Schizophrenia Research-Cognition最新文献_第7页

Brain functional connectivity associated with cognitive deficits in younger patients at first episode of schizophrenia 年轻精神分裂症首发患者脑功能连通性与认知缺陷相关

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-03-31 DOI: 10.1016/j.scog.2025.100359

Na Liu , Lihua Xu , Xiaofeng Guan , Ansi Qi , Fei Liu , Chengqing Yang , Xiangyun Long , Junjuan Zhu , Nan Huang , Jie Zhang , Yi Xu , Jing Chen , Huan Huang , Jijun Wang , Zheng Lu

Background

Cognitive deficits are a core feature of schizophrenia and are influenced by the age at onset of psychosis. Both preclinical and early-onset schizophrenia patients exhibit abnormalities in the frontal cortex, parahippocampus, precuneus, and hippocampus—regions that are closely associated with cognitive deficits. This study examines whether cognitive-related functional connectivity (FC) within these regions differs in first-episode schizophrenia (FES) patients with varying ages of onset.

Methods

FES patients (ages 18–45, n = 24) and matched healthy controls (HC, n = 29) were divided into younger and older subgroups based on the median age of 25 years: FES_young, FES_older, HC_young, and HC_older. All participants completed the MATRICS Consensus Cognitive Battery (MCCB) and underwent resting-state functional magnetic resonance imaging. FC within regions of interest (ROIs) was analyzed using the CONN toolbox.

Results

Significant cognitive differences were observed between the four groups (H = 13.447, p = 0.004, Rank ε² = 0.259). The most prominent differences were found between the FES_young and HC_young groups (Holm-adjusted p = 0.012). Cognitive deficits in FES patients were significantly associated with reduced FC between the right precuneus (A31_R) and right parahippocampal gyrus (TI_R) (rho = 0.549, p = 0.010, Fisher's z = 0.616). FES_young showed significantly lower FC between A31_R and TI_R compared to HC_young (Holm-adjusted p = 0.001).

Conclusion

Earlier onset schizophrenia is associated with more severe cognitive deficits and specific impairments in brain functional connectivity. These findings highlight the importance of considering age of onset when assessing cognitive and neural dysfunction in schizophrenia.

背景认知缺陷是精神分裂症的核心特征，并受精神病发病年龄的影响。临床前和早发性精神分裂症患者都表现出额叶皮质、副海马体、楔前叶和海马体的异常，这些区域与认知缺陷密切相关。本研究探讨了不同发病年龄的首发精神分裂症（FES）患者在这些区域的认知相关功能连接（FC）是否存在差异。方法sfes患者（18-45岁，n = 24）和匹配的健康对照（HC, n = 29）按中位年龄（25岁）分为FES_young、FES_older、HC_young和HC_older两组。所有的参与者都完成了矩阵共识认知电池（MCCB），并进行了静息状态功能磁共振成像。使用CONN工具箱分析感兴趣区域（roi）内的FC。结果四组患者认知能力差异有统计学意义（H = 13.447, p = 0.004, Rank ε2 = 0.259）。FES_young组和HC_young组之间的差异最为显著（经holm校正p = 0.012）。FES患者的认知缺陷与右侧楔前叶（A31_R）和右侧海马旁回（TI_R）之间的FC减少显著相关（rho = 0.549, p = 0.010, Fisher’s z = 0.616）。与HC_young相比，FES_young显示A31_R和TI_R之间的FC显著降低（经holm校正p = 0.001）。结论早发性精神分裂症与更严重的认知缺陷和脑功能连接特异性损伤相关。这些发现强调了在评估精神分裂症的认知和神经功能障碍时考虑发病年龄的重要性。

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引用次数: 0

Impaired non-verbal auditory memory maintenance in schizophrenia: An ERP study 精神分裂症非言语记忆维持受损：一项ERP研究

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-04-17 DOI: 10.1016/j.scog.2025.100362

Lei Liu , Wenyang Han , Juntao Yu , Lingna Lou , Dewen Zhou , Liang Li , Peng Xu , Feng Zou

