Function In First-episode Schizophrenia Research Articles

Functional and structural abnormalities of thalamus in individuals at early stage of schizophrenia

BackgroundThalamic abnormalities in schizophrenia are recognized, alongside cognitive deficits. However, the current findings about these abnormalities during the prodromal period remain relatively few and inconsistent. This study applied multimodal methods to explore the alterations in thalamic function and structure and their relationship with cognitive function in first-episode schizophrenia (FES) patients and ultra-high-risk (UHR) individuals, aiming to affirm the thalamus's role in schizophrenia development and cognitive deficits. Methods75 FES patients, 60 UHR individuals, and 60 healthy controls (HC) were recruited. Among the three groups, gray matter volume (GMV) and functional connectivity (FC) were evaluated to reflect the structural and functional abnormalities in the thalamus. Pearson correlation was used to calculate the association between these abnormalities and cognitive impairments. ResultsNo significant difference in GMV of the thalamus was found among the abovementioned three groups. Compared with HC individuals, FES patients had decreased thalamocortical FC mostly in the thalamocortical triple network, including the default mode network (DMN), salience network (SN), and executive control network (ECN). UHR individuals had similar but milder dysconnectivity as the FES group. Furthermore, FC between the left thalamus and right putamen was significantly correlated with execution speed and attention in the FES group. ConclusionsOur findings revealed decreased thalamocortical FC associated with cognitive deficits in FES and UHR subjects. This improves our understanding of the functional alterations in thalamus in prodromal stage of schizophrenia and the related factors of the cognitive impairment of the disease. Trial registrationClinicalTrials.govNCT03965598; https://clinicaltrials.gov/ct2/show/NCT03965598.

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.

Correlation study of brain-derived neurotrophic factor, EEG γ activity and cognitive function in first-episode schizophrenia

BackgroundSchizophrenia is characterised by neurotrophic, neuroelectrophysiological and cognitive dysfunction. However, there exists a paucity of research examining the association between serum brain-derived neurotrophic factor (BDNF) concentration, resting electroencephalogram (EEG) gamma activity, and cognitive impairment in individuals diagnosed with schizophrenia. MethodsIn this study, 87 first-episode schizophrenia patients and 75 healthy controls were assessed. Measurements were conducted to determine the levels of BDNF, resting EEG γ-activity at left and right frontal pole EEG electrodes respectively (FP1/FP2) leads, and cognitive function as assessed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia MATRICS Consensus Cognitive Battery (MCCB). Comparisons were made between the patient group and the control group, revealing lower BDNF levels, lower T-scores for 7 MCCB cognitive items, and higher EEG γ-activity among patients when compared to controls. ResultsAccording to the correlation analysis, there were significant associations observed in the patient group. BDNF levels were found to be correlated with EEG γ activity as well as T-scores of speed of processing (SoP), verbal learning (VeL), and reasoning problem-solving (RPS). Moreover, EEG γ activity showed an association with both the total score of the Positive and Negative Syndrome Scale (PANSS) and T-score of SoP. These findings suggest a potential relationship between BDNF levels, EEG γ activity, cognitive domains, and clinical symptoms in individuals with first-episode schizophrenia. ConclusionsIn conclusion, our findings demonstrate the coexistence of neurobiochemical and electrophysiological abnormalities alongside cognitive dysfunction during the early stages of schizophrenia. These findings provide valuable insights into the mechanism of cognitive impairment in schizophrenia. By highlighting the simultaneous occurrence of these factors, our study contributes to a better understanding of the complex nature of schizophrenia and emphasizes the importance of studying its cognitive aspects.

Decreased plasma neuropeptides in first-episode schizophrenia, bipolar disorder, major depressive disorder: associations with clinical symptoms and cognitive function.

