Cognitive dysfunction is a well-documented feature of schizophrenia (SZ) and bipolar (BD) disorder. The person's subjective experience of cognitive difficulties is less investigated. Here we investigated subjective cognition in SZ and BD compared to healthy controls (HC).
Subjective and objective cognition were assessed in 91 SZ participants, 55 BD participants and 55 HC, applying a novel measure of subjective cognition, the self-assessed cognitive complaints scale (SACCS) and a clinically relevant neuropsychological test battery. The psychometric properties of SACCS were investigated. The relationship between subjective and objective cognition, and subjective cognition and clinical variables were explored in SZ and BD.
The SACCS showed adequate psychometric properties. Clinical groups reported significantly more cognitive complaints than HCs, without differences between SZ and BD. There were no significant associations between subjective and objective cognitive measures. There was a small trend association between subjective cognition and insight in SZ participants, and moderate sized associations between subjective cognition and general psychopathology and functioning in BD participants.
Although SZ participants are more cognitively impaired than BD participants, the two groups report similar levels of subjective cognitive complaints, with no association between subjective and objective cognition. Our results suggest that the expression of subjective cognition is associated with different clinical factors in SZ and BD.
{"title":"Subjective cognition in schizophrenia and bipolar disorder: Investigation of group differences and associations with objective cognition and clinical characteristics using a novel measure of subjective cognition","authors":"Kristoffer Grimstad , Håkon Sørensen , Anja Vaskinn , Christine Mohn , Stine Holmstul Olsen , Ole A. Andreassen , Trine Vik Lagerberg , Ingrid Melle , Merete Glenne Øie , Torill Ueland , Beathe Haatveit","doi":"10.1016/j.scog.2025.100345","DOIUrl":"10.1016/j.scog.2025.100345","url":null,"abstract":"<div><div>Cognitive dysfunction is a well-documented feature of schizophrenia (SZ) and bipolar (BD) disorder. The person's subjective experience of cognitive difficulties is less investigated. Here we investigated subjective cognition in SZ and BD compared to healthy controls (HC).</div><div>Subjective and objective cognition were assessed in 91 SZ participants, 55 BD participants and 55 HC, applying a novel measure of subjective cognition, the self-assessed cognitive complaints scale (SACCS) and a clinically relevant neuropsychological test battery. The psychometric properties of SACCS were investigated. The relationship between subjective and objective cognition, and subjective cognition and clinical variables were explored in SZ and BD.</div><div>The SACCS showed adequate psychometric properties. Clinical groups reported significantly more cognitive complaints than HCs, without differences between SZ and BD. There were no significant associations between subjective and objective cognitive measures. There was a small trend association between subjective cognition and insight in SZ participants, and moderate sized associations between subjective cognition and general psychopathology and functioning in BD participants.</div><div>Although SZ participants are more cognitively impaired than BD participants, the two groups report similar levels of subjective cognitive complaints, with no association between subjective and objective cognition. Our results suggest that the expression of subjective cognition is associated with different clinical factors in SZ and BD.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100345"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.scog.2025.100346
MingLiang Ju , Bin Long , YanYan Wei , XiaoChen Tang , LiHua Xu , RanPiao Gan , HuiRu Cui , YingYing Tang , ZhengHui Yi , HaiChun Liu , ZiXuan Wang , Tao Chen , Jin Gao , Qiang Hu , LingYun Zeng , ChunBo Li , JiJun Wang , HuanZhong Liu , TianHong Zhang
Background
Psychosis is a complex brain disorder with diverse biological subtypes influenced by various pathogenic mechanisms, which can affect treatment efficacy. The ANR(Attenuated Niacin Response) subtype is characterized by pronounced negative symptoms and functional impairments, suggesting a distinct clinical profile. However, research on the cognitive characteristics associated with the ANR subtype in drug-naïve first-episode psychosis(FEP) patients remains limited.
