Neurocognitive indicators for a conversion to psychosis: Comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis

Pukrop, Ralf; Ruhrmann, Stephan; Schultze‐Lutter, Frauke; Bechdolf, Andreas; Brockhaus-Dumke, Anke; Klosterkötter, Joachim

doi:10.1016/j.schres.2007.01.020

Cited by 174 publications

(153 citation statements)

References 31 publications

Supporting

Mentioning

135

Contrasting

Order By: Relevance

“…Contrary to prior reports (Keefe et al, 2006;Pukrop et al, 2007;Lencz et al, 2006), this study did not reveal baseline neurocognitive performance differences between high-risk adolescents who converted to Axis I psychosis and those who did not. This discrepancy may be attributable to limited statistical power due to smaller sample size.…”

Section: Discussioncontrasting

confidence: 99%

“…In this way, it might be expected that discrepant cognitive functioning between at-risk converters and nonconverters may become more apparent with advanced age, as is observed in ultra high risk studies examining older cohorts of adolescents (e.g., Francey et al, 2005;Pukrop et al, 2007). This is consistent with the documented brain changes that accompany adolescence, and may be more pronounced in atrisk youth (for a review, see Lenroot and Giedd, 2006).…”

Section: Discussionsupporting

confidence: 52%

“…The most cardinal distinguishing factor, however, is again the younger age of the current sample, which renders participants not as 'imminently' at-risk compared to older samples more proximal to the age of conversion. In addition, the current sample relies more heavily on ratings of schizotypal symptoms as opposed to, for example, studies utilizing measures indexing 'attenuated positive symptoms' (Lencz et al, 2006) or 'cognitiveperceptive basic symptoms' or 'any attenuated or transient psychotic symptoms' (Pukrop et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neurocognition and conversion to psychosis in adolescents at high-risk

Walder

Mittal

Trotman

et al. 2008

Schizophrenia Research

View full text Add to dashboard Cite

This study examined neurocognitive predictors of conversion to Axis I psychosis among adolescents at high-risk for psychosis (AHRP). There were no significant differences in neurocognitive performance between adolescents at high-risk for psychosis who converted (AHRP+) and adolescents at high-risk for psychosis who did not convert (AHRP−). Within-sex comparisons revealed a relation between risk status and performance among females, with AHRP+ performing below AHRP−, but this effect did not hold for males. Between-sex comparisons revealed AHRP− males performed worse than AHRP− females on several measures. Across groups, males performed better than their female counterparts on select measures. Results are discussed in terms of implications for use of neurocognitive profiles as bio-risk markers of psychosis, while considering sex differences. Keywordspsychosis; high-risk; adolescents; cognition; sex differences; bio-risk markers Neurocognitive deficits are a well-established characteristic of schizophrenia (see Green et al., 2006). Despite strong evidence of poor premorbid intellectual functioning (for a meta-analytic review, see Aylward et al., 1984;Seidman et al., 2006;Reichenberg et al., 2006) and literature suggesting subtle functional impairments in years preceding clinical onset (e.g., , only a few studies have examined neurocognitive functioning among high-risk youth in relationship to vulnerability for conversion to Axis I psychosis.There are some recent reports of neurocognitive impairments among clinical high-risk individuals (Gschwandtner et al., 2003), including adolescents meeting criteria for schizophrenia prodromal syndrome (Hawkins et al., 2004) and youth with schizotypal personality disorder (SPD;Trotman et al., 2006), though others have not replicated this (Brewer et al., 2006). There are also some reports of a relation between cognitive dysfunction and conversion to psychosis in clinical high-risk groups (Lencz et al., 2006;Keefe et al., 2006;Brewer et al., 2005). Specifically, two investigations revealed that poorer verbal memory predicted psychosis outcome (Brewer et al., 2005;Lencz et al., 2006). Another showed that a Corresponding author: Deborah J. Walder, Department of Psychology, Brooklyn College of The City University of New York, Phone: (718) 951-5000, x. 6013, FAX: (718) 951-4814, E-mail: dwalder@brooklyn.cuny.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Bilder et al., 2000; Gittelman-Klein and Klen, 1969;Erlenmeyer-Kimling et al., 1984). The vast majority of studies indicate better premorbid functioning during childhood among fe...

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Neurocognition and conversion to psychosis in adolescents at high-risk

Walder

Mittal

Trotman

et al. 2008

Schizophrenia Research

View full text Add to dashboard Cite

show abstract

“…An abnormal P300 in the ARMS is thus consistent with data from neuropsychological studies of this group, which suggest that the ARMS is associated with impaired performance on tasks that engage attention (such as the CPT) and executive processes (Brewer et al, 2005;Cornblatt et al, 2004;Lencz et al, 2006;Pukrop et al, 2007;Woods et al, 2003). Our findings are also consistent with data from a functional imaging study of the P300 which indicated that subjects with an at-risk mental state showed less activation in the temporal cortex than controls but more than patients with schizophrenia (Morey et al, 2005).…”

