Cognitive Impairment In Schizophrenia Research Articles

Psychiatric and functional correlates of stigma associated with cognitive impairment in schizophrenia

Schizophrenia is the most strongly stigmatized psychiatric diagnosis, with negative stereotypes including assumptions of incompetence and inability to recover. Individuals with cognitive impairment associated with schizophrenia (CIAS) have reported stigma experiences, suggesting that CIAS carries stigma in addition to the stigma associated with schizophrenia as a diagnostic label. While research has established that mental illness stigma more generally is linked with poor psychiatric and functional outcomes, no research has explored correlates of CIAS stigma. This study evaluated cognitive, psychiatric, and functional correlates of CIAS stigma among 54 individuals with schizophrenia spectrum disorders participating in a cognitive remediation trial. Participants with greater estimated cognitive decline reported higher levels of CIAS stigma experiences. Participants who reported higher levels of CIAS stigma also scored higher on a measure of depressive symptom severity. No significant associations were found between CIAS stigma and positive and negative psychosis symptoms or general psychopathology ratings. CIAS stigma was not associated with performance-based functional capacity or ratings of community functioning. Findings suggest that CIAS stigma is linked with the degree of cognitive decline and depressive symptom severity among individuals with schizophrenia spectrum disorders. Additional research is needed to elucidate directionality and the relationship between CIAS stigma and functioning outcomes.

Functional associations of the gut microbiome with dopamine, serotonin, and BDNF in schizophrenia: a pilot study

BackgroundSchizophrenia is a complex neuropsychiatric disorder with various etiologic factors. Aberrant levels of neurotransmitters or growth factors such as dopamine, serotonin, and BDNF have been shown to cause cognitive impairment in schizophrenia. Recently, the gut microbiome has also been suggested as a factor in the development of the disorder. To explore this potential link, we conducted a pilot study to examine the relationship between the gut microbiome and plasma levels of neurotransmitters and growth factors in schizophrenia. Shotgun metagenome sequencing of total RNA from fecal samples were used to profile the gut microbiome of schizophrenia patients (SCZ) and healthy controls (HC). The MetaPhlAn2 and HUMaN2 pipelines were used for bioinformatic analyses. ELISA was used to measure the plasma levels of dopamine, serotonin, and BDNF. Spearman’s rank correlation coefficient was used for correlation analysis.ResultsWe found that butyrate-producing bacteria were enriched in HC, whereas succinate-producing bacteria, namely Phascolarctobacterium succinatutens and Paraprevotella clara, were enriched in SCZ. The gut microbiota of SCZ was enriched in lipid biosynthesis pathways related to bile-resistant bacteria, whereas phospholipid pathways linked with butyrate-producing bacteria were enriched in HC. Alistipes indistinctus, Dorea longicatena, and Roseburia inulinivorans were negatively correlated with dopamine levels. Roseburia intestinalis and Parabacteroides goldsteini were negatively correlated with serotonin and BDNF levels, respectively. We found a significant correlation between dopamine and serotonin levels, and the super-pathway of purine deoxyribonucleoside degradation.ConclusionsThis study provides further support that gut microbiota could modulate neurotransmitter levels. The results suggest that gut microbiome-targeted therapies may help to rebalance neurotransmitter levels, offering new hope for the treatment of schizophrenia.

Sex-specific associations between 10-year cardiovascular risk, clinical symptoms and cognitive impairments in schizophrenia.

Schizophrenia (SCZ) shortens life expectancy, with cardiovascular disease (CVD) as the leading cause of death. The links between psychiatric symptoms, cognitive function and CVD are unclear, and sex differences in this relationship are understudied. This study examined the relationship between clinical characteristics and 10-year cardiovascular risk in males and females with SCZ. This study included 802 patients with chronic SCZ. Fasting venous blood samples were collected from all patients to measure relevant glycolipid metabolic indices. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The Framingham risk score (FRS) was used to estimate the 10-year CVD risk. The mean 10-year cardiovascular risk for all patients was 11.76 ± 8.99%. Among patients with SCZ, 52.8% exhibited an intermediate-high 10-year cardiovascular risk. Multivariate linear regression analysis showed that FRS increased with higher body mass index, blood pressure, glucose, total cholesterol and triglyceride levels, while it was inversely related to high density lipoprotein levels. The general psychopathological scores were negatively associated with FRS (male: B = -0.086, P = 0.013; female: B = -0.056, P = 0.039). Negative symptom (B = -0.088, P = 0.024) and total PANSS scores (B = -0.042, P = 0.013) showed a negative association with FRS only in males. Additionally, in patients over 60years old, general psychopathology (B = -0.168, P = 0.001) and PANSS total scores (B = -0.057, P = 0.041) were associated with reduced FRS, while immediate memory (B = 0.073, P = 0.025) was associated with higher FRS. Patients with SCZ have an elevated risk of developing CVD, with males showing a higher 10-year cardiovascular risk than females. Significant sex differences exist in the relationship between the FRS and psychiatric symptoms, with negative symptoms being negatively related to FRS only in males.

