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Harvey PD, Depp CA, Rizzo AA, Strauss GP, Spelber D, Carpenter LL, Kalin NH, Krystal JH, McDonald WM, Nemeroff CB, Rodriguez CI, Widge AS, Torous J. Technology and Mental Health: State of the Art for Assessment and Treatment. Am J Psychiatry 2022; 179:897-914. [PMID: 36200275 DOI: 10.1176/appi.ajp.21121254] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Technology is ubiquitous in society and is now being extensively used in mental health applications. Both assessment and treatment strategies are being developed and deployed at a rapid pace. The authors review the current domains of technology utilization, describe standards for quality evaluation, and forecast future developments. This review examines technology-based assessments of cognition, emotion, functional capacity and everyday functioning, virtual reality approaches to assessment and treatment, ecological momentary assessment, passive measurement strategies including geolocation, movement, and physiological parameters, and technology-based cognitive and functional skills training. There are many technology-based approaches that are evidence based and are supported through the results of systematic reviews and meta-analyses. Other strategies are less well supported by high-quality evidence at present, but there are evaluation standards that are well articulated at this time. There are some clear challenges in selection of applications for specific conditions, but in several areas, including cognitive training, randomized clinical trials are available to support these interventions. Some of these technology-based interventions have been approved by the U.S. Food and Drug administration, which has clear standards for which types of applications, and which claims about them, need to be reviewed by the agency and which are exempt.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Colin A Depp
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Albert A Rizzo
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Gregory P Strauss
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - David Spelber
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Linda L Carpenter
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Ned H Kalin
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John H Krystal
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - William M McDonald
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Charles B Nemeroff
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Carolyn I Rodriguez
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Alik S Widge
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John Torous
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
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Bogert J, Rofael H, Mosca K, Ross RO, Callaerts G, Wang D, Jaeger J, Narayan VA, Drevets WC, Morrison RL. A randomized, multicenter, crossover psychometric evaluation study of an iPad-administered cognitive test battery in participants with major depressive disorder who responded to treatment with oral antidepressants. J Affect Disord 2021; 292:261-269. [PMID: 34134024 DOI: 10.1016/j.jad.2021.05.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/14/2021] [Accepted: 05/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Performance validity and test-retest reliability of ReVeRe.D, an iPad-administered cognitive test battery in major depressive disorder (MDD) were analyzed. METHODS Participants aged 18-59 years had DSM-5 diagnosis of MDD with adequate visual and hearing acuity. All had responded to oral antidepressant treatment for a major depressive episode within the most recent 24-months and were stable with no greater than mild depressive symptoms as evidenced by Montgomery Asberg Depression Rating Scale total score <17. Participants were randomly assigned to 1 of 2 test sequences (AABB or BBAA; A=ReVeRe.D; B=examiner-administered tests) in a crossover design. RESULTS 244 randomized participants (AABB: n=123; BBAA: n=121) had mean age of 38.3 years; 54.9% had a college, baccalaureate, or higher education. At first administration, Pearson correlation coefficients (PCC) for 6/10 pairs of corresponding ReVeRe.D vs examiner-administered tests exceeded the pre-specified acceptance criterion (PCC=0.53) for the primary analysis; 8 test score pairs had PCC exceeding 0.40. At second administration, PCC for 9/10 test scores pairs exceeded PCC=0.53. Together, the series of PCCs supports the concurrent validity for ReVeRe.D. Test-retest reliability for ReVeRe.D test scores was generally moderate to high. LIMITATIONS The study included stable participants with MDD who had responded to oral antidepressant treatment, with most in at least partial remission. The sample was limited to English-speaking participants, and skewed towards white, college-educated women. Further studies in acutely ill MDD patients who represent a broader demographic, are warranted. CONCLUSIONS iPad-administered ReVeRe.D is a valid and reliable computerized test battery for assessment of cognitive performance in MDD.
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Affiliation(s)
| | - Hany Rofael
- Janssen Research & Development, LLC, NJ, USA
| | | | | | | | - Daniel Wang
- Janssen Research & Development, LLC, CA, USA
| | - Judith Jaeger
- CognitionMetrics, LLC, Wilmington, DE, USA; Albert Einstein College of Medicine, Bronx, NY, USA
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The Relationship Between Habitual Physical Activity, Sitting Time, and Cognitive Function in Young Adult Women. J Phys Act Health 2021; 18:1082-1087. [PMID: 34186507 DOI: 10.1123/jpah.2020-0705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is evidence that physical activity (PA), sitting time, and obesity may impact cognition, but few studies have examined this in young women. METHODS Healthy women (18-35 y), without conditions that impair cognition, were recruited for this cross-sectional study. Participants completed anthropometric and validated computerized cognitive assessments (IntegNeuro™). Performance on 5 cognitive domains (impulsivity, attention, information processing, memory, and executive function) was reported as z scores. Sitting hours and weekly PA calculated from time in low-, moderate-, and high-intensity activity were obtained via the International Physical Activity Questionnaire. Analysis of variance/analysis of covariance, chi-square, and linear regression were used. RESULTS 299 (25.9 [5.1] y) women (low PA = 19%; moderate PA = 40%; high PA = 41%) participated. High PA women had lower body mass index (high PA = 26.1 [6.5]; moderate PA = 30.0 [8.7]; low PA = 31.0 [11.1] kg/m2; P < .001) and less sitting time (high PA = 6.6 [3.1]; moderate PA = 7.7 [2.8]; low PA = 9.3 [3.6] hr/weekday; P < .0001). Cognitive function was within normal ranges and did not differ between any PA groups (P = .42). Adjusting for body mass index, C-reactive protein, or sitting hours did not alter results. Weak correlations were found between time in high-intensity activity and impulsivity (b = 0.12, r2 = .015; P = .04), and between sitting hours and information processing efficiency (b = -0.18, r2 = .03; P = .002). Valuesare presented as mean (SD). CONCLUSIONS Cognitive function was within the normal range, regardless of PA or sitting time.