There is an urgent need to identify differentiating and disease-monitoring biomarkers of schizophrenia, bipolar disorders (BD), and major depressive disorders (MDD) to improve treatment and management. We recruited 54 first-episode schizophrenia (FES) patients, 52 BD patients, 35 MDD patients, and 54 healthy controls from inpatient and outpatient clinics. α-Melanocyte Stimulating Hormone (α-MSH), β-endorphin, neurotensin, orexin-A, oxytocin, and substance P were investigated using quantitative multiplex assay method. Psychotic symptoms were measured using the Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS), manic symptoms using the Young Mania Rating Scale (YMRS), and depressive symptoms using 17 item-Hamilton Depression Rating Scale (HAMD). We additionally measured cognitive function by using a battery of tests given to all participants. α-MSH, neurotensin, orexin-A, oxytocin, and substance P were decreased in the three patient groups compared with controls. Neurotensin outperformed all biomarkers in differentiating patient groups from controls. There were no significant differences for 6 neuropeptides in their ability to differentiate between the three patient groups. Higher neurotensin was associated with better executive function across the entire sample. Lower oxytocin and higher substance p were associated with more psychotic symptoms in FES and BD groups. β-endorphin was associated with early morning wakening symptom in all three patient groups. Our research shows decreased circulating neuropeptides have the potential to differentiate severe mental illnesses from controls. These neuropeptides are promising treatment targets for improving clinical symptoms and cognitive function in FES, BD, and MDD.

Analysis of color vision and cognitive function in first-episode schizophrenia before and after antipsychotic treatment

BackgroundA large body of recent research has demonstrated that patients with schizophrenia exhibit significant changes in visual function and ocular tissue structure in the early stages of onset. It is therefore possible to explore a novel scientific breakthrough in the etiology of schizophrenia by transforming the traditional study of brain structure and function with a view to examining the potential field of eye tissue and function. However, few studies have investigated the correlation between iris characteristics and schizophrenia, and evidence is lacking in this regard. Thus, further exploration is needed. PurposeThis study was designed to analyze the characteristics of iris structure, color vision function and cognitive function, as well as the changes therein in patients with the first-episode drug-free schizophrenia before and after antipsychotic treatment. It aimed to preliminarily identify easily-measurable biomarkers for early clinical screening and diagnosis of schizophrenia. MethodsThis study recruited 61 patients (22 males) with first-episode schizophrenia. Prior to the commencement of treatment with antipsychotic drugs, the Montreal Cognitive Assessment (MoCA) and Farnsworth-Munsell Dichotomous (D-15 Hue Test) were used as assessment tools to evaluate cognitive function and color vision function, respectively. Over a 6-week period, patients received a second-generation antipsychotic treatment (all converted to olanzapine equivalent dose) as prescribed by the doctor, and the Positive and Negative Syndrome Scale (PANSS) was applied to evaluate the clinical treatment effects before treatment (baseline), as well as at the 2nd, 4th, and 6th weeks after drug treatment. On the basis of iris characteristics, the patients were divided into groups. The observed differences in drug treatment effects between the groups were then compared and analyzed to further clarify the relationship between treatment efficacy and iris characteristics. Finally, changes in the cognitive function and color vision function of patients at baseline and at the 6th week after drug treatment were compared, and the effects of antipsychotic drug treatment on the above-mentioned functions were analyzed. ResultsOn the basis of structural iris characteristics, 61 patients were classified as follows: 28 patients without iris crypts and 33 with iris crypts; 35 without iris pigment dots and 26 with iris pigment dots; 42 without iris wrinkles and 19 with iris wrinkles. No significant difference was observed in the PANSS scores of all of the patients at baseline; however, significant differences were found in patients with iris crypts and iris pigment dots at each follow-up timepoint (i.e., at the 2nd, 4th, and 6th week). Moreover, it is noteworthy that, compared with other patients, the PANSS scores of patients without specific iris structure characteristics (iris crypts and pigment dots) decreased significantly (P<0.05), which indicated that the drug therapy was highly effective. Excluding the interference of drug factors, a significant correlation was found between the results of the D-15 (color vision function) and MoCA (cognitive function) in first-episode untreated patients (r = −0.401, P < 0.05). In addition, the MoCA scores (mean difference = 2.36, t = 10.05, P ˂ 0.01) were significantly higher after 6 weeks of antipsychotic drug treatment compared to conditions at baseline. ConclusionsThe findings of this study demonstrated that color vision function of patients with schizophrenia improved with the improvement of cognitive function. The structural characteristics of the iris with crypts and pigment dots could have a significant impact on the drug treatment effect of schizophrenia and could be considered as a potential biomarker for detecting and recognizing schizophrenia.

