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Benjamin KJM, Arora R, Feltrin AS, Pertea G, Giles HH, Stolz JM, D'Ignazio L, Collado-Torres L, Shin JH, Ulrich WS, Hyde TM, Kleinman JE, Weinberger DR, Paquola ACM, Erwin JA. Sex affects transcriptional associations with schizophrenia across the dorsolateral prefrontal cortex, hippocampus, and caudate nucleus. Nat Commun 2024; 15:3980. [PMID: 38730231 PMCID: PMC11087501 DOI: 10.1038/s41467-024-48048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Schizophrenia is a complex neuropsychiatric disorder with sexually dimorphic features, including differential symptomatology, drug responsiveness, and male incidence rate. Prior large-scale transcriptome analyses for sex differences in schizophrenia have focused on the prefrontal cortex. Analyzing BrainSeq Consortium data (caudate nucleus: n = 399, dorsolateral prefrontal cortex: n = 377, and hippocampus: n = 394), we identified 831 unique genes that exhibit sex differences across brain regions, enriched for immune-related pathways. We observed X-chromosome dosage reduction in the hippocampus of male individuals with schizophrenia. Our sex interaction model revealed 148 junctions dysregulated in a sex-specific manner in schizophrenia. Sex-specific schizophrenia analysis identified dozens of differentially expressed genes, notably enriched in immune-related pathways. Finally, our sex-interacting expression quantitative trait loci analysis revealed 704 unique genes, nine associated with schizophrenia risk. These findings emphasize the importance of sex-informed analysis of sexually dimorphic traits, inform personalized therapeutic strategies in schizophrenia, and highlight the need for increased female samples for schizophrenia analyses.
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Affiliation(s)
- Kynon J M Benjamin
- Lieber Institute for Brain Development, Baltimore, MD, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Ria Arora
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Biology, Johns Hopkins University Krieger School of Arts & Sciences, Baltimore, MD, USA
| | | | - Geo Pertea
- Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Hunter H Giles
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joshua M Stolz
- Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Laura D'Ignazio
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Leonardo Collado-Torres
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Joo Heon Shin
- Lieber Institute for Brain Development, Baltimore, MD, USA
| | | | - Thomas M Hyde
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel E Kleinman
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel R Weinberger
- Lieber Institute for Brain Development, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Apuã C M Paquola
- Lieber Institute for Brain Development, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jennifer A Erwin
- Lieber Institute for Brain Development, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Spark DL, Ma S, Nowell CJ, Langmead CJ, Stewart GD, Nithianantharajah J. Sex-Dependent Attentional Impairments in a Subchronic Ketamine Mouse Model for Schizophrenia. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:229-239. [PMID: 38298794 PMCID: PMC10829638 DOI: 10.1016/j.bpsgos.2023.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 02/02/2024] Open
Abstract
Background The development of more effective treatments for schizophrenia targeting cognitive and negative symptoms has been limited, partly due to a disconnect between rodent models and human illness. Ketamine administration is widely used to model symptoms of schizophrenia in both humans and rodents. In mice, subchronic ketamine treatment reproduces key dopamine and glutamate dysfunction; however, it is unclear how this translates into behavioral changes reflecting positive, negative, and cognitive symptoms. Methods In male and female mice treated with either subchronic ketamine or saline, we assessed spontaneous and amphetamine-induced locomotor activity to measure behaviors relevant to positive symptoms, and used a touchscreen-based progressive ratio task of motivation and the rodent continuous performance test of attention to capture specific negative and cognitive symptoms, respectively. To explore neuronal changes underlying the behavioral effects of subchronic ketamine treatment, we quantified expression of the immediate early gene product, c-Fos, in key corticostriatal regions using immunofluorescence. Results We showed that spontaneous locomotor activity was unchanged in male and female subchronic ketamine-treated animals, and amphetamine-induced locomotor response was reduced. Subchronic ketamine treatment did not alter motivation in either male or female mice. In contrast, we identified a sex-specific effect of subchronic ketamine on attentional processing wherein female mice performed worse than control mice due to increased nonselective responding. Finally, we showed that subchronic ketamine treatment increased c-Fos expression in prefrontal cortical and striatal regions, consistent with a mechanism of widespread disinhibition of neuronal activity. Conclusions Our results highlight that the subchronic ketamine mouse model reproduces a subset of behavioral symptoms that are relevant for schizophrenia.
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Affiliation(s)
- Daisy L. Spark
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Sherie Ma
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Cameron J. Nowell
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Christopher J. Langmead
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Gregory D. Stewart
- Drug Discovery Biology Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuroscience & Mental Health Therapeutic Program Area, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
- Neuromedicines Discovery Centre, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Jess Nithianantharajah
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
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Ozbek SU, Sut E, Bora E. Comparison of social cognition and neurocognition in schizophrenia and autism spectrum disorder: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 155:105441. [PMID: 37923237 DOI: 10.1016/j.neubiorev.2023.105441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/14/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND This report aimed to compare group differences in social and non-social cognition in autism spectrum disorders (ASD) and schizophrenia, and examine the influence of age and other factors on group differences. METHODS Literature searches were conducted in Pubmed and Web of Science from January 1980 to August 2022. Original research articles reporting objective measures of cognition were selected. RESULTS 57 articles involving 1864 patients with schizophrenia and 1716 patients with ASD have been included. Schizophrenia was associated with more severe non-social-cognitive impairment, particularly in fluency (g=0.47;CI[0.17-0.76]) and processing speed domains (g=0.41;CI[0.20-0.62]). Poorer performance in social cognition (Z = 3.68,p = 0.0002) and non-social cognition (Z = 2.48,p = 0.01) in schizophrenia were significantly related to older age. ASD was associated with more severe social cognitive impairment when groups were matched for non-social-cognition (g=-0.18, p = 0.04) or reasoning/problem solving (g=-0,62; CI [-1,06-(-0.08)]. DISCUSSION While both disorders present with social and non-social cognitive impairments, the pattern and developmental trajectories of these deficits are different. The limitations included heterogeneity of the cognitive measures, and the lack of sufficient information about antipsychotic use.
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Affiliation(s)
| | - Ekin Sut
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey.
| | - Emre Bora
- Department of Psychiatry, Faculty of Medicine, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia; Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
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Huang H, Du L, Pu Z, Shi Y, Xiao Z, Chen X, Yao S, Wang L, Li Z, Xue T, Cui D. Association Between Metabolic Risk Factors and Cognitive Impairment in Schizophrenia Based on Sex. Psychiatry Investig 2023; 20:930-939. [PMID: 37899216 PMCID: PMC10620336 DOI: 10.30773/pi.2023.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/06/2023] [Accepted: 07/24/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE Sex differences have been observed in many aspects of schizophrenia, including cognitive deficits. Despite extensive research into the relationship between metabolic factors and cognitive deficits in schizophrenia, few studies have explored the potential sex difference in their association. METHODS We recruited 358 schizophrenia patients and 231 healthy controls. The participants underwent measurements of body mass index (BMI), waist circumference, blood pressure, triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose. Metabolic risk factors included abdominal obesity, hypertension, hyperglycemia, and dyslipidemia. A collection of these metabolic risk factors has been defined as metabolic syndrome. These diagnoses were based on the criteria of the National Cholesterol Education Program's Adult Treatment Panel III. Cognitive performance was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A descriptive analysis, difference analysis, and linear regression model were used to identify the metabolic risk factors for cognitive function in schizophrenia. RESULTS Our findings revealed sex differences in the rate of abdominal obesity and hypertension in schizophrenic patients. Additionally, we observed sex differences in the association between metabolic risk factors and cognitive impairment in schizophrenia. Specifically, hyperglycemia was associated with the immediate memory index score of RBANS in male patients, while dyslipidemia was associated with language, attention, delayed memory index scores, and RBANS total score in female patients. CONCLUSION Our results suggest that sex should be considered when evaluating the impact of metabolic disorders on the cognitive function of schizophrenic patients. Moreover, our study identifies hyperglycemia and dyslipidemia as potential targets for precise treatment by sex stratification, which could benefit the improvement of cognitive impairment in schizophrenic patients.
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Affiliation(s)
- Hongna Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Lizhao Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zhengping Pu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Yuan Shi
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zifan Xiao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Xi Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Shun Yao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Lijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ting Xue
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Donghong Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
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Wang C, Tishler TA, Oughourlian T, Nuechterlein KH, de la Fuente-Sandoval C, Ellingson BM. Prospective, randomized, multicenter clinical trial evaluating longitudinal changes in brain function and microstructure in first-episode schizophrenia patients treated with long-acting injectable paliperidone palmitate versus oral antipsychotics. Schizophr Res 2023; 255:222-232. [PMID: 37019033 DOI: 10.1016/j.schres.2023.03.040] [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: 03/28/2022] [Revised: 02/23/2023] [Accepted: 03/18/2023] [Indexed: 04/07/2023]
Abstract
Widespread anatomical alterations and abnormal functional connectivity have shown strong association with symptom severity in first-episode schizophrenia (FES) patients. Second-generation antipsychotic treatment might slow disease progression and possibly modify the cerebral plasticity in FES patients. However, whether a long-acting injectable antipsychotic (paliperidone palmitate [PP]), available in monthly and every-3-months formulations, is more effective than oral antipsychotics (OAP) in improving cerebral organization has been unclear. Therefore, in the current longitudinal study, we evaluated the differences in functional and microstructural changes of 68 FES patients in a randomized clinical trial of PP vs OAP. When compared to OAP treatment, PP treatment was more effective in decreasing abnormally high fronto-temporal and thalamo-temporal connectivity, as well as increasing fronto-sensorimotor and thalamo-insular connectivity. Consistent with previous studies, multiple white matter pathways showed larger changes in fractional anisotropy (FA) and mean diffusivity (MD) in response to PP compared with OAP treatment. These findings suggest that PP treatment might reduce regional abnormalities and improve cerebral connectivity networks compared with OAP treatment, and identified changes that may serve as reliable imaging biomarkers associated with medication treatment efficacy.
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Affiliation(s)
- Chencai Wang
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
| | - Todd A Tishler
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Talia Oughourlian
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico; Neuropsychiatry Department, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Benjamin M Ellingson
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Neuroscience Interdisciplinary Graduate Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
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Chan SKW, Liao Y, Hui CLM, Wong TY, Suen Y, Chang WC, Lee EHM, Chen EYH. Longitudinal changes of cognitive function and its relationship with subdomains of negative symptoms in patients with adult-onset first-episode schizophrenia: A 4-year follow up study. Schizophr Res 2023; 252:181-188. [PMID: 36657362 DOI: 10.1016/j.schres.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUNDS This study explores the longitudinal changes and trajectories of cognitive functions in patients with adult-onset first-episode schizophrenia (FES) over four years and their relationships with the baseline subdomains of negative symptoms. METHODS A total of 177 patients of age 25-55 with FES were recruited. Baseline demographics, clinical, social and cognitive functions were assessed. Diminished expression and diminished motivation of negative symptoms were assessed with Scale for the Assessment of Negative Symptoms (SANS). Patients had yearly follow-up of cognitive function assessments over four years. Latent class growth analysis (LCGA) and mixed linear regression model were used to explore the longitudinal changes of cognitive functions and the effect of baseline negative symptoms on the longitudinal cognitive function changes. Relationships of baseline negative symptoms subdomains and cognitive functions were also explored. RESULTS Two trajectories of cognitive functions were identified. Longitudinal improvements were found in most cognitive functions apart from the logical memory. One trajectory of patients had significant deterioration of logical memory while the other group had significant improvement. Baseline diminished expression was associated with baseline and longitudinal changes of processing speed and verbal fluency while diminished motivation was associated with baseline and longitudinal changes of processing speed. CONCLUSIONS Adult-onset FES patients had a homogeneous longitudinal improvement in most cognitive functions but not for logical memory suggesting the unique nature of verbal memory. The distinct relationship between baseline subdomains of negative symptoms with baseline and longitudinal cognitive functions suggesting the presence of differential overlapping etiology between negative symptom subdomains and cognitive functions.