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Victoria G, Apiquian R, Rosetti MF, Ulloa RE. Cognitive impairment and its improvement after six months in adolescents with schizophrenia. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 17:100135. [PMID: 30976526 PMCID: PMC6439271 DOI: 10.1016/j.scog.2019.100135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 11/02/2022]
Abstract
Studies evaluating the cognitive impairment in schizophrenic adolescents reported a variable course following antipsychotic treatment, with improvement being associated to patients' demographic or clinical characteristics. Objectives To examine the cognitive impairments of a Mexican sample of adolescents with schizophrenia using the MATRICS Consensus Cognitive Battery (MCCB) before and after six months of antipsychotic treatment and to determine which demographic or clinical characteristics could be associated to cognitive improvement. Methods A sample of 87 Mexican patients was evaluated with the MCCB. Domain scores for three age groups (12-13, 14-15 and 16-17 y.o.) were obtained at baseline, and after 3 and 6 months of treatment. The groups were compared for demographic and clinical variables (sex, school attendance, years of education, being on their first psychotic episode, duration of illness and mean dose of antipsychotic), and a logistic regression analysis was performed to determine which variables predicted larger improvement. Results The baseline performance showed scores below the standardized mean, with improvement in all domains except for social cognition; female adolescents showed a larger improvement in attention/vigilance and visual learning domains. Conclusions We observed cognitive impairments on schizophrenic adolescents, which improved after six months of treatment in almost all domains.
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Affiliation(s)
| | | | - Marcos F Rosetti
- Instituto de Investigaciones Biomédicas, UNAM, Mexico City, Mexico
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Feenstra HE, Vermeulen IE, Murre JM, Schagen SB. Online Self-Administered Cognitive Testing Using the Amsterdam Cognition Scan: Establishing Psychometric Properties and Normative Data. J Med Internet Res 2018; 20:e192. [PMID: 29848469 PMCID: PMC6000479 DOI: 10.2196/jmir.9298] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 02/04/2018] [Accepted: 03/09/2018] [Indexed: 02/04/2023] Open
Abstract
Background Online tests enable efficient self-administered assessments and consequently facilitate large-scale data collection for many fields of research. The Amsterdam Cognition Scan is a new online neuropsychological test battery that measures a broad variety of cognitive functions. Objective The aims of this study were to evaluate the psychometric properties of the Amsterdam Cognition Scan and to establish regression-based normative data. Methods The Amsterdam Cognition Scan was self-administrated twice from home—with an interval of 6 weeks—by 248 healthy Dutch-speaking adults aged 18 to 81 years. Results Test-retest reliability was moderate to high and comparable with that of equivalent traditional tests (intraclass correlation coefficients: .45 to .80; .83 for the Amsterdam Cognition Scan total score). Multiple regression analyses indicated that (1) participants’ age negatively influenced all (12) cognitive measures, (2) gender was associated with performance on six measures, and (3) education level was positively associated with performance on four measures. In addition, we observed influences of tested computer skills and of self-reported amount of computer use on cognitive performance. Demographic characteristics that proved to influence Amsterdam Cognition Scan test performance were included in regression-based predictive formulas to establish demographically adjusted normative data. Conclusions Initial results from a healthy adult sample indicate that the Amsterdam Cognition Scan has high usability and can give reliable measures of various generic cognitive ability areas. For future use, the influence of computer skills and experience should be further studied, and for repeated measurements, computer configuration should be consistent. The reported normative data allow for initial interpretation of Amsterdam Cognition Scan performances.
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Affiliation(s)
- Heleen Em Feenstra
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Ivar E Vermeulen
- Department of Communication Science, VU University Amsterdam, Amsterdam, Netherlands
| | - Jaap Mj Murre
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Sanne B Schagen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
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Maruta J, Spielman LA, Tseretopoulos ID, Hezghia A, Ghajar J. Possible Medication-Resistant Deficits in Adult ADHD. J Atten Disord 2017; 21:1169-1179. [PMID: 24970719 DOI: 10.1177/1087054714538659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The nature of ADHD, especially in adulthood, is not well-understood. Therefore, we explored subcomponents of attention in adult ADHD. METHOD Twenty-three adults with ADHD were tested on neurocognitive and visual tracking performance both while on their regular prescription stimulant medication and while abstaining from the medication for 1 day. Pairwise comparisons to 46 two-for-one matched normal controls were made to detect medication-resistant effects of ADHD, and within-participant comparisons were made to detect medication-sensitive effects in patients. RESULTS Even when on medication, patients performed more poorly than controls on a spatial working memory task, and on visual tracking and simple reaction time tasks immediately following other attention-demanding tasks. Patients' visual tracking performance degraded while off-medication in a manner consistent with reduced vigilance. CONCLUSION There may be persistent cognitive impairments in adult ADHD despite medication. In addition, the benefit of stimulants seems reduced under cognitive fatigue.
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Affiliation(s)
- Jun Maruta
- 1 Brain Trauma Foundation, New York, NY, USA
| | | | | | | | - Jamshid Ghajar
- 1 Brain Trauma Foundation, New York, NY, USA.,2 Stanford University School of Medicine, CA, USA
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Busovaca E, Zimmerman ME, Meier IB, Griffith EY, Grieve SM, Korgaonkar MS, Williams LM, Brickman AM. Is the Alzheimer's disease cortical thickness signature a biological marker for memory? Brain Imaging Behav 2017; 10:517-23. [PMID: 26040979 DOI: 10.1007/s11682-015-9413-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Recent work suggests that analysis of the cortical thickness in key brain regions can be used to identify individuals at greatest risk for development of Alzheimer's disease (AD). It is unclear to what extent this "signature" is a biological marker of normal memory function - the primary cognitive domain affected by AD. We examined the relationship between the AD signature biomarker and memory functioning in a group of neurologically healthy young and older adults. Cortical thickness measurements and neuropsychological evaluations were obtained in 110 adults (age range 21-78, mean = 46) drawn from the Brain Resource International Database. The cohort was divided into young adult (n = 64, age 21-50) and older adult (n = 46, age 51-78) groups. Cortical thickness analysis was performed with FreeSurfer, and the average cortical thickness extracted from the eight regions that comprise the AD signature. Mean AD-signature cortical thickness was positively associated with performance on the delayed free recall trial of a list learning task and this relationship did not differ between younger and older adults. Mean AD-signature cortical thickness was not associated with performance on a test of psychomotor speed, as a control task, in either group. The results suggest that the AD signature cortical thickness is a marker for memory functioning across the adult lifespan.
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Affiliation(s)
- Edgar Busovaca
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
| | - Molly E Zimmerman
- Department of Psychology, Fordham University, Bronx, NY, USA
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Irene B Meier
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
| | - Erica Y Griffith
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA
| | - Stuart M Grieve
- Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia
- Brain Dynamics Centre, Westmead Millennium Institute, Westmead, Australia
- Sydney Medical School, Westmead, Australia
| | - Mayuresh S Korgaonkar
- Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia
- Brain Dynamics Centre, Westmead Millennium Institute, Westmead, Australia
- Sydney Medical School, Westmead, Australia
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Sierra-Pacific Mental Illness Research, Education, Clinical Center (MIRECC) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA.
