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A Summary List of Neuropsychological Tests Examined in This Report and Their Various Categorizations
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The deficit syndrome is thought to characterize a pathophysiologically distinct subgroup of patients with schizophrenia. Supporting this notion, prior research examining the neuropsychological correlates of the deficit syndrome has suggested the presence of a differential impairment in frontal and parietal functions. This article reports findings f...
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Background:
Synchronous and antisynchronous activity between neural elements at rest reflects the physiological processes underlying complex cognitive ability. Regional and pairwise-connectivity investigations suggest perturbations in these activity patterns may relate to widespread cognitive impairments seen in bipolar disorder (BD). Here we take...
Citations
... To date, only one meta-analysis compared patients with deficit and nondeficit schizophrenia, demonstrating greater impairment of cognitive inhibition in the former, as indicated by the mean effect size of between-group differences [6]. However, not all reports found significant differences between the two patient populations [29][30][31]. In addition, there is little data on potential differences between the two groups in terms of motor inhibition, and our previous study did not find the presence of such differences [32]. ...
... Nevertheless, there are studies in which motor inhibition deficits in schizophrenia have not been observed [27,28]. Our results seem to be in line with previous findings that did not find more severe deficits in terms of cognitive inhibition in deficit schizophrenia groups compared to non-deficit groups [29][30][31]. Although the meta-analysis of Bora et al. [6] showed different results, indicating that patients with deficit schizophrenia had greater difficulty with cognitive inhibition relative to their non-deficit counterparts, the studies analyzed in their work did not include additional measures to minimize the effect of Reaction Time. ...
Background
There is conflicting evidence on impulsivity and its potential relationship with inhibitory control in schizophrenia. This study therefore aimed to identify differences in impulsivity and cognitive and motor inhibition between patients with deficit (DS) and non-deficit (NDS) schizophrenia and healthy controls (HC). We also explored the relationships between impulsivity and different dimensions of inhibitory control in all studied groups.
Methods
The sample comprised 28 DS patients, 45 NDS patients, and 39 age-matched HC. A neuropsychological battery was used.
Results
DS patients scored lower in venturesomeness, while those with NDS scored higher in impulsiveness compared to HC. In addition, both groups of patients scored higher on measures of cognitive and motor inhibition, including those relatively independent of information processing speed (although the results were slightly different after adjusting for IQ and/or years of education). Correlations between impulsivity and cognitive inhibition emerged in DS patients, while links between impulsivity and motor inhibition were observed in HC.
Conclusions
Our results suggest the presence of deficits in experimentally assessed inhibitory control in schizophrenia patients, with predominant impulsivity in the NDS population. In addition, impulsivity may affect the cognitive control of inhibition in deficit schizophrenia. Nevertheless, due to the preliminary nature of these findings, they require further empirical verification in future research.
... All patients were measured on the Brief Psychiatric Rating Scale (BPRS) [36], the Scale for the Assessment of Negative Symptoms (SANS) [37], the Scale for the Assessment of Positive Symptoms (SAPS), and SDS to assess the severity of their psychiatric symptoms. ...
Deficit schizophrenia (DS) is a subtype of schizophrenia characterized by the primary and persistent negative symptoms. Previous studies have identified differences in brain functions between DS and non-deficit schizophrenia (NDS) patients. However, the genetic regulation features underlying these abnormal changes are still unknown. This study aimed to detect the altered patterns of functional connectivity (FC) in DS and NDS and investigate the gene expression profiles underlying these abnormal FC. The study recruited 82 DS patients, 96 NDS patients, and 124 healthy controls (CN). Voxel-based unbiased brain-wide association study was performed to reveal altered patterns of FC in DS and NDS patients. Machine learning techniques were used to access the utility of altered FC for diseases diagnosis. Weighted gene co-expression network analysis (WGCNA) was employed to explore the associations between altered FC and gene expression of 6 donated brains. Enrichment analysis was conducted to identify the genetic profiles, and the spatio-temporal expression patterns of the key genes were further explored. Comparing to CN, 23 and 20 brain regions with altered FC were identified in DS and NDS patients. The altered FC among these regions showed significant correlations with the SDS scores and exhibited high efficiency in disease classification. WGCNA revealed associations between DS/NDS-related gene expression and altered FC. Additionally, 22 overlapped genes, including 12 positive regulation genes and 10 negative regulation genes, were found between NDS and DS. Enrichment analyses demonstrated relationships between identified genes and significant pathways related to cellular response, neuro regulation, receptor binding, and channel activity. Spatial and temporal gene expression profiles of SCN1B showed the lowest expression at the initiation of embryonic development, while DPYSL3 exhibited rapid increased in the fetal. The present study revealed different altered patterns of FC in DS and NDS patients and highlighted the potential value of FC in disease classification. The associations between gene expression and neuroimaging provided insights into specific and common genetic regulation underlying these brain functional changes in DS and NDS, suggesting a potential genetic-imaging pathogenesis of schizophrenia.