S72. MCCB COGNITIVE PROFILE IN CHINESE FIRST EPISODE SCHIZOPHRENIA PATIENTS AND SUBJECTS AT CLINICAL HIGH RISK FOR PSYCHOSIS

BackgroundCognitive dysfunction is acknowledged as one of the most pivotal symptoms in schizophrenia. Although many studies have assessed cognitive functioning in first-episode schizophrenia (FES), the pattern and severity of impairment across cognitive domains remain unclear. Moreover, few studies have directly compared the pattern of cognitive performance between FES and subjects at clinical high risk for psychosis (CHR). The objective of the study was to examine the cognitive profile of Chinese patients with FES and to compare that to the profile of patients with subjects at CHR and healthy controls (HC).MethodsWe applied the MATRICS Consensus Cognitive Battery to evaluate the cognitive function of 56 first-episode patients with schizophrenia aged between 19–32 years old), 42 cases of clinical high risk for psychosis (aged between 18–28 years old) and 62 healthy controls (aged between 21–29 years old).All data were analyzed using SPSS 20.0 statistical software.ResultsFES showed impaired performance across all MCCB domains relative to HC（P＜0.05）. With the exception of relative preservation of reasoning and problem solving (P=0.21) and social cognition （P=0.16）in CHR, the MCCB domain scores were similar in CHR and FES.DiscussionThe findings suggest that the pattern, magnitude, and distribution of severity of impairment in CHR were similar to that observed in FES. However, early in the illness, there may be relative sparing of reasoning and problem solving and social cognition.

Associations between physiological responses to social-evaluative stress and daily functioning in first-episode schizophrenia

Schizophrenia (SZ) is associated with impaired adaptive functioning, including difficulties managing the demands of independent living, work, school, and interpersonal relationships. Prior studies have linked the physiological stress response with less effective coping in daily life. Differences in stress-response tendencies may also support heterogeneity in daily functioning in SZ. The present study examined two established measures of the stress response in patients with first-episode SZ. Salivary cortisol was included as an index of hypothalamic–pituitary–adrenal response. Vagal suppression (VS), a measure of stress-related reduction in heart rate variability, was used to assess parasympathetic flexibility. Greater cortisol response and VS to social-evaluative stress were predicted to be associated with better functioning in SZ over and above relationships with social cognition and neurocognition, two well-established predictors of functional outcome. Thirty-eight first-episode SZ outpatients and 29 healthy comparison subjects (HC) provided social cognitive, neurocognitive, and physiological measurements before and after the Trier Social Stress Test (TSST). Although SZ and HC did not differ on VS to the TSST, patients exhibited significant associations between VS and functioning across all four domains of the Role Functioning Scale. Furthermore, greater VS predicted more effective functioning with friends, beyond the contributions associated with social cognition and neurocognition, and strengthened the positive effects of higher levels of social cognition on independent living/self-care. VS elicited by social-evaluative stress in the laboratory may reflect stress-response tendencies in daily life that are relevant for daily functioning in first-episode SZ.

Cognitive remediation can improve negative symptoms and social functioning in first-episode schizophrenia: A randomized controlled trial

BackgroundMeta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include unexpected benefits for schizophrenia patients such as negative symptom reduction and improvements in functioning. In addition, some evidence indicated that these potentially beneficial effects are also present in the initial course of schizophrenia, but work in this area is still developing. MethodA RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9years and mean education of 12.3years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6months and then booster sessions over the next 6months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning. ResultsUsing GLMM, improvements over 12months were found favoring CR for SANS Expressive Symptoms (p<0.01), which was composed of Affective Flattening (p<0.01) and Alogia (p=0.04), and for SANS Experiential Symptoms, composed of Avolition/Apathy (p=0.04) and Anhedonia/Asociality (p<0.01). CR was associated with improvements in social functioning (p=0.05) as compared to HBT. ConclusionsWe confirmed that the beneficial effects of CR appear to extend beyond cognition to improvements in negative symptoms and social functioning in early course schizophrenia patients. These results suggest that cognitive remediation might have an impact when the reduction of risk factors for chronicity is most critical for promoting recovery.

Relationships between dorsolateral prefrontal cortex metabolic change and cognitive impairment in first-episode neuroleptic-naive schizophrenia patients.

