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  Cognitive subtypes in recent onset psychosis: distinct neurobiological fingerprints?

Wenzel, J., Haas, S. S., Dwyer, D. B., Ruef, A., Öztürk, Ö. F., Antonucci, L. A., et al. (2021). Cognitive subtypes in recent onset psychosis: distinct neurobiological fingerprints? NEUROPSYCHOPHARMACOLOGY, 46(8), 1475-1483. doi:10.1038/s41386-021-00963-1.

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 Creators:
Wenzel, Julian, Author
Haas, Shalaila S., Author
Dwyer, Dominic B., Author
Ruef, Anne, Author
Öztürk, Ömer Faruk1, Author           
Antonucci, Linda A., Author
von Saldern, Sebastian, Author
Bonivento, Carolina, Author
Garzitto, Marco, Author
Ferro, Adele, Author
Paolini, Marco, Author
Blautzik, Janusch, Author
Borgwardt, Stefan, Author
Brambilla, Paolo, Author
Meisenzahl, Eva, Author
Salokangas, Raimo K. R., Author
Upthegrove, Rachel, Author
Wood, Stephen J., Author
Kambeitz, Joseph, Author
Koutsouleris, Nikolaos2, Author           
Kambeitz-Ilankovic, Lana, Author more..
Affiliations:
1IMPRS Translational Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society, ou_3318616              
2Max Planck Fellow Group Precision Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society, ou_3318615              

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 Abstract: In schizophrenia, neurocognitive subtypes can be distinguished based on cognitive performance and they are associated with neuroanatomical alterations. We investigated the existence of cognitive subtypes in shortly medicated recent onset psychosis patients, their underlying gray matter volume patterns and clinical characteristics. We used a K-means algorithm to cluster 108 psychosis patients from the multi-site EU PRONIA (Prognostic tools for early psychosis management) study based on cognitive performance and validated the solution independently (N = 53). Cognitive subgroups and healthy controls (HC; n = 195) were classified based on gray matter volume (GMV) using Support Vector Machine classification. A cognitively spared (N = 67) and impaired (N = 41) subgroup were revealed and partially independently validated (N-spared = 40, N-impaired = 13). Impaired patients showed significantly increased negative symptomatology (p(fdr) = 0.003), reduced cognitive performance (p(fdr) < 0.001) and general functioning (p(fdr) < 0.035) in comparison to spared patients. Neurocognitive deficits of the impaired subgroup persist in both discovery and validation sample across several domains, including verbal memory and processing speed. A GMV pattern (balanced accuracy = 60.1%, p = 0.01) separating impaired patients from HC revealed increases and decreases across several fronto-temporal-parietal brain areas, including basal ganglia and cerebellum. Cognitive and functional disturbances alongside brain morphological changes in the impaired subgroup are consistent with a neurodevelopmental origin of psychosis. Our findings emphasize the relevance of tailored intervention early in the course of psychosis for patients suffering from the likely stronger neurodevelopmental character of the disease.

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 Dates: 2021
 Publication Status: Published in print
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Title: NEUROPSYCHOPHARMACOLOGY
Source Genre: Journal
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Pages: - Volume / Issue: 46 (8) Sequence Number: - Start / End Page: 1475 - 1483 Identifier: ISSN: 0893-133X