Advances in the Treatment of Cognitive Impairment in Schizophrenia: Targeting NMDA Receptor Pathways

Cognitive impairment is a core feature of schizophrenia, playing a pivotal role in the pathogenesis and prognosis of this disorder. Cognitive impairment in schizophrenia encompasses a wide range of domains, including processing speed, episodic memory, working memory, and executive function. These deficits persist throughout the course of the illness and significantly impact functional outcomes and quality of life. Therefore, it is imperative to identify the biological basis of cognitive deficits in schizophrenia and develop effective treatments. The role of N-methyl-D-aspartate (NMDA) receptors in synaptic transmission and plasticity has long been recognized, making them potential targets for schizophrenia treatment. This review will focus on emerging pharmacology targeting NMDA receptors, offering strategies for the prevention and treatment of cognitive deficits in schizophrenia.

Exploring the molecular targets of fingolimod and siponimod for treating the impaired cognition of schizophrenia using network pharmacology and molecular docking

The treatment of cognitive impairment in schizophrenia is an unaddressed need due to the absence of novel treatments. Recent studies demonstrated that fingolimod and siponimod have neuroprotective effects in several neuropsychiatric disorders; however, their pharmacological mechanisms are unclear. The objective of this study was to identify potential molecular mechanisms of fingolimod and siponimod for improving cognition of schizophrenia through network pharmacology and molecular docking. The putative target genes of ingredients, schizophrenia, and impaired cognition were obtained from online databases, including SwissTargetPrediction, PharmMapper, GeneCards, CTD, DisGeNET, and OMIM. A protein–protein interaction network was constructed to identify core targets. The DAVID database was used for GO and KEGG pathway enrichment analyses. An ingredient–target–pathway–disease network was constructed using Cytoscape. Finally, the interactions between ingredients and core targets were assessed with molecular docking. The analysis revealed 260 targets shared by fingolimod and siponimod, 257 unique targets for fingolimod, and 88 unique targets for siponimod. Two signaling pathways were involved in fingolimod-mediated improvements in the cognition of schizophrenia, including the PI3K-Akt and MAPK signaling pathways. The core targets that regulated these two pathways included IL1B, AKT1, TNF, IL6, INS, BCL2, and BDNF. The MAPK signaling pathway was involved in siponimod-mediated improvement in the cognition of schizophrenia. The MAPK pathway was regulated by three core targets, namely TNF, AKT1, and CASP3. Docking scores ranged from −5.0 to −10.4 kcal/mol. Our analysis revealed that fingolimod regulates the PI3K-Akt and MAPK signaling pathways via the core targets IL1B, AKT1, TNF, IL6, INS, BCL2, and BDNF, and siponimod regulates the MAPK signaling pathways via the core targets AKT1, TNF, and CASP3 to improve the cognition of schizophrenia. Our results provide potential targets and a theoretical basis for the design of new drugs to treat the impaired cognition of schizophrenia.

Diminished functional segregation and resilience are associated with symptomatic severity and cognitive impairments in schizophrenia: a large-scale study

BackgroundThe research findings on the topological properties of functional connectomes (TP-FCs) in patients with schizophrenia (SZPs) exhibit inconsistencies and contradictions, which can be attributed to limitations such as small sample...

SLC39A8.p.(Ala391Thr) is associated with poorer cognitive ability: a cross-sectional study of schizophrenia and the general UK population.