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Affiliation(s)
- Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Yingqi Liao
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Ting Yat Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yinam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
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Buka SL, Lee YH, Goldstein JM. Infections During Pregnancy and Risks for Adult Psychosis: Findings from the New England Family Study. Curr Top Behav Neurosci 2023; 61:49-69. [PMID: 36376640 DOI: 10.1007/7854_2022_397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
For the past 40 years, our team has conducted a unique program of research investigating the prenatal risks for schizophrenia and related adult psychiatric disorders. The New England Family Study is a long-term prospective cohort study of over 16,000 individuals followed from the prenatal period for over 50 years. This chapter summarizes several major phases and findings from this work, highlighting recent results on maternal prenatal bacterial infections and brain imaging. Implications regarding the causes and potential prevention of major psychotic disorders are discussed.
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Affiliation(s)
- Stephen L Buka
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Younga Heather Lee
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA
| | - Jill M Goldstein
- Departments of Psychiatry and Medicine, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, Boston, MA, USA
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Sousa AE, Ryan JD, Lepage M. Exploring the sociodemographic, clinical and neuropsychological factors associated with relational memory in schizophrenia. Cogn Neuropsychiatry 2023; 28:67-84. [PMID: 36464633 DOI: 10.1080/13546805.2022.2153657] [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] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The Transverse Patterning (TP) task has been used to measure episodic relational memory (RM) deficits in clinical populations. Individuals with schizophrenia often fail to learn TP with standard, and sometimes extensive training. Identifying the differences between TP learners and non-learners can improve our understanding of successful TP performance and its underlying mechanisms, which may help improve interventions aimed at ameliorating RM performance. We investigated sociodemographic, clinical and neuropsychological factors associated with TP performance in schizophrenia. METHODS Sixty-six participants with schizophrenia completed a semantically rich and a relational-binding dependent version of the TP task and reported on their task awareness and strategy use. RESULTS Twenty-six participants failed to learn the task rules after extensive training. Learners had superior verbal, visual and working memory, executive functions and overall cognitive functioning compared to non-learners. Learners also had superior awareness of task rules and pairs relationships and used elaborated cognitive strategies more often. CONCLUSIONS Our results support previous findings that some individuals with schizophrenia show RM impairment even with extensive TP training. We shed light on neuropsychological and metacognitive factors associated with TP performance. This knowledge could enhance interventions targeted to improve relational memory in schizophrenia when extensive training fails.
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Affiliation(s)
- Ana Elisa Sousa
- Douglas Mental Health University Institute, Montreal, Canada.,Integrated Program in Neuroscience, McGill University, Montréal, Canada
| | - Jennifer D Ryan
- Rotman Research Institute, Baycrest, Department of Psychology, University of Toronto, Toronto, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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Fabian CB, Seney ML, Joffe ME. Sex differences and hormonal regulation of metabotropic glutamate receptor synaptic plasticity. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 168:311-347. [PMID: 36868632 PMCID: PMC10392610 DOI: 10.1016/bs.irn.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Striking sex differences exist in presentation and incidence of several psychiatric disorders. For example, major depressive disorder is more prevalent in women than men, and women who develop alcohol use disorder progress through drinking milestones more rapidly than men. With regards to psychiatric treatment responses, women respond more favorably to selective serotonin reuptake inhibitors than men, whereas men have better outcomes when prescribed tricyclic antidepressants. Despite such well-documented biases in incidence, presentation, and treatment response, sex as a biological variable has long been neglected in preclinical and clinical research. An emerging family of druggable targets for psychiatric diseases, metabotropic glutamate (mGlu) receptors are G-protein coupled receptors broadly distributed throughout the central nervous system. mGlu receptors confer diverse neuromodulatory actions of glutamate at the levels of synaptic plasticity, neuronal excitability, and gene transcription. In this chapter, we summarize the current preclinical and clinical evidence for sex differences in mGlu receptor function. We first highlight basal sex differences in mGlu receptor expression and function and proceed to describe how gonadal hormones, notably estradiol, regulate mGlu receptor signaling. We then describe sex-specific mechanisms by which mGlu receptors differentially modulate synaptic plasticity and behavior in basal states and models relevant for disease. Finally, we discuss human research findings and highlight areas in need of further research. Taken together, this review emphasizes how mGlu receptor function and expression can differ across sex. Gaining a more complete understanding of how sex differences in mGlu receptor function contribute to psychiatric diseases will be critical in the development of novel therapeutics that are effective in all individuals.
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Affiliation(s)
- Carly B Fabian
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, United States
| | - Marianne L Seney
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, United States
| | - Max E Joffe
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Translational Neuroscience Program, University of Pittsburgh, Pittsburgh, PA, United States.
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10
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Freeman HB, Lee J. Sex Differences in Cognition in Schizophrenia: What We Know and What We Do Not Know. Curr Top Behav Neurosci 2022; 63:463-474. [PMID: 36271194 DOI: 10.1007/7854_2022_394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Cognitive impairment is a core feature of schizophrenia. This selective review examines whether schizophrenia patients show preserved sexual dimorphism in cognition. Existing studies using performance tasks largely show comparable sex effects between schizophrenia patients and healthy populations. This pattern appears to be similar across multiple cognitive domains and across phase of illness. Our selective review also identifies several unresolved questions about sex differences in cognition in schizophrenia. A better understanding of sex differences in cognition in schizophrenia may provide important clues to probing the relationship between cognitive impairment and pathophysiological processes of the disorder.
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Affiliation(s)
- Hyun Bin Freeman
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
- Comprehensive Neuroscience Center, The University of Alabama at Birmingham, Birmingham, AL, USA.
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Modeling the interplay of age at onset and sex on cognition in Schizophrenia. Asian J Psychiatr 2022; 75:103202. [PMID: 35907340 DOI: 10.1016/j.ajp.2022.103202] [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: 03/23/2022] [Revised: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 11/21/2022]
Abstract
Cognition remains one of the most critical features of the schizophrenia. A wide range of factors has been associated to neurocognition and, among these, sex and age of onset are two of the most consistently reported to influence the functional and cognitive outcome. This work aims to evaluate the effects of sex and age of onset and their interaction on cognition in 419 subjects with schizophrenia. Analyses of variance and analyses of covariance were performed to evaluate the effect of sex and age at onset on cognition. To model the possible interaction sex-onset on cognition, a separate slope regression analysis was performed. Analyses of variance showed significant differences between sexes for age and age at onset, both significantly higher among females, as well as for Executive Functions, with higher performance among males. When compared according to age at onset, late-onset patients performed better than both early- and intermediate-onset ones in Verbal Memory subtest, with a significant effect of length of illness. Moreover, early-onset patients showed a significantly lower IQ compared to both intermediate and late-onset ones, with no significant effect of length of illness. Finally, the separate slope regression revealed a significant interaction between sex and age at onset, with early-onset being associated to a worse global cognition only among male patients. Our finding of a significant sex-onset interaction effect on neurocognition sheds new light on the complex issue of cognitive heterogeneity in schizophrenia. Our data may help towards the development of personalized programs for preventive and rehabilitative purposes.
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Kantor JR, Gur RC, Calkins ME, Moore TM, Port AM, Ruparel K, Scott JC, Troyan S, Gur RE, Roalf DR. Comparison of two cognitive screening measures in a longitudinal sample of youth at-risk for psychosis. Schizophr Res 2022; 246:216-224. [PMID: 35809354 PMCID: PMC10838490 DOI: 10.1016/j.schres.2022.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 06/13/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Validated screening tools are needed to detect subtle cognitive impairment in individuals at-risk for developing psychosis. Here, the utility of the Mini-Mental Status Examination (MMSE) and Penn Computerized Neurocognitive Battery (CNB) were evaluated for detecting cognitive impairment in individuals with psychosis spectrum (PS) symptoms. METHODS Participants (n = 229; 54 % female) completed the MMSE and CNB at baseline and two-year follow-up. PS (n = 91) and typically developing (TD; n = 138) participants were enrolled at baseline based on the presence or absence of PS symptoms. After two years, 65 participants remained PS, 104 participants remained TD, 23 participants had Emergent (EP) subthreshold PS symptoms, and 37 participants were experiencing Other Psychopathology (OP). RESULTS Generally, those with PS had lower scores than TD on both the MMSE (p < 0.0001) and CNB (p < 0.0001). Additionally, OP participants performed lower on the MMSE than TD (p = 0.02). Receiver operating characteristic (ROC) analyses indicated similar area under the curve (AUCs) for the two instruments (0.67); the MMSE showed higher specificity (0.71 vs. 0.62), while the CNB showed higher sensitivity (0.66 vs 0.52). Use of the MMSE and CNB in combination provided the highest diagnostic classification. CONCLUSION The MMSE and CNB can be used to screen for cognitive impairment in PS. The MMSE is better at ruling out PS-related cognitive impairment while the CNB is better at ruling in PS-related cognitive impairment. Overall, our results indicate that both tests are useful in screening for cognitive impairment, particularly in combination, in a PS population.
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Affiliation(s)
- Jenna R Kantor
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Ruben C Gur
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Monica E Calkins
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Tyler M Moore
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Allison M Port
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Kosha Ruparel
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - J Cobb Scott
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; VISN4 Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center, Philadelphia, PA 19104, USA
| | - Scott Troyan
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - Raquel E Gur
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA
| | - David R Roalf
- Brain Behavior Laboratory, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Brain Institute, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, USA.
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13
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Safont G, Garriga M, Amoretti S, Cuesta MJ, Parellada M, González-Pinto A, Bergé D, Rodriguez-Jimenez R, Bejarano AR, Sarró S, Ibáñez Á, Usall J, Gutiérrez M, Vieta E, Arranz B, Berrocoso E, Verdolini N, Bernardo M. Sex and substance use in first episode psychosis: impact on clinical symptoms, psychosocial functioning and cognitive performance. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022. [DOI: 10.1016/j.rpsm.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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14
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Gaillard A, Tan EJ, Carruthers SP, Gurvich C, Hughes ME, Neill E, Sumner PJ, Van Rheenen TE, Rossell SL. No influence of sex on the relationship between schizotypy factors and executive control across the schizophrenia spectrum. J Psychiatr Res 2022; 148:325-331. [PMID: 35193036 DOI: 10.1016/j.jpsychires.2022.02.015] [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: 09/03/2021] [Revised: 01/24/2022] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
Sex differences in symptoms and executive control across schizophrenia spectrum disorders (SSD) are consistently reported. Similarly, these findings of sex differences are also observed in schizotypy, that is, schizophrenia-like features occurring in healthy individuals in the absence of a clinical diagnosis. This study aimed to examine the relationships between performance on three major domains of executive control: performance monitoring, response inhibition, and cognitive set-shifting, and schizotypy factor scores in both SSD patients and healthy controls (HCs), and whether sex moderated any relationships observed. A total of 111 (67 males and 44 females) patients with SSD and 258 (129 males and 129 females) HCs were included in this study. Schizotypal personality traits (in both SSD and HC) was assessed using the Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE). Executive control performance was assessed using seven tasks. Stepwise linear regressions revealed that performance on cognitive set-shifting tasks was significantly associated with the introvertive anhedonia, cognitive disorganisation, and unusual experiences subscales of the O-LIFE. When sex was examined as a moderator, it was not a significant moderator of any of the relationships between cognitive set-shifting tasks and schizotypy factors. The results suggest that independent of sex, cognitive set-shifting ability is associated to an increased vulnerability to schizotypal personality traits, although performance monitoring and response inhibition did not.