Methods
This observational study involved 54 FEP patients and 52 healthy controls(HC). Clinical psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS), while cognitive performance was evaluated through the Chinese version of the MATRICS Consensus Cognitive Battery(MCCB). Additionally, niacin response was measured using aqueous methylnicotinate patches, with responses quantified to classify participants into ANR or normal niacin response (NNR) groups.
Results
Among the FEP patients, 25.9 % were classified as having ANR, significantly higher than the 7.7 % in the HC group (χ2 = 6.247, p = 0.012). The ANR group exhibited more severe negative symptoms and higher total PANSS scores compared to the NNR group, with significant differences in cognitive performance on the Trail Making test and the Brief Visuospatial Memory Test-Revised. Correlation analyses revealed a significant positive relationship between overall symptom severity and niacin response, as well as between cognitive performance and niacin response, particularly for the Trail Making and Symbol coding tests.
Conclusions
This study demonstrates that the ANR subtype in first-episode psychosis is linked to more severe negative symptoms and cognitive impairments. Targeted assessments and interventions for patients with ANR may improve treatment outcomes and enhance understanding of cognitive dysfunction in psychotic disorders.
背景精神病是一种复杂的脑部疾病，具有多种生物学亚型，受多种致病机制的影响，影响治疗效果。ANR（烟酸减毒反应）亚型的特点是明显的阴性症状和功能损伤，提示一个独特的临床特征。然而，对drug-naïve首发精神病（FEP）患者中与ANR亚型相关的认知特征的研究仍然有限。方法对54例FEP患者和52例健康对照进行观察性研究。临床精神病理采用阳性和阴性综合征量表（PANSS）进行评估，认知表现采用中文版的matrix共识认知电池（MCCB）进行评估。此外，使用甲基烟酸贴片测量烟酸反应，并将反应量化为ANR或正常烟酸反应（NNR）组。结果FEP患者中ANR发生率为25.9%，显著高于HC组的7.7% （χ2 = 6.247, p = 0.012）。与NNR组相比，ANR组表现出更严重的阴性症状和更高的PANSS总分，在Trail Making test和Brief visual spatial Memory test - revised上的认知表现有显著差异。相关分析显示，总体症状严重程度与烟酸反应之间存在显著正相关，认知表现与烟酸反应之间也存在显著正相关，尤其是在Trail Making和Symbol coding测试中。结论ANR亚型在首发精神病中与更严重的阴性症状和认知障碍相关。对ANR患者进行有针对性的评估和干预可能会改善治疗效果，增强对精神障碍患者认知功能障碍的认识。
{"title":"Cognitive impairments in first-episode psychosis patients with attenuated niacin response","authors":"MingLiang Ju , Bin Long , YanYan Wei , XiaoChen Tang , LiHua Xu , RanPiao Gan , HuiRu Cui , YingYing Tang , ZhengHui Yi , HaiChun Liu , ZiXuan Wang , Tao Chen , Jin Gao , Qiang Hu , LingYun Zeng , ChunBo Li , JiJun Wang , HuanZhong Liu , TianHong Zhang","doi":"10.1016/j.scog.2025.100346","DOIUrl":"10.1016/j.scog.2025.100346","url":null,"abstract":"<div><h3>Background</h3><div>Psychosis is a complex brain disorder with diverse biological subtypes influenced by various pathogenic mechanisms, which can affect treatment efficacy. The ANR(Attenuated Niacin Response) subtype is characterized by pronounced negative symptoms and functional impairments, suggesting a distinct clinical profile. However, research on the cognitive characteristics associated with the ANR subtype in drug-naïve first-episode psychosis(FEP) patients remains limited.</div></div><div><h3>Methods</h3><div>This observational study involved 54 FEP patients and 52 healthy controls(HC). Clinical psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS), while cognitive performance was evaluated through the Chinese version of the MATRICS Consensus Cognitive Battery(MCCB). Additionally, niacin response was measured using aqueous methylnicotinate patches, with responses quantified to classify participants into ANR or normal niacin response (NNR) groups.</div></div><div><h3>Results</h3><div>Among the FEP patients, 25.9 % were classified as having ANR, significantly higher than the 7.7 % in the HC group (<em>χ</em><sup><em>2</em></sup> = 6.247, <em>p</em> = 0.012). The ANR group exhibited more severe negative symptoms and higher total PANSS scores compared to the NNR group, with significant differences in cognitive performance on the Trail Making test and the Brief Visuospatial Memory Test-Revised. Correlation analyses revealed a significant positive relationship between overall symptom severity and niacin response, as well as between cognitive performance and niacin response, particularly for the Trail Making and Symbol coding tests.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that the ANR subtype in first-episode psychosis is linked to more severe negative symptoms and cognitive impairments. Targeted assessments and interventions for patients with ANR may improve treatment outcomes and enhance understanding of cognitive dysfunction in psychotic disorders.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100346"},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-09DOI: 10.1016/j.scog.2025.100344
