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Schizophrenic patients are known to have neuropsychological deficits including impaired verbal fluency, but it is not clear whether this latter deficit is: (a) a consequence of overall intellectual deficit; (b) shared with affective psychotic patients; or (c) shared by the relatives of schizophrenic patients; and (d) shared by the relatives of affe...
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The aim of the present study was to provide a useful and quick estimate of premorbid intelligence that can be used in the population of schizophrenia patients.
Regression analysis (stepwise procedure) was used to identify which of five demographic variables significantly predicted National Adult Reading Test (NART) scores in schizophrenia patients....
The authors' goal was to investigate the issue of intellectual deterioration in schizophrenia.
They examined the childhood IQs of adult patients with schizophrenia who had attended a child psychiatry service where measurement of intelligence was routine. Follow-up IQs of 34 of these patients were obtained an average of 19.4 years later.
The mean ch...
Citations
... Indeed, these perinatal events might act as 'scars' which affect the brain in different pathways and so different abnormalities in functionality or structure might be expected (Insel, 2010). Thus, evidence suggests that, within patients with psychosis or related disorders, there is a relationship between the presence of OCs and poor cognitive performance in different domains (Borkowska & Rybakowski, 2002;Brown et al., 2011Brown et al., , 2009Ellman, Yolken, Buka, Torrey, & Cannon, 2009;Gilvarry et al., 2000Gilvarry et al., , 2001Holthausen et al., 2002;Ochoa et al., 2013;Torniainen et al., 2013;Yurgelun-Todd & Kinney, 1993), even though results are heterogeneous. In fact, these cognitive disturbances, which sometimes are present at the time of onset of the first symptoms (Bora & Murray, 2014) might be somehow related to the presence of perinatal events. ...
... Since different methodologies have been described along the literature to describe the presence of a wide range of OCs, authors decided to include OCs data as a dichotomous variable: presence or absence of OCs. Additionally, seven studies have already been divided the groups according to the presence or absence of OC (Borkowska & Rybakowski, 2002;Brown et al., 2009Brown et al., , 2011Gilvarry et al., 2000Gilvarry et al., , 2001Ochoa et al., 2013;Yurgelun-Todd & Kinney, 1993). Whether OCs data was reported on a continuous variable through scatter plot, we used a tool called WebPlotDigitizer to extract graphed data (Drevon, Fursa, & Malcolm, 2017). ...
... contacted via e-mail and one author provided retrieved nonpublished data from the publication (Ochoa et al., 2013). Following this process, 10 articles were included for the qualitative assessment, and eight of which underwent meta-analysis (Borkowska & Rybakowski, 2002;Brown et al., 2011Brown et al., , 2009Ellman et al., 2009;Gilvarry et al., 2000Gilvarry et al., . 2001Holthausen et al., 2002;Ochoa et al., 2013;Torniainen et al., 2013;Yurgelun-Todd & Kinney, 1993), while 12 were excluded due to a reason (see online Supplementary Material 3). ...
Background
Schizophrenia (SZ) is a complex brain disorder linked to cognitive and neurostructural abnormalities that involves genetic and environmental factors with obstetric complications (OCs) at birth conferring a high risk for the disease. Indeed, current research in the general population describes the deleterious effect of OCs on cognitive performance in adulthood. With this rationale, we aim to review the relationship between OCs and cognition in SZ and related psychotic disorders.
Methods
A systematic review and meta-analysis describing cognitive function and OCs in patients with SZ and related disorders were conducted. PubMed, EmBase, SCOPUS, and the Cochrane Library were systematically searched to identify eligible studies up to January 2022. We calculated the effect sizes (Hedges' g) of cognitive domains within each study and quantified the proportion of between-study variability using the I ² statistic. Homogeneity was assessed using the Q -statistic ( X ² ). The study was registered on PROSPERO (CRD42018094238).
Results
A total of 4124 studies were retrieved, with 10 studies meeting inclusion criteria for the systematic review and eight for meta-analysis. SZ subjects with OCs showed poor verbal memory [Hedges' g = −0.89 (95% CI −1.41 to −0.37), p < 0.001] and working memory performance [Hedges' g = −1.47 (95% CI −2.89 to −0.06), p = 0.01] in a random-effect model compared to those without OCs.
Conclusions
OCs appear to have a moderate impact on specific cognitive such as working memory and verbal memory. Our findings suggest that OCs are associated with brain development and might underlie the cognitive abnormalities described at onset of psychosis.
... Recent research also demonstrates that semantic fluency function could reveal potential endophenotypes for the early diagnosis of schizophrenia in the Han Chinese population 34 . Children who later developed schizophrenia, and their siblings, showed similar cognitive deficits and, compared to siblings of unaffected individuals, the probands exhibited more severe deficits in semantic fluency function 35,36 . Siblings of schizophrenic individuals may exhibit significantly less word output in the verbal fluency test, which probably indicated semantic verbal fluency deficit as a familial trait marker in schizophrenia 37 . ...