Individuals with schizophrenia (SZ) exhibit deficits in speech perception in noise, which are closely related to their abnormalities in auditory working memory (WM). Auditory WM, especially the non-verbal auditory WM, serves as a bridge between perception, action, and long-term memory, playing a crucial role in integrating sound sequences to facilitate auditory object perception and auditory scene analysis (ASA). Although considerable research has been conducted on auditory sensory memory and visual WM in schizophrenia, studies specifically addressing non-verbal auditory WM remain scarce. Therefore, this study recorded the behavioral performance and event related potentials of 36 SZ and 36 healthy controls (HC) during a modified non-musical tone-sequence delayed matching-to-sample task (DMTS). The results showed that, in the tone-sequence DMTS, SZ had not only lower accuracy but also slower reaction times compared to the HC. More importantly, during the retention period, the memory maintenance of SZ begins to decay rapidly from the mid-stage, manifested by a significantly reduction in the late sustained anterior negativity (SAN2). Meanwhile, the early sustained anterior negativity (SAN1) in patients showed a significant correlation with their general pathological symptoms. The pathological symptoms can be predicted by the SAN1 under load 4 condition. This study provides empirical evidence for the impairment of non-verbal auditory WM maintenance in schizophrenia, which is of significant importance for understanding the auditory dysfunction and ASA difficulties experienced by SZ.

精神分裂症患者在噪声环境下的言语感知缺陷与其听觉工作记忆（WM）异常密切相关。听觉WM，尤其是非言语听觉WM，是连接感知、动作和长期记忆的桥梁，在整合声音序列以促进听觉对象感知和听觉场景分析（ASA）中起着至关重要的作用。尽管对精神分裂症患者的听觉记忆和视觉脑损伤进行了大量的研究，但专门针对非言语听觉脑损伤的研究仍然很少。因此，本研究记录了36名SZ和36名健康对照（HC）在改进的非音乐音调序列延迟匹配-样本任务（DMTS）中的行为表现和事件相关电位。结果表明，在音调序列DMTS中，与HC相比，SZ不仅准确率较低，而且反应时间较慢。更重要的是，在保留期，SZ的记忆维持从中期开始迅速衰退，表现为后期持续前负性（SAN2）的显著减少。同时，患者早期持续前路阴性（SAN1）与其一般病理症状有显著相关性。负荷4条件下，SAN1可以预测病理症状。本研究为精神分裂症非言语听觉WM维持障碍提供了经验证据，对理解SZ的听觉功能障碍和ASA困难具有重要意义。

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引用次数: 0

The glare illusion in individuals with schizophrenia 精神分裂症患者的眩光错觉

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-05-19 DOI: 10.1016/j.scog.2025.100366

Hideki Tamura , Aiko Hoshino

Individuals with schizophrenia are known to display unique reactions to visual illusions, and prior research has indicated a potential link between their increased susceptibility to geometric illusions and specific symptom profiles. While various illusory experiences have been examined among individuals with schizophrenia, their responses to brightness-related illusions remain poorly understood. In this study, we investigated how individuals with schizophrenia perceive the glare illusion, in which the apparent brightness of the central region is increased. A total of 30 patients with schizophrenia and 34 control participants were recruited. During each trial, a glare or control image (standard stimulus) was presented alongside a control image (comparison stimulus) with one of seven luminance levels. In the glare condition, the standard stimulus was a glare image; in the control condition, two control images were presented, but only the luminance of the comparison stimulus varied. The participants were asked to judge which central region appeared brighter. The results revealed that individuals with schizophrenia exhibited greater susceptibility to the glare illusion than did the control participants. However, no significant associations were found between susceptibility to the glare illusion and scores assessing symptom severity. These findings suggest that differences in visual processing in patients with schizophrenia may increase their susceptibility to brightness illusions, although this phenomenon is independent of symptom characteristics. This information may provide a basis for exploring illusion susceptibility as a potential behavioral index for distinguishing between individuals with schizophrenia and control participants.

众所周知，精神分裂症患者对视觉错觉表现出独特的反应，先前的研究表明，他们对几何错觉的易感性增加与特定症状之间存在潜在的联系。虽然对精神分裂症患者的各种幻觉经历进行了研究，但他们对与亮度相关的幻觉的反应仍然知之甚少。在这项研究中，我们调查了精神分裂症患者如何感知眩光错觉，其中中央区域的表观亮度增加。总共招募了30名精神分裂症患者和34名对照参与者。在每次试验中，一个眩光或对照图像（标准刺激）与一个具有七个亮度水平之一的对照图像（比较刺激）一起呈现。眩光条件下，标准刺激为眩光图像；在控制条件下，呈现两幅对照图像，但只有比较刺激的亮度发生变化。参与者被要求判断哪个中心区域看起来更亮。结果显示，精神分裂症患者比对照组更容易出现眩光错觉。然而，在对眩光错觉的易感性和评估症状严重程度的得分之间没有发现显著的关联。这些发现表明，精神分裂症患者的视觉加工差异可能会增加他们对亮度错觉的易感性，尽管这种现象与症状特征无关。这些信息可能为探索幻觉易感性作为区分精神分裂症个体和对照组参与者的潜在行为指标提供基础。