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Affiliation(s)
- Alexandra Gaillard
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Neuroscience of Addiction and Mental Health Program, Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - Eric J Tan
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, VIC, Australia
| | - Matthew E Hughes
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Erica Neill
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Philip J Sumner
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, The University of Melbourne, Level 3, Alan Gilbert Building, 161 Barry St, Carlton, Victory, 3053, Australia
| | - Susan L Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and the Alfred Hospital, Melbourne, VIC, Australia
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15
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Rodríguez-Sánchez JM, Setién-Suero E, Suárez-Pinilla P, Mayoral Van Son J, Vázquez-Bourgon J, Gil López P, Crespo-Facorro B, Ayesa-Arriola R. Ten-year course of cognition in first-episode non-affective psychosis patients: PAFIP cohort. Psychol Med 2022; 52:770-779. [PMID: 32686636 DOI: 10.1017/s0033291720002408] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A large body of research states that cognitive impairment in schizophrenia is static. Nevertheless, most previous studies lack a control group or have small study samples or short follow-up periods. METHOD We aimed to address these limitations by studying a large epidemiological cohort of patients with first-episode schizophrenia spectrum disorders and a comparable control sample for a 10-year period. RESULTS Our results support the generalized stability of cognitive functions in schizophrenia spectrum disorders considering the entire group. However, the existence of a subgroup of patients characterized by deteriorating cognition and worse long-term clinical outcomes must be noted. Nevertheless, it was not possible to identify concomitant factors or predictors of deterioration (all Ps > 0.05). CONCLUSIONS Cognitive functions in schizophrenia spectrum disorder are stable; however, a subgroup of subjects that deteriorate can be characterized.
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Affiliation(s)
- José Manuel Rodríguez-Sánchez
- Red de Salud Mental de Bizkaia. Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12 48903, Barakaldo, Bizkaia, España
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
| | - Esther Setién-Suero
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Paula Suárez-Pinilla
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | | | - Javier Vázquez-Bourgon
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
| | - Patxi Gil López
- Red de Salud Mental de Bizkaia. Biocruces Bizkaia Health Research Institute, Plaza de Cruces 12 48903, Barakaldo, Bizkaia, España
| | - Benedicto Crespo-Facorro
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
- Hospital universitario Virgen del Roció, IBiS, Universidad de Sevilla, Spain
| | - Rosa Ayesa-Arriola
- CIBERSAM, Centro Investigación Biomédica en Red Salud Mental, Spain
- Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL. School of Medicine, University of Cantabria, Santander, Spain
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16
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Koch E, Nyberg L, Lundquist A, Kauppi K. Polygenic Risk for Schizophrenia Has Sex-Specific Effects on Brain Activity during Memory Processing in Healthy Individuals. Genes (Basel) 2022; 13:genes13030412. [PMID: 35327966 PMCID: PMC8950000 DOI: 10.3390/genes13030412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/10/2022] [Accepted: 02/23/2022] [Indexed: 12/28/2022] Open
Abstract
Genetic risk for schizophrenia has a negative impact on memory and other cognitive abilities in unaffected individuals, and it was recently shown that this effect is specific to males. Using functional MRI, we investigated the effect of a polygenic risk score (PRS) for schizophrenia on brain activation during working memory and episodic memory in 351 unaffected participants (167 males and 184 females, 25–95 years), and specifically tested if any effect of PRS on brain activation is sex-specific. Schizophrenia PRS was significantly associated with decreased brain activation in the left dorsolateral prefrontal cortex (DLPFC) during working-memory manipulation and in the bilateral superior parietal lobule (SPL) during episodic-memory encoding and retrieval. A significant interaction effect between sex and PRS was seen in the bilateral SPL during episodic-memory encoding and retrieval, and sex-stratified analyses showed that the effect of PRS on SPL activation was male-specific. These results confirm previous findings of DLPFC inefficiency in schizophrenia, and highlight the SPL as another important genetic intermediate phenotype of the disease. The observed sex differences suggest that the previously shown male-specific effect of schizophrenia PRS on cognition translates into an additional corresponding effect on brain functioning.
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Affiliation(s)
- Elise Koch
- Department of Integrative Medical Biology, Umeå University, 901 87 Umeå, Sweden; (L.N.); (K.K.)
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden;
- Correspondence: ; Tel.: +46-90-786-50-00
| | - Lars Nyberg
- Department of Integrative Medical Biology, Umeå University, 901 87 Umeå, Sweden; (L.N.); (K.K.)
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden;
- Department of Radiation Sciences, Diagnostic Radiology, University Hospital, Umeå University, 901 87 Umeå, Sweden
| | - Anders Lundquist
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden;
- Department of Statistics, School of Business, Economics and Statistics, Umeå University, 901 87 Umeå, Sweden
| | - Karolina Kauppi
- Department of Integrative Medical Biology, Umeå University, 901 87 Umeå, Sweden; (L.N.); (K.K.)
- Umeå Center for Functional Brain Imaging, Umeå University, 901 87 Umeå, Sweden;
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12A, 171 65 Solna, Sweden
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17
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Diviccaro S, Cioffi L, Falvo E, Giatti S, Melcangi RC. Allopregnanolone: An overview on its synthesis and effects. J Neuroendocrinol 2022; 34:e12996. [PMID: 34189791 PMCID: PMC9285581 DOI: 10.1111/jne.12996] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 12/23/2022]
Abstract
Allopregnanolone, a 3α,5α-progesterone metabolite, acts as a potent allosteric modulator of the γ-aminobutyric acid type A receptor. In the present review, the synthesis of this neuroactive steroid occurring in the nervous system is discussed with respect to physiological and pathological conditions. In addition, its physiological and neuroprotective effects are also reported. Interestingly, the levels of this neuroactive steroid, as well as its effects, are sex-dimorphic, suggesting a possible gender medicine based on this neuroactive steroid for neurological disorders. However, allopregnanolone presents low bioavailability and extensive hepatic metabolism, limiting its use as a drug. Therefore, synthetic analogues or a different therapeutic strategy able to increase allopregnanolone levels have been proposed to overcome any pharmacokinetic issues.
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Affiliation(s)
- Silvia Diviccaro
- Dipartimento di Scienze Farmacologiche e BiomolecolariUniversità degli Studi di MilanoMilanoItaly
| | - Lucia Cioffi
- Dipartimento di Scienze Farmacologiche e BiomolecolariUniversità degli Studi di MilanoMilanoItaly
| | - Eva Falvo
- Dipartimento di Scienze Farmacologiche e BiomolecolariUniversità degli Studi di MilanoMilanoItaly
| | - Silvia Giatti
- Dipartimento di Scienze Farmacologiche e BiomolecolariUniversità degli Studi di MilanoMilanoItaly
| | - Roberto Cosimo Melcangi
- Dipartimento di Scienze Farmacologiche e BiomolecolariUniversità degli Studi di MilanoMilanoItaly
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18
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Wójciak P, Domowicz K, Zabłocka M, Michalak M, Rybakowski JK. Association of Negative Symptoms of Schizophrenia Assessed by the BNSS and SNS Scales With Neuropsychological Performance: A Gender Effect. Front Psychiatry 2021; 12:797386. [PMID: 35002812 PMCID: PMC8738094 DOI: 10.3389/fpsyt.2021.797386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/08/2021] [Indexed: 01/01/2023] Open
Abstract
Objective: The relationship between negative symptoms and neurocognitive performance in schizophrenia is well documented, but the mechanism of these connections remains unclear. The study aims to measure the relationship between the results on the new scales for the assessment of negative symptoms such as Brief Negative Symptom Scale (BNSS) and Self-evaluation of Negative Symptoms (SNS), and the results of some neurocognition tests. The second aim is to assess a possible gender effect on these associations. Methods: The study included 80 patients (40 men, 40 women) with schizophrenia, aged 19-63 (mean 38 years), during the improvement period (total PANSS score <80, unchanged pharmacological treatment in the last 3 weeks). They were assessed using the BNSS, SNS, Personal and Social Performance (PSP) scales, and the tests for neuropsychological performance such as the Trail Making Test (TMT-A, TMT-B), Stroop Color-Word Interference Test, Verbal fluency tests (VFT), Category fluency test (CFT), and Digit Symbol Substitution Test (DSST). Results: Male patients obtained higher scores than females on some PANSS and BNSS items. No gender differences were observed for the SNS scale. Female patients scored better in the PSP and CFT. In male patients, a significant positive correlation between the intensity of negative symptoms measured by the BNSS and the results of PSP with the Trail Making Test was observed. In female patients, we found a positive correlation between the results of BNSS and PSP with the Stroop Color-Word Interference Test. Conclusion: The obtained results confirm the relationship between negative symptoms and neurocognition in schizophrenia patients. However, in male and female patients such association was observed for different cognitive domains. Further research is needed to explain the nature of these differences.
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Affiliation(s)
- Paweł Wójciak
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Klaudia Domowicz
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Marta Zabłocka
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Janusz K. Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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The effect of sex on social cognition and functioning in schizophrenia. NPJ SCHIZOPHRENIA 2021; 7:57. [PMID: 34853324 PMCID: PMC8636592 DOI: 10.1038/s41537-021-00188-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/03/2021] [Indexed: 12/04/2022]
Abstract
Social cognitive impairment is a core feature of schizophrenia and plays a critical role in poor community functioning in the disorder. However, our understanding of the relationship between key biological variables and social cognitive impairment in schizophrenia is limited. This study examined the effect of sex on the levels of social cognitive impairment and the relationship between social cognitive impairment and social functioning in schizophrenia. Two hundred forty-eight patients with schizophrenia (61 female) and 87 healthy controls (31 female) completed five objective measures and one subjective measure of social cognition. The objective measures included the Facial Affect Identification, Emotion in Biological Motion, Self-Referential Memory, MSCEIT Branch 4, and Empathic Accuracy tasks. The subjective measure was the Interpersonal Reactivity Index (IRI), which includes four subscales. Patients completed measures of social and non-social functional capacity and community functioning. For objective social cognitive tasks, we found a significant sex difference only on one measure, the MSCEIT Branch 4, which in both patient and control groups, females performed better than males. Regarding the IRI, females endorsed higher empathy-related items on one subscale. The moderating role of sex was found only for the association between objective social cognition and non-social functional capacity. The relationship was stronger in male patients than female patients. In this study, we found minimal evidence of a sex effect on social cognition in schizophrenia across subjective and objective measures. Sex does not appear to moderate the association between social cognition and functioning in schizophrenia.