The missense SNP NC_000004.12:g.102267552C>T (SLC39A8.p.(Ala391Thr), rs13107325) in SLC39A8, which encodes a zinc transporter, has been linked to schizophrenia and is the likely causal variant for one of the genome-wide association loci associated with the disorder. We tested whether the schizophrenia-risk allele at p.(Ala391Thr) was associated with schizophrenia-related phenotypes, including positive, negative, and disorganised symptoms, cognitive ability, educational attainment, and age of psychosis onset, within three schizophrenia cohorts (combined N=1,232) and, with equivalent phenotypes, in a sample of population controls (UK Biobank, N=355,069). We used regression analyses controlling for age, sex, and population stratification. Within the schizophrenia cohorts, after correction for multiple testing, p.(Ala391Thr) was not significantly associated with any schizophrenia-related phenotypes. In the unaffected participants from the UK Biobank, the schizophrenia-risk allele at p.(Ala391Thr) was associated with significantly poorer cognitive ability and fluid intelligence, a lower probability of obtaining GCSEs or a degree-level qualification, and fewer years in education. There was no association between p.(Ala391Thr) and self-reported psychotic experiences in this cohort. The schizophrenia-risk allele was associated with poorer cognitive ability, but not psychotic experiences, in a volunteer sample drawn from of the general population. To determine whether p.(Ala391Thr) is associated with cognitive phenotypes in people with schizophrenia, and to understand the role of p.(Ala391Thr) in the aetiology of cognitive impairment in schizophrenia, larger independent samples are required.

Dopamine D1 receptors activation rescues hippocampal synaptic plasticity and cognitive impairments in the MK-801 neonatal schizophrenia model

Schizophrenia is a disorder with a higher cognitive decline in early adulthood, causing impaired retention of episodic memories. However, the physiological and behavioral functions that underlie cognitive deficits with a potential mechanism to ameliorate and improve cognitive performance are unknown. In this study, we used the MK-801 neurodevelopmental schizophrenia-like model. Rats were divided into two groups: one received MK-801, and the other received saline for five consecutive days (7–11 postnatal days, PND). We evaluated synaptic plasticity late-LTP and spatial memory consolidation in early adolescence and young adulthood using extracellular field recordings in acute hippocampal slices and the Barnes maze task. Next, we examined D1 receptor (D1R) activation as a mechanism to ameliorate cognitive impairments. Our results suggest that MK-801 neonatal treatment induces impairment in late-LTP expression and deficits in spatial memory retrieval in early adolescence that is maintained until young adulthood. Furthermore, we found that activation of dopamine D1R ameliorates the impairments and promotes a robust expression of late-LTP and an improved performance in the Barnes maze task, suggesting a novel and potential therapeutic role in treating cognitive impairments in schizophrenia.

The Foundations and Practice of Neuropsychological Diagnostics in the Context of Forensic Psychiatric Examination

Background: cognitive impairments are comorbid for most mental disorders and can be important in assessing the ability of a subject to understand and control their actions in legally significant situations. The aim of review: аnalysis of neurobiological correlates and cognitive impairments in individuals suffering from mental disorders — organic personality disorder, schizophrenia, borderline personality disorder, in the context of forensic psychiatric examination. Material and methods: using keywords: “cognitive impairments in schizophrenia”, “cognitive impairments in organic personality disorders”, “cognitive impairments in personality disorders”, “MRI in schizophrenia”, “MRI in organic personality disorder”, “MRI in personality disorder”, “forensic neuropsychology”, “schizophrenia and criminal actions”, “organic personality disorders and criminal actions”, “personality disorders and criminal actions” the search and analysis of scientific publications was carried out in PubMed, Scopus, and RSCI databases over the past 5 years. Conclusion: schizophrenia shows deviations in the functioning of frontal and temporal lobes characterized by cognitive impairments: executive functions, attention, auditory-verbal memory, psychomotor slowness, inconsistent behavior, and deficits in volitional efforts. Borderline personality disorder is associated with reduced volume of the anterior cingulate gyrus, hippocampus, amygdala, and prefrontal cortex, dysfunctional interaction between limbic and prefrontal areas resulting in difficulties in emotion identification and impulsivity. Individuals with a history of traumatic brain injury (TBI) and secondary personality disorders exhibit diffuse gray matter damage affecting frontal, temporal, and parietal regions, emphasizing dysfunction of limbic-reticular complex structures with cognitive impairments including decreased thinking speed, attention stability, executive functions, auditory-verbal memory, visual-spatial memory, visual-motor coordination, and decreased impulse control. Individuals with mental disorders who commit criminal acts often exhibit deficiencies in frontal lobes and associated disturbances in executive components of mental activity, particularly cognitive flexibility and planning. Neuropsychological methods for studying cognitive functions can be used to obtain additional information in forensic psychiatric examinations.