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Feenstra HEM, Murre JMJ, Vermeulen IE, Kieffer JM, Schagen SB. Reliability and validity of a self-administered tool for online neuropsychological testing: The Amsterdam Cognition Scan. J Clin Exp Neuropsychol 2017; 40:253-273. [PMID: 28671504 DOI: 10.1080/13803395.2017.1339017] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION To facilitate large-scale assessment of a variety of cognitive abilities in clinical studies, we developed a self-administered online neuropsychological test battery: the Amsterdam Cognition Scan (ACS). The current studies evaluate in a group of adult cancer patients: test-retest reliability of the ACS and the influence of test setting (home or hospital), and the relationship between our online and a traditional test battery (concurrent validity). METHOD Test-retest reliability was studied in 96 cancer patients (57 female; Mage = 51.8 years) who completed the ACS twice. Intraclass correlation coefficients (ICCs) were used to assess consistency over time. The test setting was counterbalanced between home and hospital; influence on test performance was assessed by repeated measures analyses of variance. Concurrent validity was studied in 201 cancer patients (112 female; Mage = 53.5 years) who completed both the online and an equivalent traditional neuropsychological test battery. Spearman or Pearson correlations were used to assess consistency between online and traditional tests. RESULTS ICCs of the online tests ranged from .29 to .76, with an ICC of .78 for the ACS total score. These correlations are generally comparable with the test-retest correlations of the traditional tests as reported in the literature. Correlating online and traditional test scores, we observed medium to large concurrent validity (r/ρ = .42 to .70; total score r = .78), except for a visuospatial memory test (ρ = .36). Correlations were affected-as expected-by design differences between online tests and their offline counterparts. CONCLUSIONS Although development and optimization of the ACS is an ongoing process, and reliability can be optimized for several tests, our results indicate that it is a highly usable tool to obtain (online) measures of various cognitive abilities. The ACS is expected to facilitate efficient gathering of data on cognitive functioning in the near future.
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Affiliation(s)
- Heleen E M Feenstra
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Jaap M J Murre
- b Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Ivar E Vermeulen
- c Department of Communication Science , VU University Amsterdam , Amsterdam , The Netherlands
| | - Jacobien M Kieffer
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Sanne B Schagen
- a Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands.,b Department of Psychology , University of Amsterdam , Amsterdam , The Netherlands
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9
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Lavrencic LM, Churches OF, Keage HAD. Cognitive reserve is not associated with improved performance in all cognitive domains. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:473-485. [DOI: 10.1080/23279095.2017.1329146] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Louise M. Lavrencic
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, South Australia, Australia
| | - Owen F. Churches
- Brain and Cognition Laboratory, School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Hannah A. D. Keage
- Cognitive Ageing and Impairment Neurosciences Laboratory, School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, South Australia, Australia
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10
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Can brain games help smokers quit?: Results of a randomized clinical trial. Drug Alcohol Depend 2016; 168:112-118. [PMID: 27635998 DOI: 10.1016/j.drugalcdep.2016.08.621] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/25/2016] [Accepted: 08/17/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND AIMS Deficits in cognitive function are observed during nicotine withdrawal and present a challenge to successful smoking cessation. This clinical trial evaluated a cognitive exercise training (CT) program to improve smoking cessation rates. METHODS Adult treatment-seeking smokers (n=213) were randomized to receive nicotine patch therapy and 12 weeks of either computerized CT or computerized relaxation (control) training. Smoking status was biochemically verified at the end of treatment and 6-month follow-up. RESULTS Quit rates did not differ by treatment arm at either time-point, nor were there effects on withdrawal symptoms or smoking urges. Reaction time for emotion recognition and verbal interference tasks showed improvement in the CT group. When including only successful quitters, improvements in recognition memory, verbal interference accuracy, and attention switching error rate were also observed in the CT group, while commission errors on the continuous performance task decreased in the control group. CONCLUSIONS Despite modest changes in cognitive performance, these results do not support the efficacy of computerized cognitive training as an adjunctive therapy for smoking cessation.
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11
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McGregor AL, Dysart J, Tingle MD, Russell BR, Kydd RR, Finucane G. Varenicline improves motor and cognitive symptoms in early Huntington's disease. Neuropsychiatr Dis Treat 2016; 12:2381-2386. [PMID: 27695336 PMCID: PMC5034909 DOI: 10.2147/ndt.s111083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to describe the effects of varenicline, a smoking cessation aid that acts as a nicotinic agonist, on cognitive function in patients with early clinical Huntington's disease (HD) who were current smokers. Three gene-positive patients transitioning to symptomatic HD were evaluated using the Unified Huntington's Disease Rating Scale part I and III (motor and behavioral subscales) at baseline and after 4 weeks of treatment. Cognitive function was assessed using a touch screen computer-based neurocognitive test battery (IntegNeuro®). Varenicline (1 mg twice daily) significantly improved performance in executive function and emotional recognition tasks. Our case reports describe no clinically significant adverse effects and suggest that varenicline improves aspects of cognitive function in patients with early HD. A randomized controlled study is now underway.
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Affiliation(s)
- Ailsa L McGregor
- New Zealand's National School of Pharmacy, Division of Health Sciences, University of Otago, Dunedin, New Zealand; Centre for Brain Research, University of Auckland
| | - Jo Dysart
- Liaison Psychiatry, Auckland City Hospital
| | | | - Bruce R Russell
- New Zealand's National School of Pharmacy, Division of Health Sciences, University of Otago, Dunedin, New Zealand; Centre for Brain Research, University of Auckland
| | - Rob R Kydd
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
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12
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Anderson VM, McIlwain ME, Kydd RR, Russell BR. Does cognitive impairment in treatment-resistant and ultra-treatment-resistant schizophrenia differ from that in treatment responders? Psychiatry Res 2015; 230:811-8. [PMID: 26564550 DOI: 10.1016/j.psychres.2015.10.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/29/2015] [Accepted: 10/30/2015] [Indexed: 12/31/2022]
Abstract
This study aimed to investigate whether cognitive impairment is more pronounced in people with treatment-resistant schizophrenia compared with those who respond well to first-line antipsychotic medication. Fifty-one patients with schizophrenia were assigned to one of three groups dependent on their clinical history: (i) 16 people who had responded well to first-line antipsychotic medication, (ii) 20 people who were treatment-resistant but responding to clozapine monotherapy, (iii) 15 people who were ultra-treatment-resistant/clozapine-resistant but responding to antipsychotic polypharmacy. Twenty-two controls were also recruited. Groups were matched for age, sex, disease duration and psychopathology. All participants undertook a computerised battery of neuropsychological tests that assessed multiple cognitive domains. Raw data were converted to z-scores, and test performance was compared between groups. People with schizophrenia performed significantly worse than controls in the majority of neuropsychological tests, with verbal memory, sustained attention, and sensorimotor the most commonly impaired domains. No significant differences in performance between people deemed to be treatment-resistant or ultra-treatment-resistant, and those who responded well to first-line antipsychotic medication were observed. There was no significant relationship between antipsychotic dose and scores on any of the neuropsychological tests. Cognitive impairment is a central feature of schizophrenia, but our results suggest that treatment-resistance may not be associated with more severe deficits.
