Cognitive performance in early, treatment-resistant psychosis patients: Could cognitive control play a role in persistent symptoms?

Thomas, Megan; Szentgyorgyi, Timea; Vanes, Lucy; Mouchlianitis, Elias; Barry, Elizabeth; Patel, Krisna; Wong, Katie; Joyce, Dan W.; Shergill, Sukhwinder S.

doi:10.1016/j.psychres.2020.113607

Cited by 8 publications

(9 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, 46 patients with schizophrenia (SZ), 107 patients with first episode psychosis (FEP) and 46 healthy adults were recruited as part of the MUTRIPS study (Thomas et al, 2021). We excluded five SZ, eight FEP and seven HC due to incomplete or missing scanning data on the trust game.…”

Section: Participantsmentioning

confidence: 99%

“…Deficits in level 1-CC are well-documented across the psychosis spectrum, and do not seem to improve over time. They are seen in patients with first episode psychosis (FEP) (Avery et al, 2019), in individuals at high-risk of developing psychosis (Guo et al, 2020), and in individuals with treatment resistant psychosis (Thomas et al, 2021). Level 2-CC impairments show that emotional cues impair decision making (Anticevic, Repovs, & Barch, 2012;Averbeck & Duchaine, 2009;Tully, Lincoln, & Hooker, 2014), is compromised by symptom severity in early stages of psychotic illness (Horne et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Understanding the mechanisms underlying cognitive control in psychosis

Maitra,

Lemmers-Jansen,

Vooren

et al. 2024

Psychol. Med.

Self Cite

View full text Add to dashboard Cite

Background Cognitive control (CC) involves a top–down mechanism to flexibly respond to complex stimuli and is impaired in schizophrenia. Methods This study investigated the impact of increasing complexity of CC processing in 140 subjects with psychosis and 39 healthy adults, with assessments of behavioral performance, neural regions of interest and symptom severity. Results The lowest level of CC (Stroop task) was impaired in all patients; the intermediate level of CC (Faces task) with explicit emotional information was most impaired in patients with first episode psychosis. Patients showed activation of distinct neural CC and reward networks, but iterative learning based on the higher-order of CC during the trust game, was most impaired in chronic schizophrenia. Subjects with first episode psychosis, and patients with lower symptom load, demonstrate flexibility of the CC network to facilitate learning, which appeared compromised in the more chronic stages of schizophrenia. Conclusion These data suggest optimal windows for opportunities to introduce therapeutic interventions to improve CC.

show abstract

Section: Participantsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Understanding the mechanisms underlying cognitive control in psychosis

Maitra,

Lemmers-Jansen,

Vooren

et al. 2024

Psychol. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…As reported in a growing body of literature, abnormalities in cognitive functioning may represent a key component of schizophrenia. 140,141 Several studies have investigated the associations between impaired cognition as assessed by neuropsychological tests and TMS-EMG or TMS-EEG biometrics in schizophrenia.…”

Section: Relationship With Cognition In Patients With Schizophreniamentioning

confidence: 99%

A systematic review of TMS and neurophysiological biometrics in patients with schizophrenia