Qian Guo , Zexin Zhao , Wenzheng Wang , Xiaonan Hu , Hao Hu , Yao Hu , Lihua Xu , Xu Liu , Xiaohua Liu , Guanjun Li , Zhongying Shi , Jijun Wang
Evidence suggests that attenuated mismatch negative (MMN) waves have a close link to auditory verbal hallucinations (AVH) and their clinical outcomes, especially impaired neural oscillations such as θ, β representing attentional control. In current study, thirty patients with schizophrenia and AVH (SZ) and twenty-nine healthy controls (HC) underwent multi-feature MMN paradigm measurements including frequency and duration deviant stimuli (fMMN and dMMN). Clinical symptoms and MMN paradigm were followed up among SZ group after 8-week treatment. Results demonstrated that hallucinating patients exhibited attenuated dMMN amplitudes across Fz (p = 0.010), F1 (p = 0.020) and F2 (p = 0.014) electrodes, which were trendily recovered after treatment. Meanwhile, θ band and TBR at frontal fMMN and right temporal dMMN were significantly reduced in SZs. After treatment, SZs showed reduced scores of Hoffman's Auditory Hallucinations Rating Scale (AHRS), with a remarkable recovery in right temporal TBR of dMMN (p = 0.042) and a trending change in frontal TBR of fMMN (p = 0.090). The β band was decreased in dMMN (p = 0.035) by time. Additionally, P3 scores of Positive and Negative Syndrome Scale (PANSS) were negatively correlated with θ band of fMMN at baseline. Baseline scores of AHRS negatively predicted changes of dMMN amplitude after treatment, and changes of β band in left temporal dMMN predicted the reduction in scores of PANSS negative scale. These findings supported that deficits in θ oscillation and TBR during auditory attention process were crucial to clinical progression of schizophrenia with AVH.
{"title":"Altered theta band and theta/beta ratio in mismatch negativity associate with treatment effect in schizophrenia with auditory hallucinations","authors":"Qian Guo , Zexin Zhao , Wenzheng Wang , Xiaonan Hu , Hao Hu , Yao Hu , Lihua Xu , Xu Liu , Xiaohua Liu , Guanjun Li , Zhongying Shi , Jijun Wang","doi":"10.1016/j.scog.2025.100344","DOIUrl":"10.1016/j.scog.2025.100344","url":null,"abstract":"<div><div>Evidence suggests that attenuated mismatch negative (MMN) waves have a close link to auditory verbal hallucinations (AVH) and their clinical outcomes, especially impaired neural oscillations such as θ, β representing attentional control. In current study, thirty patients with schizophrenia and AVH (SZ) and twenty-nine healthy controls (HC) underwent multi-feature MMN paradigm measurements including frequency and duration deviant stimuli (fMMN and dMMN). Clinical symptoms and MMN paradigm were followed up among SZ group after 8-week treatment. Results demonstrated that hallucinating patients exhibited attenuated dMMN amplitudes across Fz (p = 0.010), F1 (p = 0.020) and F2 (p = 0.014) electrodes, which were trendily recovered after treatment. Meanwhile, θ band and TBR at frontal fMMN and right temporal dMMN were significantly reduced in SZs. After treatment, SZs showed reduced scores of Hoffman's Auditory Hallucinations Rating Scale (AHRS), with a remarkable recovery in right temporal TBR of dMMN (p = 0.042) and a trending change in frontal TBR of fMMN (p = 0.090). The β band was decreased in dMMN (p = 0.035) by time. Additionally, P3 scores of Positive and Negative Syndrome Scale (PANSS) were negatively correlated with θ band of fMMN at baseline. Baseline scores of AHRS negatively predicted changes of dMMN amplitude after treatment, and changes of β band in left temporal dMMN predicted the reduction in scores of PANSS negative scale. These findings supported that deficits in θ oscillation and TBR during auditory attention process were crucial to clinical progression of schizophrenia with AVH.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100344"},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-08DOI: 10.1016/j.scog.2024.100343
Amélie M. Achim , Dominique Knutsen , Marc-André Roy , Souleymane Gadio , Marion Fossard
Introduction
People with schizophrenia spectrum disorders present with language dysfunctions, yet we know little about their use of reference markers (indefinite markers, definite markers, pronouns or names), a fundamental aspect of efficient speech production.