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Affiliation(s)
- Valerie M Anderson
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Meghan E McIlwain
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Robert R Kydd
- Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Department of Psychological Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Bruce R Russell
- School of Pharmacy, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand; Centre for Brain Research, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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13
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van Erp TGM, Preda A, Turner JA, Callahan S, Calhoun VD, Bustillo JR, Lim KO, Mueller B, Brown GG, Vaidya JG, McEwen S, Belger A, Voyvodic J, Mathalon DH, Nguyen D, Ford JM, Potkin SG. Neuropsychological profile in adult schizophrenia measured with the CMINDS. Psychiatry Res 2015; 230:826-34. [PMID: 26586142 PMCID: PMC4692593 DOI: 10.1016/j.psychres.2015.10.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 10/19/2015] [Accepted: 10/24/2015] [Indexed: 12/21/2022]
Abstract
Schizophrenia neurocognitive domain profiles are predominantly based on paper-and-pencil batteries. This study presents the first schizophrenia domain profile based on the Computerized Multiphasic Interactive Neurocognitive System (CMINDS(®)). Neurocognitive domain z-scores were computed from computerized neuropsychological tests, similar to those in the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB), administered to 175 patients with schizophrenia and 169 demographically similar healthy volunteers. The schizophrenia domain profile order by effect size was Speed of Processing (d=-1.14), Attention/Vigilance (d=-1.04), Working Memory (d=-1.03), Verbal Learning (d=-1.02), Visual Learning (d=-0.91), and Reasoning/Problem Solving (d=-0.67). There were no significant group by sex interactions, but overall women, compared to men, showed advantages on Attention/Vigilance, Verbal Learning, and Visual Learning compared to Reasoning/Problem Solving on which men showed an advantage over women. The CMINDS can readily be employed in the assessment of cognitive deficits in neuropsychiatric disorders; particularly in large-scale studies that may benefit most from electronic data capture.
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Affiliation(s)
- Theo G M van Erp
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA.
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Jessica A Turner
- Departments of Psychology and Neuroscience, Georgia State University, Atlanta, GA 30303, USA; Mind Research Network, Albuquerque, NM 87106, USA
| | - Shawn Callahan
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Vince D Calhoun
- Mind Research Network, Albuquerque, NM 87106, USA; Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM 97106, USA; Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM 87131, USA
| | - Juan R Bustillo
- Departments of Psychiatry & Neuroscience, University of New Mexico, Albuquerque, NM 87131, USA
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Bryon Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55454, USA
| | - Gregory G Brown
- VA San Diego Healthcare System and Department of Psychiatry, University of California San Diego, CA 92161, USA
| | - Jatin G Vaidya
- Department of Psychiatry, University of Iowa, Iowa City, IA 52242, USA
| | - Sarah McEwen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Aysenil Belger
- Departments of Psychiatry and Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - James Voyvodic
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC 27710, USA
| | - Daniel H Mathalon
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Dana Nguyen
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
| | - Judith M Ford
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Steven G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA 92617, USA
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Cognitive deficits characterization using the CogState Research Battery in first-episode psychosis patients. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:140-145. [PMID: 29379763 PMCID: PMC5779298 DOI: 10.1016/j.scog.2015.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/24/2015] [Accepted: 03/27/2015] [Indexed: 12/22/2022]
Abstract
The computer-based CogState Research Battery (CSRB) proposes a test structure which follows MATRICS recommended cognitive domains but lacks direct comparison to pen and paper batteries in first-episode psychosis (FEP). The aim of this study was to compare performances obtained with the CSRB and a pen and paper battery in a historical cohort of FEP patients. Among patients entering an early intervention program between 2003 and 2014, separate cohorts completed the traditional pen and paper cognitive battery (n = 182) and the CSRB (n = 97). Composite z-scores were derived using normative data of matched controls (n = 64 pen and paper, n = 69 CSRB) and were compared between the two batteries for the 7 cognitive domains. The cohort tested using the CSRB performed better on the domains of processing speed, attention, visual memory, and verbal memory than the cohort tested using the pen and paper battery (all p < 0.001). Performance did not differ between the two types of batteries for the working memory, executive functions, and social cognition domains. Cognitive profiles identified in the two patient cohorts were similar, with verbal memory being the most impaired domain. Better performances on the CSRB may be primarily due to the minimal demand of the computerized tests on graphomotor abilities and reading speed compared to the pen and paper tests. Our investigation offers a better understanding on how the results obtained with computerized batteries may compare to earlier work done with traditional tests.