... The Brief Psychiatric Rating Scale (BPRS), organized into positive, negative, disorganized, and affect syndromes based on the findings of the factor analysis of 18-item, 25 ...
Aim
Deficit schizophrenia (DS), defined by primary and enduring negative symptoms, has been proposed as a promising homogeneous subtype of schizophrenia. It has been demonstrated that unimodal neuroimaging characteristics of DS were different from non‐deficit schizophrenia (NDS), however, whether multimodal‐based neuroimaging features could identify deficit syndrome remains to be determined.
Methods
Functional and structural multimodal magnetic resonance imaging of DS, NDS and healthy controls were scanned. Voxel‐based features of gray matter volume, fractional amplitude of low‐frequency fluctuations, and regional homogeneity were extracted. The support vector machine classification models were constructed using these features separately and jointly. The most discriminative features were defined as the first 10% of features with the greatest weights. Moreover, relevance vector regression was applied to explore the predictive values of these top‐weighted features in predicting negative symptoms.
Results
The multimodal classifier achieved a higher accuracy (75.48%) compared with the single modal model in distinguishing DS from NDS. The most predictive brain regions were mainly located in the default mode and visual networks, exhibiting differences between functional and structural features. Further, the identified discriminative features significantly predicted scores of diminished expressivity factor in DS but not NDS.
Conclusions
The present study demonstrated that local properties of brain regions extracted from multimodal imaging data could distinguish DS from NDS with a machine learning‐based approach and confirmed the relationship between distinctive features and the negative symptoms subdomain. These findings may improve the identification of potential neuroimaging signatures and improve the clinical assessment of the deficit syndrome.
... However, their results do not clearly indicate whether the observed dysfunction reflects a general or specific cognitive deficit [8]. Some light on this unclear matter is shed by the results of two metaanalyses [3,9], suggesting more general cognitive impairments in deficit compared to non-deficit schizophrenia. Notwithstanding, the authors propose that some patients with deficit schizophrenia may in fact manifest a differential pattern of neuropsychological impairment, which could be considerably more complicated than previously thought and which warrants a more sophisticated and rigorous examination of the cognitive dysfunctions underlying the deficit syndrome with the use of more extensive batteries of tests. ...
... Seemingly, however, the analysis of the links between psychopathological symptoms and cognitive deficits in deficit schizophrenia has been widely neglected (c.f. [3,9]). Even though Yu et al. [26] found a relationship between negative symptoms and cognitive function in both deficit and non-deficit schizophrenia, these links differed within different cognitive domains. ...
This study compared cognitive domains between deficit schizophrenia (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), analyzing relationships between psychopathological dimensions and cognitive domains. A total of 29 DS patients, 45 NDS patients, and 39 HC subjects participated. Cognitive domains were measured using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Battery. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale. Clinical groups performed poorer than HC groups in regards to speed of processing, attention/vigilance, working memory, verbal and visual learning and memory, reasoning and problem solving, and social cognition. DS patients scored poorer than NDS patients in terms of all cognitive domains and the overall score, except for reasoning and problem solving. Positive, negative, disorganization, and resistance symptoms were related to cognitive functions only in NDS patients. Our findings suggest that the MCCB battery is sensitive to detecting cognitive dysfunctions in both deficit and non-deficit schizophrenia.