Methods
Twenty-five (25) participants with a recent-onset schizophrenia spectrum disorder (SZ) and 25 healthy controls (HC) completed two referential communication tasks. The tasks involved presenting to an interaction partner a series of movie characters (character identification task) and movie scenes composed of six images (narration task). A manipulation was introduced such that half of the movies could be considered as Likely-Known by the interaction partner, whereas the other half was Likely-Unknown. The analyses focused on the reference markers used to present the movie characters during the tasks.
Results
During the character identification task, the SZ group used fewer names and more pronouns than the HC. During the narration task, the SZ group used fewer names and more definite references when initially introducing the main story characters, while no group effect emerged for subsequent mentions of the characters. The observed effects of conditions were generally present across both groups, except for a lesser adjustment in the use of definite markers when introducing the story characters.
Conclusions
While some group differences emerged, people with SZ were generally sensitive to the manipulation regarding their interaction partner's likely knowledge of the characters. A better understanding of the conditions in which speech production is affected in SZ could help promote more efficient communication.
{"title":"Use of reference markers in the speech of people with schizophrenia spectrum disorders: Evidence from two referential communication tasks manipulating common ground with the interaction partner","authors":"Amélie M. Achim , Dominique Knutsen , Marc-André Roy , Souleymane Gadio , Marion Fossard","doi":"10.1016/j.scog.2024.100343","DOIUrl":"10.1016/j.scog.2024.100343","url":null,"abstract":"<div><h3>Introduction</h3><div>People with schizophrenia spectrum disorders present with language dysfunctions, yet we know little about their use of reference markers (indefinite markers, definite markers, pronouns or names), a fundamental aspect of efficient speech production.</div></div><div><h3>Methods</h3><div>Twenty-five (25) participants with a recent-onset schizophrenia spectrum disorder (SZ) and 25 healthy controls (HC) completed two referential communication tasks. The tasks involved presenting to an interaction partner a series of movie characters (character identification task) and movie scenes composed of six images (narration task). A manipulation was introduced such that half of the movies could be considered as Likely-Known by the interaction partner, whereas the other half was Likely-Unknown. The analyses focused on the reference markers used to present the movie characters during the tasks.</div></div><div><h3>Results</h3><div>During the character identification task, the SZ group used fewer names and more pronouns than the HC. During the narration task, the SZ group used fewer names and more definite references when initially introducing the main story characters, while no group effect emerged for subsequent mentions of the characters. The observed effects of conditions were generally present across both groups, except for a lesser adjustment in the use of definite markers when introducing the story characters.</div></div><div><h3>Conclusions</h3><div>While some group differences emerged, people with SZ were generally sensitive to the manipulation regarding their interaction partner's likely knowledge of the characters. A better understanding of the conditions in which speech production is affected in SZ could help promote more efficient communication.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100343"},"PeriodicalIF":2.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11763843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-05DOI: 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.