The present study aimed to explore the possible associations between the dorsolateral prefrontal cortex (DLPFC) metabolites and the cognitive function in first-episode schizophrenia (FES).This study included 58 patients with FES (29 males and 29 females; mean age, 22.66 ± 7.64 years) recruited from the First Affiliated Hospital, College of Medicine, Zhejiang University, and 43 locally recruited healthy controls (16 males and 27 females; mean age, 23.07 ± 7.49 years). The single-voxel proton magnetic resonance spectroscopy was used to measure the levels of N-acetylaspartate (NAA); complex of glutamate, glutamine, and γ-aminobutyric acid (Glx); choline-containing compounds; and myo-inositol in the DLPFC. The ratios of metabolites to creatine (Cr) were calculated. The cognitive function was assessed by Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Correlation analysis was used to assess the relationships between the DLPFC metabolites and the cognitive function.Compared with the healthy controls, the patients with FES showed significantly reduced scores in each part of the MCCB, significantly reduced NAA/Cr, and significantly increased Glx/Cr in the left DLPFC. Poor performance in verbal learning and visual learning was correlated to the reduced NAA/Cr ratio in the left DLPFC.These findings suggest that a lower NAA/Cr ratio in the left DLPFC is associated with the cognitive deficits in patients with FES, and may be an early biochemical marker for the cognitive impairment in schizophrenia.

Association study on serum protein factors and cognitive function in first-episode schizophrenia characterized by positive and negative symptoms

Objective To investigate the relationship between the serum concentration of IL-6, S100β, NT-3 and the cognitive functions in first-episode schizophrenia characterized by positive or negative symptoms. Methods 44 first-episode schizophrenic patients characterized by positive symptoms (positive group), 36 first-episode schizophrenic patients characterized by negative symptoms (negative group) and 50 healthy controls (controls) were collected. The serum levels of IL-6, S100β and NT-3 were measured by enzyme-linked immunosorbent assay (ELISA). The systematic evaluation tool-MCCB was applied to assess cognitive function in patients and controls. Results NT-3 serum levels in positive or negative groups were lower than those in controls and the differences were significant((118.39±37.50) ng/L, (112.55±32.29) ng/L vs (141.18±29.67) ng/L) (P<0.01). IL-6 and S100β serum levels in positive or negative groups were higher than those in controls and the differences were statistically significant((5.74±1.00)ng/L, (5.07±1.17)ng/L vs (4.23±0.91)ng/L), ((132.98±46.71)ng/L, (124.99±43.14)ng/L vs (103.63±31.57)ng/L)(P<0.01). IL-6 serum levels in the positive group ((5.07±1.17)ng/L) were lower than those in the negative group ((5.74±0.99)ng/L) and the difference was statistically significant (P<0.05). In MCCB test, the TMT scores in patients characterize by positive symptoms or patients characterize by negative symptoms were higher than those in healthy control group (P<0.01). BACS SC, HVLT-R WMS-Ⅲ, SS, NAB, BVMT-R, CF in patients characterize by positive symptoms or by negative symptoms were lower than those in healthy control group(P<0.01). There were no statistical difference in the MCCB scores between the patients with positive symptoms and negative symptoms. In positive group, there was a positive correlation between the IL-6 serum concentration and the general symptom scores in PANSS (P<0.05). In positive group, NT-3 serum concentration was positively correlated with the general symptom scores or total scores of PANSS (P<0.05). BVMT-R scores in MCCB were also positively correlated with IL-6 or NT-3 serum concentration in positive group (P<0.05). Conclusion The impairment of part of cognitive functions for schizophrenic patients may be related to the serum protein factors. There may be different in pathophysiology between the first-episode schizophrenic patients characterized by positive symptoms and those characterized by negative symptoms. Key words: First-episode schizophrenia; Positive symptoms; Negative symptoms; Serum protein factor; Cognitive function

97. Adding Aerobic Exercise to Cognitive Training Improves Negative Symptoms and Social Functioning in First-Episode Schizophrenia: An Initial RCT

97. Adding Aerobic Exercise to Cognitive Training Improves Negative Symptoms and Social Functioning in First-Episode Schizophrenia: An Initial RCT

Cognitive effectiveness of risperidone and olanzapine in first-episode schizophrenia