... Over the years, several models of schizophrenia have been proposed, from homogeneous to multi-factorial concepts. One such approach was to distinguish two separate types of schizophrenia: deficit schizophrenia (DS) and non-deficit schizophrenia (NDS), based on negative (deficit) symptom severity at onset [4], risk factors [5,6], family history [7], disease course [8,9], response to treatment [10], neuropsychological functioning [11,12], and neurobiological differences [13]. ...
... Moreover, previous studies have yielded inconclusive results, with some suggesting no differences in premorbid IQ between DS and NDS patients [30,31] but others demonstrating lower premorbid IQ and more impaired executive functions in DS patients compared to NDS patients [32][33][34][35]. In addition, previous studies used neuropsychological tests to measure a smaller range of executive functions and did so in a more selective fashion, such as through problem-solving (e.g., the Wisconsin Card Sorting Test), cognitive flexibility (e.g., the Trail Making Test), or cognitive inhibition (e.g., the Stroop Test) [11,14]. What is more, only a few studies have attempted to investigate the differences while controlling for psychopathology. ...
... Moreover, this meta-analysis [14] indicates that patients with DS are more impaired in all cognitive domains compared to NDS. Our results do not fully con-firm this, because DS patients achieved similar results for planning to HC. Cohen et al. [11] also did not find significant differences in frontal or parietal abilities for DS patients. The mini-review of Tyburski et al. [17] of 16 studies indicates that DS and NDS have greater problems with regard to nonverbal flexibility, concept formation, and problem-solving, but some of the analyzed studies did not show differences, which means that there is no consistency in terms of performance deficits between the two clinical groups. ...
This study: (a) compared executive functions between deficit (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), controlling premorbid IQ and level of education; (b) compared executive functions in DS and NDS patients, controlling premorbid IQ and psychopathological symptoms; and (c) estimated relationships between clinical factors, psychopathological symptoms, and executive functions using structural equation modelling. Participants were 29 DS patients, 44 NDS patients, and 39 HC. Executive functions were measured with the Mazes Subtest, Spatial Span Subtest, Letter Number Span Test, Color Trail Test, and Berg Card Sorting Test. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. Compared to HC, both clinical groups performed poorer on cognitive flexibility, DS patients on verbal working memory, and NDS patients on planning. DS and NDS patients did not differ in executive functions, except planning, after controlling premorbid IQ and negative psychopathological symptoms. In DS patients, exacerbation had an effect on verbal working memory and cognitive planning; in NDS patients, positive symptoms had an effect on cognitive flexibility. Both DS and NDS patients presented deficits, affecting the former to a greater extent. Nonetheless, clinical variables appeared to significantly affect these deficits.
... The deficit group had significantly lower GAF scores (p < 0.01), indicating poorer overall function. As expected, the deficit group scored significantly higher on the CGI-SCH for negative symptoms, cognitive symptoms, 31 and overall severity (p < 0.001), but did not differ for positive or depressive symptoms (p > 0.1). 32 The remaining sociodemographic and clinical details did not differ significantly between the two groups (though there were Table 3 shows the prevalence of different risk factors in their approximate chronological order. ...
Aim
We examined whether timing of known risk factors for schizophrenia may influence the development of schizophrenia with primary negative symptoms.
Method
This cross-sectional single-centre study in England used a clinical cohort of 167 clozapine-treated schizophrenia patients. Deficit and nondeficit schizophrenia models were used as clinical proxies of patients with and without primary negative symptoms respectively. Patients were assessed using the Schedule for the Deficit Syndrome. We examined previously replicated risk factors (family history of psychosis, advanced paternal age, male gender, birth weight <3000 g, summer birth, cannabis use, exposure to physical or sexual abuse and/or bullying) as well as other traumatic events for deficit and nondeficit schizophrenia.
Results
We found a distinct risk factor pattern for the two groups. Compared to the nondeficit group, patients with deficit schizophrenia reported a significantly lower prevalence of cannabis use (p = 0.005) at the time of first-episode psychosis (FEP), physical or sexual abuse (p = 0.033) prior to FEP, less exposure to crime-related traumatic events (p = 0.012) and significantly associated with summer birth (p = 0.017). The groups did not differ in terms of family history of psychosis, advanced paternal age, male gender, or low birth weight. To account for multiple comparisons, a confirmatory analysis was performed using logistic regression which yielded similar results except that summer birth no longer reached statistical significance.