{"title":"Neurocognitive dysfunctions in childhood-onset schizophrenia: A systematic review","authors":"A. Armita , J. Guivarch , E. Dor , G. Laure , R. Zeghari , M. Gindt , S. Thümmler , F. Askenazy , A. Fernandez","doi":"10.1016/j.scog.2024.100342","DOIUrl":"10.1016/j.scog.2024.100342","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Method</h3><div>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).</div></div><div><h3>Result</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100342"},"PeriodicalIF":2.3,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-18DOI: 10.1016/j.scog.2024.100341
Kathryn E. Lewandowski
{"title":"Ecological validity in cognitive assessment and treatment","authors":"Kathryn E. Lewandowski","doi":"10.1016/j.scog.2024.100341","DOIUrl":"10.1016/j.scog.2024.100341","url":null,"abstract":"","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100341"},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143654573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-14DOI: 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.
{"title":"Efficacy and safety of iclepertin (BI 425809) with adjunctive computerized cognitive training in patients with schizophrenia","authors":"Philip D. Harvey , Sean McDonald , Eric Fu , Corey Reuteman-Fowler","doi":"10.1016/j.scog.2024.100340","DOIUrl":"10.1016/j.scog.2024.100340","url":null,"abstract":"<div><div>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.</div></div><div><h3>Clinical trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: <span><span>NCT03859973</span><svg><path></path></svg></span></div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"40 ","pages":"Article 100340"},"PeriodicalIF":2.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-29DOI: 10.1016/j.scog.2024.100339
Junjie Wang , Yanyan Wei , Qiang Hu , Yingying Tang , Hongliang Zhu , Jijun Wang
Background and objective
The dorsolateral prefrontal cortex (DLPFC) - cerebellum circuit has been implicated in the pathogenesis of negative symptoms of schizophrenia (SZ). Both areas are considered separate targets for repetitive transcranial magnetic stimulation (rTMS) treatment, showing potential for improving negative symptoms. However, there is still a lack of research that targets both DLPFC and cerebellum simultaneously. In this study, we will explore the efficacy and safety of dual-target rTMS based on the DLPFC-cerebellum circuit in the treatment of negative symptoms in SZ.
Methods
The study is a multicenter randomized, double-blind, and sham-controlled trial. First-episode schizophrenia is treated with adjunctive 1 Hz rTMS to the right DLPFC and intermittent theta burst stimulation (iTBS) to the cerebellum delivered sequentially in 20 sessions (active group) or a sham condition (sham group) along with antipsychotics. Clinical symptoms are assessed using the Positive and Negative Symptom Scale (PANSS) at baseline (T0), at the middle of the TMS intervention (after 10 sessions, T1), at the end of the intervention (after 20 sessions, T2), and at a 4-week follow-up after the intervention concludes (T3). Subjects will undergo magnetic resonance imaging (MRI) scans twice: once at baseline (T0) and again at the end of TMS intervention (T2). Comparisons of improvements in negative symptoms are conducted between the active and sham groups. Alterations in functional connectivity (FC) are also compared between both groups. Pearson or Spearman correlation analysis is performed to estimate the relationship between FC alteration and clinical symptom remission (PANSS negative subscale reduction scores and response rates, etc) depending on whether the data follows a normal distribution. In addition, potential neuroimaging biomarkers based on MRI associated with TMS treatment will be explored.
Discussion
Positive results from this double-blind, sham-controlled, randomized study may optimize the TMS treatment strategy for SZ, particularly in managing negative symptoms. Clinicians can select TMS with increased confidence as a safe adjunctive treatment option. Furthermore, the findings of this trial may offer preliminary insights into the potential neuroimaging therapeutic mechanisms of TMS interventions targeting the prefrontal-cerebellar circuit.
