Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T01:19:05.783Z Has data issue: false hasContentIssue false
  • English
  • Français

Do cognitive and neuropsychological functioning deficits coincide with hippocampal alteration during first-psychotic episode?

Published online by Cambridge University Press:  03 December 2018

Bashkim Kadriu Open the ORCID record for Bashkim Kadriu [Opens in a new window] ,
Wen Gu ,
Panagiota Korenis  and
Jeffrey M Levine
Bashkim Kadriu*
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
Wen Gu
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Panagiota Korenis
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Jeffrey M Levine
Affiliation:
Bronx-Lebanon Hospital Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
*
*Address for correspondence: Bashkim Kadriu, MD, National Institute of Mental Health, National Institutes of Health, 10 Center Dr, Room 7-5545, Bethesda, MD 20892, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Numerous studies shown that structural hippocampal alterations are present in subjects at high risk of developing psychosis or schizophrenia. These findings indicate that in a subset of patients undergoing first-psychosis episode (FPE), hippocampal volume alterations are accompanied by associated cognitive and neuropsychological deficits. The combination of psychological deficits and neuroanatomical alterations, in turn, appears to increase treatment complexity and worsen clinical outcomes.

Objective

We aim to determine whether cognitive and neuropsychological functioning deficits precede or follow hippocampal alterations during early onset psychosis.

Methods

This cross-sectional study describes 3 case-studies of adolescent subjects, ages 16–17, admitted at the child and adolescent inpatient psychiatric unit in lieu of first psychotic episode. We conducted detailed structured clinical psychiatric interviews, anatomical-structural magnetic resonance imaging (MRI), sleep-deprived electroencephalogram (EEG) recordings, laboratory testing, and a comprehensive battery of psychological testing to better understand their clinical pictures.

Results

Psychological testing in each patient demonstrated the presence of low to borderline intellectual functioning coupled with neuropsychological deficits in different psychiatric domains. Interestingly, these changes coincided with structural MRI alterations in the hippocampal area.

Conclusions

Our case report adds to the armamentarium of literature signifying that radiologically detectable alterations of the hippocampus may occur either concomitantly or closely following the development of early cognitive deficits in patients with FPE.