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15
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Scott JC, Matt GE, Wrocklage KM, Crnich C, Jordan J, Southwick SM, Krystal JH, Schweinsburg BC. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychol Bull 2015. [PMID: 25365762 DOI: 10.1037/a00389039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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Affiliation(s)
- J Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center, Philadelphia VA Medical Center
| | - Georg E Matt
- Department of Psychology, San Diego State University
| | | | | | - Jessica Jordan
- National Center for PTSD, VA Connecticut Healthcare System
| | | | - John H Krystal
- National Center for PTSD, VA Connecticut Healthcare System
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16
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Scott JC, Matt GE, Wrocklage KM, Crnich C, Jordan J, Southwick SM, Krystal JH, Schweinsburg BC. A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder. Psychol Bull 2015; 141:105-140. [PMID: 25365762 PMCID: PMC4293317 DOI: 10.1037/a0038039] [Citation(s) in RCA: 308] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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Affiliation(s)
- J. Cobb Scott
- VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA, 19104, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA, 92182, USA
| | | | | | - Jessica Jordan
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Steven M. Southwick
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
| | - John H. Krystal
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
- Department of Neurobiology, Yale University School of Medicine, New Haven, CT 06510 USA
- Psychiatry Services, Yale-New Haven Hospital, New Haven, CT 06510
| | - Brian C. Schweinsburg
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06511, USA
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17
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Barkl SJ, Lah S, Starling J, Hainsworth C, Harris AWF, Williams LM. Facial emotion identification in early-onset psychosis. Schizophr Res 2014; 160:150-6. [PMID: 25464918 DOI: 10.1016/j.schres.2014.10.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/21/2014] [Accepted: 10/23/2014] [Indexed: 10/24/2022]
Abstract
Facial emotion identification (FEI) deficits are common in patients with chronic schizophrenia and are strongly related to impaired functioning. The objectives of this study were to determine whether FEI deficits are present and emotion specific in people experiencing early-onset psychosis (EOP), and related to current clinical symptoms and functioning. Patients with EOP (n=34, mean age=14.11, 53% female) and healthy controls (HC, n=42, mean age 13.80, 51% female) completed a task of FEI that measured accuracy, error pattern and response time. Relative to HC, patients with EOP (i) had lower accuracy for identifying facial expressions of emotions, especially fear, anger and disgust, (ii) were more likely to misattribute other emotional expressions as fear or disgust, and (iii) were slower at accurately identifying all facial expressions. FEI accuracy was not related to clinical symptoms or current functioning. Deficits in FEI (especially for fear, anger and disgust) are evident in EOP. Our findings suggest that while emotion identification deficits may reflect a trait susceptibility marker, functional deficits may represent a sequelae of illness.
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Affiliation(s)
- Sophie J Barkl
- School of Psychology, University of Sydney, NSW, Australia; The Brain Dynamics Centre, Sydney Medical School and Westmead Millennium Institute, University of Sydney, NSW, Australia; ARC Centre of Excellence in Cognition and Its Disorders, Sydney, NSW, Australia
| | - Suncica Lah
- School of Psychology, University of Sydney, NSW, Australia; ARC Centre of Excellence in Cognition and Its Disorders, Sydney, NSW, Australia
| | - Jean Starling
- Walker Unit, Concord Centre for Mental Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Cassandra Hainsworth
- Department of Psychological Medicine, The Children's Hospital, Westmead, NSW, Australia
| | - Anthony W F Harris
- The Brain Dynamics Centre, Sydney Medical School and Westmead Millennium Institute, University of Sydney, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Leanne M Williams
- The Brain Dynamics Centre, Sydney Medical School and Westmead Millennium Institute, University of Sydney, NSW, Australia; Psychiatry and Behavioral Sciences, Stanford University, CA, USA.
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Bakkour N, Samp J, Akhras K, El Hammi E, Soussi I, Zahra F, Duru G, Kooli A, Toumi M. Systematic review of appropriate cognitive assessment instruments used in clinical trials of schizophrenia, major depressive disorder and bipolar disorder. Psychiatry Res 2014; 216:291-302. [PMID: 24656516 DOI: 10.1016/j.psychres.2014.02.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 02/03/2014] [Accepted: 02/09/2014] [Indexed: 12/01/2022]
Abstract
Cognitive dysfunction is increasingly recognized as a symptom in mental conditions including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BPD). Despite the many available cognitive assessment instruments, consensus is lacking on their appropriate use in clinical trials. We conducted a systematic literature review in Embase, PubMed/Medline and PsychINFO to identify appropriate cognitive function instruments for use in clinical trials of schizophrenia, MDD, and BPD. Instruments were identified from the articles. Instruments and articles were excluded if they did not address schizophrenia, MDD, or BPD. Instrument appropriateness was further assessed by the criteria of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative: test-retest reliability, utility, relationship to functional status, potential changeability to pharmacological agents, and tolerability and practicality for clinical trials. The database search yielded 173 articles describing 150 instruments used to assess cognitive function. Seventeen additional instruments were identified through Google and clinicaltrials.gov. Among all these, only 30 (18%) were deemed appropriate for use in the diseases of interest. Of these, 27 were studied in schizophrenia, one in MDD and two in BPD. These findings suggest the need for careful selection of appropriate cognitive assessment instruments, as not all may be valid in these disorders.
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Affiliation(s)
- Nadia Bakkour
- Creativ-Ceutical, 500 Lake Cook Road #350, Deerfield, IL, USA
| | - Jennifer Samp
- Takeda Pharmaceuticals International, One Takeda Parkway, Deerfield, IL, USA
| | - Kasem Akhras
- Takeda Pharmaceuticals International, One Takeda Parkway, Deerfield, IL, USA
| | - Emna El Hammi
- Creativ-Ceutical, 500 Lake Cook Road #350, Deerfield, IL, USA
| | - Imen Soussi
- Creativ-Ceutical, 500 Lake Cook Road #350, Deerfield, IL, USA
| | - Fatma Zahra
- Creativ-Ceutical, 500 Lake Cook Road #350, Deerfield, IL, USA
| | - Gérard Duru
- University of Lyon, University Claude Bernard Lyon I, UFR d׳Odontologie, 11 rue Guillaume Paradin, 69372 Lyon, Cedex 08, France
| | - Amna Kooli
- Creativ-Ceutical, 500 Lake Cook Road #350, Deerfield, IL, USA
| | - Mondher Toumi
- University of Lyon, University Claude Bernard Lyon I, UFR d׳Odontologie, 11 rue Guillaume Paradin, 69372 Lyon, Cedex 08, France.