Juvenile bright light exposure ameliorates adult behavioral abnormalities by enhancing neurogenesis in a N-methyl-D-aspartate receptor dysfunction mouse model relevant for cognitive impairment in schizophrenia

Exposure to light has been demonstrated to stimulate brain regions associated with cognition; however, investigations into its cognitive-enhancing effects have primarily focused on wild-type rodents. This study seeks to elucidate how bright light exposure mitigates cognitive deficits associated with schizophrenia by examining its impact on hippocampal neurogenesis and its potential to alleviate sub-chronic MK-801-induced cognitive impairments in mice. Following three weeks of juvenile bright light exposure (5–8 weeks old), significant increases in proliferating neurons (BrdU+) and immature neurons (DCX+ cells) were observed in the dentate gyrus (DG) and lateral ventricle of MK-801-treated mice. Long-term bright light treatment further promoted the differentiation of BrdU+ cells into immature neurons (BrdU+ DCX+ cells), mature neurons (BrdU+ NeuN+ cells), or astrocytes (BrdU+ GFAP+ cells) in the hippocampal DG. This augmented neurogenesis correlated with the attenuation of sub-chronic MK- 801-induced cognitive deficits, as evidenced by enhancements in Y-maze, novel object recognition (NOR), novel location recognition (NLR), and Morris water maze (MWM) test performances. These findings suggest a promising noninvasive clinical approach for alleviating cognitive impairments associated with neuropsychiatric disorders.

Intermittent Theta Burst Stimulation Combined with Cognitive Training to Improve Negative Symptoms and Cognitive Impairment in Schizophrenia: A Pilot Study.

Schizophrenia is a chronic psychiatric disorder severely affecting patients' functioning and quality of life. Unlike positive symptoms, cognitive impairment and negative symptoms cannot be treated pharmacologically and represent consistent predictors of the illness's prognosis. Cognitive remediation (CR) interventions have been applied to target these symptoms. Brain stimulation also provides promising yet preliminary results in reducing negative symptoms, whereas its effect on cognitive impairment remains heterogeneous. Here, we combined intermittent theta burst stimulation (iTBS) with CR to improve negative symptoms and cognitive impairment in schizophrenia spectrum patients. One hundred eligible patients were invited, and twenty-one participated. We randomized them into four groups, manipulating the stimulation condition (real vs. sham) and CR (no training vs. training). We delivered fifteen iTBS sessions over the left dorsolateral prefrontal cortex for three weeks, followed (or not) by 50 min of training. Consensus-based clinical and cognitive assessment was administered at baseline and after the treatment, plus at three follow-ups occurring one, three, and six months after the intervention. Mixed-model analyses were run on cognitive and negative symptom scores. The preliminary findings highlighted a marginal modulation of iTBS on negative symptoms, whereas CR improved isolated cognitive functions. We herein discuss the limitations and strengths of the methodological approach.

National Institute of Mental Health Support for Cognitive Treatment Development in Schizophrenia: A Narrative Review.

For several decades the National Institute of Mental Health (NIMH) has supported basic and translational research into cognitive impairment in schizophrenia. This article describes the Institute's ongoing commitment to cognitive assessment and intervention research, as reflected by three signature initiatives-Measurement and Treatment Research to Improve Cognition in Schizophrenia; Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia; and Research Domain Criteria-and related funding announcements that span basic experimental studies, efficacy and comparative effectiveness trials, and implementation research designed to promote cognitive healthcare in real-world treatment settings. We discuss how trends in science and public health policy since the early 2000s have influenced NIMH treatment development activities, resulting in greater attention to (1) inclusive teams that reflect end-user perspectives on the utility of proposed studies; (2) measurement of discrete neurocognitive processes to inform targeted interventions; (3) clinical trials that produce useful information about putative illness mechanisms, promising treatment targets, and downstream clinical effects; and (4) "productive urgency" in pursuing feasible and effective cognitive interventions for psychosis. Programs employing these principles have catalyzed cognitive measurement, drug development, and behavioral intervention approaches that aim to improve neurocognition and community functioning among persons with schizophrenia. NIMH will maintain support for innovative and impactful investigator-initiated research that advances patient-centered, clinically effective, and continuously improving cognitive health care for persons with psychotic disorders.