What’s the neurocognitive deficit as an endophenotype to familial schizophrenia? Here, we investigate the neurocognitive endophenotype in first-episode patients with familial schizophrenia (FS) and sporadic schizophrenia (SS), and their parents. 98 FS patients and their 105 parents; 190 SS patients and their 207 parents; 195 controls matched with patients, and 190 controls matched with the patients’ parents, were assessed with the short version of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC), the immediate and delayed logical memory tests from the Wechsler Memory Scale-Revised in China (WMS-RC), the Verbal Fluency Test (VFT), the Trail Making Test Parts A and B-Modified (TMA, TMB-M), and the Modified Wisconsin Card Sorting Test (WCST-M). The results showed that with age, gender, and education as covariates, after controlling for false discovery rates, the FS group and their parent group performed worse than the SS group and their parent group on VFT. No significant differences were found for other neurocognitive tests between the FS and SS patient groups, and their respective parent groups. Our findings suggest the patients with familial and sporadic schizophrenia and their respective parent groups may have a different genetic predisposition in relation to a cognitive endophenotype.
... The magnitude of neurocognitive deficits in BD is intermediate between those reported in major depressive disorder and schizophrenia (92,93). Evidence indicates that verbal memory and executive function deficits are apparent in unaffected relatives of individuals with BD (94,95). Moreover, neurocognitive deficits (e.g., verbal and working memory) have been reported in monozygotic twins discordant for BD (66,96). ...
To provide a strategic framework for the prevention of bipolar disorder (BD) that incorporates a 'Big Data' approach to risk assessment for BD.
Computerized databases (e.g., Pubmed, PsychInfo, and MedlinePlus) were used to access English-language articles published between 1966 and 2012 with the search terms bipolar disorder, prodrome, 'Big Data', and biomarkers cross-referenced with genomics/genetics, transcriptomics, proteomics, metabolomics, inflammation, oxidative stress, neurotrophic factors, cytokines, cognition, neurocognition, and neuroimaging. Papers were selected from the initial search if the primary outcome(s) of interest was (were) categorized in any of the following domains: (i) 'omics' (e.g., genomics), (ii) molecular, (iii) neuroimaging, and (iv) neurocognitive.
The current strategic approach to identifying individuals at risk for BD, with an emphasis on phenotypic information and family history, has insufficient predictive validity and is clinically inadequate. The heterogeneous clinical presentation of BD, as well as its pathoetiological complexity, suggests that it is unlikely that a single biomarker (or an exclusive biomarker approach) will sufficiently augment currently inadequate phenotypic-centric prediction models. We propose a 'Big Data'- bioinformatics approach that integrates vast and complex phenotypic, anamnestic, behavioral, family, and personal 'omics' profiling. Bioinformatic processing approaches, utilizing cloud- and grid-enabled computing, are now capable of analyzing data on the order of tera-, peta-, and exabytes, providing hitherto unheard of opportunities to fundamentally revolutionize how psychiatric disorders are predicted, prevented, and treated. High-throughput networks dedicated to research on, and the treatment of, BD, integrating both adult and younger populations, will be essential to sufficiently enroll adequate samples of individuals across the neurodevelopmental trajectory in studies to enable the characterization and prevention of this heterogeneous disorder.
Advances in bioinformatics using a 'Big Data' approach provide an opportunity for novel insights regarding the pathoetiology of BD. The coordinated integration of research centers, inclusive of mixed-age populations, is a promising strategic direction for advancing this line of neuropsychiatric research.
... deficits have been reported in bipolar disorder, along with evidence that these deficits may be evident even during euthymic periods (Glahn et al., 2004; Rubinsztein, Michael, Paykel, & Sahakian, 2000). Several studies have reported verbal memory and executive deficits in the unaffected relatives of bipolar individuals (Gilvarry et al., 2001; Keri, Kelemen, Benedek, & Janka, 2001; Zalla et al., 2004). One twin study that assessed neuropsychological functioning in monozygotic twins discordant for bipolar disorder reported deficits in verbal and working memory in healthy co-twins (Gourovitch et al., 1999). ...
Childhood bipolar disorder remains a controversial but increasingly diagnosed disorder that is associated with significant impairment, chronic course and treatment resistance. Therefore, the search for prodromes or early markers of risk for later childhood bipolar disorder may be of great importance for prevention and/or early identification.
Literature searches were conducted to identify reviews, case reports and empirical papers addressing the issue of prodromes of childhood bipolar disorder.
