The character of cognitive deficit in schizophrenia is not clear due to the heterogeneity in research results. In heterogeneous conditions, the cluster solution allows the classification of individuals based on profiles. Our aim was to examine the cognitive profiles of first-episode schizophrenia spectrum disorder (FES) subjects based on cluster analysis, and to correlate these profiles with clinical variables and resting state brain connectivity, as measured with magnetic resonance imaging. A total of 67 FES subjects were assessed with a neuropsychological test battery and on clinical variables. The results of the cognitive domains were cluster analyzed. In addition, functional connectivity was calculated using ROI-to-ROI analysis with four groups: Three groups were defined based on the cluster analysis of cognitive performance and a control group with a normal cognitive performance. The connectivity was compared between the patient clusters and controls. We found different cognitive profiles based on three clusters: Cluster 1: decline in the attention, working memory/flexibility, and verbal memory domains. Cluster 2: decline in the verbal memory domain and above average performance in the attention domain. Cluster 3: generalized and severe deficit in all of the cognitive domains. FES diagnoses were distributed among all of the clusters. Cluster comparisons in neural connectivity also showed differences between the groups. Cluster 1 showed both hyperconnectivity between the cerebellum and precentral gyrus, the salience network (SN) (insula cortex), and fronto-parietal network (FPN) as well as between the PreCG and SN (insula cortex) and hypoconnectivity between the default mode network (DMN) and seeds of SN [insula and supramarginal gyrus (SMG)]; Cluster 2 showed hyperconnectivity between the DMN and cerebellum, SN (insula) and precentral gyrus, and FPN and IFG; Cluster 3 showed hypoconnectivity between the DMN and SN (insula) and SN (SMG) and pallidum. The cluster solution confirms the prevalence of a cognitive decline with different patterns of cognitive performance, and different levels of severity in FES. Moreover, separate behavioral cognitive subsets can be linked to patterns of brain functional connectivity.

Bilingualism (BL) is increasing around the world. Although BL has been shown to have a broad impact-both positive and negative-on language and cognitive functioning, cognitive models and standards are mainly based on monolinguals. If we take cognitive performance of monolinguals as a standard, then the performance of bilinguals might not be accurately estimated. The assessment of cognitive functions is an important part of both the diagnostic process and further treatment in neurological and neuropsychiatric patients. In order to identify the presence or absence of cognitive deficit in bilingual patients, it will be important to determine the positive and/or negative impact of BL properties on measured cognitive performance. However, research of the impact of BL on cognitive performance in neuropsychiatric patients is limited. This article aims to compare the influence of the language (dominant-L1, second-L2) used for assessment of verbal cognitive performance in two cases of bilingual neuropsychiatric patients (English/Czech). Despite the fact that the two cases have different diagnoses, similarities in working memory and verbal learning profiles for L1 and L2 were present in both patients. We expected L1 to have higher performance in all measures when compared with L2. This assumption was partially confirmed. As expected, verbal working memory performance was better when assessed in L1. In contrast, verbal learning showed the same or better performance in L2 when compared with L1. Verbal fluency and immediate recall results were comparable in both languages. In conclusion, the language of administration partially influenced verbal performance of bilingual patients. Whether the language itself influenced low performance in a given language or it was a result of a deficit requires further research. According to our results, we suggest that an assessment in both languages needs to be a component of reasonable cognitive assessment of bilingual patients.

Introduction: Cognitive impairment is among the core features of schizophrenia. In a healthy population, the cognitive deficit is often linked with cannabis abuse, and although the same would be expected in patients with schizophrenia, research has presented contradictory results. Methods: Participants were patients with first-episode schizophrenia (FES) spectrum disorder who had been lifetime cannabis users (N = 30), FES non-users (N = 53) as well as healthy controls (HC) also divided into cannabis users (N = 20) and non-users (N = 49). All participants underwent an extensive neurocognitive assessment and filled in a cannabis questionnaire, which allowed for a comparison of the four groups on cognitive functioning. Results: FES patients using cannabis showed less impaired cognitive functioning with the most prominent difference in visual memory compared to FES non-users. However, they differed neither in the clinical assessment of general psychopathology, positive and negative symptoms, nor in medication from the patient's non-users. A comparison of the HC who used cannabis, and those who did not, revealed no sizeable differences in cognitive performance between the groups. Conclusions: The results delivered supporting evidence for the trend of superior neurocognitive performance in FES patients with a lifetime history of cannabis use compared to non-using patients.