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Allen DN, Bello DT, Thaler NS. Neurocognitive predictors of performance‐based functional capacity in bipolar disorder. J Neuropsychol 2014; 9:159-71. [DOI: 10.1111/jnp.12042] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 01/29/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel N. Allen
- Department of Psychology University of Nevada Las Vegas Nevada USA
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20
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Kozlowska K, Palmer DM, Brown KJ, Scher S, Chudleigh C, Davies F, Williams LM. Conversion disorder in children and adolescents: A disorder of cognitive control. J Neuropsychol 2014; 9:87-108. [DOI: 10.1111/jnp.12037] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Kasia Kozlowska
- Psychological Medicine; The Children's Hospital at Westmead; New South Wales Australia
- Disciplines of Psychiatry and of Paediatrics and Child Health; University of Sydney Medical School; New South Wales Australia
- Brain Dynamics Centre at Westmead Hospital and Westmead Millennium Institute; Westmead New South Wales Australia
| | - Donna M. Palmer
- Brain Dynamics Centre at Westmead Hospital and Westmead Millennium Institute; Westmead New South Wales Australia
- University of Sydney Medical School; New South Wales Australia
| | - Kerri J. Brown
- Brain Dynamics Centre at Westmead Hospital and Westmead Millennium Institute; Westmead New South Wales Australia
- University of Sydney Medical School; New South Wales Australia
- NSW Institute of Psychiatry; Parramatta BC New South Wales Australia
| | - Stephen Scher
- Department of Psychiatry; Harvard Medical School; McLean Hospital; Belmont Massachusetts USA
| | - Catherine Chudleigh
- Psychological Medicine; The Children's Hospital at Westmead; New South Wales Australia
| | - Fiona Davies
- Psychological Medicine; The Children's Hospital at Westmead; New South Wales Australia
| | - Leanne M. Williams
- Brain Dynamics Centre at Westmead Hospital and Westmead Millennium Institute; Westmead New South Wales Australia
- University of Sydney Medical School; New South Wales Australia
- Psychiatry and Behavioral Sciences; Stanford University; California USA
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21
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Calamia M, Markon K, Tranel D. The robust reliability of neuropsychological measures: meta-analyses of test-retest correlations. Clin Neuropsychol 2013; 27:1077-105. [PMID: 24016131 DOI: 10.1080/13854046.2013.809795] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Test-retest reliability is an important psychometric property relevant to assessment instruments typically used in neuropsychological assessment. This review presents a quantitative summary of test-retest reliability coefficients for a variety of widely used neuropsychological measures. In general, the meta-analytic test-retest reliabilities of the test scores ranged from adequate to high (i.e., r=.7 and higher). Furthermore, the reliability values were largely robust across factors such as age, clinical diagnosis, and the use of alternate forms. The values for some of the memory and executive functioning scores were lower (i.e., less than r=.7). Some of the possible reasons for these lower values include ceiling effects, practice effects, and across time variability in cognitive abilities measured by those tests. In general, neuropsychologists who use these measures in their assessments can be encouraged by the magnitude of the majority of the meta-analytic test-retest correlations obtained.
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Affiliation(s)
- Matthew Calamia
- a Department of Psychology , University of Iowa , Iowa City , IA , USA
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Burton CZ, Vella L, Harvey PD, Patterson TL, Heaton RK, Twamley EW. Factor structure of the MATRICS Consensus Cognitive Battery (MCCB) in schizophrenia. Schizophr Res 2013; 146:244-8. [PMID: 23507359 PMCID: PMC3740948 DOI: 10.1016/j.schres.2013.02.026] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 02/15/2013] [Accepted: 02/20/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND The MATRICS Consensus Cognitive Battery (MCCB) and proposed co-primary measures are gaining momentum as outcome measures in clinical trials, highlighting the need to evaluate their psychometric properties. The MCCB composite score has been proposed to be the optimal primary outcome measure, though its validity is unknown. This study aimed to evaluate the factor structure of the MCCB in a schizophrenia sample and determine whether its cognitive domains are separable. METHODS 183 outpatients with schizophrenia or schizoaffective disorder completed a comprehensive test battery. Confirmatory factor analysis was used to test the factor structure of the MCCB; hierarchical regression then examined the relative contribution of individual cognitive variables to predict the MCCB factor scores. Finally, the relationships between the resulting factors and two performance-based measures of functional capacity were explored. RESULTS A three-factor MCCB model representing processing speed, attention/working memory, and learning fits the data well and was an improvement over a unifactorial model. Symbol coding, spatial span, and visual learning were the most robust predictors for each of the three factors; symbol coding proved to be the best single predictor of overall cognitive performance. The three factors were also significantly related to a performance-based measure of everyday functioning but not a performance-based measure of social skills. CONCLUSIONS These analyses suggest that the six MCCB "domains" as constructed can be collapsed into fewer domains composed of multiple item scores; they also support the notion that impaired processing speed is a fundamental cognitive deficit in schizophrenia and that MCCB performance is related to functional capacity. Cognition and functional capacity measures require more research to determine if they differ.
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Affiliation(s)
- Cynthia Z. Burton
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, San Diego, CA, 92120, USA
| | - Lea Vella
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Court, San Diego, CA, 92120, USA
| | - Philip D. Harvey
- University of Miami Miller School of Medicine, Department of Psychiatry and Behavioral Sciences, 1120 NW 14th Street, Suite 1450, Miami, FL, 33136, USA
| | - Thomas L. Patterson
- University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC: 0603, La Jolla, CA, 92093, USA
| | - Robert K. Heaton
- University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC: 0603, La Jolla, CA, 92093, USA
| | - Elizabeth W. Twamley
- University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, MC: 0603, La Jolla, CA, 92093, USA, Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116A), San Diego, CA 92161, USA, Corresponding author at: UCSD Department of Psychiatry140 Arbor Drive, (0851) San Diego, CA 92103, USA. Tel.: +1 1 1 619 543 6684; fax: +1 1 1 619 543 6489. (E.W. Twamley)
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Silverstein SM, Wang Y, Keane BP. Cognitive and neuroplasticity mechanisms by which congenital or early blindness may confer a protective effect against schizophrenia. Front Psychol 2013; 3:624. [PMID: 23349646 PMCID: PMC3552473 DOI: 10.3389/fpsyg.2012.00624] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 12/31/2012] [Indexed: 12/12/2022] Open
Abstract
Several authors have noted that there are no reported cases of people with schizophrenia who were born blind or who developed blindness shortly after birth, suggesting that congenital or early (C/E) blindness may serve as a protective factor against schizophrenia. By what mechanisms might this effect operate? Here, we hypothesize that C/E blindness offers protection by strengthening cognitive functions whose impairment characterizes schizophrenia, and by constraining cognitive processes that exhibit excessive flexibility in schizophrenia. After briefly summarizing evidence that schizophrenia is fundamentally a cognitive disorder, we review areas of perceptual and cognitive function that are both impaired in the illness and augmented in C/E blindness, as compared to healthy sighted individuals. We next discuss: (1) the role of neuroplasticity in driving these cognitive changes in C/E blindness; (2) evidence that C/E blindness does not confer protective effects against other mental disorders; and (3) evidence that other forms of C/E sensory loss (e.g., deafness) do not reduce the risk of schizophrenia. We conclude by discussing implications of these data for designing cognitive training interventions to reduce schizophrenia-related cognitive impairment, and perhaps to reduce the likelihood of the development of the disorder itself.