A total of 54 articles were found that related to bipolar prodromes, risk factors for later childhood bipolar disorder, childhood risk for adult bipolar disorder, mania manifestations in early childhood, and neuropsychological and biological markers of childhood bipolar disorder. A review of articles suggest (a) childhood bipolar prodromes may be detectable prior to the onset of the disorder, (b) prodromal symptoms may display episodicity during childhood, (c) there is evidence of possible endophenotypic markers such as deficits in executive function, sustained attention, and emotion labeling, (d) there is a potential association with functional, structural, and biochemical alterations evident in brain structures involved in mood regulation, (e) a link between childhood bipolar disorder with early tempermental markers, such as emotional regulation and behavioral disinhibition and (f) there is some early but promising evidence of effective psychotherapeutic preventions.
There has been very limited investigation of early prodromes of childhood bipolar disorder. Based on the promising findings of prodromes as well as high-risk states and possible endophenotypic markers, more controlled and targeted investigations into the early markers of bipolar disorder appear warranted and potentially fruitful. Until such longitudinal studies with appropriate controls are conducted, specific markers for bipolar prodromes will remain elusive, although evidence suggests they are manifest in at least some subgroups. The finding of promising psychotherapeutic prevention programs underscores the need to find specific and sensitive markers of bipolar prodromes in childhood.
... A recent meta-analysis revealed a large effect size (0.68) in category fl uency (Snitz et al., 2006). Verbal fl uency may be signifi cantly correlated with intelligence (Gilvarry et al., 2001); another study reported defi cits in verbal fl uency and executive function among relatives of SZ patients (Keefe et al., 1994). The possibility of verbal fl uency defi cits in young relatives was assessed by the Pittsburgh High-Risk Study (see below) which found signifi cant defi cits at the baseline assessment. ...
Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune “window” to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed.
... Language area asymmetry deficits in schizophrenia (Crow 1997a(Crow , 2000aHallett et al., 1986) may have genetic bases (Crow 2000a,b), and may manifest in genetically predisposed subjects. Volumetric and lateralization alterations of the PT noted in patients (Selemon et al., 2003;Wisco et al., 2007) may also occur in relatives of patients and underlie verbal fluency deficits in this population (Gilvarry et al., 2001;Keefe et al., 1994;Klosterkotter et al., 2001;Lencz et al., 2006;Simon et al., 2007). Studies in those at genetic risk for schizophrenia independently show verbal fluency deficits (Gilvarry et al., 2001;Keefe et al., 1994;Klosterkotter et al., 2001;Lencz et al., 2006;Simon et al., 2007) and alterations of language area lateralization (Sharma et al., 1999) but it is unclear if these phenomena are correlated. ...
... Volumetric and lateralization alterations of the PT noted in patients (Selemon et al., 2003;Wisco et al., 2007) may also occur in relatives of patients and underlie verbal fluency deficits in this population (Gilvarry et al., 2001;Keefe et al., 1994;Klosterkotter et al., 2001;Lencz et al., 2006;Simon et al., 2007). Studies in those at genetic risk for schizophrenia independently show verbal fluency deficits (Gilvarry et al., 2001;Keefe et al., 1994;Klosterkotter et al., 2001;Lencz et al., 2006;Simon et al., 2007) and alterations of language area lateralization (Sharma et al., 1999) but it is unclear if these phenomena are correlated. ...
Alterations of verbal fluency may correlate with deficits of gray matter volume and hemispheric lateralization of language brain regions like the pars triangularis (PT) in schizophrenia. Examining non-psychotic individuals at high genetic risk (HR) for schizophrenia may clarify if these deficits represent heritable trait markers or state dependent phenomena. We assessed adolescent and young adult HR subjects (N=60) and healthy controls (HC; N=42) using verbal fluency tests and Freesurfer to process T1-MRI scans. We hypothesized volumetric and lateralization alterations of the PT and their correlation with verbal fluency deficits. HR subjects had letter verbal fluency deficits (controlling for IQ), left PT deficits (p=.00), (controlling ICV) and reversal of the L>R PT asymmetry noted in HC. Right Heschl's (p=.00), left supramarginal (p=.00) and right angular gyrii (p=.02) were also reduced in HR subjects. The L>R asymmetry of the Heschl's gyrus seen in HC was exaggerated and asymmetries of L>R of supramarginal and R>L of angular gyri, seen in HC were attenuated in HR subjects. L>R asymmetry of the PT predicted better verbal fluency across the pooled HR and HC groups. Young relatives of schizophrenia patients have verbal fluency deficits, gray matter volume deficits and reversed asymmetry of the pars triangularis. A reversed structural asymmetry of the PT in HR subjects may impair expressive language abilities leading to verbal fluency deficits. Volumetric deficits and altered asymmetry in inferior parietal and Heschl's gyrii may accompany genetic liability to schizophrenia.