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引用次数: 0

Cognition as a predictor of social network size and early communication in clinically high risk for psychosis individuals 认知作为精神病临床高危个体社会网络大小和早期沟通的预测因子

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-05-08 DOI: 10.1016/j.scog.2025.100365

Nashya Linares , Danielle N. Pratt , Katherine S.F. Damme , Vijay A. Mittal

Social networks provide critical support, yet individuals at clinical high-risk for psychosis (CHR) often experience deficits in social functioning and have smaller networks compared to healthy controls (HCs). Cognitive impairment, a hallmark characteristic of this group, may be associated with these challenges. This study is the first investigation into the relationships between general and specific domains of cognition and social network and communication abilities in people at CHR. The sample included 91 participants (HC = 43, CHR = 48) with complete cognitive and social network assessments from the same visit, with additional analyses including guardian ratings of social responsiveness and communication. Cognitive ability was significantly associated with social network size in both groups (b = 0.38, p < .0001), with significant contributions from working memory (b = 0.29, p = .004), speed of processing (b = 0.23, p = 002), verbal learning (b = 0.24, p = .007), and social cognition (b = 0.25, p = .012). Higher scores on cognitive functioning correlated with better social reciprocity (b = 1.28, p = .009) and fewer communication difficulties (b = 0.25, p < .002). Processing speed was particularly relevant to both social responsiveness (b = 0.88, p < .022) and communication difficulties (b = 0.12, p < .03). An interaction effect revealed that associations between cognitive ability on communication skills were more pronounced in CHR individuals compared to HCs (b = 0.26, p < .037). These findings underscore the potential role of specific cognitive domains, such as processing speed, in social functioning among CHR individuals. Future research should examine the directionality of these relationships to better understand underlying mechanisms of social functioning impairments and inform treatment development.

社会网络提供了关键的支持，然而临床精神病高危人群（CHR）往往经历社会功能缺陷，与健康对照组（hc）相比，他们的社会网络更小。认知障碍，这一群体的一个标志性特征，可能与这些挑战有关。本研究首次调查了CHR人员的一般认知和特定认知领域与社会网络和沟通能力之间的关系。样本包括91名参与者（HC = 43, CHR = 48），他们在同一次访问中进行了完整的认知和社会网络评估，并进行了额外的分析，包括监护人对社会反应性和沟通的评分。两组的认知能力与社会网络规模显著相关(b = 0.38, p <；.0001)，其中工作记忆（b = 0.29, p = 0.004）、加工速度（b = 0.23, p = 002）、言语学习（b = 0.24, p = 0.007）和社会认知（b = 0.25, p = 0.012）的贡献显著。认知功能得分越高，社会互惠性越好（b = 1.28, p = 0.009），沟通困难越少(b = 0.25, p <；.002)。处理速度与社会反应特别相关(b = 0.88, p <；.022)和沟通困难(b = 0.12, p <；03)。交互效应显示，认知能力与沟通技巧之间的关联在高智商人群中更为显著(b = 0.26, p <；.037)。这些发现强调了特定认知领域的潜在作用，如处理速度，在CHR个体的社会功能中。未来的研究应该检查这些关系的方向性，以更好地了解社会功能障碍的潜在机制，并为治疗发展提供信息。

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引用次数: 0

Effects of modifying the pulse width on cognitive side effects with electroconvulsive therapy for schizophrenia 调整脉冲宽度对精神分裂症电休克治疗认知副作用的影响

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-05-24 DOI: 10.1016/j.scog.2025.100369

Qi Si , Yingbo Dong , Yuting Li , Guoxin Xu , Yilin Tang , Peiyu Cao , Congxin Chen , Fangfang Ren , Runda Li , Yuxiu Sui

Background

The majority of studies have shown substantially reduced cognitive impairment with ultra-brief pulse (UBP) electroconvulsive therapy (ECT) compared to brief pulse (BP) ECT, though the results remain inconclusive.