Conclusion
Our results suggest the timing of the insult may influence the symptom presentation, with insults later in life (cannabis or traumatic events) being associated with psychotic presentation and less with primary negative symptoms.
... As for negative SZ profiles, despite emotional and cognitive deficits define this syndrome (American Psychiatric Association [APA], 2013), theoretical accounts are underdeveloped. Negative SZ profiles would be related to a desensitization to socio-emotional information (Martin et al., 2013), demonstrated by less capacity to experience suspicion, hostility, or stress (Kirkpatrick et al., 1993;Subotnik et al., 2000;Tek et al., 2001), which may be related to attentional deficits and impaired control strategies (Cohen et al., 2007). Therefore, the study of attention to emotional information can be relevant to understand mechanisms underlying psychopathological expressions of SZ. ...
... faster prosaccades) and poorer inhibitory control (i.e. higher antisaccade error rate and/or slower antisaccade latencies to angry faces) toward threatening stimuli. Conversely, following the desensitization to socioemotional information in NSZ (Cohen et al., 2007;Martin et al., 2013), the negative SZ profile would be associated with a lack of attentional engagement toward emotional stimuli (i.e. slower prosaccade latencies). ...
... Secondly, as for negative SZ profile, the attentional engagement to faces was impaired in the NSZ group. The lack of attentional engagement to faces supports the notion about a desensitization to socioemotional stimuli for negative SZ profiles (Cohen et al., 2007;Martin et al., 2013). Interestingly, this deficit was modulated by the valence of facial expression, obtaining an advantage for pathology-congruent information as threatening stimuli (Underwood et al., 2016). ...
Despite schizophrenia (SZ) is characterized by a high psychopathological heterogeneity, the underlying psychological mechanisms that result in different clinical profiles are unclear. This study examined the cognitive processing of emotional faces (angry, happy, neutral, and sad) by means of assessing inhibitory control (antisaccade task) and attentional engagement (prosaccade task) with the eye-tracking paradigm. Firstly, two clinical SZ subgroups classified according to the predominance of positive (PSZ; n = 20) or negative symptoms (NSZ; n = 34) and a control group of 32 individuals were compared. Secondly, the association between prosaccade and antisac-cade measurements and the severity of positive and negative symptoms were analyzed. The PSZ group showed slower antisaccades when angry faces were displayed, and higher positive symptoms were associated with slower prosaccade latencies to ones. Conversely, the NSZ group made overall slower prosaccades with an emotional advantage for angry faces, and higher negative symptoms were associated with faster antisaccade laten-cies to ones. Hence, whereas positive SZ profile is related to a lack of attentional engagement and an impaired in-hibitory control to threatening information; negative SZ profile is linked to a lack of attentional engagement to faces, mainly with non-threat ones, and with an advantage to ignore distracting threatening stimuli. These findings support affective information-processing theories suggesting a hypersensitivity to threat for positive SZ profiles , and a desensitization to socio-emotional information for negative ones. Consequently, characterizing psychological mechanisms of SZ may allow improving current treatments to threat management when positive symptoms are predominant, or emotion sensitization when negative symptoms prevail.
... Previous studies have found that DS patients had more severe impairment in almost all cognitive domains when compared with NDS patients [29]. A meta-analysis by Cohen et al. reported evidence of moderate widespread cognitive impairment in patients with defect syndrome [58]. Previous studies have found that schizophrenia patients with persistent negative symptoms showed more severe continuous attention impairment in related cognitive assessments [59][60][61]. ...
... Compared with NDS patients, DS patients had more severe impairments in all neurocognitive domains, and it was correlated with the attention factors of SANS: the more severe the negative symptoms, the worse the neurocognitive function. However, NDS patients performed between DS and healthy controls in all cognitive domains, negative symptoms were not associated with cognitive function in the NDS group, which is consistent with previous reports of more severe cognitive impairment in DS patients [7,36,58]. There were significant differences in the neurocognitive impairment patterns between the two groups, mainly because of the differences in attention and executive function between the two groups. ...