Keywords

Electroencephalogram (EEG)first-psychosis episodehippocampalmorphometric alterationsneuropsychological testing
Type
Case based Review
Information
CNS Spectrums , Volume 24 , Issue 5 , October 2019 , pp. 472 - 478
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dean, DJ, Orr, JM, Bernard, JA, et al. Hippocampal shape abnormalities predict symptom progression in neuroleptic-free youth at ultrahigh risk for psychosis. Schizophr Bull. 2016; 42(1): 161–169.Google ScholarPubMed
Buehlmann, E, Berger, GE, Aston, J, et al. Hippocampus abnormalities in at risk mental states for psychosis? A cross-sectional high resolution region of interest magnetic resonance imaging study. J Psychiatr Res. 2010; 44(7): 447–453.CrossRefGoogle ScholarPubMed
Anvari, AA, Friedman, LA, Greenstein, D, Gochman, P, Gogtay, N, Rapoport, JL. Hippocampal volume change relates to clinical outcome in childhood-onset schizophrenia. Psychol Med. 2015; 45(12): 2667–2674.CrossRefGoogle ScholarPubMed
Csernansky, JG, Joshi, S, Wang, L, et al. Hippocampal morphometry in schizophrenia by high dimensional brain mapping. Proc Natl Acad Sci U S A. 1998; 95(19): 11406–11411.CrossRefGoogle ScholarPubMed
Walter, A, Studerus, E, Smieskova, R, et al. Hippocampal volume in subjects at high risk of psychosis: a longitudinal MRI study. Schizophr Res. 2012; 142(1–3): 217–222.CrossRefGoogle ScholarPubMed
Bois, C, Levita, L, Ripp, I, et al. Hippocampal, amygdala and nucleus accumbens volume in first-episode schizophrenia patients and individuals at high familial risk: a cross-sectional comparison. Schizophr Res. 2015; 165(1): 45–51.CrossRefGoogle ScholarPubMed
Vargas, T, Dean, DJ, Osborne, KJ, et al. Hippocampal Subregions Across the Psychosis Spectrum. Schizophr Bull. 2018; 44(5): 1091–1099.CrossRefGoogle ScholarPubMed
Baglivo, V, Cao, B, Mwangi, B, et al. Hippocampal subfield volumes in patients with first-episode psychosis. Schizophr Bull. 2018; 44(3): 552–559.CrossRefGoogle ScholarPubMed
Ho, NF, Holt, DJ, Cheung, M, et al. Progressive decline in hippocampal CA1 volume in individuals at ultra-high-risk for psychosis who do not remit: findings from the Longitudinal Youth at Risk Study. Neuropsychopharmacology. 2017; 42(6): 1361–1370.CrossRefGoogle Scholar
Addington, J, Brooks, BL, Addington, D. Cognitive functioning in first episode psychosis: initial presentation. Schizophr Res. 2003; 62(1–2): 59–64.CrossRefGoogle ScholarPubMed
Wood, SJ, Brewer, WJ, Koutsouradis, P, et al. Cognitive decline following psychosis onset: data from the PACE clinic. Br J Psychiatry Suppl. 2007; 51: S52–57.CrossRefGoogle ScholarPubMed
Bilder, RM, Goldman, RS, Robinson, D, et al. Neuropsychology of first-episode schizophrenia: initial characterization and clinical correlates. Am J Psychiatry. 2000; 157(4): 549–559.CrossRefGoogle ScholarPubMed
Watson, DR, Bai, F, Barrett, SL, et al. Structural changes in the hippocampus and amygdala at first episode of psychosis. Brain Imaging Behav. 2012; 6(1): 49–60.CrossRefGoogle ScholarPubMed
Ellison-Wright, I, Glahn, DC, Laird, AR, Thelen, SM, Bullmore, E. The anatomy of first-episode and chronic schizophrenia: an anatomical likelihood estimation meta-analysis. Am J Psychiatry. 2008; 165(8): 1015–1023.CrossRefGoogle ScholarPubMed
Gur, RE, Keshavan, MS, Lawrie, SM. Deconstructing psychosis with human brain imaging. Schizophr Bull. 2007; 33(4): 921–931.CrossRefGoogle ScholarPubMed
Ota, M, Obu, S, Sato, N, Asada, T. Neuroimaging study in subjects at high risk of psychosis revealed by the Rorschach test and first-episode schizophrenia. Acta Neuropsychiatr. 2011; 23(3): 125–131.CrossRefGoogle ScholarPubMed
Brewer, WJ, Wood, SJ, Phillips, LJ, et al. Generalized and specific cognitive performance in clinical high-risk cohorts: a review highlighting potential vulnerability markers for psychosis. Schizophr Bull. 2006; 32(3): 538–555.CrossRefGoogle Scholar
Bora, E, Lin, A, Wood, SJ, Yung, AR, McGorry, PD, Pantelis, C. Cognitive deficits in youth with familial and clinical high risk to psychosis: a systematic review and meta-analysis. Acta Psychiatr Scand. 2014; 130(1): 1–15.CrossRefGoogle ScholarPubMed
Lencz, T, Smith, CW, McLaughlin, D, et al. Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiatry. 2006; 59(9): 863–871.CrossRefGoogle ScholarPubMed
Mathew, I, Gardin, TM, Tandon, N, et al. Medial temporal lobe structures and hippocampal subfields in psychotic disorders: findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study. JAMA Psychiatry. 2014; 71(7): 769–777.CrossRefGoogle ScholarPubMed
Harrisberger, F, Smieskova, R, Vogler, C, et al. Impact of polygenic schizophrenia-related risk and hippocampal volumes on the onset of psychosis. Transl Psychiatry. 2016; 6(8): e868.CrossRefGoogle Scholar
Vassos, E, Di Forti, M, Coleman, J, et al. An examination of polygenic score risk prediction in individuals with first-episode psychosis. Biol Psychiatry. 2017; 81(6): 470–477.CrossRefGoogle ScholarPubMed
Kebir, O, Chaumette, B, Krebs, MO. Epigenetic variability in conversion to psychosis: novel findings from an innovative longitudinal methylomic analysis. Transl Psychiatry. 2018; 8(1): 93.CrossRefGoogle ScholarPubMed