Methods

This study employed a randomized, double-blind, controlled trial design. A total of 114 patients with schizophrenia (SCZ) were enrolled and received BP ECT (63 participants) or UBP ECT (51 participants). Cognitive function was assessed before and after treatment, with peripheral blood biomarkers and hippocampal magnetic resonance spectroscopy (MRS) data collected concurrently.

Results

No significant baseline differences in demographic or clinical characteristics were observed between the two groups. After the end of ECT sessions, the UBP group and BP group respectively showed advantages in the Trail Making Test (TMT) and Hopkins Verbal Learning Test (HVLT). No between-group differences reached statistical significance in other cognitive tests. The homocysteine, prolactin, inducible nitric oxide synthase and left hippocampal myoinositol (MI) levels were significantly elevated in the UBP group than those in the BP group. Multiple linear regression analysis indicated that right hippocampal MI levels were positively correlated with TMT scores.

Conclusion

There are no significant differences in efficacy between UBP ECT at high-dosage and BP ECT, and further research is required to determine whether this modality can reduce cognitive impairment after treatment.

Clinical trial registration

https://www.chictr.org.cn/showproj.html?proj=243964, registration number: ChiCTR2400091601.

大多数研究表明，与短脉冲（BP）电痉挛治疗相比，超短脉冲（UBP）电痉挛治疗（ECT）大大减少了认知障碍，尽管结果仍不确定。方法采用随机、双盲、对照试验设计。共有114名精神分裂症患者（SCZ）被纳入研究，并接受了BP ECT（63名参与者）或UBP ECT（51名参与者）。治疗前后评估认知功能，同时收集外周血生物标志物和海马磁共振波谱（MRS）数据。结果两组患者在人口学和临床特征方面无显著基线差异。电刺激结束后，UBP组和BP组分别在造径测试（TMT）和霍普金斯语言学习测试（HVLT）中表现出优势。其他认知测试组间差异无统计学意义。UBP组大鼠同型半胱氨酸、催乳素、诱导型一氧化氮合酶和左海马肌醇（MI）水平显著高于BP组。多元线性回归分析表明，右侧海马MI水平与TMT评分呈正相关。结论高剂量UBP ECT与BP ECT的疗效无显著差异，该方式是否能减轻治疗后认知功能障碍仍需进一步研究。临床试验注册https://www.chictr.org.cn/showproj.html?proj=243964，注册号：ChiCTR2400091601。

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引用次数: 0

Cognitive changes in schizophrenia before and after illness onset: A meta-analysis examining consistency in measurement tools as a moderator 精神分裂症发病前后的认知变化：一项检验测量工具一致性作为调节因素的荟萃分析

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-09-01 Epub Date: 2025-06-02 DOI: 10.1016/j.scog.2025.100371

Noaz Cohen , Mark Weiser , Abraham Reichenberg , John M. Davis , Michael Davidson , Nomi Werbeloff

Background

Cognitive impairment, a core feature of schizophrenia, is often evident before the onset of illness. The current study aimed to quantify IQ decline following the onset of illness by conducting a meta-analysis of longitudinal studies that evaluated cognitive functioning both before and after the first psychotic episode. Consistency in measurement tools – i.e. whether the same measurement tool was used at both assessments – was considered a potential moderating variable.

Method

Eleven studies were included in the meta-analysis - seven using the same measurement tool at both time-points and four using different tools. In addition, meta-regression explored whether the magnitude of IQ decline was associated with age at baseline.

Results

The meta-analysis effect size was −0.343 (95 % CI: −0.503 to −0.184), equivalent to a decrease of 5 IQ points. Use of the same (SMD −0.321, 95 % CI: −0.501 to −0.142) vs different (SMD −0.427, 95 % CI: −0.777 to −0.077) measurement tools was not a moderator of IQ change (p = 0.279). The meta-regression results were not significant (p = 0.544).

Conclusion

The current meta-analysis indicates a slight cognitive decline from the premorbid stage to post-onset. The use of different measurement tools yielded a slightly larger effect size and greater heterogeneity, suggesting that employing the same assessment tool could lead to more accurate results. Future longitudinal studies should focus on determining the timeline of cognitive decline.