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20
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Guan LY, Hou WL, Zhu ZH, Cao JQ, Tang Z, Yin XY, Xu DW, Yu X, Jia QF, Tang WJ, Zhang JP, Hui L. Associations among gonadal hormone, triglycerides and cognitive decline in female patients with major depressive disorders. J Psychiatr Res 2021; 143:580-586. [PMID: 33213891 DOI: 10.1016/j.jpsychires.2020.11.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Cognitive impairment has been identified as a core feature of depression. Serum triglycerides (TG), gonadal hormone and sex difference were shown to influence cognitive performance. The purpose of this study was to investigate the associations among serum TG, gonadal hormone, sex difference and cognitive performance in patients with major depressive disorders (MDD). METHODS The enrolled 183 patients (male/female = 80/103) meeting DSM-IV criteria for MDD were divided into high TG group (patients-HTG) and normal TG group (patients-NTG) according to TG level. Serum TG, estradiol (E2) and testosterone (T) levels were measured by the glycerokinase peroxidase-peroxidase and chemiluminescence methods. Cognition was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The study was conducted between August 2016 and January 2020. RESULTS In female, patients-HTG had lower immediate memory, language, attention, delayed memory and RBANS total scores than patients-NTG after adjusting for covariates. There were significant differences in serum E2 and T levels between patients-HTG and patients-NTG in female after controlling for covariates. In female patients-HTG, serum E2 level was positively associated with immediate memory, delayed memory and RBANS total scores, and serum T level was positively related to immediate memory, language and RBANS total scores. These findings were not seen in male patients. CONCLUSIONS Our data suggested that patients-HTG exhibited poorer cognitive function compared with patients-NTG in female. Moreover, the decline in serum gonadal hormone level might contribute to the high TG development of female MDD, and was further implicated in their cognitive decline.
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Affiliation(s)
- Lu Yang Guan
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Wen Long Hou
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Zhen Hua Zhu
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Jia Qi Cao
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Zhen Tang
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Xu Yuan Yin
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Dong Wu Xu
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China
| | - Xin Yu
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Institute of Mental Health, Peking University, Beijing, 100083, PR China
| | - Qiu Fang Jia
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China
| | - Wen Jie Tang
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China.
| | - Jian-Ping Zhang
- Department of Psychiatry, Weill Cornell Medical College, Cornell University, New York, NY, 10605, USA
| | - Li Hui
- School of Mental Health, First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, PR China; Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Soochow University, Suzhou, 215137, Jiangsu, PR China.
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21
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Sex-specific effects of polygenic risk for schizophrenia on lifespan cognitive functioning in healthy individuals. Transl Psychiatry 2021; 11:520. [PMID: 34635642 PMCID: PMC8505489 DOI: 10.1038/s41398-021-01649-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/16/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Polygenic risk for schizophrenia has been associated with lower cognitive ability and age-related cognitive change in healthy individuals. Despite well-established neuropsychological sex differences in schizophrenia patients, genetic studies on sex differences in schizophrenia in relation to cognitive phenotypes are scarce. Here, we investigated whether the effect of a polygenic risk score (PRS) for schizophrenia on childhood, midlife, and late-life cognitive function in healthy individuals is modified by sex, and if PRS is linked to accelerated cognitive decline. Using a longitudinal data set from healthy individuals aged 25-100 years (N = 1459) spanning a 25-year period, we found that PRS was associated with lower cognitive ability (episodic memory, semantic memory, visuospatial ability), but not with accelerated cognitive decline. A significant interaction effect between sex and PRS was seen on cognitive task performance, and sex-stratified analyses showed that the effect of PRS was male-specific. In a sub-sample, we observed a male-specific effect of the PRS on school performance at age 12 (N = 496). Our findings of sex-specific effects of schizophrenia genetics on cognitive functioning across the lifespan indicate that the effects of underlying disease genetics on cognitive functioning is dependent on biological processes that differ between the sexes.
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22
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Yang M, Gao S, Xiong W, Zhang XY. Sex-differential associations between cognitive impairments and white matter abnormalities in first episode and drug-naïve schizophrenia. Early Interv Psychiatry 2021; 15:1179-1187. [PMID: 33058544 DOI: 10.1111/eip.13059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/24/2020] [Accepted: 09/26/2020] [Indexed: 11/30/2022]
Abstract
AIM Previous evidence has suggested that schizophrenia patients may display sex differences in cognitive impairments and cognitive impairments are related to disrupted white matter (WM) microstructure. The current research aims to address the intriguing possibility for the sex-specific association between cognitive deficits and WM abnormalities in first-episode and drug-naïve schizophrenia. METHODS Cognitive performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) was measured in 39 FEND patients (females:males = 23:16) and 30 healthy controls (females:males = 17:13), together with whole-brain WM fractional anisotropy (FA) values determined using voxel-based diffusion tensor imaging. Correlations between cognitive performance and FA values were assessed. RESULTS Patients performed significantly worse than healthy controls in the total score and most of the subscores of MCCB. Female patients displayed better cognitive performance than male patients on the Trail Making A Test, the Hopkins Verbal Learning Test and the Spatial Span Test in the Wechsler Memory Scale. More importantly, sex-differential association between cognitive performance and FA values was found in patients, but not in healthy controls. In particular, FA values in the cerebellum were negatively correlated with the continuous performance and digital sequence scores in male patients but positively correlated with the performance on the Spatial Span Test in the Wechsler Memory Scale in female patients. CONCLUSIONS These findings suggest sex-specific neurobiological substrates involved in cognitive deficits in early-onset schizophrenia and have important implications for differentially targeted interventions between males and females.
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Affiliation(s)
- Mi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Shan Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Weisen Xiong
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China.,School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Singh RS, Singh KK, Singh SM. Origin of Sex-Biased Mental Disorders: An Evolutionary Perspective. J Mol Evol 2021; 89:195-213. [PMID: 33630117 PMCID: PMC8116267 DOI: 10.1007/s00239-021-09999-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Sexual dimorphism or sex bias in diseases and mental disorders have two biological causes: sexual selection and sex hormones. We review the role of sexual selection theory and bring together decades of molecular studies on the variation and evolution of sex-biased genes and provide a theoretical basis for the causes of sex bias in disease and health. We present a Sexual Selection-Sex Hormone theory and show that male-driven evolution, including sexual selection, leads to: (1) increased male vulnerability due to negative pleiotropic effects associated with male-driven sexual selection and evolution; (2) increased rates of male-driven mutations and epimutations in response to early fitness gains and at the cost of late fitness; and (3) enhanced female immunity due to antagonistic responses to mutations that are beneficial to males but harmful to females, reducing female vulnerability to diseases and increasing the thresholds for disorders such as autism. Female-driven evolution, such as reproduction-related fluctuation in female sex hormones in association with stress and social condition, has been shown to be associated with increased risk of certain mental disorders such as major depression disorder in women. Bodies have history, cells have memories. An evolutionary framework, such as the Sexual Selection–Sex Hormone theory, provides a historical perspective for understanding how the differences in the sex-biased diseases and mental disorders have evolved over time. It has the potential to direct the development of novel preventive and treatment strategies.
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Affiliation(s)
- Rama S Singh
- Department of Biology, McMaster University, Hamilton, Canada.
| | - Karun K Singh
- Stem Cell and Cancer Research Institute, McMaster University, Hamilton, Canada.,Krembil Research Institute, University Health Network, Toronto, Canada
| | - Shiva M Singh
- Department of Biology, University of Western Ontario, London, Canada
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24
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Shi H, Guan XN, Liu DY, Zhu L, Wu ZW, Luo GZ, Wang J, Xiu MH, Zhang XY. Sex-specific Association of Antipsychotic-induced Weight Gain and Treatment Response for Antipsychotic-Naive First Episode Schizophrenia Patients: A Prospective 8-week Longitudinal Study. PHARMACOPSYCHIATRY 2021; 54:68-74. [PMID: 33626593 DOI: 10.1055/a-1353-6544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patients with antipsychotic-naïve first-episode (ANFE) schizophrenia (SZ) can help clarify many confounding factors in determining sex differences in antipsychotic drug induced weight gain and its association with symptom improvement. METHODS This 8-week longitudinal trial of ANFE patients with SZ enrolled 526 patients and 313 healthy controls. We evaluated bodyweight and the efficacy of antipsychotics on the Positive and Negative Syndrome Scale (PANSS) at baseline and at the end of week 8. RESULTS Males and females after treatment showed no sex difference in weight gain, BMI increase, and percentage of weight gain. However, at baseline, male patients had more positive symptoms than female patients, and decreases in positive symptoms, general psychopathology, and total PANSS scores were less in male than female patients. Adjusting for confounding factors using multiple linear regression confirmed that weight gain was significantly associated with these decreases in PANSS symptoms only in men not women. CONCLUSIONS The relationship between weight gain and symptom reduction after 8 weeks of antipsychotic treatment exists only in male patients with ANFE SZ and not in female patients.
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Affiliation(s)
- Hui Shi
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao Ni Guan
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Dian Ying Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Lin Zhu
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Zhi Wei Wu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.,Shenzhen Mental Health center. Shenzhen, Guangdong, China
| | - Guo Zhi Luo
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.,Shenzhen Mental Health center. Shenzhen, Guangdong, China
| | - Jun Wang
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Mei Hong Xiu
- Peking University Hui Long Guan Clinical Medical School, Beijing Hui Long Guan Hospital, Beijing, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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The relationship between cortical thickness and language comprehension varies with sex in healthy young adults: a large sample analysis. Neuroreport 2021; 31:184-188. [PMID: 31895746 DOI: 10.1097/wnr.0000000000001393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Functional neuroimaging studies evaluating sex differences in language processing have been previously reported. However, it remains largely unclear whether there are structural bases for language comprehension and whether these are partially affected by sexual dimorphism in cortical thickness. To this end, we performed correlation analysis between cortical thickness and language comprehension in a large (N = 1017, 549 females, 468 males) young and healthy subjects from Human Connectome Project, with a specific focus on the impact of sex. We identified significant relationship between cortical thickness of the posterior cingulate cortex (PCC) and vocabulary comprehension in females (r = 0.318, r = 10%), while the association was significantly reduced in males (P = 0.017, Cohen's q = 0.154). Furthermore, thickness difference in the PCC was observed to be smaller in females (P < 0.0001, t = -7.12, Cohen's d = 0.45); however, the difference disappeared when controlling for brain size (Cohen's d = 0.002). Our findings indicated that variability in cortical thickness may affect cognitive function much more in females than in males, and highlighted the importance of brain size in explaining sex-specific cortical thickness.