Objective: To study the impairments of cognitive function in first-episode schizophrenia and the potential effectiveness of risperidone and olanzapine monotherapy on first-episode schizophrenia. Methods: A total of 57 first-episode schizophrenia and 30 healthy controls were assessed at baseline, and patients were assessed again after 8-week antipsychotics therapy. Results: The positive and negative symptom scale (PANSS) reductive ratio between the two groups was similar. At baseline, the performance of schizophrenia patients was significant poor than healthy controls in the four domains of cognitive function (P<0.05); after 8-week's antipsychotics therapy, the performance of Trail Making Test (t=3.862, P<0.05) and Verbal Learning (t=-3.073, P<0.05) got significant improvements in patients with risperidone, while in group of patients with olanzapine, the performance of Trail Making Test (t=3.587, P<0.05) and working memory domain (t=-2.891, P<0.05) got significant improvements. Spearman correlation analyses suggested that dosage of risperidone was negatively correlated with the score-reducing rate of the performance of Trail Making Test of patients (r=-0.391, P=0.048). Conclusions: The effects of the two psychotroptic drugs on clinical symptoms and cognitive functions are almost equal. Comprehensive cognitive impairment is found in first-episode schizophrenia, and risperidone and olanzapine could partially improve the performance of cognitive function as well as clinical symptoms. The higher the dosage of risperidone is, the less improvement the patients has in the speed of process domain.

Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset

BackgroundThe mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia. MethodsThis study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points. ResultsWe identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group. ConclusionsThe present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.

Effect of time and duration of untreated psychosis on cognitive and social functioning in Chinese patients with first-episode schizophrenia: A 1-year study

Background: Duration of untreated psychosis (DUP) is believed to exert a deleterious effect on cognitive and social function. However, to date, results remain inconclusive. Aims: To investigate the effect of time and DUP on cognitive and social functioning in first-episode schizophrenia (FES) subjects in Shanghai, China. Methods: FES patients were subjected to a comprehensive neuropsychological battery, the Personal and Social Performance scale (PSP) and the Positive and Negative Symptoms Scale (PANSS) at baseline, 6 month and 1 year. DUP was defined as the time from onset of first psychotic symptoms to first contact made with psychiatric services. Results: Though the rate of non-completers in our observational study was relatively high (40%), we did not find any significant differences between the completers and non-completers (P-values > 0.05). Significant impairments in verbal learning and memory and executive function were noted over the course of 1 year. Meanwhile, social function improved significantly over the course of 1 year. Although, DUP did not share any significant relationship with cognitive or social function the effect estimate (range: − 0.03 to 0.02) of an increase of 1 month in DUP was clinically non-negligible in this study. Conclusions: In Chinese FES patients, the longitudinal course of cognitive function tends to worsen in verbal learning and memory, executive function and motor speed, while that of social function tends to improve. DUP was not found to be associated with cognitive or social deterioration in Chinese FES.

A multimodal analysis of antipsychotic effects on brain structure and function in first-episode schizophrenia.

Recent data suggest that treatment with antipsychotics is associated with reductions in cortical gray matter in patients with schizophrenia. These findings have led to concerns about the effect of antipsychotic treatment on brain structure and function; however, no studies to date have measured cortical function directly in individuals with schizophrenia and shown antipsychotic-related reductions of gray matter. To examine the effects of antipsychotics on brain structure and function in patients with first-episode schizophrenia, using cortical thickness measurements and administration of the AX version of the Continuous Performance Task (AX-CPT) during event-related functional magnetic resonance imaging. This case-control cross-sectional study was conducted at the Imaging Research Center of the University of California, Davis, from November 2004 through July 2012. Participants were recruited on admission into the Early Diagnosis and Preventive Treatment Clinic, an outpatient clinic specializing in first-episode psychosis. Patients with first-episode schizophrenia who received atypical antipsychotics (medicated patient group) (n = 23) and those who received no antipsychotics (unmedicated patient group) (n = 22) and healthy control participants (n = 37) underwent functional magnetic resonance imaging using a 1.5-T scanner. Behavioral performance was measured by trial accuracy, reaction time, and d'-context score. Voxelwise statistical parametric maps tested differences in functional activity during the AX-CPT, and vertexwise maps of cortical thickness tested differences in cortical thickness across the whole brain. Significant cortical thinning was identified in the medicated patient group relative to the control group in prefrontal (mean reduction [MR], 0.27 mm; P < .001), temporal (MR, 0.34 mm; P = .02), parietal (MR, 0.21 mm; P = .001), and occipital (MR, 0.24 mm; P = .001) cortices. The unmedicated patient group showed no significant cortical thickness differences from the control group after clusterwise correction. The medicated patient group showed thinner cortex compared with the unmedicated patient group in the dorsolateral prefrontal cortex (DLPFC) (MR, 0.26 mm; P = .001) and temporal cortex (MR, 0.33 mm; P = .047). During the AX-CPT, both patient groups showed reduced DLPFC activity compared with the control group (P = .02 compared with the medicated group and P < .001 compared with the unmedicated group). However, the medicated patient group demonstrated higher DLPFC activation (P = .02) and better behavioral performance (P = .02) than the unmedicated patient group. These findings highlight the complex relationship between antipsychotic treatment and the structural, functional, and behavioral deficits repeatedly identified in schizophrenia. Although short-term treatment with antipsychotics was associated with prefrontal cortical thinning, treatment was also associated with better cognitive control and increased prefrontal functional activity. This study adds important context to the growing literature on the effects of antipsychotics on the brain and suggests caution in interpreting neuroanatomical changes as being related to a potentially adverse effect on brain function.

