From cognitive and clinical substrates to functional profiles: Disentangling heterogeneity in schizophrenia

Bosia, Marta; Bechi, Margherita; Bosinelli, Francesca; Politi, Ernestina; Buonocore, Mariachiara; Spangaro, Marco; Bianchi, Laura; Cocchi, Federica; Guglielmino, Carmelo; Cavallaro, Roberto

doi:10.1016/j.psychres.2018.12.026

Cited by 22 publications

(19 citation statements)

References 38 publications

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“…Moreover, the different cognitive deficits predict the course of clinical symptoms (Putnam & Harvey, 2000), structural brain changes (Geisler et al, 2015), response to treatment (Gilbert et al, 2014), and primarily functional outcome (Fu, Czajkowski, Rund, & Torgalsbøen, 2017;Kaneda, Jayathilak, & Meltzer, 2009). Significant roles are played especially by processing speed, attention, and verbal memory (Bosia et al, 2019). Different cognitive clusters correlate with findings from functional magnetic resonance, as confirmed in our previous study (Rodriguez et al, 2019).…”

Section: Introductionsupporting

confidence: 72%

Cognitive profiles of healthy siblings of first‐episode schizophrenia patients

Voráčková

Knytl

Španiel

et al. 2020

Early Intervention Psych

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Aim: Cognitive deficit in psychotic illness is intensively studied, different cognitive subtypes have been suggested. In recent years, there has been an increase in the number of studies in patients with schizophrenia and their relatives searching for endophenotypes of the disease. The aim of our study was to investigate cognitive performance and cognitive subtypes in the siblings of the patients.Methods: Four groups of subjects were included: patients with a first episode of psychotic illness, the siblings of these patients, and two control groups. All the study subjects (N = 84) had a battery of neuropsychological tests that measured basic cognitive domainsmemory, executive functions, attention, visual-spatial skills, language skills and psychomotor speedadministered to them. The data were assessed with pairwise t-tests for group comparisons. The siblings were distributed into three groups according to their cognitive performance: non-deficit, partial deficit, and global deficit. Subsequently, the patients were assigned into three groups corresponding to their siblings' performance.Results: Our results revealed attenuation of abstract thinking in the siblings compared to the controls. As expected, the patients showed impairment across all cognitive domains. The patients and siblings demonstrated similar profiles in each subtype, in the severity of their impairment, and in their patterns of cognitive performance. Conclusions:Our results suggest that the cognitive profile can be considered as an endophenotype of psychotic disorders.

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Section: Introductionsupporting

confidence: 72%

Cognitive profiles of healthy siblings of first‐episode schizophrenia patients

Voráčková

Knytl

Španiel

et al. 2020

Early Intervention Psych

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“…76,77 However, the course of cognitive change is still controversial in the literature, mainly due to the heterogeneity of the presentations. 78 Indeed, different cognitive profiles in SZ have been established, 79 even among individuals with high premorbid intellectual functioning. 65 A recent systematic review showed that the results vary widely and can be grouped into several cognitive subtypes, ranging from 3 to 5 clusters with different profiles.…”

Section: Cognitive Trajectoriesmentioning

confidence: 99%

Heterogeneous trajectories in schizophrenia: insights from neurodevelopment and neuroprogression models

Reckziegel

Czepielewski

Hasse-Sousa

et al. 2022

Braz. J. Psychiatry

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The notion that schizophrenia is a neuroprogressive disorder is based on clinical perception of cumulative impairments over time and is supported by neuroimaging and biomarker research. Nevertheless, increasing evidence has indicated that schizophrenia first emerges as a neurodevelopmental disorder that could follow various pathways, some of them neuroprogressive. The objective of this review is to revisit basic research on cognitive processes and neuroimaging findings in a search for candidate keys to the intricate connections between neurodevelopment and neuroprogression in schizophrenia. In the complete panorama, schizophrenia is a neurodevelopmental disorder, possibly associated with an additional burden over the course of the disease through pathologically accelerated aging, and cognitive heterogeneity may explain the different trajectories of each patient.

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“…Heterogeneity in clinical presentation and etiology of schizophrenia presents a challenge to discovering pathways and mechanisms that underlie the complex symptoms of the disorder (62)(63)(64). Despite the challenges of disentangling this heterogeneity, understanding mechanisms that may underlie symptoms of the disorder are important to consider and investigate.…”

mentioning

confidence: 99%

Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits

Goldsmith

Rapaport

2020

Front. Psychiatry

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Negative symptoms of schizophrenia are debilitating and chronic in nature, are difficult to treat, and contribute to poor functional outcomes. Motivational deficits are a core negative symptom and may involve alterations in reward processing, which involve subcortical regions such as the basal ganglia. More specifically, dopamine-rich regions like the ventral striatum, have been implicated in these reward-processing deficits. Inflammation is one mechanism that may underlie negative symptoms, and specifically motivational deficits, via the effects of inflammatory cytokines on the basal ganglia. Previous work has demonstrated that inflammatory stimuli decrease neural activity in the ventral striatum and decrease connectivity in reward-relevant neural circuitry. The immune system has been shown to be involved in the pathophysiology of schizophrenia, and inflammatory cytokines have been shown to be altered in patients with the disorder. This paper reviews the literature on associations between inflammatory markers and negative symptoms of schizophrenia as well as the role of anti-inflammatory drugs to target negative symptoms. We also review the literature on the role of inflammation and reward processing deficits in both healthy controls and individuals with depression. We use the literature on inflammation and depression as a basis for a model that explores potential mechanisms responsible for inflammation modulating certain aspects of negative symptoms in patients with schizophrenia. This approach may offer novel targets to treat these symptoms of the disorder that are significant barriers to functional recovery and do not respond well to available antipsychotic medications.

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From cognitive and clinical substrates to functional profiles: Disentangling heterogeneity in schizophrenia

Cited by 22 publications

References 38 publications

Cognitive profiles of healthy siblings of first‐episode schizophrenia patients

Cognitive profiles of healthy siblings of first‐episode schizophrenia patients

Heterogeneous trajectories in schizophrenia: insights from neurodevelopment and neuroprogression models

Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits

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