认知障碍是精神分裂症的一个核心特征，通常在发病前就很明显。目前的研究旨在通过对纵向研究进行荟萃分析，评估首次精神病发作前后的认知功能，从而量化疾病发作后的智商下降。测量工具的一致性——即在两次评估中是否使用相同的测量工具——被认为是一个潜在的调节变量。5项研究纳入meta分析，其中7项在两个时间点使用相同的测量工具，4项使用不同的工具。此外，meta回归研究了智商下降的幅度是否与基线年龄有关。结果meta分析效应值为- 0.343 (95% CI: - 0.503 ~ - 0.184)，相当于降低了5个智商点。使用相同（SMD - 0.321, 95% CI: - 0.501至- 0.142）和不同（SMD - 0.427, 95% CI: - 0.777至- 0.077）的测量工具对智商变化没有调节作用（p = 0.279）。meta回归结果无统计学意义（p = 0.544）。结论当前的荟萃分析表明，从发病前到发病后，认知能力略有下降。使用不同的测量工具产生了稍大的效应大小和更大的异质性，这表明使用相同的评估工具可能导致更准确的结果。未来的纵向研究应侧重于确定认知能力下降的时间线。

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引用次数: 0

Evaluation of a brief online multi-index assessment for predicting increased psychotic-like experiences in the community: A perceptual, cognitive and affective approach. 一个简短的在线多指标评估，用于预测社区中增加的精神病样体验：知觉、认知和情感方法。

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-06-01 Epub Date: 2025-03-12 DOI: 10.1016/j.scog.2025.100357

Caroline Cullen , Keith Gaynor , Klaus Kessler

Research has shown that impairments in perception, reasoning, and social cognition are evident across the psychosis continuum and are implicated in the transition from subclinical symptoms to clinical psychosis. In this pilot feasibility study, a brief computerised assessment of visual perception, reasoning, social cognition and emotion dysregulation was administered to 157 adults in the community alongside self-report measures of psychotic-like experiences. The feasibility, reliability, and the predictive validity of the assessment tool were examined. The assessment procedure was feasible, evidenced through high completion rates. However, reliability estimates were suboptimal for online assessment measures. Self-reported visual perception and state emotion dysregulation predicted psychotic-like experiences explaining 53% of the variance when controlling for age. This study provides preliminary evidence that state difficulties with emotion regulation and self-reported visual perception abnormalities can predict increased psychotic-like experiences in the community. Future adaptations could address technological issues encountered with assessment tasks and ensure measures are psychometrically robust when administered online. Brief online assessments hold potential for research of both cognition and affect along the psychosis continuum although caution must be exercised with the chosen methodology.

研究表明，知觉、推理和社会认知障碍在整个精神病连续体中都很明显，并且与从亚临床症状到临床精神病的转变有关。在这项试点可行性研究中，对社区157名成年人进行了视觉感知、推理、社会认知和情绪失调的简短计算机评估，同时对类似精神病的经历进行了自我报告。对评估工具的可行性、可靠性和预测效度进行了检验。评估程序是可行的，高完成率证明了这一点。然而，可靠性估计是次优的在线评估措施。自我报告的视觉感知和状态情绪失调预测了类似精神病的经历，在控制年龄的情况下，解释了53%的方差。这项研究提供了初步的证据，表明情绪调节的状态困难和自我报告的视觉感知异常可以预测社区中类似精神病的经历的增加。未来的调整可以解决评估任务中遇到的技术问题，并确保在线管理时的测量在心理测量学上是稳健的。简短的在线评估具有研究精神病连续体认知和影响的潜力，尽管必须谨慎选择方法。

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引用次数: 0

Cognitive predictors and genetic moderators of employment outcomes in people with schizophrenia 精神分裂症患者就业结果的认知预测因子和遗传调节因子

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-06-01 Epub Date: 2025-03-13 DOI: 10.1016/j.scog.2025.100356

Rachael Keir Blackman , Dwight Dickinson , Michael D. Gregory , Bhaskar S. Kolachana , Daniel P. Eisenberg , Karen F. Berman