Objective: The study evaluates the equivalence of alternative forms of three frequently used neuropsychological testing methods in their Czech versions, i.e. the Rey Auditory Verbal Learning Test (RAVLT), the Complex Figure Test (CFT) and letter and categorical Verbal Fluency (VF). Methods: In a within-subject design, 59 healthy volunteers were assessed using the original test forms and their proposed alternative forms, first at baseline and then after three months. The performance of the original and alternative forms of the tests was subjected to the t-test and U-test for paired samples based on the normality of distribution. Results: There was no significant mean difference between the original and alternative forms of the RAVLT. In the CFT, the Taylor figure scores were higher than the original Rey-Osterrieth figure scores, suggesting that the figures are not equal in difficulty. In the letter VF, the newly proposed "BTL" set was found to be more difficult than the original "NKP". For the categorical VF, the category of "given names" can be considered as an alternative form to the "animals" category. Conclusions: The RAVLT alternative forms 1 and 2 introduced in the Neuropsychological Battery of Psychiatric Center Prague are equivalent to the original RAVLT. The "BTL" VF set and Taylor Figure were found not to be equivalent to their original test forms "NKP" and Rey-Osterrieth Figure. "Given names" may be a good alternative form to the "animals" category in VF. The study contributes with normative data for the original test forms for a specific demographic sample. Souhrn Cíle: Studie ověřuje ekvivalenci alternativních forem ke třem běžně používaným neuropsychologickým testovým metodám, a to Paměťovému testu učení (Rey Auditory Verbal Learning Test; RAVLT), Reyově-Osterriethově komplexní figuře (Complex Figure Test; CFT) a testu fonemická a kategoriální Verbální fluence (VF). Metody: Padesát devět zdravých dobrovolníků podstoupilo v rámci vnitrosubjektového designu vyšetření původními a navrhovanými alternativními formami, a to v prvním měření a následně po třech měsících. Výkony v původních a alternativních verzích byly srovnány pomocí t-testu a U-testu pro párový výběr na základě normality rozložení výkonů. Výsledky: Mezi výkonem v původní a v alternativních formách RAVLT nebyl nalezen signifikantní rozdíl. U CFT byly výkony vyšší v Taylorově figuře než v původní Reyově-Osterriethově figuře, což naznačuje, že figury nejsou srovnatelně náročné. U fonemické VF byla nově navržená sada "BTL" shledána jako těžší než původní "NKP". U sémantické VF vyšla kategorie "křestní jména" jako srovnatelně náročná alternativa ke kategorii "zvířata". Závěry: Alternativní formy 1 a 2 pro RAVLT uvedené v Neuropsychologické baterii Psychiatrického centra Praha jsou srovnatelně náročné k původní verzi RAVLT. Sada "BTL" VF a Taylorova figura nebyly srovnatelné v náročnosti vzhledem k jejich původním verzím "NKP" a Reyově-Osterriethově figuře. "Křestní jména" mohou být srovnatelnou alternativou ke kategorii "zvířata" u VF. Studie p...

Background: Neuroactive steroids (NAS) affect neurotransmitter systems and cognition; thus, they play role in etiopathogenesis of psychiatric disorders. Aims: The primary aim was to examine cognition and effects of NAS on cognitive functioning in first-episode psychosis patients and in their healthy siblings. The secondary aims were to verify whether cognitive deficit is an endophenotype of psychosis and whether higher NAS levels represent a high-risk factor for psychosis. Methods: Studied participants were 1) patients with first episode of psychosis, 2) healthy siblings of the patients, and 3) matching healthy controls. Study procedures included administration of a battery of neuropsychological tests assessing six cognitive domains and examination of NAS plasma levels [cortisol (CORT), 11-deoxycorticosterone (DOC), testosterone (TEST), dehydroepiandrostendione (DHEA), dihydrotestosterone (DHT), and progesterone (PROG)]. Results: A total of 67 subjects were analyzed (16 patients, 22 siblings, and 29 controls). Significant group differences were found in most of the cognitive domains; the patients had the lowest scores. The Kruskal–Wallis test revealed significant group differences in CORT levels ( p < 0.01), TEST ( p < 0.01), and DHT ( p < 0.001); no difference was found in PROG, DHEA, and DOC. All cognitive domains, except for attention, were affected by the NAS levels. CORT levels of patients correlated with speed of processing ( r = 0.55) and working memory ( r = 0.52), while PROG levels correlated with abstraction ( r = −0.63). In siblings, there was a negative correlation between TEST levels and verbal memory ( r = −0.51) and PROG with attention ( r = −0.47). Conclusions: Our results verified that individual domains of cognitive deficit (abstraction and verbal memory) can be considered as an endophenotype of psychosis. Higher levels of cortisol and testosterone in siblings are consistent with high-risk states for psychosis. Multiple interactions between NAS and cognitive functioning, particularly memory functions, were observed. Study limitations (small sample size and administration of antipsychotic medication) did not allow us to establish unequivocally NAS as an endophenotype.