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Gaillard A, Fehring DJ, Rossell SL. Sex differences in executive control: A systematic review of functional neuroimaging studies. Eur J Neurosci 2021; 53:2592-2611. [PMID: 33423339 DOI: 10.1111/ejn.15107] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 01/21/2023]
Abstract
The number of studies investigating sex differences in executive functions, particularly those using human functional neuroimaging techniques, has risen dramatically in the past decade. However, the influences of sex on executive function are still underexplored and poorly characterized. To address this, we conducted a systematic literature review of functional neuroimaging studies investigating sex differences in three prominent executive control domains of cognitive set-shifting, performance monitoring, and response inhibition. PubMed, Web of Science, and Scopus were systematically searched. Following the application of exclusion criteria, 21 studies were included, with a total of 677 females and 686 males. Ten of these studies were fMRI and PET, eight were EEG, and three were NIRS. At present, there is evidence for sex differences in the neural networks underlying all tasks of executive control included in this review suggesting males and females engage different strategies depending on task demands. There was one task exception, the 2-Back task, which showed no sex differences. Due to methodological variability and the involvement of multiple neural networks, a simple overarching statement with regard to gender differences during executive control cannot be provided. As such, we discuss limitations within the current literature and methodological considerations that should be employed in future research. Importantly, sex differences in neural mechanisms are present in the majority of tasks assessed, and thus should not be ignored in future research. PROSPERO registration information: CRD42019124772.
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Affiliation(s)
- Alexandra Gaillard
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC., Australia
| | - Daniel J Fehring
- Cognitive Neuroscience Laboratory, Monash Biomedicine Discovery Institute, Department of Physiology, Monash University, Clayton, VIC., Australia.,ARC Centre of Excellence in Integrative Brain Function, Monash University, Clayton, VIC., Australia
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC., Australia.,Psychiatry, St Vincent's Hospital, Melbourne, VIC., Australia
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27
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Gao J, Xiu MH, Liu DY, Wei CW, Zhang X. Interactive effect of MTHFR C677T polymorphism and sex on symptoms and cognitive functions in Chinese patients with chronic schizophrenia. Aging (Albany NY) 2020; 12:10290-10299. [PMID: 32497019 PMCID: PMC7346048 DOI: 10.18632/aging.103248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/20/2020] [Indexed: 12/23/2022]
Abstract
The etiology of schizophrenia is still unknown, and the MTHFR gene has been shown to be associated with SCZ. Previous studies have shown that patients with schizophrenia exhibit sex differences in symptoms and cognitive function. However, no study has been conducted to investigate the sex difference in the association between C677T polymorphism and symptoms and cognitive impairment in Chinese patients with schizophrenia. The C677T polymorphism was genotyped in 957 patients with schizophrenia and 576 controls. Patients were also rated on the Positive and Negative Syndrome Scale (PANSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The results showed that there were significant differences in MTHFR C677T genotype and allele distributions between male patients and male controls (both p<0.05), while there was no significant difference between female patients and female controls (both p>0.05). Further analysis showed that there were significant sex differences in the association between C677T genotype and negative symptoms, immediate memory or attention index score in schizophrenia (p<0.05). This study suggests that the complex interactive effect between MTHFR C677T polymorphism and sex plays an important role in some clinical characteristics of patients with schizophrenia.
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Affiliation(s)
- Jie Gao
- Department of Cardiac Surgery, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Mei Hong Xiu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, China
| | - Dian Ying Liu
- Department of Psychiatry, The Third People's Hospital of Ganzhou, Ganzhou, Jiangxi, China
| | - Chang Wei Wei
- Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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28
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Ittig S, Studerus E, Papmeyer M, Uttinger M, Koranyi S, Ramyead A, Riecher-Rössler A. Sex Differences in Cognitive Functioning in At-Risk Mental State for Psychosis, First Episode Psychosis and Healthy Control Subjects. Eur Psychiatry 2020; 30:242-50. [DOI: 10.1016/j.eurpsy.2014.11.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 09/30/2014] [Accepted: 11/09/2014] [Indexed: 10/24/2022] Open
Abstract
AbstractBackground:Several sex differences in schizophrenia have been reported including differences in cognitive functioning. Studies with schizophrenia patients and healthy controls (HC) indicate that the sex advantage for women in verbal domains is also present in schizophrenia patients. However, findings have been inconsistent. No study focused on sex-related cognitive performance differences in at-risk mental state for psychosis (ARMS) individuals yet. Thus, the aim of the present study was to investigate sex differences in cognitive functioning in ARMS, first episode psychosis (FEP) and HC subjects. We expected a better verbal learning and memory performance of women in all groups.Methods:The neuropsychological data analysed in this study were collected within the prospective Früherkennung von Psychosen (FePsy) study. In total, 118 ARMS, 88 FEP individuals and 86 HC completed a cognitive test battery covering the domains of executive functions, attention, working memory, verbal learning and memory, IQ and speed of processing.Results:Women performed better in verbal learning and memory regardless of diagnostic group. By contrast, men as compared to women showed a shorter reaction time during the working memory task across all groups.Conclusion:The results provide evidence that women generally perform better in verbal learning and memory, independent of diagnostic group (ARMS, FEP, HC). The finding of a shorter reaction time for men in the working memory task could indicate that men have a superior working memory performance since they responded faster during the target trials, while maintaining a comparable overall working memory performance level.
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29
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Penney D, Joober R, Malla A, Lepage M. Understanding sex differences in cognitive insight across first-and-multiple episode psychosis. Schizophr Res 2020; 218:276-282. [PMID: 31980343 DOI: 10.1016/j.schres.2019.12.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/19/2019] [Accepted: 12/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Cognitive insight represents the capacity to self-reflect and consider external feedback when re-evaluating faulty beliefs. It is associated with specific cognitive capacities such as verbal memory, of which there is substantial evidence for sex differences in psychotic disorders. Like more general cognitive capacities, cognitive insight might too be modulated by sex differences. METHOD One hundred and seventy-one first episode psychosis (FEP; 123 males, 48 females), and 203 multiple episode psychosis (MEP; 147 males, 56 females) participants completed the Beck Cognitive Insight Scale (BCIS). A two-way MANOVA was conducted on the three BCIS measures (self-reflectiveness, self-certainty, composite index) with sex (male, female) and illness stage (FEP, MEP) as factors, followed by two-way ANOVAs and a post hoc test of simple effects. RESULTS The only significant interaction to emerge was between sex and illness stage in self-certainty (F(1, 373) = 5.88, p = .016). A test of simple effects revealed that self-certainty group means were significantly different for males and females in FEP, where females had lower self-certainty than males (p = .053) but not during MEP (p = .119). CONCLUSION Sex differences do not modulate cognitive insight in MEP, which may be attributable to females having greater positive symptom severity than males. In FEP however, results revealed that females were significantly less self-certain than males. Lower self-certainty relative to self-reflectiveness predicts treatment response in psychological interventions, and as such future FEP studies should explore sex differences in psychological interventions.
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Affiliation(s)
- Danielle Penney
- Douglas Mental Health University Institute, Montréal, Canada; Department of psychology, Université du Québec à Montréal, Canada
| | - Ridha Joober
- Douglas Mental Health University Institute, Montréal, Canada; Department of psychiatry, McGill University, Montréal, Canada
| | - Ashok Malla
- Douglas Mental Health University Institute, Montréal, Canada; Department of psychiatry, McGill University, Montréal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montréal, Canada; Department of psychiatry, McGill University, Montréal, Canada.
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30
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Wei CW, Chen YQ, Ma M, Xiu MH, Zhang XY. Sex differences in the association of body mass index with symptoms and cognitive deficits in Chinese patients with chronic schizophrenia. Transl Psychiatry 2020; 10:18. [PMID: 32066717 PMCID: PMC7026182 DOI: 10.1038/s41398-020-0717-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/19/2019] [Accepted: 11/28/2019] [Indexed: 12/17/2022] Open
Abstract
Accumulating studies have revealed gender differences in many aspects of schizophrenia (SZ), including obesity and cognitive function. The relationship between obesity and cognitive impairment in SZ has been studied before; however, the results are inconsistent. This study was designed to examine the sex differences in the relationship between body mass index (BMI) and cognitive deficits in Chinese patients with chronic SZ, which have not been investigated yet. 176 chronic patients with SZ (male/female = 108/68) and 200 controls (male/female = 120/80) were enrolled to compare the sex differences in cognitive functions measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), BMI, and their associations. The clinical symptoms were evaluated using the positive and negative syndrome scales (PANSS). Our results showed that male patients had lower BMI and more negative symptoms but fewer positive symptoms than female patients (all p < 0.05). However, there was no significant sex difference in RBANS scores. In male patients, BMI was correlated with age of onset, PANSS general psychopathology, total score, negative symptom, together with RBANS language, visuospatial/construction, and attention. Further regression analysis showed that in male patients, BMI was significantly associated with RBANS language, PANSS general psychopathology, PANSS total score, and age of onset, with adjusted R2 = 0.22. These findings revealed significant sex differences in BMI, cognitive dysfunctions and their association in SZ. Nonetheless, these results should only be considered as preliminary because of the cross-sectional design, which will deserve further replication in first-episode patients using a prospective longitudinal design.
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Affiliation(s)
- Chang Wei Wei
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, P. R. China
| | - Ying Qi Chen
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, P. R. China
| | - Mi Ma
- grid.452792.fQingdao Mental Health Center, Qingdao, P. R. China
| | - Mei Hong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, P. R. China.
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, P. R. China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, P. R. China.
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31
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Giatti S, Diviccaro S, Serafini MM, Caruso D, Garcia-Segura LM, Viviani B, Melcangi RC. Sex differences in steroid levels and steroidogenesis in the nervous system: Physiopathological role. Front Neuroendocrinol 2020; 56:100804. [PMID: 31689419 DOI: 10.1016/j.yfrne.2019.100804] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/10/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
Abstract
The nervous system, in addition to be a target for steroid hormones, is the source of a variety of neuroactive steroids, which are synthesized and metabolized by neurons and glial cells. Recent evidence indicates that the expression of neurosteroidogenic proteins and enzymes and the levels of neuroactive steroids are different in the nervous system of males and females. We here summarized the state of the art of neuroactive steroids, particularly taking in consideration sex differences occurring in the synthesis and levels of these molecules. In addition, we discuss the consequences of sex differences in neurosteroidogenesis for the function of the nervous system under healthy and pathological conditions and the implications of neuroactive steroids and neurosteroidogenesis for the development of sex-specific therapeutic interventions.
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Affiliation(s)
- Silvia Giatti
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Silvia Diviccaro
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Melania Maria Serafini
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Donatella Caruso
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Luis Miguel Garcia-Segura
- Instituto Cajal, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Barbara Viviani
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy
| | - Roberto C Melcangi
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
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Abstract
The central cholinergic system is one of the most important modulator neurotransmitter system implicated in diverse behavioral processes. Activation of the basal forebrain cortical cholinergic input system represents a critical step in cortical information processing. This chapter explores recent developments illustrating cortical cholinergic transmission mediate defined cognitive operations, which is contrary to the traditional view that acetylcholine acts as a slowly acting neuromodulator that influences arousal cortex-wide. Specifically, we review the evidence that phasic cholinergic signaling in the prefrontal cortex is a causal mediator of signal detection. In addition, studies that support the neuromodulatory role of cholinergic inputs in top-down attentional control are summarized. Finally, we review new findings that reveal sex differences and hormonal regulation of the cholinergic-attention system.
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Affiliation(s)
- Vinay Parikh
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA.
| | - Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA, USA
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Wallentin M. Gender differences in language are small but matter for disorders. HANDBOOK OF CLINICAL NEUROLOGY 2020; 175:81-102. [DOI: 10.1016/b978-0-444-64123-6.00007-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Abstract
Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.