Psychometric evaluation of the patient-reported experience of cognitive impairment in schizophrenia (PRECIS) scale

BackgroundCognitive impairment associated with schizophrenia (CIAS) represents a distinct, persistent, and core group of schizophrenia symptoms. Cognitive symptoms have been shown to have an impact on quality of life. There are several published CIAS measures, but none based on direct patient self-report. It is important to capture the patient’s perspective to supplement performancebased outcome measures of cognition to provide a complete picture of the patient’s experience. This paper describes additional validation work on the Patient-Reported Experience of Cognitive Impairment in Schizophrenia (PRECIS) instrument.MethodsData from two large, international, pharmaceutical clinical trials in medically and psychiatrically stable English-speaking patients with schizophrenia and 88 healthy controls were analyzed. An exploratory factor analysis (EFA) was conducted in one trial (n = 215), using the original 35-item PRECIS. The factor structure suggested by EFA was further evaluated using item response theory (IRT; Samejima’s graded response model), and tested using confirmatory factor analysis (CFA). Both EFA and CFA results were tested in a second trial with similar inclusion/exclusion characteristics (n = 410). Additional statistical properties were evaluated in healthy controls.ResultsEFA suggested that the best solution after item reduction suggested a factor structure of 6 factors based on 26 items (memory, communication, self-control, executive function, attention, sharpness of thought), supporting a total score, with an additional 2-item bother score (28 items in all). IRT analysis indicated the items were well-ordered within each domain. The CFA demonstrated excellent model fit, accounting for 69% of the variance. The statistical properties of the 28-item version of the PRECIS were confirmed in the second trial. Evidence for internal consistency and test-retest reliability was robust. Known-groups validity was supported by comparison of healthy controls with patients with schizophrenia. Correlations indicated moderate associations between PRECIS and functioning instruments like the Schizophrenia Cognition Rating Scale (SCoRS), but weak correlations with performance-based outcomes like MATRICS Consensus Cognitive Battery (MCCB).DiscussionUsing two clinical trial samples, we identified a robust factor structure for the PRECIS and were able to replicate it in the second sample. Evaluation of the meaningful score difference (MSD) should be repeated in future studies, as these samples did not show enough change for it to be evaluated.ConclusionsThis analysis provides strong evidence for the reliability and validity of the PRECIS, a 28-item, patient-reported instrument to assess cognitive impairment associated with schizophrenia. The correlation with functioning and the weak correlation with performance on cognitive tasks suggests that patient reports of cognitive impairment measure a unique aspect of patient experience.

Comparative analysis of anticholinergic burden scales to explain iatrogenic cognitive impairment in schizophrenia: results from the multicenter FACE-SZ cohort.

The anticholinergic properties of medications are associated with poorer cognitive performance in schizophrenia. Numerous scales have been developed to assess anticholinergic burden and yet, there is no consensus indicating which anticholinergic burden scale is more relevant for patients with schizophrenia. We aimed to identify valid scales for estimating the risk of iatrogenic cognitive impairment in schizophrenia. We identified 27 scales in a literature review. The responses to neuropsychological tests of 839 individuals with schizophrenia or schizoaffective disorder in the FACE-SZ database were collected between 2010 and 2021. We estimated the association between objective global cognitive performance and the 27 scales, the number of psychotropic drugs, and chlorpromazine and lorazepam equivalents in bivariable regressions in a cross-sectional design. We then adjusted the bivariable models with covariates: the predictors significantly associated with cognitive performance in multiple linear regressions were considered to have good concurrent validity to assess cognitive performance. Eight scales, the number of psychotropic drugs, and drug equivalents were significantly associated with cognitive impairment. The number of psychotropic drugs, the most convenient predictor to compute, was associated with worse executive function (Standardized β = -0.12, p = .004) and reasoning (Standardized β = -0.08, p = .037). Anticholinergic burden, the number of psychotropic drugs, and drug equivalents were weakly associated with cognition, thus suggesting that cognitive impairment in schizophrenia and schizoaffective disorder is explained by factors other than medication. The number of psychotropic drugs was the most parsimonious method to assess the risk of iatrogenic cognitive impairment.

Cognitive impairment in schizophrenia is associated with prefrontal-striatal functional hypoconnectivity and striatal dopaminergic abnormalities.