Cognitive functioning in first-episode schizophrenia: MATRICS Consensus Cognitive Battery (MCCB) Profile of Impairment

BackgroundAlthough many studies have assessed cognitive functioning in first-episode schizophrenia (FESz), the pattern and severity of impairment across cognitive domains remain unclear. Moreover, few studies have directly compared the pattern of cognitive performance between FESz and chronic schizophrenia (CSz). In this study we examined the cognitive impairment profile in FESz using a standardized neurocognitive battery (MATRICS Consensus Cognitive Battery; MCCB). MethodsMCCB data were compared from 105 FESz patients, 176 CSz patients and 300 non-psychiatric (NP) participants. Mixed model analysis evaluated group differences in MCCB profiles and relative strengths and weaknesses in the MCCB profiles of patients. Clinical implications of MCCB performance were also examined; we compared the proportion of participants from each group who exhibited clinically-significant global cognitive impairment based on the MCCB Overall Composite score. ResultsFESz and CSz showed impaired performance across all MCCB domains relative to NP. With the exception of relative preservation of working memory and social cognition in FESz, the MCCB domain scores were similar in FESz and CSz. The distribution of impairment on the Overall Composite score did not significantly differ between FESz and CSz; compared to NP, both patient groups were overrepresented in moderate and severe impairment categories. ConclusionThe pattern, magnitude, and distribution of severity of impairment in FESz were similar to that observed in CSz. However, early in the illness, there may be relative sparing of working memory and social cognition.

Cognitive deficits and its relation with psychopathology and global functioning in first episode schizophrenia

AimThe aim was to examine the cognitive deficits profile in first episode schizophrenia patients as well as examine the correlation between cognitive deficits, psychopathology and global functioning. Better understanding of these various facets of this debilitating illness is imperative in planning treatment, thereby limiting decline in global functioning. MethodsForty-nine schizophrenia patients with illness duration less than two years comprised the sample. A comprehensive battery of neuropsychological tests, the Positive and Negative Syndrome Scale and WHO Disability Assessment schedule were administered to assess cognitive functions, psychopathology and global functioning respectively. ResultsCognitive deficit quotient for each patient was calculated. In this cohort 16.3% of patients had less than 25% of cognitive deficits, 38.8% had 25–50% of cognitive deficits, 36.7% had 50–75% of cognitive deficits and 8.2% of patients had more than 75% cognitive deficits. More than 50% of the patients in the present cohort showed deficits in the domains of attention, executive functions and learning and memory. Psychopathology significantly correlated with global functioning. Negative symptoms significantly correlated with cognitive functions of motor speed, attention and executive functions. Step wise linear regression analysis showed that duration of illness, attention (sustained attention), executive function (response inhibition), negative and positive psychopathology predicted level of global functioning at varied levels. ConclusionsCognitive deficits in multiple domains were observed in the present cohort. Attention and executive functions predicted global functioning. There is a need for longitudinal studies with larger sample to examine the course of the cognitive deficits with progress in illness.