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Affiliation(s)
- Richard Lewine
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States.
| | - Mara Hart
- Department of Psychiatry, Worcester Recovery Center and Hospital, Worcester, MA, United States
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Prospective memory in schizophrenia: A meta-analysis of comparative studies. Schizophr Res 2019; 212:62-71. [PMID: 31447355 DOI: 10.1016/j.schres.2019.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 06/17/2019] [Accepted: 08/05/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Impairment of prospective memory (PM) in schizophrenia has gained increasing attention. This meta-analysis systematically examined PM impairment in schizophrenia. METHODS Both English (PubMed, PsycINFO, EMBASE, and Cochrane Library) and Chinese (WanFang, Chinese Biomedical and China Journal Net databases) databases were systematically searched from their inception until August 14, 2017. Case-control studies of PM in schizophrenia were included. Standardized mean differences (SMDs) and their 95% confidence interval (CI) were calculated using the random-effects model. RESULTS Twenty-nine case-control studies (n = 2492) were included in the analyses. The overall and three subtypes of PM were compared between patients with schizophrenia (n = 1284) and healthy controls (n = 1208). Compared to healthy controls, patients performed significantly poorer in overall (SMD = -1.125), time-based (SMD = -1.155), event-based (SMD = -1.068), and activity-based PM (SMD = -0.563). Subgroup analyses revealed significant differences between older and younger patients (SMD = -1.398 vs. -0.763), higher male predominance and no sex predominance (SMD = -1.679 vs. -0.800), lower and higher education level (SMD = -1.373 vs.-0.637), chronic and first-episode patients (SMD = -1.237 vs. -0.641) and between eco-valid and dual-task laboratory measurements (SMD = -1.542 vs. -0.725) regarding overall PM. Meta-regression analysis showed that higher negative symptom score was significantly associated with more severe overall PM impairment in patients (P = 0.022). CONCLUSIONS In this meta-analysis the overall PM and all its subtypes, particularly the time-based PM, were significantly impaired in schizophrenia.
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Abstract
Neuroimaging studies suggest differences in the underlying biology of sexual arousal associated with sex and sexual orientation, yet their findings are conflicting. Following a thorough statistical review of all significant neuroimaging studies, we offer strong quantitative evidence that the neuronal response to visual sexual stimuli, contrary to the widely accepted view, is independent of biological sex. Both men and women show increased activation in many cortical and subcortical brain regions thought to be involved in the response to visual sexual stimuli, while the limited sex differences that have been found and reported previously refer to subjective rating of the content. Sexual arousal is a dynamical, highly coordinated neurophysiological process that is often induced by visual stimuli. Numerous studies have proposed that the cognitive processing stage of responding to sexual stimuli is the first stage, in which sex differences occur, and the divergence between men and women has been attributed to differences in the concerted activity of neural networks. The present comprehensive metaanalysis challenges this hypothesis and provides robust quantitative evidence that the neuronal circuitries activated by visual sexual stimuli are independent of biological sex. Sixty-one functional magnetic resonance imaging studies (1,850 individuals) that presented erotic visual stimuli to men and women of different sexual orientation were identified. Coordinate-based activation likelihood estimation was used to conduct metaanalyses. Sensitivity and clustering analyses of averaged neuronal response patterns were performed to investigate robustness of the findings. In contrast to neutral stimuli, sexual pictures and videos induce significant activations in brain regions, including insula, middle occipital, anterior cingulate and fusiform gyrus, amygdala, striatum, pulvinar, and substantia nigra. Cluster analysis suggests stimulus type as the most, and biological sex as the least, predictor for classification. Contrast analysis further shows no significant sex-specific differences within groups. Systematic review of sex differences in gray matter volume of brain regions associated with sexual arousal (3,723 adults) did not show any causal relationship between structural features and functional response to visual sexual stimuli. The neural basis of sexual arousal in humans is associated with sexual orientation yet, contrary to the widely accepted view, is not different between women and men.
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Perez SM, Donegan JJ, Lodge DJ. Effect of estrous cycle on schizophrenia-like behaviors in MAM exposed rats. Behav Brain Res 2019; 362:258-265. [PMID: 30660776 PMCID: PMC6394843 DOI: 10.1016/j.bbr.2019.01.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/20/2018] [Accepted: 01/16/2019] [Indexed: 11/28/2022]
Abstract
Although there are clear sex differences in individuals with schizophrenia, preclinical research has historically favored the use of male rats for behavioral studies. The methylazoxymethanol acetate (MAM) model is a gestational disruption model of schizophrenia and has been reported to produce robust behavioral, neurophysiological and anatomical alterations in male rats; however, whether similar effects are observed in female rats is less well known. In this study, we characterize the behavioral, electrophysiological and molecular alterations induced by prenatal MAM administration in female rats while also examining the potential effects of the estrous cycle on schizophrenia-like behaviors. Specifically, MAM-treated female offspring demonstrated deficits in sensorimotor gating, latent inhibition, and social interaction, consistent with those observed in male animals. Interestingly, amphetamine-induced locomotor activity, latent inhibition, and social interaction were also affected by the estrous cycle. To examine the potential cellular mechanisms associated with these behavioral alterations, we analyzed hippocampal parvalbumin (PV) interneurons. Deficits in PV interneuron number and high-frequency gamma oscillations were disrupted in female MAM-treated rats regardless of the stage of the estrous cycle; however, alterations in PV protein expression were more prominent during metestrus/diestrus. Taken together, these data suggest that prenatal MAM exposure in female rats produces robust behavioral, molecular, and physiological deficits consistent with those observed in the male MAM model of schizophrenia. Moreover, our results also suggest that specific schizophrenia-like symptoms can also be influenced by the estrous cycle, and further emphasize the importance of sex as a biological variable when using preclinical models.
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Affiliation(s)
- Stephanie M Perez
- UT Health San Antonio, Department of Pharmacology, Center for Biomedical Neuroscience, 7703 Floyd Curl Drive, MC 7764, San Antonio, TX, 78229, USA.
| | - Jennifer J Donegan
- UT Health San Antonio, Department of Pharmacology, Center for Biomedical Neuroscience, 7703 Floyd Curl Drive, MC 7764, San Antonio, TX, 78229, USA.
| | - Daniel J Lodge
- UT Health San Antonio, Department of Pharmacology, Center for Biomedical Neuroscience, 7703 Floyd Curl Drive, MC 7764, San Antonio, TX, 78229, USA.
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38
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de Vos C, Leanza L, Mackintosh A, Lüdtke T, Balzan R, Moritz S, Andreou C. Investigation of sex differences in delusion-associated cognitive biases. Psychiatry Res 2019; 272:515-520. [PMID: 30616118 DOI: 10.1016/j.psychres.2018.12.121] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/21/2018] [Accepted: 12/22/2018] [Indexed: 11/19/2022]
Abstract
In the past few decades, sex differences have been identified in a number of clinical, cognitive and functional outcomes in patients with schizophrenia spectrum disorders. However, to date, sex differences in higher-order cognitive biases have not been systematically studied. The present study aimed to examine sex differences in jumping-to-conclusions and evidence integration impairment based on data collected in two previous studies in patients with schizophrenia spectrum disorders and healthy controls. For this purpose, data from n = 58 patients and n = 60 healthy controls on the Fish Task (as a measure of jumping to conclusions) and bias against disconfirmatory evidence (BADE; as a measure of evidence integration) task were analyzed. Results indicated a lack of sex differences in jumping-to-conclusions and evidence integration impairment both in patients with schizophrenia spectrum disorders and healthy controls. Although the present study was adequately powered to detect sex differences of a low medium effect size, larger studies are warranted to exclude differences of a smaller magnitude between men and women regarding delusion-associated cognitive biases.
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Affiliation(s)
- Chloé de Vos
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Letizia Leanza
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Amatya Mackintosh
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland
| | - Thies Lüdtke
- Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Ryan Balzan
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, Australia
| | - Steffen Moritz
- Neuropsychology Unit, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany
| | - Christina Andreou
- Center for Psychotic Disorders, University Psychiatric Clinics Basel, University of Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland.
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39
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Sex differences in stress reactivity in arousal and attention systems. Neuropsychopharmacology 2019; 44:129-139. [PMID: 30022063 PMCID: PMC6235989 DOI: 10.1038/s41386-018-0137-2] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/21/2018] [Accepted: 06/15/2018] [Indexed: 01/04/2023]
Abstract
Women are more likely than men to suffer from psychiatric disorders with hyperarousal symptoms, including posttraumatic stress disorder (PTSD) and major depression. In contrast, women are less likely than men to be diagnosed with schizophrenia and attention deficit hyperactivity disorder (ADHD), which share attentional impairments as a feature. Stressful events exacerbate symptoms of the aforementioned disorders. Thus, researchers are examining whether sex differences in stress responses bias women and men towards different psychopathology. Here we review the preclinical literature suggesting that, compared to males, females are more vulnerable to stress-induced hyperarousal, while they are more resilient to stress-induced attention deficits. Specifically described are sex differences in receptors for the stress neuropeptide, corticotropin-releasing factor (CRF), that render the locus coeruleus arousal system of females more vulnerable to stress and less adaptable to CRF hypersecretion, a condition found in patients with PTSD and depression. Studies on the protective effects of ovarian hormones against CRF-induced deficits in sustained attention are also detailed. Importantly, we highlight how comparing males and females in preclinical studies can lead to the development of novel therapeutics to improve treatments for psychiatric disorders in both women and men.
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40
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Li AWY, Hui CLM, Lee EHM, Chang WC, Chan SKW, Chen EYH. Gender differences in correlates of cognition in first-episode psychosis. Psychiatry Res 2019; 271:412-420. [PMID: 30537663 DOI: 10.1016/j.psychres.2018.12.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/19/2018] [Accepted: 12/02/2018] [Indexed: 01/01/2023]
Abstract
Studies of gender cognitive differences in schizophrenia have reported mixed results. This study examined cognitive correlates including demographics, symptoms and functioning in men and women in a large sample of first-episode adult-onset psychosis patients. Detailed demographic, clinical and functioning data were collected from 360 first-episode patients upon admission into an early intervention service for psychotic disorders. They were also administered a comprehensive neurocognitive battery. Correlation analyses showed that memory and working memory were more significantly associated with onset age, negative symptoms and side effects in women. Processing speed correlated with antipsychotic dosage in men and side effects in women. Selective attention correlated with reality distortion and negative symptoms in women, and onset age and education in men. Executive function correlated with onset age and reality distortion in women. All cognitive domains significantly correlated with educational level and functioning in both genders. Negative symptoms explained significant variability in cognition in both genders, while reality distortion, side effects and affective symptoms were significant factors that differentiated between genders. Although there are similarities in cognitive deficits, considerable heterogeneity exists in associations of symptoms and cognition in men and women. Results facilitate individualised tailoring of interventions, including cognitive remediation therapy.