... Various researches have shown that these cognitive deficits are pertinent even in the relatives of these patients, although present in a milder degree (Kremen et al, 1998;Toomey et al, 1998;Faraone et al, 1999;Cannon et al, 2000;Gilvarry et al, 2001;Toulopoulou et al, 2003). These deficits are more pronounced in discordant monozygotic twins than in discordant dizygotic twins (Goldberg et al, 1995;Cannon et al, 2000) and are conspicuous even in subjects who are at high risk for schizophrenia. ...
... Various researches have shown that these cognitive deficits are pertinent even in the relatives of these patients, although present in a milder degree (Kremen et al, 1998;Toomey et al, 1998;Faraone et al, 1999;Cannon et al, 2000;Gilvarry et al, 2001;Toulopoulou et al, 2003). These deficits are more pronounced in discordant monozygotic twins than in discordant dizygotic twins (Goldberg et al, 1995;Cannon et al, 2000) and are conspicuous even in subjects who are at high risk for schizophrenia. ...
... Verbal fluency has been shown to be a sensitive indicator of brain dysfunction in general (Lezak 1995) and of frontal and temporal brain dysfunction specific to schizophrenia (Henry and Crawford 2004). Numerous studies have investigated verbal fluency in schizophrenic patients (Allen et al. 1993, Besche-Richard et al. 1999, Curtis et al. 1998, Frith et al. 1995, Gilvarry et al. 2001, Howanitz et al. 2000, Kremen et al. 2003, Mellers et al. 1998, Sumiyoshi et al. 2001, Vinogradov et al. 2002, Woodward et al. 2003. Considering diagnostic subtypes, first-episode patients show impaired performance on these tasks (Hutton et al. 1998) and deficits are documented in at-risk patients (Hawkins et al. 2004) as well as in relatives of schizophrenic patients (Sitskoorn et al. 2004). ...
Objective: Deficits in verbal fluency tasks are well known in psychotic patients. However little is known about the discriminating power of verbal fluency tasks. Six different verbal fluency tasks were examined in a sample of first episode psychosis patients and controls. The main aim of the study was to evaluate the power of verbal fluency tasks to discriminate between patients and controls. Analyses compared phonematic and semantic fluency tasks, switching and non-switching tasks, as well as one minute and two minute performance times with respect to discriminating power. Another aim was to examine a putative link between verbal fluency performance and other cognitive functions. Method: 15 stabilized first episode psychosis patients and 15 normal controls completed a comprehensive neuropsychological test battery. Results: The investigated fluency tasks differed in terms of their ability to discriminate between the patient and control groups, with switching tasks discriminating more accurately than, or equally as well as non-switching tasks. Longer (two-minute) task condition did not discriminate more accurately than the one-minute condition in five of six tasks. Phonematic fluency tasks discriminated patients and controls equally well as semantic fluency tasks. After adjustment for multiple comparisons, fluency performance correlated significantly with two memory tasks and psychomotor speed in the patient group. No significant correlations were found in the control group. Conclusions: The present study suggests that verbal fluency tasks discriminate between patients and healthy controls irrespective of task duration. However switching tasks are better suited to discriminate between patients and controls compared to the widely used non-switching tasks. Patients' fluency task performance might be limited by memory performance and speed of processing.
... Several neuropsychological studies have directly compared patients with psychotic BD and schizophrenia in both acute illness phases and remission (see Table 1). These studies generally did not find a significant difference between patient groups in the acute phase, although some differences have been noted in stabilized patients (53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63)(64). Particular executive functions (cognitive flexibility and working memory) seem to be equally impaired in psychotic BD and schizophrenia [although see Seidman et al. (57) for an exception] (53,54,(58)(59)(60)(61)(62). ...
... Relatively few studies have compared the neuropsychological performances of affective patients with and without a history of psychotic symptoms (Table 1). While Selva et al. (59) did not find a difference between groups, some other studies found more severe deficits for executive functions, working memory (63,116) and verbal memory (117). ...
... Another study found that cognitive flexibility deficits were only observed in the relatives of psychotic BD patients (120). Further, working memory deficits seem to be evident only in psychotic rather than non-psychotic BD patients (63). ...
Evidence related to overlapping clinical and genetic risk factors in schizophrenia and bipolar disorder (BD) have raised concerns about the validity of 'Kraepelinian dichotomy'. As controversies mainly arise in mixed psychoses that occupy the intermediate zone between schizophrenia and BD, investigating neurobiological markers of mixed psychoses may be relevant to understanding the nature of psychotic disorders.
In this article, we review studies comparing magnetic resonance imaging, neuropsychological and electrophysiological findings in mixed psychoses with each other, as well as with more prototypical cases of schizophrenia and BD.
The evidence reviewed suggests that mixed psychoses may be associated with different genetic and neurobiological markers compared with prototypical forms of schizophrenia and BD.
These findings may be compatible with more sophisticated versions of dimensional and continuum models or, alternatively, they may suggest that there is an intermediate third category between prototypical schizophrenia and BD.
