Cognitive impairments in patients with first episode psychosis: The relationship between neurophysiological and neuropsychological assessments

A longitudinal study of event related potentials and correlations with psychosocial functioning and clinical features in first episode psychosis patients

“…Psychopathology severity and antipsychotic medications were unrelated to P3 amplitude effect size (Polich and Jeon, 2003). Patients with first episode psychosis (FEP) and individuals at ultra high risk for psychosis also show amplitude reductions (Brown et al, 2002;de Wilde et al, 2008;del Re et al, 2015;Devrim-Üçok et al, 2006;Hirayasu et al, 1998;Kruiper et al, 2018;Morales-Muñoz et al, 2017;Renoult et al, 2007;Salisbury et al, 1998;Sumich et al, 2006;Umbricht et al, 2006;van Tricht et al, 2011). A meta-analysis of P3b found a reduction of amplitude in unaffected relatives of patients as compared to controls with a moderate pooled standardized effect size of 0.61 (Bramon et al, 2005).…”

“…Several studies found reduced P3a amplitude in chronic SZ (Devrim-Üçok et al, 2006;Hamilton et al, 2018;Jahshan et al, 2012a;Kirihara et al, 2009;Mathalon et al, 2000;Pfefferbaum et al, 1989;Rissling et al, 2012) as well as in FEP patients (del Re et al, 2015;Hermens et al, 2010;Jahshan et al, 2012a;Kaur et al, 2011;Kruiper et al, 2018;Morales-Muñoz et al, 2017), suggesting that P3a deficit is already present at an early stage. The N1 and P2 ERPs reflect perceptual information registration and processing (Dien et al, 2004;Picton and Hillyard, 1974).…”

“…Studies have generally found impairments in these ERPs in chronic SZ (Baribeau-Braun et al, 1983;Brown et al, 2000;Foxe et al, 2011;McCarley et al, 1991;O'Donnell et al, 1994;Roth et al, 1981;Salisbury et al, 2010;Shenton et al, 1989;Turetsky et al, 2009) but not always (Egan et al, 1994). In FEP patients, some studies found deficits in N1 and P2 (Brown et al, 2002;del Re et al, 2015;Foxe et al, 2011;Morales-Muñoz et al, 2017;Salisbury et al, 2010;Sumich et al, 2006) though there are also inconsistent findings (del Re et al, 2015;Morales-Muñoz et al, 2017;Valkonen-Korhonen et al, 2003). There is still debate regarding trait versus state dependence of the P3a, N1, and P2 ERPs (Ahveninen et al, 2006;Ethridge et al, 2015;Frangou et al, 1997;Karoumi et al, 2000;Michie et al, 2002;Rosburg et al, 2008;van Tricht et al, 2011), whether deficits are indicators of a trait or if they wax and wane with symptom severity or disease chronicity.…”

Do cognitive and neuropsychological functioning deficits coincide with hippocampal alteration during first-psychotic episode?

“…37 The established presence of cognitive deficits supports the theory of converging neurophysiological and neuropsychological impairments during the first psychotic episode. 11,38,39 In addition, early treatment and recovery of hippocampal volume has been associated with better outcomes across clinical, functional, and cognitive domains. 36 The hippocampus is a highly plastic region of the brain (or of the limbic system) that historically has been the focus of extensive studies in patients with first episode psychosis or schizophrenia; yet, the underlying etiologies of hippocampal alterations remain unclear.…”

“…36 The hippocampus is a highly plastic region of the brain (or of the limbic system) that historically has been the focus of extensive studies in patients with first episode psychosis or schizophrenia; yet, the underlying etiologies of hippocampal alterations remain unclear. It is still uncertain whether these alterations result from early cognitive impairments 18,38,39 that ultimately lead to disruption or arrest of normal neurodevelopment, [40][41][42][43] or whether the anatomical alterations are epiphenomenal to cognitive changes. 44 Clinical studies have shown that decreased time between the onset of psychosis and the initiation of appropriate treatment is associated with a greater chance of recovery 45 and better functional outcomes.…”