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Molecular Psychiatry Jun 2024This study aims to determine whether 1) individuals with treatment-resistant schizophrenia display early cognitive impairment compared to treatment-responders and...
This study aims to determine whether 1) individuals with treatment-resistant schizophrenia display early cognitive impairment compared to treatment-responders and healthy controls and 2) N-methyl-D-aspartate-receptor hypofunction is an underlying mechanism of cognitive deficits in treatment-resistance. In this case‒control 3-year-follow-up longitudinal study, n = 697 patients with first-episode psychosis, aged 18 to 35, were screened for Treatment Response and Resistance in Psychosis criteria through an algorithm that assigns patients to responder, limited-response or treatment-resistant category (respectively resistant to 0, 1 or 2 antipsychotics). Assessments at baseline: MATRICS Consensus Cognitive Battery; N-methyl-D-aspartate-receptor co-agonists biomarkers in brain by MRS (prefrontal glutamate levels) and plasma (D-serine and glutamate pathways key markers). Patients were compared to age- and sex-matched healthy controls (n = 114). Results: patient mean age 23, 27% female. Treatment-resistant (n = 51) showed lower scores than responders (n = 183) in processing speed, attention/vigilance, working memory, verbal learning and visual learning. Limited responders (n = 59) displayed an intermediary phenotype. Treatment-resistant and limited responders were merged in one group for the subsequent D-serine and glutamate pathway analyses. This group showed D-serine pathway dysregulation, with lower levels of the enzymes serine racemase and serine-hydroxymethyltransferase 1, and higher levels of the glutamate-cysteine transporter 3 than in responders. Better cognition was associated with higher D-serine and lower glutamate-cysteine transporter 3 levels only in responders; this association was disrupted in the treatment resistant group. Treatment resistant patients and limited responders displayed early cognitive and persistent functioning impairment. The dysregulation of NMDAR co-agonist pathways provides underlying molecular mechanisms for cognitive deficits in treatment-resistant first-episode psychosis. If replicated, our findings would open ways to mechanistic biomarkers guiding response-based patient stratification and targeting cognitive improvement in clinical trials.
PubMed: 38849515
DOI: 10.1038/s41380-024-02631-4 -
Journal of Interpersonal Violence Jun 2024This study aims to investigate the forms of verbal abuse by teachers toward students during the teaching and learning process, the prototype of verbal abuse recognized...
This study aims to investigate the forms of verbal abuse by teachers toward students during the teaching and learning process, the prototype of verbal abuse recognized by teachers, and the specific features of verbal abuse of students by teachers. This study used mixed methods that combine qualitative and quantitative methods. The quantitative method focused on investigating the frequency of verbal abuse by teachers using the Korean Verbal Abuse Questionnaire. Meanwhile, the qualitative method examined the prototype of verbal abuse recognized by teachers and the features of verbal abuse that teachers use toward students. This study recruited 204 students from the fourth to the sixth grades of elementary school and 30 teacher representatives from five elementary schools in Indonesia. The data were collected through online surveys and interviews. The data on the frequency of verbal abuse by teachers during the teaching and learning process were analyzed using descriptive statistics. In contrast, the data from the open-ended questionnaire for teachers and the interviews with students and teachers were analyzed using content analysis. This study found that there are four types of verbal abuse by teachers. These are raising their voices, telling students that they are acting stupid or like brats, scolding, and calling names that make students feel inadequate. Teachers tend to define abuse as something that is physically aggressive, suggesting that teachers often categorize abuse within the realm of physical violence. There are four types of verbal abuse features found in teachers' utterances; these are labeling students' cognitive ability, labeling students' behaviors, shaming students' physiques, and raising their voices. The results of this study can be employed to develop communication strategies for teachers to lessen verbal abuse during the teaching and learning process.
PubMed: 38847338
DOI: 10.1177/08862605241254135 -
Journal of the American Medical... Jun 2024The purpose of this study was to identify the most parsimonious combination of cognitive tests that accurately predicts the likelihood of passing an on-road driving...
OBJECTIVES
The purpose of this study was to identify the most parsimonious combination of cognitive tests that accurately predicts the likelihood of passing an on-road driving evaluation in order to develop a screening measure that can be administered as an in-office test.
DESIGN
This was a psychometric study of the new test's diagnostic accuracy.
SETTINGS AND PARTICIPANTS
The study was conducted at the Florida Atlantic University's Memory Center and Clinical Research Unit, both easily accessible to older drivers. Participants were older drivers who received a driving evaluation at the Memory Center and agreed to have their results included in the Driving Repository and community-based older drivers who volunteered to participate.