Hou

Santoro

Biondi

et al. 2021

jpn

View full text Add to dashboard Cite

Background: Transcranial magnetic stimulation can be combined with electromyography (TMS-EMG) and electroencephalography (TMS-EEG) to evaluate the excitatory and inhibitory functions of the cerebral cortex in a standardized manner. It has been postulated that schizophrenia is a disorder of functional neural connectivity underpinned by a relative imbalance of excitation and inhibition. The aim of this review was to provide a comprehensive overview of TMS-EMG and TMS-EEG research in schizophrenia, focused on excitation or inhibition, connectivity, motor cortical plasticity and the effect of antipsychotic medications, symptom severity and illness duration on TMS-EMG and TMS-EEG indices. Methods: We searched PsycINFO, Embase and Medline, from database inception to April 2020, for studies that included TMS outcomes in patients with schizophrenia. We used the following combination of search terms: transcranial magnetic stimulation OR tms AND interneurons OR glutamic acid OR gamma aminobutyric acid OR neural inhibition OR pyramidal neurons OR excita* OR inhibit* OR GABA* OR glutam* OR E-I balance OR excitation-inhibition balance AND schizoaffective disorder* OR Schizophrenia OR schizophreni*. Results: TMS-EMG and TMS-EEG measurements revealed deficits in excitation or inhibition, functional connectivity and motor cortical plasticity in patients with schizophrenia. Increased duration of the cortical silent period (a TMS-EMG marker of γ-aminobutyric acid B receptor activity) with clozapine was a relatively consistent finding. Limitations: Most of the studies used patients with chronic schizophrenia and medicated patients, employed cross-sectional group comparisons and had small sample sizes. Conclusion: TMS-EMG and TMS-EEG offer an opportunity to develop a novel and improved understanding of the physiologic processes that underlie schizophrenia and to assess the therapeutic effect of antipsychotic medications. In the future, these techniques may also help predict disease progression and further our understanding of the excitatory/inhibitory balance and its implications for mechanisms that underlie treatment-resistant schizophrenia.

show abstract

Section: Introductionmentioning

confidence: 99%

“…6 More recent findings in people with treatment-resistant schizophrenia (TRS) demonstrated greater impairment in cognitive control compared to those who were treatment responsive, indicating both a possible non-dopaminergic mechanism in TRS and an avenue for therapeutic intervention. 7,8 Antidepressants are commonly prescribed in the treatment of comorbid depression in people with schizophrenia. The prevalence of depression varies significantly between 7% and 75% in this population.…”

Section: Introductionmentioning

confidence: 99%

Vortioxetine as adjunctive therapy in the treatment of schizophrenia

Redaelli

Porffy

Oloyede

et al. 2022

Therapeutic Advances in Psychopharmacology

View full text Add to dashboard Cite

Background: The evidence for safe and effective interventions to treat the negative and cognitive symptoms of schizophrenia is lacking. Objectives: Vortioxetine is a novel antidepressant that has been used as adjunctive therapy for the treatment of psychosis; however, its effectiveness in clinical practice is relatively unknown. In this study, we aimed to determine the potential clinical effectiveness and safety and tolerability of vortioxetine in psychosis. Design: This is a non-interventional, retrospective study on the add-on use of vortioxetine in a group of people with schizophrenia-spectrum disorders in a large UK NHS mental health trust. Methods: Clinical effectiveness of vortioxetine was retrospectively assessed through the Clinical Global Impression – Severity (CGI-S) scale at 3 months. Safety and tolerability were evaluated through treatment discontinuation rates at 3, 6, and 12 months, and clinical reasons were evaluated at the primary endpoint of 3 months. Results: Data were available for 40 subjects with a diagnosis of schizophrenia or schizoaffective disorder–prescribed vortioxetine treatment; 30 (75%) remained on treatment at 3 months. At CGI-S assessment, 15 of the 35 evaluated subjects reported at least a 1-point improvement, from 5 at baseline to 4 after 3 months of treatment. Twenty-six (65%) remained on treatment at 1-year follow-up. The main reasons for those discontinuing treatment were inadequate response (10%) and manic switch (7.5%), while one subject refused treatment. Tolerability to treatment was good, and 36 subjects (90%) reported no adverse events specific to vortioxetine treatment. Conclusion: Schizophrenia is a complex illness, and there is insufficient treatment response in many individuals. A significant proportion of whom may require adjunctive treatments depending on the nature of the residual symptoms. Vortioxetine could be a potentially safe and effective option in such people, but further controlled studies are required.

show abstract

Cognitive performance in early, treatment-resistant psychosis patients: Could cognitive control play a role in persistent symptoms?

Cited by 8 publications

References 53 publications

Understanding the mechanisms underlying cognitive control in psychosis

Understanding the mechanisms underlying cognitive control in psychosis

A systematic review of TMS and neurophysiological biometrics in patients with schizophrenia

Vortioxetine as adjunctive therapy in the treatment of schizophrenia

Contact Info

Product

Resources

About