Section: Discussionsupporting

confidence: 69%

Abnormal P300 in people with high risk of developing psychosis

et al. 2008

View full text Add to dashboard Cite

Background: Individuals with an "At Risk Mental State" (or "prodromal" symptoms) have a 20-40% chance of developing psychosis; however it is difficult to predict which of them will become ill on the basis of their clinical symptoms alone. We examined whether neurophysiological markers could help to identify those who are particularly vulnerable.Method: 35 cases meeting PACE criteria for the At Risk Mental State (ARMS) and 57 controls performed an auditory oddball task whilst their electroencephalogram was recorded. The latency and amplitude of the P300 and N100 waves were compared between groups using linear regression.Results: The P300 amplitude was significantly reduced in the ARMS group [8.6 ±6.4 microvolt] compared to controls [12.7 ±5.8 microvolt] (p<0.01). There were no group differences in P300 latency or in the amplitude and latency of the N100. Of the at-risk subjects that were followed up, seven (21%) developed psychosis. Please find attached a fully revised manuscript titled "Abnormal P300 in people with high risk of developing psychosis". We also enclose a letter with the comments from the reviewers and our detailed answers on how we have done all the changes requested. (t-test; p=0.93). Those making a transition to psychosis were marginally more educated but this was only at trend level with a 3 year average difference in the age at which they completed their studies (t-test; p=0.07).Similarly, logistic regression analyses showed that compared to those who remained at risk, the seven cases who made a transition to psychosis had no significant differences in P300 amplitude/latency or N100 amplitude/latency (p values ranging from 0.30 to 0.63 for all four analyses). We have reported these comparisons very concisely and cautiously because referee #2 said that these analyses with only 7 individual making a transition were preliminary and power is limited. Please see results section paragraph 2. RESPONSE TO REVIEWER #2:Thank you for your suggestions, which have improved the paper. Below are your comments in blue-italics and how we have amended the manuscript accordingly in black with cross-references to the revised manuscript.This paper addresses an important and timely topic, namely, whether auditory P300 is reduced in subjects with at risk mental states and whether the P300 predicts subsequent conversion to psychosis. The study finds a significant deficit in P300 in ARMS subjects, relative to controls, replicating a previously a previously published report. The study had the potential to incrementally * 2. Response to Reviews 2 contribute to the literature by examining the utility of baseline P300 deficits as a predictor of subsequent conversion to psychosis; however, the negative finding coupled with the lack of power for this analysis (only 7 converters) make this aspect of the study inconclusive. More detailed comments are provided below:We have added a paragraph in the discussion to acknowledge the limitation of our small group of converters and how we have low statistical power to compa...

show abstract

“…8 For example, in a recent study of Riecher-Rössler et al 4 neuropsychological data were combined with psychopathological ratings (i.e., Brief Psychiatric Rating Scale, BPRS) 9 and Scale for the Assessment of Negative Symptoms (SANS) 10 to enhance prediction of transition to psychosis.…”

Section: Introductionmentioning

confidence: 99%

EEG spectral power and negative symptoms in at-risk individuals predict transition to psychosis

Zimmermann

Gschwandtner²,

Wilhelm

et al. 2010

Schizophrenia Research

View full text Add to dashboard Cite

Objective: EEG power in the delta, theta and beta1 bands has been shown to be positively correlated with negative symptoms in first episode psychotic patients. The present study investigates this correlation in an "at risk mental state for psychosis" (ARMS) with the aim to improve prediction of transition to psychosis.Methods: Thirteen ARMS patients with later transition to psychosis (ARMS-T) and fifteen without (follow-up period of at least 4 years) (ARMS-NT) were investigated using spectral resting EEG data (of 8 electrodes over the fronto-central scalp area placed according to the 10 -20 system) and summary score of the Scale for the Assessment of Negative Symptoms (SANS).Linear regressions were used to evaluate the correlation of SANS and EEG power in seven bands (delta, theta, alpha1, alpha2, beta1, beta2, beta3) in both ARMS groups and logistic regressions were used to predict transition to psychosis. Potentially confounding factors were controlled. Results: ARMS-T and ARMS-NT showed differential correlations of EEG power and SANSin delta, theta, and beta1 bands (p <0.05): ARMS-T showed positive and ARMS-NT negative correlations. Logistic regressions showed that neither SANS score nor EEG spectral power alone predicted transition to psychosis. However, SANS score in combination with power in the delta, theta, beta1, and beta2 bands, respectively, predicted transition significantly (p <0.03). Limitations:The number of subjects is relatively small. The difference in age of both study groups might be considered as a further limitation even though age had no effect on the results according to confounder analysis.Conclusions: ARMS-T and ARMS-NT show differential correlations of SANS summary score and EEG power in delta, theta, and beta bands. Prediction of transition to psychosis is possible using combined information from a negative symptom scale and EEG spectral data.

show abstract

Neurocognitive indicators for a conversion to psychosis: Comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis

Cited by 174 publications

References 31 publications

Neurocognition and conversion to psychosis in adolescents at high-risk

Neurocognition and conversion to psychosis in adolescents at high-risk

Abnormal P300 in people with high risk of developing psychosis

EEG spectral power and negative symptoms in at-risk individuals predict transition to psychosis

Contact Info

Product

Resources

About