A better understanding of the mechanisms underlying cognitive impairment in schizophrenia is imperative, as it causes poor functional outcomes and a lack of effective treatments. This study aimed to investigate the relationships of two proposed main pathophysiology of schizophrenia, altered prefrontal-striatal connectivity and the dopamine system, with cognitive impairment and their interactions. Thirty-three patients with schizophrenia and 27 healthy controls (HCs) who are right-handed and matched for age and sex were recruited. We evaluated their cognition, functional connectivity (FC) between the dorsolateral prefrontal cortex (DLPFC)/middle frontal gyrus (MiFG) and striatum, and the availability of striatal dopamine transporter (DAT) using a cognitive battery investigating attention, memory, and executive function, resting-state functional magnetic resonance imaging with group independent component analysis and single-photon emission computed tomography with 99mTc-TRODAT. Patients with schizophrenia exhibited poorer cognitive performance, reduced FC between DLPFC/MiFG and the caudate nucleus (CN) or putamen, decreased DAT availability in the left CN, and decreased right-left DAT asymmetry in the CN compared to HCs. In patients with schizophrenia, altered imaging markers are associated with cognitive impairments, especially the relationship between DLPFC/MiFG-putamen FC and attention and between DAT asymmetry in the CN and executive function. This study is the first to demonstrate how prefrontal-striatal hypoconnectivity and altered striatal DAT markers are associated with different domains of cognitive impairment in schizophrenia. More research is needed to evaluate their complex relationships and potential therapeutic implications.

Eosinophils and Cognitive Impairment in Schizophrenia: A New Perspective.

Schizophrenia is a complex psychiatric disorder characterized by a wide array of cognitive impairments. While research has predominantly focused on the neurological aspects of schizophrenia, emerging evidence suggests that the immune system, specifically eosinophils, may play a significant role in the cognitive deficits associated with the disorder. This review presents a novel perspective on the interplay between eosinophils and cognitive impairment in schizophrenia. Eosinophils, traditionally associated with allergic responses and inflammation, have garnered limited attention within the realm of neuropsychiatry. Recent studies have hinted at a potential link between eosinophil activation and the pathogenesis of schizophrenia. In this comprehensive review, we delve into the world of eosinophils, elucidating their nature, functions, and interactions with the immune system. We examine the cognitive deficits observed in individuals with schizophrenia and discuss existing theories on the etiology of these impairments, focusing on immune system involvement. The paper also highlights the evolving body of research that supports the idea of eosinophilic influence on schizophrenia-related cognitive deficits. Furthermore, we explore potential mechanisms through which eosinophils may exert their effects on cognitive function in schizophrenia, including interactions with other immune cells and inflammatory pathways. By discussing the clinical implications and potential therapeutic avenues stemming from this newfound perspective, we underscore the practical significance of this emerging field of research. While this paper acknowledges the limitations and challenges inherent in studying eosinophils within the context of schizophrenia, it serves as a posit for novel thought in this vexing disease space as well as a call to action for future research endeavors. By providing a comprehensive survey of the existing literature and posing unanswered questions, we aim to inspire a reimagining of the relationship between eosinophils and cognitive impairment in schizophrenia, ultimately advancing our understanding and treatment of this debilitating disorder.

Cross-cohort replicable resting-state functional connectivity in predicting symptoms and cognition of schizophrenia.

Schizophrenia (SZ) is a debilitating mental illness characterized by adolescence or early adulthood onset of psychosis, positive and negative symptoms, as well as cognitive impairments. Despite a plethora of studies leveraging functional connectivity (FC) from functional magnetic resonance imaging (fMRI) to predict symptoms and cognitive impairments of SZ, the findings have exhibited great heterogeneity. We aimed to identify congruous and replicable connectivity patterns capable of predicting positive and negative symptoms as well as cognitive impairments in SZ. Predictable functional connections (FCs) were identified by employing an individualized prediction model, whose replicability was further evaluated across three independent cohorts (BSNIP, SZ = 174; COBRE, SZ = 100; FBIRN, SZ = 161). Across cohorts, we observed that altered FCs in frontal-temporal-cingulate-thalamic network were replicable in prediction of positive symptoms, while sensorimotor network was predictive of negative symptoms. Temporal-parahippocampal network was consistently identified to be associated with reduced cognitive function. These replicable 23 FCs effectively distinguished SZ from healthy controls (HC) across three cohorts (82.7%, 90.2%, and 86.1%). Furthermore, models built using these replicable FCs showed comparable accuracies to those built using the whole-brain features in predicting symptoms/cognition of SZ across the three cohorts (r = .17-.33, p < .05). Overall, our findings provide new insights into the neural underpinnings of SZ symptoms/cognition and offer potential targets for further research and possible clinical interventions.