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Affiliation(s)
- Steven M. Silverstein
- University Behavioral HealthCare, University of Medicine and Dentistry of New JerseyPiscataway, NJ, USA
- Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical SchoolPiscataway, NJ, USA
| | - Yushi Wang
- University Behavioral HealthCare, University of Medicine and Dentistry of New JerseyPiscataway, NJ, USA
| | - Brian P. Keane
- University Behavioral HealthCare, University of Medicine and Dentistry of New JerseyPiscataway, NJ, USA
- Department of Psychiatry, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical SchoolPiscataway, NJ, USA
- Rutgers University Center for Cognitive SciencePiscataway, NJ, USA
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Vesterager L, Christensen TØ, Olsen BB, Krarup G, Melau M, Forchhammer HB, Nordentoft M. Cognitive and clinical predictors of functional capacity in patients with first episode schizophrenia. Schizophr Res 2012; 141:251-6. [PMID: 23017825 DOI: 10.1016/j.schres.2012.08.023] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 08/14/2012] [Accepted: 08/27/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND The predictors of functional capacity in first episode schizophrenia among seven separable cognitive domains and clinical variables are unknown. AIM To investigate predictors of functional capacity in first episode schizophrenia and the associations between functional capacity and measures of real-world functioning. METHODS Socio-demographic, clinical, and cognitive measures from a sample of patients with first episode schizophrenia spectrum disorders aged 18-34years (N=117) were examined at baseline, 4-month follow-up, and 10-month follow-up and used to predict concurrent and longitudinal functional capacity. Symptoms were assessed with the Positive and Negative Syndrome Scale, cognitive functioning with the MATRICS Cognitive Consensus Battery, and functional capacity with the brief version of the University of California San Diego Performance-based Skills Assessment. Linear and logistic regression analyses were adjusted for age, gender, and site. RESULTS Working memory, negative symptoms, and social cognition accounted for 41% of the variance in functional capacity at baseline. Longitudinally, verbal learning, working memory, and negative symptoms predicted 4-month functional capacity. Working memory and visual learning predicted 10-month functional capacity. Functional capacity was associated to global functioning in the univariate analysis, but in multivariable analyses global functioning, financial independence, and independent living were predicted by negative symptoms or general symptoms explaining 15-23% of the variance. CONCLUSIONS The strongest single predictor of functional capacity is working memory, followed by negative symptoms. Clinical symptoms, but not functional capacity, predicted real-world functioning. The usability of the UPSA-B in first episode schizophrenia is discussed. Neurocom, ClinicalTrials.gov Identifier: NCT00472862, http://clinicaltrials.gov/ct2/show/NCT00472862?term=neurocom&rank=1.
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Affiliation(s)
- Lone Vesterager
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Bispebjerg Bakke 23, DK-2400, Copenhagen, Denmark.
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D'Souza DC, Ahn K, Bhakta S, Elander J, Singh N, Nadim H, Jatlow P, Suckow RF, Pittman B, Ranganathan M. Nicotine fails to attenuate ketamine-induced cognitive deficits and negative and positive symptoms in humans: implications for schizophrenia. Biol Psychiatry 2012; 72:785-94. [PMID: 22717030 DOI: 10.1016/j.biopsych.2012.05.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 05/03/2012] [Accepted: 05/08/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The uncompetitive N-methyl-D-aspartate receptor (NMDAR) antagonist, ketamine, induces a range of symptoms resembling those seen in schizophrenia. Enhancement of nicotinic acetylcholine receptor (nAChR) function may have potential as a treatment for the cognitive deficits and negative symptoms of schizophrenia. Accordingly, we examined the modulatory effects of brain nAChR systems on NMDAR antagonist-induced effects. METHODS The interactive effects of ketamine and nicotine were evaluated in 37 healthy subjects in a randomized, placebo-controlled, double-blind, crossover counterbalanced, 2 (intravenous ketamine or placebo) × 2 (intravenous nicotine or placebo) design. Verbal and visual memory, sustained attention, working memory, response inhibition, emotion recognition, executive function, reaction time, motor function, and speed of processing were assessed once per test day, while negative and positive symptoms, perceptual alterations, and a number of feeling states were measured several times before and after administration of drugs. RESULTS Ketamine induced cognitive deficits and negative and positive symptoms. Nicotine worsened immediate recall, auditory working memory, response inhibition, and executive function and serial processing. Nicotine decreased (improved) reaction time on the sustained attention and choice reaction time tasks. Nicotine did not reduce ketamine-induced cognitive deficits or negative and positive symptoms. CONCLUSIONS At blood levels comparable with tobacco smoking, nicotine infusion does not appear to alleviate the ketamine-induced transient cognitive and behavioral effects in healthy subjects that resemble those seen in schizophrenia. The lack of an effect of nicotine on a spectrum of ketamine effects suggests that the consequences of NMDAR antagonism are not likely under the direct influence of nAChR.
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Affiliation(s)
- Deepak Cyril D'Souza
- Psychiatry Service, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA.
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Forbes F, Galletly C, Liu D, Tyllis P, Clark CR. Assessing Cognition in Schizophrenia: A Comparison of Clinician and Computerized Test Administration. APPLIED NEUROPSYCHOLOGY-ADULT 2012; 19:9-15. [DOI: 10.1080/09084282.2011.595459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Faye Forbes
- a School of Psychology, Flinders University , Bedford Park , Australia
| | - Cherrie Galletly
- b Discipline of Psychiatry, The University of Adelaide , Adelaide , Australia
| | - Dennis Liu
- c Northern Mental Health, Central Northern Adelaide Health Service , Salisbury , Australia
| | - Panayiotis Tyllis
- c Northern Mental Health, Central Northern Adelaide Health Service , Salisbury , Australia
| | - C. Richard Clark
- a School of Psychology, Flinders University , Bedford Park , Australia
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The interdependence of subtype and severity: contributions of clinical and neuropsychological features to melancholia and non-melancholia in an outpatient sample. J Int Neuropsychol Soc 2012; 18:361-9. [PMID: 22300644 DOI: 10.1017/s1355617711001858] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Major depressive disorder is often considered to be a homogenous disorder that changes in terms of severity; however, the presence of distinct subtypes and a variety of presenting symptoms suggests much heterogeneity. Aiming to better understand the relationship between heterogeneity and diagnosis we used an exploratory approach to identify subtypes of depression on the basis of clinical symptoms and neuropsychological performance. Cluster analysis identified two groups of patients distinguished by level of cognitive dysfunction with the more severe cluster being associated with melancholic depression. While the relationship between cluster and subtype was significant, only 58% of melancholic patients were assigned to cluster 1 (the more severe cluster) and 66% of non-melancholic patients assigned to cluster 2. Subtypes also displayed a distinctive profile of impairment such that melancholic patients (n = 65) displayed more variability in attention while non-melancholic patients (n = 59) displayed memory recall impairment. While melancholia and non-melancholia are associated with a more severe and less severe form of depression respectively, findings indicate that differences between melancholia and non-melancholia are more than simple variation on severity. In summary, findings provide support for the heterogeneity of depression.