METHODS
Mini-Mental State Exam (MMSE), Trail Making Tests A and B, Clock Test, Hopkins Verbal Learning Test, and Driving Health Inventory results were compared with an on-road driving evaluation to identify those tests that best predict the ability to pass the on-road evaluation.
RESULTS
Altogether, 412 older drivers, 179 men and 233 women, were included in the analysis. Fifty-four percent of Driving Repository participants failed the on-road evaluation compared with 8% of the community sample. The highest correlation to the on-road evaluation was Trails B time in seconds r = -0.713 (P < .001). Variables with high multicollinearity and/or low correlation with the on-road evaluation were eliminated and sets of receiver operating characteristics curves were generated to assess the predictive accuracy of the remaining tests. A linear combination of Trails B in seconds and MMSE using the highest of the Serial 7s or WORLD spelled backward scores accounted for the highest area under the curve of 0.915. Finally, an algorithm was created to rapidly generate the prediction for an individual patient.
CONCLUSIONS AND IMPLICATIONS
The Fit2Drive algorithm demonstrated a strong 91.5% predictive accuracy. Usefulness in office-based patient consultations is promising but remains to be rigorously tested.
PubMed: 38843871
DOI: 10.1016/j.jamda.2024.105054 -
Cognitive Impairments in Drug-Naive Patients With First-Episode Negative Symptom-Dominant Psychosis.JAMA Network Open Jun 2024Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis...
IMPORTANCE
Available antipsychotic medications are predominantly used to treat positive symptoms, such as hallucinations and delusions, in patients with first-episode psychosis (FEP). However, treating negative and cognitive symptoms, which are closely related to functional outcomes, remains a challenge.
OBJECTIVE
To explore the cognitive characteristics of patients with negative symptom-dominant (NSD) psychosis.
DESIGN, SETTING, AND PARTICIPANTS
This large-scale cross-sectional study of patients with FEP was led by the Shanghai Mental Health Center in China from 2016 to 2021, with participants recruited from 10 psychiatric tertiary hospitals. A comprehensive cognitive assessment was performed among 788 patients with FEP who were drug-naive. Symptom profiles were determined using the Positive and Negative Symptoms Scale (PANSS), and NSD was defined as a PANSS score for negative symptoms higher than that for positive and general symptoms. Positive symptom-dominant (PSD) and general symptom-dominant (GSD) psychosis were defined similarly. Data were analyzed in 2023.
EXPOSURE
Psychotic symptoms were categorized into 3 groups: NSD, PSD, and GSD.
MAIN OUTCOMES AND MEASURES
Neurocognitive performance, assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery.
RESULTS
This study included 788 individuals with FEP (median age, 22 [IQR, 17-28] years; 399 men [50.6%]). Patients with NSD exhibited more-pronounced cognitive impairment than did those with PSD or GSD. Specifically, cognitive differences between the NSD and PSD group, as well as between the NSD and GSD group, were most notable in the processing speed and attention domains (Trail Making [F = 4.410; P = .01], Symbol Coding [F = 4.957; P = .007], Verbal Learning [F = 3.198; P = .04], and Continuous Performance [F = 3.057; P = .05]). Patients with PSD and GSD showed no significant cognitive differences. Cognitive impairment was positively associated with the severity of negative symptoms. Most of the cognitive function tests used were able to differentiate patients with NSD from those with PSD and GSD, with significant differences observed across a range of tests, from Brief Visuospatial Memory Test-Revised (χ2 = 3.968; P = .05) to Brief Assessment of Cognition in Schizophrenia symbol coding (χ2 = 9.765; P = .002).
CONCLUSIONS AND RELEVANCE
The findings of this cross-sectional study of patients with FEP suggest the presence of a clinical subtype characterized by a predominance of negative symptoms and cognitive impairment.
Topics: Humans; Male; Female; Cross-Sectional Studies; Cognitive Dysfunction; Psychotic Disorders; Adult; China; Young Adult; Psychiatric Status Rating Scales; Schizophrenia; Adolescent; Neuropsychological Tests
PubMed: 38842809
DOI: 10.1001/jamanetworkopen.2024.15110 -
Brain and Behavior Jun 2024Cerebral specialization and interhemispheric cooperation are two vital features of the human brain. Their dysfunction may be associated with disease progression in...