Trial registration: ClinicalTrials.govNCT04853485
Primary sponsor: Jijun WANG (J. Wang), Principal Investigator: [email protected]
{"title":"The efficacy and safety of dual-target rTMS over dorsolateral prefrontal cortex (DLPFC) and cerebellum in the treatment of negative symptoms in first-episode schizophrenia: Protocol for a multicenter, randomized, double-blind, sham-controlled study","authors":"Junjie Wang , Yanyan Wei , Qiang Hu , Yingying Tang , Hongliang Zhu , Jijun Wang","doi":"10.1016/j.scog.2024.100339","DOIUrl":"10.1016/j.scog.2024.100339","url":null,"abstract":"<div><h3>Background and objective</h3><div>The dorsolateral prefrontal cortex (DLPFC) - cerebellum circuit has been implicated in the pathogenesis of negative symptoms of schizophrenia (SZ). Both areas are considered separate targets for repetitive transcranial magnetic stimulation (rTMS) treatment, showing potential for improving negative symptoms. However, there is still a lack of research that targets both DLPFC and cerebellum simultaneously. In this study, we will explore the efficacy and safety of dual-target rTMS based on the DLPFC-cerebellum circuit in the treatment of negative symptoms in SZ.</div></div><div><h3>Methods</h3><div>The study is a multicenter randomized, double-blind, and sham-controlled trial. First-episode schizophrenia is treated with adjunctive 1 Hz rTMS to the right DLPFC and intermittent theta burst stimulation (iTBS) to the cerebellum delivered sequentially in 20 sessions (active group) or a sham condition (sham group) along with antipsychotics. Clinical symptoms are assessed using the Positive and Negative Symptom Scale (PANSS) at baseline (T0), at the middle of the TMS intervention (after 10 sessions, T1), at the end of the intervention (after 20 sessions, T2), and at a 4-week follow-up after the intervention concludes (T3). Subjects will undergo magnetic resonance imaging (MRI) scans twice: once at baseline (T0) and again at the end of TMS intervention (T2). Comparisons of improvements in negative symptoms are conducted between the active and sham groups. Alterations in functional connectivity (FC) are also compared between both groups. Pearson or Spearman correlation analysis is performed to estimate the relationship between FC alteration and clinical symptom remission (PANSS negative subscale reduction scores and response rates, etc) depending on whether the data follows a normal distribution. In addition, potential neuroimaging biomarkers based on MRI associated with TMS treatment will be explored.</div></div><div><h3>Discussion</h3><div>Positive results from this double-blind, sham-controlled, randomized study may optimize the TMS treatment strategy for SZ, particularly in managing negative symptoms. Clinicians can select TMS with increased confidence as a safe adjunctive treatment option. Furthermore, the findings of this trial may offer preliminary insights into the potential neuroimaging therapeutic mechanisms of TMS interventions targeting the prefrontal-cerebellar circuit.</div><div>Trial registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT04853485</span><svg><path></path></svg></span></div><div>Primary sponsor: Jijun WANG (J. Wang), Principal Investigator: <span><span><span>[email protected]</span></span><svg><path></path></svg></span></div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100339"},"PeriodicalIF":2.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Studies of schizophrenia and homelessness are minimal from the Indian subcontinent. Women with schizophrenia and homelessness in India remain a highly vulnerable group and there is no data to date regarding their clinical characteristics. Cognitive impairment in schizophrenia remains a major factor determining outcomes in schizophrenia. We examined the cognitive functioning of women with schizophrenia and homelessness (WSH) and compared it to an age-matched group of women with schizophrenia living with their family (WSF).
Methods
36 women with schizophrenia and homelessness, and 32 women with schizophrenia who were living with family were evaluated for psychopathology using Scale for Assessment of Positive Symptoms (SAPS)/ Scale for assessment of negative symptoms (SANS) scales. Cognitive function was assessed using Montreal Cognitive Assessment (MOCA)/Rowland Universal Dementia Scale (RUDAS), and Frontal Assessment Battery (FAB), disability using World Health Organization - Disability assessment Scale (WHO-DAS) and psychosocial factors using a semi-structured proforma. The groups were compared using t-tests and chi-square for continuous and categorical variables respectively.