Effects of amisulpride on the cognitive function in first-episode schizophrenia patients

Objective To explore the effects of amisulpride on the cognitive function in first-episode schizophrenia patients. Methods 64 patients in first-episode schizophrenia were divided into two groups randomly according to the method of tossing a coin, then treated with amisulpride or risperidone respectively for 12 weeks.The efficacy and adverse effect were evaluated with positive and negative scale (PANSS) and treatment emergent side effect scale (TESS) before treatment and after treatment for 2 weeks, 4 weeks, 8 weeks, 12 weeks.Before and after treatment for 12 weeks, cognitive function of all the patients was blindly evaluated with Wechsler Scale-revised China (WMS-RC) , Wisconsin Card Sorting Test(WCST)and Trail Making test A and B. Results After 12-week treatment, statistical difference was found in amisulpride(44.7±6.7) and risperidone(45.2±7.4) groups (P 0.05). The cognitive function in first-episode schizophrenia was damaged obviously.In two groups, the scores in recognize, association, comprehend, back a few and MQ of WMS and TAT-A, TAT-B were improved significantly after treatment for 12 weeks(P>0.05). These items of WCST were improved more remarkably than baseline (amisulpride(20.63±13.06), (28.75±15.72), (43.17±22.13), (3.62±2.21), P 0.05). Conclusion The study shows that the cognitive dysfunction in first-episode schizophrenia can be improved by amisulpride, and the efficacy was similar with risperidone. Key words: Amisulpride; Risperidone; Schizophrenia; Cognitive function

Executive function in first-episode schizophrenia: A three-year prospective study of the Hayling Sentence Completion Test

In recent decade, deficits in the mechanism of Supervisory Attentional System (SAS) have become increasingly influential in explaining the nature of dysexecutive syndrome experienced by schizophrenic patients. The SAS model is characterized by having a detailed sub-classification of specific executive function components, among which semantic inhibition has been investigated using the Hayling Sentence Completion Test (HSCT). Several studies thus far have indicated that schizophrenic patients show impairment in HSCT performance. However, HSCT data concerning first-episode patients is still scarce. Besides, as previous HSCT studies were all cross-sectional in nature, they were not able to assess changes in HSCT performance over time. In order to address the paucity of knowledge about the longitudinal trajectories and correlates of semantic inhibition deficits in early schizophrenia, this paper reports a three-year prospective study of HSCT performance in medication-naïve, first-episode patients with schizophrenia-spectrum disorders. HSCT performance was assessed in 34 patients at four times over a period of three years, while the 34 healthy controls were assessed once. We found that medication-naïve patients demonstrated impairment in the inhibition condition in HSCT as compared to controls, but not in the initiation condition. Such HSCT impairment gradually improved in the three years following the first psychotic episode; however, HSCT performance did not predict improvement in negative or positive symptoms over the three-year period. The present findings suggest that semantic inhibition impairment is a specific deficit in schizophrenia that may require early intervention efforts, with the goal of facilitating more successful verbal communication and thereby better interpersonal functioning.

Retracted: Effect of blonanserin on cognitive function in antipsychotic-naïve first-episode schizophrenia

Objective The purpose of this study was to evaluate the effects of blonanserin, a novel antipsychotic, on cognitive function in first-episode schizophrenia. Methods Twenty-four antipsychotic-naïve patients with first-episode schizophrenia participated in the study. Blonanserin was given in an open-label design for 8 weeks. The Brief Assessment of Cognition in Schizophrenia—Japanese language version (BACS-J) was administered as the primary outcome measure at baseline and 8 weeks. Clinical evaluation included the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale—Japanese language version (SQLS-J), and the Clinical Global Impression—Severity of Illness Scale (CGI-S). To exclude the possibility of retest effects on the BACS-J, 10 age-matched patients with chronic schizophrenia treated with blonanserin were tested at baseline and after an 8-week interval. Results Twenty first-episode patients completed the study. Repeated measures analysis of covariance revealed a significant group-by-time interaction effect on the letter fluency task due to better performance in the first-episode group, but not in the control group. Main effect of time or group-by-time interaction effect on the Tower of London task was not significant; however, the first-episode group, but not the control group, showed substantial improvement with a moderate effect size. All items on the PANSS, SQLS-J, and CGI-S significantly improved after 8 weeks of treatment. Conclusions These results suggest that blonanserin improves some types of cognitive function associated with prefrontal cortical function. Copyright © 2012 John Wiley & Sons, Ltd.