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Affiliation(s)
- Adrienne W Y Li
- Department of Psychiatry, University of Hong Kong, Hong Kong, China; Department of Clinical, Educational and Health Psychology, University College London, United Kingdom
| | - Christy L M Hui
- Department of Psychiatry, University of Hong Kong, Hong Kong, China.
| | - Edwin H M Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong, China
| | - W C Chang
- Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Sherry K W Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
| | - Eric Y H Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong, China
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41
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Walsh-Messinger J, Stepanek C, Wiedemann J, Goetz D, Goetz RR, Malaspina D. Normal sexual dimorphism in theory of mind circuitry is reversed in Schizophrenia. Soc Neurosci 2018; 14:583-593. [PMID: 30373474 DOI: 10.1080/17470919.2018.1536613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The ability to mentalize, or theory of mind (ToM), is sexually dimorphic in humans and impaired in schizophrenia. This sex-stratified study probed cognitive (indexed by intelligence) and affective (indexed by olfactory tasks) contributions to ToM performance in 37 individuals with schizophrenia and 31 healthy controls. The schizophrenia group showed impairments in mental state identification and inferring intentions compared to controls. Higher intelligence was correlated with mental state identification and inferring intentions in healthy females, whereas better smell identification was associated with mental state identification in healthy males. Conversely, higher intelligence was associated with mental state identification and inferring intentions in schizophrenia males, while better smell identification was correlated with mental state identification in schizophrenia females. These findings suggest that for ToM circuitry, the cognitive influences in healthy females and affective influences in healthy males are reversed in schizophrenia and may be displaced to lower circuitries by disease pathology. Symptom associations with emotion and cognition are also dimorphic, plausibly due to similar pathology superimposed on normal sex-specific circuitries. Males appear to rely on limbic processing for ToM, and disruption to this circuitry may contribute to development of negative symptoms. These findings highlight the importance of utilizing sex-stratified designs in schizophrenia research.
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Affiliation(s)
- Julie Walsh-Messinger
- a Department of Psychology, University of Dayton , Dayton , OH , USA.,b Department of Psychiatry, Wright State University Boonshoft School of Medicine , Dayton , OH , USA
| | - Christine Stepanek
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Julia Wiedemann
- a Department of Psychology, University of Dayton , Dayton , OH , USA
| | - Deborah Goetz
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Raymond R Goetz
- d New York State Psychiatric Institute, Columbia University Medical Center , New York , NY , USA
| | - Dolores Malaspina
- c Departments of Psychiatry, Neuroscience, and Genetics, Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Stefanatou P, Karatosidi CS, Tsompanaki E, Kattoulas E, Stefanis NC, Smyrnis N. Premorbid adjustment predictors of cognitive dysfunction in schizophrenia. Psychiatry Res 2018; 267:249-255. [PMID: 29940456 DOI: 10.1016/j.psychres.2018.06.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/24/2022]
Abstract
Premorbid adjustment (PA) in academic and social domain is a key-predictor of cognitive performance in schizophrenia. Prior studies provided inconsistent findings regarding the differential relationships of PA domains with post-illness cognition. Multivariate associations of academic and social PA in each developmental stage (childhood, early and late adolescence) with post-onset cognitive variables were explored. Furthermore, possible differential relationships of PA domain deterioration courses with post-onset cognitive dysfunction were investigated. Seventy-five schizophrenia patients were evaluated with Premorbid Adjustment Scale (PAS). General cognitive ability, verbal IQ, verbal memory and learning, processing speed, working memory, executive function and premorbid IQ were assessed. Canonical Correlation Analyses revealed that poorer academic PA across childhood and early adolescence was related to worse post-onset verbal IQ, working memory, verbal learning and executive function, while academic PA deterioration between early and late adolescence was associated with poorer verbal learning and executive function and, as further analysis indicated, predicts IQ decline. Academic PA was exclusively associated with post-onset cognitive impairment. New evidence emerged for the specificity of each developmental period in constructing academic PA in its relation to post-illness cognition. Early premorbid academic maladjustment possibly constitutes the onset of a cognitive dysmaturational process which results to post-diagnosis impaired cognition.
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Affiliation(s)
- Pentagiotissa Stefanatou
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Chrysovalado-Sofia Karatosidi
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Evgenia Tsompanaki
- Department of Statistics, School of Information Sciences and Technology, Athens University of Economics and Business, Athens, Greece
| | - Emmanouil Kattoulas
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Nicholas C Stefanis
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens, Greece
| | - Nikolaos Smyrnis
- Psychiatry Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece; University Mental Health Research Institute, Athens, Greece.
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43
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McGregor C, Riordan A, Thornton J. Estrogens and the cognitive symptoms of schizophrenia: Possible neuroprotective mechanisms. Front Neuroendocrinol 2017; 47:19-33. [PMID: 28673758 DOI: 10.1016/j.yfrne.2017.06.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 06/25/2017] [Accepted: 06/27/2017] [Indexed: 02/07/2023]
Abstract
Schizophrenia is a complex neuropsychiatric illness with marked sex differences. Women have later onset and lesser symptoms, which has led to the hypothesis that estrogens are protective in schizophrenia. Cognitive dysfunction is a hallmark of the disease and the symptom most correlated with functional outcome. Here we describe a number of mechanisms by which estrogens may be therapeutic in schizophrenia, with a focus on cognitive symptoms. We review the relationship between estrogens and brain derived neurotrophic factor, neuroinflammation, NMDA receptors, GABA receptors, and luteinizing hormone. Exploring these pathways may enable novel treatments for schizophrenia and a greater understanding of this devastating disease.
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Affiliation(s)
- Claire McGregor
- Department of Neuroscience, Oberlin College, 119 Woodland St, Oberlin, OH 44074, USA.
| | - Alexander Riordan
- Department of Neuroscience, Oberlin College, 119 Woodland St, Oberlin, OH 44074, USA
| | - Janice Thornton
- Department of Neuroscience, Oberlin College, 119 Woodland St, Oberlin, OH 44074, USA
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44
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Bangasser DA, Eck SR, Telenson AM, Salvatore M. Sex differences in stress regulation of arousal and cognition. Physiol Behav 2017; 187:42-50. [PMID: 28974457 DOI: 10.1016/j.physbeh.2017.09.025] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 01/02/2023]
Abstract
There are sex differences in the prevalence and presentation of many psychiatric disorders. For example, posttraumatic stress disorder (PTSD) and major depression are more common in women than men, and women with these disorders present with more hyperarousal symptoms than men. In contrast, attention deficit hyperactivity disorder (ADHD) and schizophrenia are more common in men than women, and men with these disorders have increased cognitive deficits compared to women. A shared feature of the aforementioned psychiatric disorders is the contribution of stressful events to their onset and/or severity. Here we propose that sex differences in stress responses bias females towards hyperarousal and males towards cognitive deficits. Evidence from clinical and preclinical studies is detailed. We also describe underlying neurobiological mechanisms. For example, sex differences in stress receptor signaling and trafficking in the locus coeruleus-arousal center are detailed. In learning circuits, evidence for sex differences in dendritic morphology is provided. Finally, we describe how evaluating sex-specific mechanisms for responding to stress in female and male rodents can lead to better treatments for stress-related psychiatric disorders.
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Affiliation(s)
- Debra A Bangasser
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, USA.
| | - Samantha R Eck
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, USA
| | - Alexander M Telenson
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, USA
| | - Madeleine Salvatore
- Department of Psychology and Neuroscience Program, Temple University, Philadelphia, PA 19122, USA
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45
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Gender differences measured by the MATRICS consensus cognitive battery in chronic schizophrenia patients. Sci Rep 2017; 7:11821. [PMID: 28928440 PMCID: PMC5605539 DOI: 10.1038/s41598-017-12027-w] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/01/2017] [Indexed: 11/08/2022] Open
Abstract
Using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), previous study showed significant gender differences for cognitive deficits in immediate and delayed memory in schizophrenia patients. However, RBANS does not include reasoning and problem solving, and social cognition. These cognitive functions can significantly affect the outcomes and daily life in patients. This study examined the gender differences of cognition using the measurement and treatment research to improve cognition in schizophrenia (MATRICS) consensus cognitive battery (MCCB), especially focusing on reasoning and problem solving, and social cognition in schizophrenia patients. The results showed that healthy controls exemplified better cognition than patients in both genders in all examined MCCB scores. Male healthy controls had better reasoning and problem solving and working memory than females, but these gender differences were not presented in schizophrenia patients. Also, male schizophrenia patients showed worse cognition than females on social cognition, processing speed, verbal learning and visual learning. Our results support that male schizophrenia patients had more cognitive impairment than females on reasoning and problem solving, social cognition, processing speed, working memory, verbal learning and visual learning.
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46
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Li Q, Shi L, Lu G, Yu HL, Yeung FK, Wong NK, Sun L, Liu K, Yew D, Pan F, Wang DF, Sham PC. Chronic Ketamine Exposure Causes White Matter Microstructural Abnormalities in Adolescent Cynomolgus Monkeys. Front Neurosci 2017; 11:285. [PMID: 28579941 PMCID: PMC5437169 DOI: 10.3389/fnins.2017.00285] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/02/2017] [Indexed: 01/05/2023] Open
Abstract
Acute and repeated exposures to ketamine mimic aspects of positive, negative, and cognitive symptoms of schizophrenia in humans. Recent studies by our group and others have shown that chronicity of ketamine use may be a key element for establishing a more valid model of cognitive symptoms of schizophrenia. However, current understanding on the long-term consequences of ketamine exposure on brain circuits has remained incomplete, particularly with regard to microstructural changes of white matter tracts that underpin the neuropathology of schizophrenia. Thus, the present study aimed to expand on previous investigations by examining causal effects of repeated ketamine exposure on white matter integrity in a non-human primate model. Ketamine or saline (control) was administered intravenously for 3 months to male adolescent cynomolgus monkeys (n = 5/group). Diffusion tensor imaging (DTI) experiments were performed and tract-based spatial statistics (TBSS) was used for data analysis. Fractional anisotropy (FA) was quantified across the whole brain. Profoundly reduced FA on the right side of sagittal striatum, posterior thalamic radiation (PTR), retrolenticular limb of the internal capsule (RLIC) and superior longitudinal fasciculus (SLF), and on the left side of PTR, middle temporal gyrus and inferior frontal gyrus were observed in the ketamine group compared to controls. Diminished white matter integrity found in either fronto-thalamo-temporal or striato-thalamic connections with tracts including the SLF, PTR, and RLIC lends support to similar findings from DTI studies on schizophrenia in humans. This study suggests that chronic ketamine exposure is a useful pharmacological paradigm that might provide translational insights into the pathophysiology and treatment of schizophrenia.
