Perinatal complications and executive dysfunction in early-onset schizophrenia

Abstract

Background: The present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS. Methods: The participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses. Results: Perinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls. Conclusions: Exposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.

Identification of cerebrospinal fluid and serum metabolomic biomarkers in first episode psychosis patients

“…4-hydroxyproline, as an NMDAR-related amino acid was reported to be elevated in FEP patients and inferred to induce a compensatory response to glutamatergic hypofunction [ 42 ]. Our pathway analysis also identified a potential involvement of the 4-hydroxyproline pathway, which is associated with executive dysfunction in schizophrenia [ 43 ].…”

Esquizofrenia e Cognição

“…A cognição é essencial para a vida humana e nos habilitam para o autocuidado, para as relações sociais e o trabalho. Na esquizofrenia, pode haver prejuízo dessas funções em todas as fases (Teigset, Mohn, & Rund, 2020), sendo os distúrbios da função executiva os déficits cognitivos mais comumente observados. Ademais, Psicol.…”

“…Por outro lado, no que se refere especificamente aos déficits cognitivos, os pacientes apresentam prejuízos em tarefas relacionadas ao córtex pré-frontal dorso lateral (CPFDL). Os circuitos neurais relacionados à tomada de decisão e controle cognitivo tem, nessa região, a sua localização principal (Teigset, Mohn, & Rund, 2020). Ainda é importante salientar que, como o córtex pré-frontal do feto é o último a amadurecer, consequentemente ele pode ser mais suscetível a problemas de crescimento e de complicações pré e perinatais, podendo afetar diretamente as redes neuronais e prejudicar principalmente o desenvolvimento da função executiva (Teigset, Mohn, & Rund, 2020 Outros sistemas de neurotransmissão também são estudados tanto no entendimento da gênese da esquizofrenia quanto em sintomas específicos, como é o caso dos déficits cognitivos.…”

Reliability of the performance-based measure of executive functions in people with schizophrenia

“…Executive dysfunction is one of the major cognitive dysfunction in people with schizophrenia. Executive functions indicate higher-level cognitive functions that enable people to form goals, plan how to achieve those goals, and then execute the plans effectively [1][2][3]. According to recent evidences [4][5][6], around 50-70% of people with schizophrenia who have executive dysfunction show difficulty in planning, mental flexibility, and problem solving, which affect their independence in the activities of daily living, work, and social participation at home and in the community [3,7,8].…”

“…Executive functions indicate higher-level cognitive functions that enable people to form goals, plan how to achieve those goals, and then execute the plans effectively [1][2][3]. According to recent evidences [4][5][6], around 50-70% of people with schizophrenia who have executive dysfunction show difficulty in planning, mental flexibility, and problem solving, which affect their independence in the activities of daily living, work, and social participation at home and in the community [3,7,8]. Therefore, a reliable measure of executive functions for people with schizophrenia is a necessity for clinicians to assess their difficulties of executive functions and to make treatment plans.…”