This study aimed to investigate the association between baseline cognitive performance and the clinical response to antipsychotics in first-episode schizophrenia (FES) patients.
This study examined 769 patients from a multi-center research cohort. Neurocognition was measured using the MATRICS Consensus Cognitive Battery (MCCB) in schizophrenia at baseline. Clinical response was defined as ≥ 50% reduction in PANSS total score from baseline to week 8. Pearson correlation analysis was performed for preliminary exploratory assessment. Multivariable logistic regression models (response: yes/no) were fitted with each cognitive domain as dependent variable, adjusted confounding factors. To test effect modification, we added interaction terms: (i) cognition × antipsychotic type and (ii) cognition × baseline illness severity. For domains with significant interactions (
P
< 0.05), stratified analyses were performed within each drug group and severity stratum.
Logistic regression analysis demonstrated that all baseline neurocognitive domains were significantly associated with clinical response (All
P
< 0.05). Significant interactions between neurocognitive performance and antipsychotics were observed across all domains except Working Memory and Reasoning/problem solving. Similarly, significant interactions between neurocognition and baseline illness severity were found for all domains except Visual and Verbal learning. Further stratified analyses revealed that baseline cognitive performance was associated to clinical response to amisulpride and risperidone. Additionally, significant associations between neurocognition and clinical response were consistently observed in patients with moderate-to-severe illness severity across all domains, with the exception of Visual and Verbal Learning.
The association between baseline cognitive performance and treatment response is contingent on medication regimen and baseline illness severity.
The study was registered on ClinicalTrials.gov (NCT03451734) with a registration date of January 23, 2018.
BDNF Val66Met polymorphism was significantly associated with clinical symptom severity, cognitive function, and treatment-related improvement among Acehnese individuals with schizophrenia, and the Val/Val genotype was associated with a more favorable clinical and cognitive profile and stronger early clinical and cognitive response.
Introduction: Cognitive dysfunction (“brain fog”) is a common manifestation of post-acute COVID-19 syndrome (PACS) and may persist long after the acute infection. While cross-sectional studies have described cognitive deficits, longitudinal evidence on recovery trajectories remains limited. Methods: We conducted a longitudinal observational study of neurocognitive performance and neuropsychiatric symptoms in patients with PACS. Participants underwent assessment with 20 standardized tests covering five cognitive domains (memory, attention, language, executive functions, psychomotor processing speed); anxiety, depression, and sleep quality were assessed at three time points. Changes were analysed using the Friedman test. Results: Forty-two patients were included (median age 57 years; 35.7% female) from a predominantly hospitalized cohort (81% hospitalised; 66.7% requiring respiratory support). Patients who completed all three assessments (completers, n = 42) were compared with those who attended the first evaluation but did not complete follow-up (non-completers, n = 544); completers were more severely ill during the acute phase rather than healthier or more motivated. At the group level, statistically significant improvements over time were observed across the whole sample in verbal short-term learning, visuospatial memory, working memory, constructional praxis, phonological verbal fluency, and psychomotor processing speed (all p ≤ 0.05); after Benjamini–Hochberg adjustment across the twenty cognitive outcomes, visuospatial span forward and backward and psychomotor processing speed remained significant (all FDR-adjusted p ≤ 0.013), with the change confined to the first six months. Sleep quality also improved (p < 0.0001). Conclusion: In this cohort, group-level performance improved in six of the twenty tests administered, of which three remained significant after correction for multiple comparisons, while 28 of 42 patients (66.7%) still scored in the impaired range on at least one test at 12 months, and 17 (40.5%) on two or more. These findings highlight the importance of long-term neuropsychological monitoring and integrated cognitive-psychiatric evaluation in post-COVID care. Given the small, predominantly hospitalized sample, improvements should be interpreted cautiously and confirmed in larger controlled studies, although the use of alternate forms for part of the battery makes task-specific learning an incomplete explanation.
G. Del Duca, M. Camici, Isabella Sperduti et al.· Neurology International· 0 citations
BACKGROUND
Subcortical regions are widely implicated in the pathological mechanisms and treatment of schizophrenia, and accumulating evidence, including our prior findings, suggests that subcortical functional dysconnectivity is closely associated with treatment response. Accordingly, the present study aimed to examine the relationship between the subcortical functional connectivity (FC) and treatment outcomes in schizophrenia using multivariate analytical approaches and machine learning algorithms.
METHODS
One hundred and nineteen individuals with first-episode schizophrenia were recruited for this study. All patients underwent MRI scanning and completed assessments with the Positive and Negative Syndrome Scale (PANSS) at baseline and at follow-up after 12 weeks of antipsychotic medication. We employed partial least squares analysis to explore the multivariate associations between changes in subcortical FC (∆FC) and changes in symptom severity (∆PANSS). In addition, a machine learning algorithm was used to predict the antipsychotic treatment outcome based on the distinctive subcortical FC pattern at baseline.
RESULTS
We identified a distinctive subcortical FC pattern dominated by the striatum that was associated with overall treatment outcomes in first-episode schizophrenia. Furthermore, the reduction in PANSS total scores predicted using baseline subcortical FC patterns was positively correlated with the actual reduction in PANSS total scores following antipsychotic treatment.
CONCLUSION
These results indicate that the distinctive subcortical FC pattern holds promise as a biomarker for schizophrenia, supporting individualized treatment approaches and facilitating early intervention to improve clinical outcomes.
C. Hou, Huan Huang, Sisi Jiang et al.· Schizophrenia Research· 0 citations
Background Patients with psychotic disorders often exhibit premorbid cognitive deficits and future cognitive changes following the onset of illness. This study examined cognitive trajectories in schizophrenia (SCZ), schizoaffective disorder (SZA) and bipolar disorder (BD) compared with healthy matched controls. Method Cases included individuals with SCZ (n = 24), SZA (n = 15), or BD (n = 11), and 50 controls matched for age, sex, and socioeconomic status (SES). Participants underwent IQ testing at age 17 as part of mandatory military screening (T1); the same tests were administered after illness onset (T2). Results Participants were assessed approximately 10 years after T1 (SD = 2.6). Cases with SCZ had a non-significant 4-point lower IQ than controls at T1. At T2, SCZ cases showed a 4-point IQ decline, whereas controls demonstrated a 5-point increase, resulting in a significant time × group interaction (F(1, 46) = 12.30, p = .006). At T2 the IQ of cases with SZ was 13 points lower than that of controls (96.97 ± 16.57 vs. 110.19 ± 11.87, respectively; Cohen's d = 0.91; p = .009). A similar trend was observed among cases with SZA and BD, although the magnitude was smaller and the interaction was non-significant. In SCZ, premorbid IQ was positively correlated with years of education (r = 0.670, p < .01), while IQ decline was associated with more psychiatric hospitalizations (r = −0.547, p < .01). Conclusion SCZ showed cognitive decline relative to controls over time, whereas SZA and BD demonstrated less pronounced cognitive changes. These findings are consistent with both neurodevelopmental and neurodegenerative models of psychotic illness.
Noaz Cohen, N. Werbeloff, Lucian Tatsa-Laur et al.· Schizophrenia Research: Cogn...· 0 citations