Results
Women with schizophrenia and homelessness were found to have significantly lower cognitive functioning, and much higher disability. Cognition and disability for women with schizophrenia and homelessness differed by 2–3 standard deviations with the mean for women living with family (i.e. z scores). Women with schizophrenia experiencing homelessness (WSH group) exhibited higher literacy levels and previous work experience compared to their counterparts. Those with family support are likely to face reduced pressures to work or earn, which further suggests that premorbid levels of functioning may not be the primary factors influencing the differences observed in cognitive assessments.
Conclusions
The study demonstrates significantly higher cognitive dysfunction in women with homelessness and schizophrenia, raising the possibility of much higher cognitive dysfunction being a predictor for homelessness in Indian women with schizophrenia.
背景印度次大陆对精神分裂症和无家可归问题的研究极少。在印度，患有精神分裂症且无家可归的女性仍然是一个极易受到伤害的群体，迄今为止还没有关于她们临床特征的数据。精神分裂症患者的认知功能障碍仍然是决定精神分裂症治疗效果的主要因素。我们研究了患有精神分裂症且无家可归的女性（WSH）的认知功能，并将其与年龄匹配的与家人同住的精神分裂症女性（WSF）进行了比较。认知功能评估采用蒙特利尔认知评估量表（MOCA）/罗兰老年痴呆通用量表（RUDAS）和额叶评估电池（FAB），残疾评估采用世界卫生组织残疾评估量表（WHO-DAS），社会心理因素评估采用半结构化问卷。结果发现，患有精神分裂症且无家可归的妇女的认知功能明显较低，残疾程度也高得多。患有精神分裂症且无家可归的女性的认知能力和残疾程度与与家人生活在一起的女性的平均值相差 2-3 个标准差（即 z 分数）。与同龄人相比，无家可归的精神分裂症女性患者（WSH 组）具有更高的文化水平和工作经验。有家庭支持的妇女面临的工作或收入压力可能会减少，这进一步表明，病前的功能水平可能不是影响认知评估差异的主要因素。
{"title":"Cognitive functioning and functional ability in women with schizophrenia and homelessness","authors":"Jayakumar Menon , Suvarna Jyothi Kantipudi , Aruna Mani , Rajiv Radhakrishnan","doi":"10.1016/j.scog.2024.100338","DOIUrl":"10.1016/j.scog.2024.100338","url":null,"abstract":"<div><h3>Background</h3><div>Studies of schizophrenia and homelessness are minimal from the Indian subcontinent. Women with schizophrenia and homelessness in India remain a highly vulnerable group and there is no data to date regarding their clinical characteristics. Cognitive impairment in schizophrenia remains a major factor determining outcomes in schizophrenia. We examined the cognitive functioning of women with schizophrenia and homelessness (WSH) and compared it to an age-matched group of women with schizophrenia living with their family (WSF).</div></div><div><h3>Methods</h3><div>36 women with schizophrenia and homelessness, and 32 women with schizophrenia who were living with family were evaluated for psychopathology using Scale for Assessment of Positive Symptoms (SAPS)/ Scale for assessment of negative symptoms (SANS) scales. Cognitive function was assessed using Montreal Cognitive Assessment (MOCA)/Rowland Universal Dementia Scale (RUDAS), and Frontal Assessment Battery (FAB), disability using World Health Organization - Disability assessment Scale (WHO-DAS) and psychosocial factors using a semi-structured proforma. The groups were compared using <em>t</em>-tests and chi-square for continuous and categorical variables respectively.</div></div><div><h3>Results</h3><div>Women with schizophrenia and homelessness were found to have significantly lower cognitive functioning, and much higher disability. Cognition and disability for women with schizophrenia and homelessness differed by 2–3 standard deviations with the mean for women living with family (i.e. z scores). Women with schizophrenia experiencing homelessness (WSH group) exhibited higher literacy levels and previous work experience compared to their counterparts. Those with family support are likely to face reduced pressures to work or earn, which further suggests that premorbid levels of functioning may not be the primary factors influencing the differences observed in cognitive assessments.</div></div><div><h3>Conclusions</h3><div>The study demonstrates significantly higher cognitive dysfunction in women with homelessness and schizophrenia, raising the possibility of much higher cognitive dysfunction being a predictor for homelessness in Indian women with schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100338"},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.scog.2024.100337
Yunfei Ji , Bingjie Huang , Jia Huang , Xiaodong Guo , Tianqi Gao , Yue Zheng , Wanheng Hu , Xiaolin Yin , Xianghe Wang , Xin Yu , Chengcheng Pu
