performing significantly worse than controls. Patients performed significantly worse on 18/26 measures examined, with large effect sizes (d > 0.8) on tests of speed of processing, verbal learning and specific executive/working memory processes. Almost all tests produced at least one outcome measure on which ∼25–50% of the BD sample performed at more than 1 standard deviation (s.d.) below the control mean. Between 20% and 34% of patients performed at or below the fifth percentile of the control group in working memory, verbal learning and memory, and psychomotor/processing speed. PCA highlighted overall differences between groups, with fewer extracted components and less specificity in patients.ConclusionsOverall, neurocognitive test performance is significantly reduced in BD patients when depressed. The use of different methods of analysing cognitive performance is highlighted, along with the relationship between processes, indicating important directions for future research.

Bipolar Disorder, Obesity and Cognitive Impairment

2017 ◽  
Vol 41 (S1) ◽  
pp. S207-S207 ◽  
Author(s):  
M. La Montagna ◽  
E. Stella ◽  
F. Ricci ◽  
L. Borraccino ◽  
A.I. Triggiani ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Problem Solving ◽  
Cognitive Deficits ◽  
Cognitive Functions ◽  
Visual Learning ◽  
Verbal Learning ◽  
Speed Of Processing ◽  
Anthropometric Measures ◽  
Cognitive Domains

IntroductionAccording to scientific literature, cognitive impairment is a disabling feature of the bipolar disorder (BD), present in all the phases of the disease. Obesity and metabolic disorders represent another risk factor for cognitive dysfunctions in BD, since the excess of weight could adversely influence several cognitive domains.ObjectiveTo highlight the presence of impairment of cognitive functions in a sample of subjects suffering from BD and obesity.AimsEvaluation of the cognitive performance in a sample of BD patients, considering their anthropometric measures (height and weight) and body mass index (BMI).MethodsThe neuropsychological battery MATRICS Consensus Cognitive Battery (MCCB) was administered by trained physicians for the evaluation of seven different cognitive domains in 46 patients (mean age: 43.17 years old; 39.13% male), affected by BD enrolled in the psychiatric unit of Azienda Sanitaria Locale and University of Foggia. In particular, cognitive functions assessed were speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. BMI was calculated, and patients were divided into a group of normal weight and another one of overweight or obese, on the base of BMI value (BMI cut-off = 25).ResultsThe obese patients amounted at 56.52%. We have found the presence of cognitive deficits in two of the seven domains assessed, that are speed of processing (P < 0.01) and reasoning and problem solving (P < 0.05) in the sample of overweight patients.ConclusionsCognitive deficits are clearly revealed in BD patients during the euthymic phase of the disorder. The obesity in BD could contribute to increase dysfunctions in cognitive domains.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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