... A 2017 meta-analysis showed that cognitive deficits were more severe in DS patients, and language fluency was identified as one of the more severely affected cognitive areas, as alogia was a typical feature of the disease in schizophrenia patients with persistent negative symptoms [65]. Other studies have reported impaired sustained attention [7,36,[58][59][60][61] and visuospatial memory [42,66] in DS patients. Patients with DS have been previously reported to have abnormal frontal and parietal lobe function. ...
Abstract Background The cognitive impairment pattern of deficit schizophrenia (DS) is centered on an impaired attention function. Previous studies have suggested that the exploratory eye movement (EEM) tests reflect attention deficits in patients with schizophrenia. However, no study has investigated the characteristics of eye movement in DS in the Chinese Han population. This study aimed to investigate the pattern of eye movement characteristics in DS patients and to examine whether eye movement characteristic is associated with serious negative symptoms and cognitive decline in this schizophrenia subtype. Methods A total of 86 male patients [37 DS and 49 non-deficit schizophrenia (NDS)] and 80 healthy controls (HC) participated in this study. Clinical symptoms were assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). Cognitive function was assessed using the Mattis Dementia Rating Scale (MDRS-2). Eye movement data of subjects were collected using an eye movement tracking analyzer. Results There were significant differences in the overall eye movement data and cognitive test scores among the three groups (all P
... Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) were utilized so as to evaluate the severity of negative and positive symptoms. The BPRS scale was divided into positive, negative, disorganized, and affectsyndromes, according to the results of the most comprehensive factor analysis of the 18-item BPRS (27). ...
Deficit schizophrenia (DS), which is marked by stable negative symptoms, is regarded as a homogeneous subgroup of schizophrenia. While DS patients have structurally altered nucleus accumbens (NAcc) compared to non-deficit schizophrenia (NDS) patients and healthy individuals, the investigation of NAcc functional connectivity (FC) with negative symptoms and neurocognition could provide insights into the pathophysiology of schizophrenia. 58 DS, 93 NDS, and 113 healthy controls (HCs) underwent resting-state functional magnetic resonance (rsfMRI). The right and left NAcc were respectively used as seed points to construct the functional NAcc network in whole-brain FC analysis. ANCOVA compared the differences in NAcc network FC and partial correlation analysis explored the relationships between altered FC of NAcc, negative symptoms and neurocognition. Compared to HCs, both DS and NDS patients showed decreased FC between the left NAcc (LNAcc) and bilateral middle cingulate gyrus, and between the right NAcc (RNAcc) and right middle frontal gyrus (RMFG), as well as increased FC between bilateral NAcc and bilateral lingual gyrus. Moreover, the FC between the LNAcc and bilateral calcarine gyrus (CAL) was lower in the DS group compared to NDS patients. Correlation analysis indicated that FC value of LNAcc-CAL was negatively correlated to negative symptoms. Furthermore, aberrant FC values within the NAcc network were correlated with severity of clinical symptoms and neurocognitive impairments in DS and NDS patients. This study demonstrated abnormal patterns of FC in the NAcc network between DS and NDS. The presence of altered LNAcc-CAL FC might be involved in the pathogenesis of negative symptoms in schizophrenia.
... A number of white matter abnormalities have been seen in both medicated an unmedicated schizophrenia patients, including a disruption in white matter integrity which is correlated with cognitive impairment (191)(192)(193). Importantly this disruption in white matter integrity occurs before the onset of frank schizophrenia and worsens as symptoms progress (194)(195)(196). ...
Schizophrenia is associated with increased levels of oxidative stress, as reflected by an increase in the concentrations of damaging reactive species and a reduction in anti-oxidant defences to combat them. Evidence has suggested that whilst not the likely primary cause of schizophrenia, increased oxidative stress may contribute to declining course and poor outcomes associated with schizophrenia. Here we discuss how oxidative stress may be implicated in the aetiology of schizophrenia and examine how current understanding relates associations with symptoms, potentially via lipid peroxidation induced neuronal damage. We argue that oxidative stress may be a good target for future pharmacotherapy in schizophrenia and suggest a multi-step model of illness progression with oxidative stress involved at each stage.