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Velligan D, Brenner R, Sicuro F, Walling D, Riesenberg R, Sfera A, Merideth C, Sweitzer D, Jaeger J. Assessment of the effects of AZD3480 on cognitive function in patients with schizophrenia. Schizophr Res 2012; 134:59-64. [PMID: 22088556 DOI: 10.1016/j.schres.2011.10.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Revised: 10/05/2011] [Accepted: 10/11/2011] [Indexed: 11/20/2022]
Abstract
AZD3480 is a selective agonist of α4β2 central neuronal nicotinic receptors (NNRs). This study investigated its effects on cognition, relative to placebo, in 440 patients with stable schizophrenia who were taking a single atypical antipsychotic medication and who were active cigarette smokers. Mean age was 41 (range 19 to 55) years and the majority of patients (88%) had a diagnosis of paranoid schizophrenia. Patients were randomized to one of 3 doses of AZD3480: 5 mg, 20 mg, and 35/100 mg (depending on CYP2D6 metabolic status), or to placebo. Treatment was given once daily for 12 weeks. The primary outcome measure was change in cognitive function from baseline to Week 12, as measured by IntegNeuro computerized test battery of cognitive function scores. Secondary outcome measures included assessment of functional capacity (University of California at San Diego Performance Based Skills Assessment [UPSA2]) and adaptive function (Social Functioning Scale [SFS]). AZD3480 failed to improve cognition relative to placebo in this population of patients or in subpopulations defined by disposition, metabolic status, antipsychotic treatment, age, age of illness onset, and sex. Likewise, no improvement relative to placebo was observed in either the SFS measure of adaptive functioning or the UPSA2 measure of functional capacity. AZD3480 was generally well tolerated in the population studied.
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Affiliation(s)
- Dawn Velligan
- Division of Schizophrenia and Related Disorders, Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA.
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Recent developments in neuropsychological endophenotypes for schizophrenia: Development of the MATRICS battery, liability syndromes and the near future. CHINESE SCIENCE BULLETIN-CHINESE 2011. [DOI: 10.1007/s11434-011-4759-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cognition-UPSA score relationships: a further analysis of Silverstein et al. (2010) data and some caveats. Psychiatry Res 2011; 187:424-31. [PMID: 21216013 DOI: 10.1016/j.psychres.2010.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 11/22/2010] [Accepted: 12/01/2010] [Indexed: 11/22/2022]
Abstract
Silverstein et al. (2010) reported correlations between scores on the UCSD Performance-Based Skills Assessment (UPSA) and scores on two cognitive test batteries (MATRICS Consensus Cognitive Battery and IntegNeuro) that were lower than those reported in past studies. The large sample size of that 4-site study (155 patients with schizophrenia) allowed for further analyses of the data to explore the reasons for the discrepancy. We examined the data from Silverstein et al. (2010) to determine if the correlation values obtained were affected by UPSA scoring method, site differences, patient level of functioning, range restriction, missing data, and/or whether data from the first or second administration of each cognitive test battery were used. Results indicate that the overall lower cognition-UPSA correlations were a function of a single site with unusually low correlations. However, the low correlations at this site were not a function of any of the potential causes we examined. Correlations at the other sites were close to or within the range reported in past studies. Interestingly, the correlation between IntegNeuro and UPSA composite scores was higher at Time 2, suggesting that cognition-UPSA correlations are affected by familiarity with the computerized test format.
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Williams LM, Rush AJ, Koslow SH, Wisniewski SR, Cooper NJ, Nemeroff CB, Schatzberg AF, Gordon E. International Study to Predict Optimized Treatment for Depression (iSPOT-D), a randomized clinical trial: rationale and protocol. Trials 2011; 12:4. [PMID: 21208417 PMCID: PMC3036635 DOI: 10.1186/1745-6215-12-4] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 01/05/2011] [Indexed: 12/05/2022] Open
Abstract
Background Clinically useful treatment moderators of Major Depressive Disorder (MDD) have not yet been identified, though some baseline predictors of treatment outcome have been proposed. The aim of iSPOT-D is to identify pretreatment measures that predict or moderate MDD treatment response or remission to escitalopram, sertraline or venlafaxine; and develop a model that incorporates multiple predictors and moderators. Methods/Design The International Study to Predict Optimized Treatment - in Depression (iSPOT-D) is a multi-centre, international, randomized, prospective, open-label trial. It is enrolling 2016 MDD outpatients (ages 18-65) from primary or specialty care practices (672 per treatment arm; 672 age-, sex- and education-matched healthy controls). Study-eligible patients are antidepressant medication (ADM) naïve or willing to undergo a one-week wash-out of any non-protocol ADM, and cannot have had an inadequate response to protocol ADM. Baseline assessments include symptoms; distress; daily function; cognitive performance; electroencephalogram and event-related potentials; heart rate and genetic measures. A subset of these baseline assessments are repeated after eight weeks of treatment. Outcomes include the 17-item Hamilton Rating Scale for Depression (primary) and self-reported depressive symptoms, social functioning, quality of life, emotional regulation, and side-effect burden (secondary). Participants may then enter a naturalistic telephone follow-up at weeks 12, 16, 24 and 52. The first half of the sample will be used to identify potential predictors and moderators, and the second half to replicate and confirm. Discussion First enrolment was in December 2008, and is ongoing. iSPOT-D evaluates clinical and biological predictors of treatment response in the largest known sample of MDD collected worldwide. Trial registration International Study to Predict Optimised Treatment - in Depression (iSPOT-D) ClinicalTrials.gov Identifier: NCT00693849 URL: http://clinicaltrials.gov/ct2/show/NCT00693849?term=International+Study+to+Predict+Optimized+Treatment+for+Depression&rank=1
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Affiliation(s)
- Leanne M Williams
- BRAINnet Foundation, 71 Stephenson Street, Suite 400, San Francisco, CA, 94105, USA.
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