Although some individuals with schizophrenia are able to maintain gainful employment, many are not. To better understand this differential real-life outcome, we tested general and specific cognitive measures as predictors of future employment and genetic moderators of these relationships. One hundred and twenty-four patients with schizophrenia spectrum illness (31.5 % female, mean age 32.5 ± 10.5 years) participated in a research study at the National Institute of Mental Health Intramural Research Program's Clinical Center and were later recontacted regarding outcomes (average time to recontact = 8.6 ± 4.0 years). At the initial visit, patients completed a comprehensive battery of neuropsychological tests and provided blood samples for genotyping. Cognitive scores at the initial visit were tested as predictors of future employment status (employed vs. unemployed) at follow-up using logistic regressions, and polygenic risk scores for schizophrenia were tested as moderators. At follow-up, 45.2 % of individuals were employed. General cognitive ability indexes (“g” and IQ) and verbal memory were predictive of subsequent employment status. Additionally, polygenic risk for schizophrenia moderated the effect of working memory cognitive scores on the prediction of future employment. The results suggest that certain broad indexes of cognitive dysfunction may be particularly salient in targeting interventions to address real-world functioning in schizophrenia. These data also suggest that further investigation into the genetic underpinnings of real-life outcomes in this illness is warranted.

虽然一些精神分裂症患者能够维持有收入的工作，但许多人不能。为了更好地理解这种不同的现实生活结果，我们测试了一般和特定的认知测量作为未来就业的预测因子和这些关系的遗传调节因子。124名精神分裂症谱系疾病患者（31.5%为女性，平均年龄32.5±10.5岁）参加了美国国立精神卫生研究所校内研究项目临床中心的一项研究，随后对结果进行了重新接触（平均重新接触时间= 8.6±4.0年）。在初次就诊时，患者完成了一系列全面的神经心理学测试，并提供了用于基因分型的血液样本。在随访中，使用逻辑回归测试了初次就诊时的认知评分作为未来就业状况（就业与失业）的预测因子，并测试了精神分裂症的多基因风险评分作为调节因子。在随访中，45.2%的人找到了工作。一般认知能力指数（“g”和智商）和言语记忆可以预测随后的就业状况。此外，精神分裂症的多基因风险降低了工作记忆认知评分对未来就业预测的影响。结果表明，某些广泛的认知功能障碍指标可能在针对精神分裂症现实世界功能的干预措施中特别突出。这些数据还表明，有必要对这种疾病的现实结果的遗传基础进行进一步调查。

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引用次数: 0

Efficacy and safety of iclepertin (BI 425809) with adjunctive computerized cognitive training in patients with schizophrenia iclepertin （BI 425809）与辅助计算机认知训练对精神分裂症患者的疗效和安全性。

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-06-01 Epub Date: 2024-12-14 DOI: 10.1016/j.scog.2024.100340

Philip D. Harvey , Sean McDonald , Eric Fu , Corey Reuteman-Fowler

Despite significant patient burden, there are no approved pharmacotherapies to treat symptoms of cognitive impairment associated with schizophrenia (CIAS). This double-blind, placebo-controlled, parallel-group Phase II trial assessed the efficacy and safety of pharmacological augmentation of at-home computerized cognitive training (CCT) with iclepertin (BI 425809, a glycine transporter-1 inhibitor). Participants with schizophrenia (aged 18–50 years) on stable antipsychotic therapy, who were compliant with CCT during the run-in period, were enrolled. Patients were randomized (1:1) to once daily iclepertin 10 mg or placebo for 12 weeks, and all patients completed adjunctive CCT. At Week 12, the change from baseline in neurocognitive composite T-score of the MATRICS Consensus Cognitive Battery (primary endpoint), Schizophrenia Cognition Rating Scale interviewer total score, and Positive and Negative Syndrome Scale total score (secondary endpoints) were assessed. Performance was also assessed using Virtual Reality Functional Capacity Assessment Tool adjusted total time T-score. Of 200 randomized patients, 154 (77.0 %) completed the trial. At efficacy endpoint assessment, no differences were observed between treatment groups. Adverse events (AEs) were reported by 39 patients in the iclepertin 10 mg + CCT group and 57 patients in the placebo + CCT group; most AEs were mild to moderate. To our knowledge, this trial is the largest of its kind combining daily pharmacotherapy for CIAS with at-home CCT. Although efficacy was not demonstrated, the safety profile of iclepertin 10 mg was consistent with previous studies and no new risks were identified.

