Clinical, Functional, and Intertask Correlations of Measures Developed by the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia Consortium

Abstract

The goal of the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium was to develop measures of discrete cognitive processes, allowing for the interpretation of specific deficits that could be linked to specific neural systems. Here we report on the intertask, clinical, and functional correlates of the 4 tasks that were investigated in large groups of patients with schizophrenia (>100) and healthy controls (>73) at 5 sites across the United States. In both healthy and patient groups, the key dependent measures from the CNTRACS tasks were minimally intercorrelated, suggesting that they are measuring discrete abilities. Correlations were examined between CNTRACS tasks and measures of functional capacity, premorbid IQ, symptom severity, and level of community functioning. Performance on tasks measuring relational memory encoding, goal maintenance, and visual gain control were correlated with premorbid IQ and the former 2 tasks with the functional capacity. Goal maintenance task performance was negatively correlated with negative symptom severity and informant reports of community function. These correlations reflect the relationship of specific abilities with functional outcome. They are somewhat lower than functional outcome correlations observed with conventional neuropsychological tests that confound multiple cognitive and motivational deficits. The measures of visual integration and gain control were not significantly correlated with clinical symptoms or function. These results suggest that the CNTRACS tasks measure discrete cognitive abilities, some of which relate to aspects of functional capacity/outcome in schizophrenia.Key words: cognitive neuroscience/relational memory/ executive control/visual integration The Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative was designed to identify critical constructs and promising measurement approaches from the basic cognitive neuroscience literature that, with appropriate modification and psychometric validation, could be useful in the context of clinical trials in schizophrenia. 1 The results of that consensus building process have been reported in several papers. 2-4The Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium followed from the CNTRICS initiative and was intended to do the task optimization and psychometric analysis needed before nominated measures could be recommended for use in clinical trials. We selected for study 4 of the tasks that were nominated as part of the CNTRICS initiative, spanning aspects of visual perception to higher order cognitive control and episodic memory encoding and retrieval processing as these are important areas of impairment in schizophrenia and span multiple neural systems.5 These tasks were then tested in a multisite study with large samples of schizophrenia patients and healthy controls. The results for each of these measures were described in the 4 other articles accomp...

Role of Visual Integration in Gaze Perception and Emotional Intelligence in Schizophrenia

“…Several studies have shown a linkage between visual perception and a range of adaptive functioning 16,17 and disorganized symptoms. 12 Although a recent large-sample study found no correlation between visual integration and community skills in SCZ, 18 this sample was relatively high functioning and had mild visual integration problems. Further, specific social cognitive processes may be more affected than broad measures of functional outcome in SCZ.…”

The Clinical Translation of a Measure of Gain Control: The Contrast-Contrast Effect Task

“…21 However, in the current data set, we did not find significant correlations between CCE task performance and goal-maintenance performance (see ref. 36 ). As such, our findings suggest that the need for further research to establish the degree to which patients with schizophrenia show evidence of gain control abnormalities during visual perception independent of the effects of lapses in attention during the performance of this demanding task.…”

Generalized and Specific Neurocognitive Deficits in Psychotic Disorders: Utility for Evaluating Pharmacological Treatment Effects and as Intermediate Phenotypes for Gene Discovery

“…CNTRACS has addressed several of the challenges that the use of experimental paradigms developed from the cognitive neurosciences pose with respect to practical implementation in clinical research, including psychometric issues, use in multisite clinical studies, and relationship to functional outcomes. 64,65 The CNTRACS Consortium battery comprises tasks that assess visual processing, 66,67 episodic memory, 68 and goal maintenance, 69 and deficits among schizophrenia and schizoaffective patients using these measures have been observed. 70 Importantly, in a study examining the association between tasks on the CNTRACS and selected subtests from the MCCB, both common and unique deficits were detectible and shown to relate to functional impairments, albeit modestly.…”