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Affiliation(s)
- Qi Li
- Department of Psychiatry, The University of Hong KongHong Kong, Hong Kong.,State Key Laboratory for Cognitive and Brain Sciences, The University of Hong KongHong Kong, Hong Kong.,The University of Hong Kong Shenzhen Institute of Research and Innovation (HKU-SIRI), The University of Hong KongHong Kong, Hong Kong
| | - Lin Shi
- Department of Medicine and Therapeutics, Chinese University of Hong KongHong Kong, Hong Kong.,Chow Yuk Ho Center of Innovative Technology for Medicine, Chinese University of Hong KongHong Kong, Hong Kong
| | - Gang Lu
- School of Biomedical Sciences, Chinese University of Hong KongHong Kong, Hong Kong
| | - Hong-Luan Yu
- Department of Psychology, Qilu Hospital of Shandong UniversityJinan, China
| | - Fu-Ki Yeung
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - Nai-Kei Wong
- Chemical Biology Laboratory for Infectious Diseases, Shenzhen Institute of Hepatology, The Third People's Hospital of ShenzhenShenzhen, China
| | - Lin Sun
- Department of Psychology, Weifang Medical UniversityWeifang, China
| | - Kai Liu
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - David Yew
- School of Chinese Medicine, Chinese University of Hong KongHong Kong, Hong Kong
| | - Fang Pan
- Department of Medical Psychology, Shandong University School of MedicineJinan, China
| | - De-Feng Wang
- Research Center for Medical Image Computing, Department of Imaging and Interventional Radiology, Chinese University of Hong KongHong Kong, Hong Kong
| | - Pak C Sham
- Department of Psychiatry, The University of Hong KongHong Kong, Hong Kong.,State Key Laboratory for Cognitive and Brain Sciences, The University of Hong KongHong Kong, Hong Kong.,Genome Research Centre, The University of Hong KongHong Kong, Hong Kong
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47
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Haring L, Mõttus R, Kajalaid K, Koch K, Uppin K, Maron E, Vasar E. The course of cognitive functioning after first-episode of psychosis: A six month follow-up study. Schizophr Res 2017; 182:31-41. [PMID: 27746055 DOI: 10.1016/j.schres.2016.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/30/2016] [Accepted: 10/10/2016] [Indexed: 12/22/2022]
Abstract
Our aim with the present study was to evaluate rank-order and mean-level cognitive functioning stability among first-episode psychosis (FEP) patients, measured using the Cambridge Neuropsychological Test Automated Battery (CANTAB), over a six month period. We also aimed to examine longitudinal measurement invariance and identify factors-such as age, gender, educational level, treatment and psychopathological change scores-potentially linked to cognitive change among patients. In addition, correlations between objectively measured and subjectively evaluated cognitive functioning were estimated. Neuropsychological assessments were administered to 85 patients after the initial stabilisation of their psychosis; 82 of the patients were retested. Subjectively perceived cognitive functioning was measured using a subscale derived from the Estonian version of the Subjective Well-Being Under Neuroleptic Scale (SWN-K-E). On average, executive functioning and processing speed improved significantly, while memory test scores decreased significantly, over time. Very high rank-order stability (r=0.80 to 0.94, p<0.001) was observed with all measured ability scores. Confirmatory factor analysis revealed the loadings of a single (broad ability) factor model were equal across both measurement occasions, but the lack of intercept invariance suggested that mean-level comparisons are more appropriately carried out at a subtest level. On average psychopathology scores and antipsychotics doses declined over time, with the latter also significantly correlating with better executive functioning. Gender was a significant moderator of some domains of cognitive performance, and decline tended to be somewhat more pronounced for women. The results also indicated the lack of any relationship between objective and subjective measurements of cognitive functioning.
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Affiliation(s)
- Liina Haring
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - René Mõttus
- Department of Psychology, University of Edinburgh, Edinburgh, UK; Department of Psychology, University of Tartu, Tartu, Estonia.
| | | | - Kadri Koch
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Kärt Uppin
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia.
| | - Eduard Maron
- Psychiatry Clinic of Tartu University Hospital, Tartu, Estonia; North Estonia Medical Centre, Department of Psychiatry, Tallinn, Estonia; Centre for Mental Health, Imperial College London, UK.
| | - Eero Vasar
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia; Centre of Excellence for Genomics and Translational Medicine, University of Tartu, Tartu, Estonia.
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48
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Ruiz-Veguilla M, Moreno-Granados J, Salcedo-Marin MD, Barrigon ML, Blanco-Morales MJ, Igunza E, Cañabate A, Garcia MD, Guijarro T, Diaz-Atienza F, Ferrin M. Sex-specific cognitive abnormalities in early-onset psychosis. BRAZILIAN JOURNAL OF PSYCHIATRY 2017; 39:28-35. [PMID: 28291864 PMCID: PMC7112732 DOI: 10.1590/1516-4446-2015-1807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 05/18/2016] [Indexed: 11/25/2022]
Abstract
Objectives: Brain maturation differs depending on the area of the brain and sex. Girls show an earlier peak in maturation of the prefrontal cortex. Although differences between adult females and males with schizophrenia have been widely studied, there has been less research in girls and boys with psychosis. The purpose of this study was to examine differences in verbal and visual memory, verbal working memory, auditory attention, processing speed, and cognitive flexibility between boys and girls. Methods: We compared a group of 80 boys and girls with first-episode psychosis to a group of controls. Results: We found interactions between group and sex in verbal working memory (p = 0.04) and auditory attention (p = 0.01). The female controls showed better working memory (p = 0.01) and auditory attention (p = 0.001) than males. However, we did not find any sex differences in working memory (p = 0.91) or auditory attention (p = 0.93) in the psychosis group. Conclusions: These results are consistent with the presence of sex-modulated cognitive profiles at first presentation of early-onset psychosis.
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Affiliation(s)
- Miguel Ruiz-Veguilla
- Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Sevilla, Unidad de Hospitalizacion de Salud Mental, Sevilla, Spain
| | - Josefa Moreno-Granados
- Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Sevilla, Unidad de Hospitalizacion de Salud Mental, Sevilla, Spain
| | - Maria D Salcedo-Marin
- Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Consejo Superior de Investigaciones Científicas (CSIC), Universidad de Sevilla, Unidad de Hospitalizacion de Salud Mental, Sevilla, Spain
| | - Maria L Barrigon
- Departamento de Psiquiatría, ISS Fundación Jiménez Díaz, Universidad Autónoma, Centro de Investigación en Salud Mental (CIBERSAM), Madrid, Spain
| | | | - Evelio Igunza
- Unidad de Salud Mental Infantil (USMI), Hospital Virgen Macarena, Sevilla, Spain
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49
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Chow TJ, Tee SF, Yong HS, Tang PY. Genetic Association of TCF4 and AKT1 Gene Variants with the Age at Onset of Schizophrenia. Neuropsychobiology 2017; 73:233-40. [PMID: 27305091 DOI: 10.1159/000446285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/19/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Age at onset (AAO) is a known prognostic indicator for schizophrenia and is hypothesized to correlate with cognition and symptom severity. TCF4 and AKT1 are schizophrenia risk genes involved in cognitive functions. The current study examined the interactive effects of TCF4 and AKT1 variants with gender, family history of psychiatric disorders and ethnicity on the AAO of schizophrenia. METHODS This study consisted of 322 patients with schizophrenia meeting the DSM-IV criteria. Six single nucleotide polymorphisms (SNPs) of TCF4 (rs12966547, rs8766, rs2958182, rs9960767, rs10401120 and rs17512836) and seven AKT1 SNPs (rs2498804, rs3803304, rs2494732, rs3730358, rs1130214, rs2498784 and rs3803300) were genotyped using the TaqMan® SNP genotyping-based assays method. The relationship of AAO with each variant was investigated using analyses of covariance. RESULTS Among the TCF4 variants, rs12966547 (p = 0.024) and rs8766 (p = 0.021) were significantly associated with earlier AAO. We found a lower average AAO in patients with the AA genotype of rs12966547, while the CT genotype of rs8766 was demonstrated to have a protective effect on AAO. For rs8766, there was significant gene × gender interaction (p = 0.012) in influencing AAO. However, these results were not significant after false discovery rate correction. Significant gene × ethnicity interactions were observed to influence AAO (p < 0.05). The Kaplan-Meier curve of the minor AA genotype of rs12966547 displayed a significant trend (p = 0.008) for onset after 19 years of age. Similarly, the minor CC genotype of rs8766 showed a significantly (p = 0.034) lower AAO compared to the TT genotype. CONCLUSION Our analyses suggest that individual risk genotypes may influence the risk of schizophrenia in an age-specific manner.
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Affiliation(s)
- Tze Jen Chow
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Tunku Abdul Rahman University, Kajang, Malaysia
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O’Tuathaigh CMP, Fumagalli F, Desbonnet L, Perez-Branguli F, Moloney G, Loftus S, O’Leary C, Petit E, Cox R, Tighe O, Clarke G, Lai D, Harvey RP, Cryan JF, Mitchell KJ, Dinan TG, Riva MA, Waddington JL. Epistatic and Independent Effects on Schizophrenia-Related Phenotypes Following Co-disruption of the Risk Factors Neuregulin-1 × DISC1. Schizophr Bull 2017; 43:214-225. [PMID: 27613806 PMCID: PMC5216856 DOI: 10.1093/schbul/sbw120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Few studies have addressed likely gene × gene (ie, epistatic) interactions in mediating risk for schizophrenia. Using a preclinical genetic approach, we investigated whether simultaneous disruption of the risk factors Neuregulin-1 (NRG1) and Disrupted-in-schizophrenia 1 (DISC1) would produce a disease-relevant phenotypic profile different from that observed following disruption to either gene alone. NRG1 heterozygotes exhibited hyperactivity and disruption to prepulse inhibition, both reversed by antipsychotic treatment, and accompanied by reduced striatal dopamine D2 receptor protein expression, impaired social cognition, and altered glutamatergic synaptic protein expression in selected brain areas. Single gene DISC1 mutants demonstrated a disruption in social cognition and nest-building, altered brain 5-hydroxytryptamine levels and hippocampal ErbB4 expression, and decreased cortical expression of the schizophrenia-associated microRNA miR-29b. Co-disruption of DISC1 and NRG1, indicative of epistasis, evoked an impairment in sociability and enhanced self-grooming, accompanied by changes in hypothalamic oxytocin/vasopressin gene expression. The findings indicate specific behavioral correlates and underlying cellular pathways downstream of main effects of DNA variation in the schizophrenia-associated genes NRG1 and DISC1.
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Affiliation(s)
- Colm M. P. O’Tuathaigh
- School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork, Ireland;,Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland;,*To whom correspondence should be addressed; School of Medicine, Brookfield Health Sciences Complex, University College Cork, Cork T12 YN60, Ireland; tel: +353-(0)21-420-5303, fax: +353-(0)21-490-1594, e-mail:
| | - Fabio Fumagalli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita` degli Studi di Milano, Milan,
Italy
| | - Lieve Desbonnet
- Neurogastroenterology Laboratory, Alimentary Pharmabiotic Centre, Biosciences Institute, University College Cork, Cork, Ireland
| | - Francesc Perez-Branguli
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, Ireland;,IZKF Junior Research Group and BMBF Research Group Neuroscience, IZKF, Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Erlangen, Germany
| | - Gerard Moloney
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Samim Loftus
- Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Claire O’Leary
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland
| | - Emilie Petit
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland
| | - Rachel Cox
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland
| | - Orna Tighe
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland
| | - Gerard Clarke
- Neurogastroenterology Laboratory, Alimentary Pharmabiotic Centre, Biosciences Institute, University College Cork, Cork, Ireland;,Department of Psychiatry, University College Cork, Cork, Ireland
| | - Donna Lai
- Victor Chang Cardiac Research Institute, Sydney, Australia
| | | | - John F. Cryan
- Neurogastroenterology Laboratory, Alimentary Pharmabiotic Centre, Biosciences Institute, University College Cork, Cork, Ireland;,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Kevin J. Mitchell
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, Ireland
| | - Timothy G. Dinan
- Neurogastroenterology Laboratory, Alimentary Pharmabiotic Centre, Biosciences Institute, University College Cork, Cork, Ireland;,Department of Psychiatry, University College Cork, Cork, Ireland
| | - Marco A. Riva
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita` degli Studi di Milano, Milan,
Italy
| | - John L. Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2,Ireland;,Jiangsu Key Laboratory of Translational Research & Therapy for Neuro-Psychiatric-Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
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