Neuropsychology of First-Episode Schizophrenia: Initial Characterization and Clinical Correlates

Bilder, Robert M.; Goldman, Robert; Robinson, Delbert G.; Reiter, G.; Bell, Lisa; Bates, John A.; Pappadopulos, Elizabeth; Willson, Deborah F.; Alvir, J.; Woerner, Margaret G.; Geisler, Stephen; Kane, John M.; Lieberman, Jeffrey A.

doi:10.1176/appi.ajp.157.4.549

Cited by 814 publications

(556 citation statements)

References 61 publications

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“…Second, neurocognitive deficits have become a major treatment focus in recent years, with the growing realization that they constitute an important limiting factor for rehabilitation and outcome (Bilder, 1997;Bilder et al, 2000;Green, 1996). If indeed excessive glutamate release (ie abnormal dynamics of the glutamate system, whether as a result of NMDA receptor hypofunction or excessive signaling through the 5-HT 2A receptor) plays a role in these deficits, then 5-HT 2A receptor antagonists, but not dopamine D 2 receptor antagonists, would be expected to exert beneficial effects: In the scenario of a primary deficit in NMDAR-dependent neurotransmission, 5-HT 2A antagonists may counteract its secondary effects on the glutamate system, whereas in the case of 5-HT 2A receptor-related dysfunction their effect may be direct.…”

Section: Discussionmentioning

confidence: 99%

Effects of the 5-HT2A Agonist Psilocybin on Mismatch Negativity Generation and AX-Continuous Performance Task: Implications for the Neuropharmacology of Cognitive Deficits in Schizophrenia

Umbricht

Vollenweider

Schmid

et al. 2003

Neuropsychopharmacol

164

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Previously the NMDA (N-methyl-D-aspartate) receptor (NMDAR) antagonist ketamine was shown to disrupt generation of the auditory event-related potential (ERP) mismatch negativity (MMN) and the performance of an 'AX'-type continuous performance test (AX-CPT)Fmeasures of auditory and visual context-dependent information processingFin a similar manner as observed in schizophrenia. This placebo-controlled study investigated effects of the 5-HT 2A receptor agonist psilocybin on the same measures in 18 healthy volunteers. Psilocybin administration induced significant performance deficits in the AX-CPT, but failed to reduce MMN generation significantly. These results indirectly support evidence that deficient MMN generation in schizophrenia may be a relatively distinct manifestation of deficient NMDAR functioning. In contrast, secondary pharmacological effects shared by NMDAR antagonists and the 5-HT 2A agonist (ie disruption of glutamatergic neurotransmission) may be the mechanism underlying impairments in AX-CPT performance observed during both psilocybin and ketamine administration. Comparable deficits in schizophrenia may result from independent dysfunctions of 5-HT 2A and NMDAR-related neurotransmission.

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Section: Discussionmentioning

confidence: 99%

Effects of the 5-HT2A Agonist Psilocybin on Mismatch Negativity Generation and AX-Continuous Performance Task: Implications for the Neuropharmacology of Cognitive Deficits in Schizophrenia

Umbricht

Vollenweider

Schmid

et al. 2003

Neuropsychopharmacol

164

View full text Add to dashboard Cite

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“…Composite scores for the BACS were calculated as the mean of Z scores, separately computed for each measure relative to the mean and standard deviation of the healthy comparison sample used in the BACS validation study (Keefe et al, 2004). Consistent with previous reports characterizing first episode samples relative to healthy comparison samples with other batteries (Bilder et al, 2000;Hill et al, 2004a), the BACS composite indicated moderate overall cognitive impairment for participants who completed baseline (Z 5 21.54 6 0.93) and 12-week (5 21.49 6 0.92) assessments.…”

Section: Neurocognitive Measuresmentioning

confidence: 98%

“…Generalized cognitive deficits have been well documented in schizophrenia and are considered core features of the disorder (Bilder et al, 2000;Blanchard & Neale, 1994;Gold et al, 1992;Hill et al, 2001;Saykin et al, 1991). Moderate to marked deficits are typically seen across a wide range of cognitive abilities, are present during the first episode of psychosis, and endure after pharmacological treatment (Hill et al, 2004a;Hoff et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Efficiency of the CATIE and BACS neuropsychological batteries in assessing cognitive effects of antipsychotic treatments in schizophrenia

Hill

Sweeney

Hamer

et al. 2008

J. Inter. Neuropsych. Soc.

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Efficient and reliable assessments of cognitive treatment effects are essential for the comparative evaluation of procognitive effects of pharmacologic therapies. Yet, no studies have addressed the sensitivity and efficiency with which neurocognitive batteries evaluate cognitive abilities before and after treatment. Participants were primarily first episode schizophrenia patients who completed baseline (n 5 367) and 12-week (n 5 219) assessments with the BACS (Brief Assessment of Cognition in Schizophrenia) and CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) neuropsychological batteries in a clinical trial comparing olanzapine, quetiapine, and risperidone. Exploratory factor analysis revealed that performance on both batteries was characterized by a single factor of generalized cognitive deficit for both baseline performance and cognitive change after treatment. Both batteries estimated similar levels of change following treatment, although the BACS battery required half the administration time. Because a unitary factor characterized baseline cognitive abilities in early psychosis as well as cognitive change after treatment with atypical antipsychotic medications, short batteries such as the BACS may efficiently provide sufficient assessment of procognitive treatment effects with antipsychotic medications. Assessment of cognitive effects of adjunctive therapies targeting specific cognitive domains or impairments may require more extensive testing of the domains targeted to maximize sensitivity for detecting specific predicted cognitive outcomes. (JINS, 2008, 14, 209-221.)

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“…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 females (compared to males) who later developed schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, despite well-established sex differences in cognitive in schizophrenia (Lewine, Walker, Shurett, Caudle & Haden 1996;Hoff & Kremen 2002; for review, see Leung & Chue 2000), few studies have examined sex differences in neurocognitive functioning, including IQ, prior to illness onset (for review, see Aylward, Walker and Bettes, 1984;Weiser et al, 2000;Offord 1974;Jones and Done, 1997;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 females (compared to males) who later developed schizophrenia.…”

mentioning

confidence: 99%

Neurocognition and conversion to psychosis in adolescents at high-risk

Walder

Mittal

Trotman

et al. 2008

Schizophrenia Research

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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...

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Neuropsychology of First-Episode Schizophrenia: Initial Characterization and Clinical Correlates

Cited by 814 publications

References 61 publications

Effects of the 5-HT2A Agonist Psilocybin on Mismatch Negativity Generation and AX-Continuous Performance Task: Implications for the Neuropharmacology of Cognitive Deficits in Schizophrenia

Effects of the 5-HT2A Agonist Psilocybin on Mismatch Negativity Generation and AX-Continuous Performance Task: Implications for the Neuropharmacology of Cognitive Deficits in Schizophrenia

Efficiency of the CATIE and BACS neuropsychological batteries in assessing cognitive effects of antipsychotic treatments in schizophrenia

Neurocognition and conversion to psychosis in adolescents at high-risk

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