The Bidirectional Relationship between Weight Gain and Cognitive Function in First-Episode Schizophrenia: A Longitudinal Study in China.

Patients with schizophrenia often encounter notable weight gain during their illness, heightening the risk of metabolic diseases. While previous studies have noted a correlation between obesity and cognitive impairment in schizophrenia, many were cross-sectional, posing challenges in establishing a causal relationship between weight gain and cognitive function. The aim of this longitudinal study is to examine the relationship between weight gain and cognitive function in patients with first-episode schizophrenia (FES) during the initial 6-month antipsychotic treatments. Employing linear and logistic regression analyses, the study involved 337 participants. Significantly, baseline scores in processing speed (OR = 0.834, p = 0.007), working memory and attention (OR = 0.889, p = 0.043), and executive function (OR = 0.862, p = 0.006) were associated with clinically relevant weight gain (CRW, defined as an increase in body weight > 7%) at the 6-month endpoint. On the other hand, CRW correlated with improvements in the Brief Visuospatial Memory Test (p = 0.037). These findings suggest that patients with lower baseline cognitive performance undergo more substantial weight gain. Conversely, weight gain was correlated with cognitive improvements, particularly in the domain of visual learning and memory. This suggested a potential bidirectional relationship between weight gain and cognitive function in first-episode schizophrenia patients.

Schizophrenia and Nicotine - A Bittersweet Psychiatric Story

Abstract Background: Schizophrenia is a chronic mental disorder affecting mood, perception, and most importantly cognition. This severely interferes with the functioning of such patients. On the other hand, nicotine use (both smoke and smokeless tobacco) is very much prevalent in schizophrenic patients, much more than normal population. This study aims to find the relation between nicotine use and cognition in schizophrenic patients. Methodology: Fifty-six new patients diagnosed with schizophrenia of both sexes between ages 18 and 60 years, giving valid and informed consent, were selected for the study. Fagerstrom test for nicotine dependence was done and the patients were divided into two groups: scores 4 or less (low-to-moderate dependence) and scores 5 or more (severe dependence). The Cognitive Assessment Interview was performed. Then, an independent sample t-test was used to compare the scores on various cognitive domains between the two groups. Results: The cognitive scores were better in the group with severe tobacco dependence, both globally and across individual domains. These associations were statistically significant (P = 0.001). The mean difference was highest in the social cognition group. Among all the domains, the t-value was highest for the speed of processing domain, indicating that this particular cognitive domain has the best discriminative value when compared between two groups of nicotine users. Conclusions: Hence, to conclude, whether nicotine has indeed a beneficial effect on cognition in schizophrenia has to be investigated longitudinally so that a possible treatment option to address cognitive impairment in schizophrenia is obtained. Extensive longitudinal studies needs to be conducted to better understand the long-term effect of tobacco use and cognition in schizophrenia patients.

Brain network analysis of working memory in schizophrenia based on multi graph attention network

The cognitive impairment in schizophrenia (SZ) is characterized by significant deficits in working memory task. In order to explore the brain changes of SZ during a working memory task, we performed time-domain and time–frequency analysis of event related potentials (ERP) of SZ during a 0-back task. The P3 wave amplitude was found to be significantly lower in SZ patients than in healthy controls (HC) (p < 0.05). The power in the θ and α bands was significantly enhanced in the SZ group 200 ms after stimulation, while the θ band was significantly enhanced and the β band was weakened in the HC group. Furthermore, phase lag index (PLI) based brain functional connectivity maps showed differences in the connections between parietal and frontotemporal lobes between SZ and HC (p < 0.05). Due to the natural similarity between brain networks and graph data, and the fact that graph attention network can aggregate the features of adjacent nodes, it has more advantages in learning the features of brain regions. We propose a multi graph attention network model combined with adaptive initial residual (AIR) for SZ classification, which achieves an accuracy of 90.90 % and 78.57 % on an open dataset (Zenodo) and our 0-back dataset, respectively. Overall, the proposed methodology offers promising potential for understanding the brain functional connections of schizophrenia.