Clinical trial registration

ClinicalTrials.gov identifier: NCT03859973

尽管患者负担沉重，但目前还没有批准的药物治疗方法来治疗与精神分裂症（CIAS）相关的认知障碍症状。这项双盲、安慰剂对照、平行组II期试验评估了iclepertin （BI 425809，一种甘氨酸转运蛋白-1抑制剂）药物增强家庭计算机化认知训练（CCT）的有效性和安全性。接受稳定抗精神病药物治疗的精神分裂症患者（18-50岁）在磨合期接受CCT治疗。患者被随机分配（1:1）至每日一次iclepertin 10 mg或安慰剂组，持续12周，所有患者完成辅助CCT。在第12周，评估从基线开始的神经认知综合t评分（主要终点）、精神分裂症认知评定量表采访者总分和阳性和阴性综合征量表总分（次要终点）的变化。还使用虚拟现实功能能力评估工具调整总时间t评分对性能进行评估。在200名随机患者中，154名（77.0%）完成了试验。在疗效终点评估中，治疗组间无差异。iclepertin 10 mg + CCT组报告了39例不良事件（ae），安慰剂+ CCT组报告了57例；大多数ae为轻度至中度。据我们所知，该试验是同类试验中最大的将CIAS每日药物治疗与家庭CCT相结合的试验。虽然没有证实疗效，但iclepertin 10mg的安全性与先前的研究一致，没有发现新的风险。临床试验注册：ClinicalTrials.gov标识符：NCT03859973。

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引用次数: 0

Neurocognitive dysfunctions in childhood-onset schizophrenia: A systematic review 儿童精神分裂症的神经认知功能障碍：一项系统综述。

IF 2.3 Q2 PSYCHIATRY

Schizophrenia Research-Cognition

Pub Date : 2025-06-01 Epub Date: 2025-01-05 DOI: 10.1016/j.scog.2024.100342

A. Armita , J. Guivarch , E. Dor , G. Laure , R. Zeghari , M. Gindt , S. Thümmler , F. Askenazy , A. Fernandez

Objective

To conduct a systematic review of neurocognitive dysfunctions in patients with childhood-onset schizophrenia (COS), a neuropsychiatric disorder that occurs before age 13 and is rarer and more severe than adult-onset schizophrenia.

Method

A search was made in the PubMed database. Sixty-seven studies (out of 543) which analyzed Intellectual Quotient (IQ), attentional, memory and executive functions were selected by two independent researchers. Study's appraisal was done according to the Mixed Methods Appraisal Tool (MMAT). This systematic review was registered on PROSPERO (CRD42024548945).

Result

COS shows neurocognitive dysfunction in IQ with mean scores ranging from one to two standard deviation lower than normative data. Attentional deficits are observed with longer reaction time, more errors of omission and commission and slower processing speed than controls. In addition, working memory and executive functions, such as planification and flexibility are impaired. COS exhibit significantly more neurocognitive deficits than adolescent and adult-onset forms and display deterioration in intellectual functioning between premorbid period and after onset of psychosis.

Conclusion

COS is characterized by major cognitive impairments, both before the onset of the disease and throughout its course. As in adult-onset schizophrenia, generalized cognitive impairment is found without the emergence of a specific profile, providing further support for the continuum hypothesis between early-onset and adult-onset schizophrenia. Collaborative research on a larger scale (including meta-analyses) and using complementary approaches (dimensional and multimodal) is needed to gain a better understanding of the cognitive impact of COS and pave the way for more precise and targeted cognitive remediation.

目的：对儿童期精神分裂症（COS）患者的神经认知功能障碍进行系统回顾，COS是一种发生在13岁之前的神经精神障碍，比成人精神分裂症更罕见且更严重。方法：检索PubMed数据库。在543项研究中，有67项研究分析了智商（IQ）、注意力、记忆力和执行功能，由两名独立的研究人员选出。采用混合方法评价工具（MMAT）对研究进行评价。本系统评价已在PROSPERO注册（CRD42024548945）。结果：COS表现为智力神经认知功能障碍，平均得分比标准数据低1 ~ 2个标准差。注意缺陷表现为反应时间较长，遗漏和委托错误较多，加工速度较慢。此外，工作记忆和执行功能，如平面化和灵活性受损。与青少年和成人相比，COS表现出更多的神经认知缺陷，并在发病前和发病后表现出智力功能的恶化。结论：无论在发病前还是在整个病程中，COS都以严重的认知障碍为特征。与成年性精神分裂症一样，全身性认知障碍的发现没有出现特定的特征，这进一步支持了早发性精神分裂症和成年性精神分裂症之间的连续性假设。为了更好地了解COS的认知影响，并为更精确、更有针对性的认知补救铺平道路，需要更大规模的合作研究（包括荟萃分析）和使用互补方法（维度和多模态）。

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