Humor, a higher-order social cognitive process unique to humans, is commonly impaired in patients with chronic schizophrenia. However, humor processing and its association with the clinical characteristics in the early stage of the illness remain unknown. In this study, we investigated humor processing and its relationship with clinical features in patients with first-episode schizophrenia (FES). We recruited 45 patients with FES and 44 healthy controls matched for age, sex, and education level. The participants completed the Picture Humor Processing Task (HPT-p) and Video Humor Processing Task (HPT-v), which evaluated humor comprehension and appreciation, and a questionnaire assessing their humor styles. Clinical participants also completed clinical and social functioning measurements. Signal detection theory analysis was used to calculate the d' and β values, which represent the detection of humor signals in the comprehension phase and inner criteria of the humor appreciation phase, respectively. In the HPT-p, patients with FES showed a higher false alarm rate (p = 0.048) than healthy controls, whereas the hitting rate, signal recognition ability (d' value), and intrinsic evaluation criterion (β value) were comparable between the two participants groups. In the HPT-v, patients with FES showed lower within-group coherence in the funniness rating (p = 0.023) than healthy controls. In addition, the false alarm rate in the HPT-p and negative symptoms effectively predicted social functioning in patients with FES (R2 = 0.681, p < 0.001). Our results indicate that impairment of humor comprehension in patients with schizophrenia is generated in the first episode and contributes to social functioning deficits, which require early recognition and intervention.
{"title":"Humor processing and its relationship with clinical features in patients with first-episode schizophrenia","authors":"Yunfei Ji , Bingjie Huang , Jia Huang , Xiaodong Guo , Tianqi Gao , Yue Zheng , Wanheng Hu , Xiaolin Yin , Xianghe Wang , Xin Yu , Chengcheng Pu","doi":"10.1016/j.scog.2024.100337","DOIUrl":"10.1016/j.scog.2024.100337","url":null,"abstract":"<div><div>Humor, a higher-order social cognitive process unique to humans, is commonly impaired in patients with chronic schizophrenia. However, humor processing and its association with the clinical characteristics in the early stage of the illness remain unknown. In this study, we investigated humor processing and its relationship with clinical features in patients with first-episode schizophrenia (FES). We recruited 45 patients with FES and 44 healthy controls matched for age, sex, and education level. The participants completed the Picture Humor Processing Task (HPT-p) and Video Humor Processing Task (HPT-v), which evaluated humor comprehension and appreciation, and a questionnaire assessing their humor styles. Clinical participants also completed clinical and social functioning measurements. Signal detection theory analysis was used to calculate the d' and β values, which represent the detection of humor signals in the comprehension phase and inner criteria of the humor appreciation phase, respectively. In the HPT-p, patients with FES showed a higher false alarm rate (<em>p</em> = 0.048) than healthy controls, whereas the hitting rate, signal recognition ability (d' value), and intrinsic evaluation criterion (β value) were comparable between the two participants groups. In the HPT-v, patients with FES showed lower within-group coherence in the funniness rating (<em>p</em> = 0.023) than healthy controls. In addition, the false alarm rate in the HPT-p and negative symptoms effectively predicted social functioning in patients with FES (R<sup>2</sup> = 0.681, <em>p</em> < 0.001). Our results indicate that impairment of humor comprehension in patients with schizophrenia is generated in the first episode and contributes to social functioning deficits, which require early recognition and intervention.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"39 ","pages":"Article 100337"},"PeriodicalIF":2.3,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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