Kebir, O, Chaumette, B, Rivollier, F, et al. Methylomic changes during conversion to psychosis. Mol Psychiatry. 2017; 22(4): 512–518.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JB. Structured Clinical Interview for DSM-IV TR Axis I Disorders, Research Version, Patient Edition. New York State Psychiatric Institute, Biometrics Research; New York: 2001.Google Scholar
Wechsler, DS, Engstrom, LD, Alexander, BM, Motto, DG, Roulston, D. A novel chromosomal inversion at 11q23 in infant acute myeloid leukemia fuses MLL to CALM, a gene that encodes a clathrin assembly protein. Genes Chromosomes Cancer. 2003; 36(1): 26–36.CrossRefGoogle ScholarPubMed
Wechsler, D, Kaplan, E, Fein, D, et al. Wechsler Intelligence Scale for Children Fourth Edition–Integrated: Technical and Interpretative Manual. San Antonio, TX: The Psychological Corporation; 2004.Google Scholar
Wechsler, D, Coalson, DL, Raiford, SE. WAIS-IV: Wechsler Adult Intelligence Scale. San Antonio, TX: Pearson; 2008.Google Scholar
Randolph, C, Tierney, MC, Mohr, E, Chase, TN. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. J Clin Exp Neuropsychol. 1998; 20(3): 310–319.CrossRefGoogle ScholarPubMed
Beatty, WW, Mold, JW, Gontkovsky, ST. RBANS performance: influences of sex and education. J Clin Exp Neuropsychol. 2003; 25(8): 1065–1069.CrossRefGoogle Scholar
Reitan, RM, Wolfson, D. Category Test and Trail Making Test as measures of frontal lobe functions. The Clinical Neuropsychologist. 1995; 9(1): 50–56.CrossRefGoogle Scholar
Morey, L. Personality Assessment Inventory professional manual 2nd ed. Lutz, FL: Psychological Assessment Resources; 2007.Google Scholar
Rorschach, H. Psychodiagnostics—A Diagnostic Test Based on Perception. Read Books Ltd; 2013. Germany.Google Scholar
Gur, RC, Calkins, ME, Satterthwaite, TD, et al. Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry. 2014; 71(4): 366–374.CrossRefGoogle ScholarPubMed
Gur, RE, Keshavan, MS, Lawrie, SM. Deconstructing psychosis with human brain imaging. In: Tamminga CA, Sirovatka PJ, Regier DA, Os Jv, eds. Deconstructing psychosis: Refining the research agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2010: 109–129.Google Scholar
Lappin, JM, Morgan, C, Chalavi, S, et al. Bilateral hippocampal increase following first-episode psychosis is associated with good clinical, functional and cognitive outcomes. Psychol Med. 2014; 44(6): 1279–1291.CrossRefGoogle ScholarPubMed
Green, MF. Cognitive remediation in schizophrenia: is it time yet? Am J Psychiatry. 1993; 150(2): 178–187.Google ScholarPubMed
Morales-Muñoz, I, Jurado-Barba, R, Fernández-Guinea, S, et al. Cognitive impairments in patients with first episode psychosis: the relationship between neurophysiological and neuropsychological assessments. J Clin Neurosci. 2017; 36: 80–87.CrossRefGoogle ScholarPubMed
Lecardeur, L, Meunier-Cussac, S, Dollfus, S. [Cognitive deficits in first episode psychosis patients and people at risk for psychosis: from diagnosis to treatment]. Encephale. 2013; 39(Suppl 1): S64–71.CrossRefGoogle Scholar
Hyza, M, Huttlova, J, Kerkovsky, M, Kasparek, T. Psychosis effect on hippocampal reduction in schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2014; 48: 186–192.CrossRefGoogle Scholar
Pantelis, C, Yucel, M, Wood, SJ, McGorry, PD, Velakoulis, D. Early and late neurodevelopmental disturbances in schizophrenia and their functional consequences. Aust N Z J Psychiatry. 2003; 37(4): 399–406.CrossRefGoogle ScholarPubMed
Velakoulis, D, Wood, SJ, McGorry, PD, Pantelis, C. Evidence for progression of brain structural abnormalities in schizophrenia: beyond the neurodevelopmental model. Aust N Z J Psychiatry. 2000; 34(Suppl 2): S113–126.CrossRefGoogle ScholarPubMed
Velakoulis, D, Wood, SJ, Wong, MTH, et al. Hippocampal and amygdala volumes according to psychosis stage and diagnosis: a magnetic resonance imaging study of chronic schizophrenia, first-episode psychosis, and ultra-high-risk individuals. Arch Gen Psychiatry. 2006; 63(2): 139–149.CrossRefGoogle ScholarPubMed
Nelson, MD, Saykin, AJ, Flashman, LA, Riordan, HJ. Hippocampal volume reduction in schizophrenia as assessed by magnetic resonance imaging: a meta-analytic study. Arch Gen Psychiatry. 1998; 55(5): 433–440.CrossRefGoogle ScholarPubMed
Perkins, DO, Gu, H, Boteva, K, Lieberman, JA. Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. Am J Psychiatry. 2005; 162(10): 1785–1804.CrossRefGoogle ScholarPubMed
Bradford, DW, Perkins, DO, Lieberman, JA. Pharmacological management of first-episode schizophrenia and related nonaffective psychoses. Drugs. 2003; 63(21): 2265–2283.CrossRefGoogle ScholarPubMed
Nenadic, I, Dietzek, M, Schönfeld, N, et al. Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study. Schizophr Res. 2015; 161(2–3): 169–176.CrossRefGoogle ScholarPubMed
Brent, BK, Thermenos, HW, Keshavan, MS, Seidman, LJ. Gray matter alterations in schizophrenia high-risk youth and early-onset schizophrenia: a review of structural MRI findings. Child Adolesc Psychiatr Clin N Am. 2013; 22(4): 689–714.CrossRefGoogle ScholarPubMed
Stone, JM, Day, F, Tsagaraki, H, et al. Glutamate dysfunction in people with prodromal symptoms of psychosis: relationship to gray matter volume. Biol Psychiatry. 2009; 66(6): 533–539.CrossRefGoogle ScholarPubMed
Clancy, MJ, Clarke, MC, Connor, DJ, Cannon, M, Cotter, DR. The prevalence of psychosis in epilepsy: a systematic review and meta-analysis. BMC Psychiatry. 2014; 14: 75.CrossRefGoogle ScholarPubMed