BACKGROUND
Cerebral specialization and interhemispheric cooperation are two vital features of the human brain. Their dysfunction may be associated with disease progression in patients with Alzheimer's disease (AD), which is featured as progressive cognitive degeneration and asymmetric neuropathology.
OBJECTIVE
This study aimed to examine and define two inherent properties of hemispheric function in patients with AD by utilizing resting-state functional magnetic resonance imaging (rs-fMRI).
METHODS
Sixty-four clinically diagnosed AD patients and 52 age- and sex-matched cognitively normal subjects were recruited and underwent MRI and clinical evaluation. We calculated and compared brain specialization (autonomy index, AI) and interhemispheric cooperation (connectivity between functionally homotopic voxels, CFH).
RESULTS
In comparison to healthy controls, patients with AD exhibited enhanced AI in the left middle occipital gyrus. This increase in specialization can be attributed to reduced functional connectivity in the contralateral region, such as the right temporal lobe. The CFH of the bilateral precuneus and prefrontal areas was significantly decreased in AD patients compared to controls. Imaging-cognitive correlation analysis indicated that the CFH of the right prefrontal cortex was marginally positively related to the Montreal Cognitive Assessment score in patients and the Auditory Verbal Learning Test score. Moreover, taking abnormal AI and CFH values as features, support vector machine-based classification achieved good accuracy, sensitivity, specificity, and area under the curve by leave-one-out cross-validation.
CONCLUSION
This study suggests that individuals with AD have abnormal cerebral specialization and interhemispheric cooperation. This provides new insights for further elucidation of the pathological mechanisms of AD.
Topics: Humans; Alzheimer Disease; Female; Male; Aged; Magnetic Resonance Imaging; Brain; Middle Aged; Support Vector Machine; Aged, 80 and over
PubMed: 38841739
DOI: 10.1002/brb3.3550 -
Journal of Affective Disorders Jun 2024Age at first onset of depression as a clinical factor affecting cognitive improvement in late life depression was investigated.
Cognitive improvement in late-life depression treated with vortioxetine and duloxetine in an eight-week randomized controlled trial: The role of age at first onset and change in depressive symptoms.
BACKGROUND
Age at first onset of depression as a clinical factor affecting cognitive improvement in late life depression was investigated.
METHODS
This is a secondary analysis of an eight-week randomized controlled trial involving 452 elderly patients treated by vortioxetine, duloxetine or placebo (1:1:1). Patients were subcategorized into early-onset (LLD-EO) and late-onset (LLD-LO) groups divided by onset age of 50. Cognitive performance was assessed by composite score of Digit Symbol Substitution Test (DSST) and the Rey Auditory Verbal Learning Test (RAVLT) tasks, while depressive symptoms were assessed by Montgomery-Åsberg Depression Rating Scale (MADRS).
RESULTS
Vortioxetine and duloxetine exhibited advantages versus placebo in improving cognitive performance in the LLD-LO group, yet not in the LLD-EO group after eight weeks. Patients in the LLD-EO group showed overall advantage to placebo in depressive symptoms before endpoint (week 8) of treatment, while patients in the LLO-LO group showed no advantage until endpoint. Path analysis suggested a direct effect of vortioxetine (B = 0.656, p = .036) and duloxetine (B = 0.726, p = .028) on improving cognition in the LLD-LO group, yet in all-patients treated set both medications improved cognition indirectly through changes of depressive symptoms.
LIMITATION
Reliability of clinical history could raise caution as it was collected by subjective recall of patients.
CONCLUSION
Age at first onset might affect cognitive improvement as well as change in depressive symptoms and its mediation towards cognitive improvement in late life depression treated with vortioxetine and duloxetine.
PubMed: 38838790
DOI: 10.1016/j.jad.2024.06.003 -
Psychopharmacology Jun 2024Recent reports have shown increased cannabis use among women, leading to growing concerns about cannabis use disorder (CUD). While there is preclinical evidence...
RATIONALE
Recent reports have shown increased cannabis use among women, leading to growing concerns about cannabis use disorder (CUD). While there is preclinical evidence suggesting biological sex influences cannabinoid effects, human research remains scant. We investigated sex differences in the acute response to oral tetrahydrocannabinol (THC) in humans.
METHODS
56 healthy men and women with prior exposure to cannabis but no history of CUD participated in a randomized, placebo-controlled, human laboratory study where they received a single 10 mg dose of oral THC (dronabinol). Subjective psychoactive effects were assessed by the visual analog scale of "high", psychotomimetic effects by the Clinician-Administered Dissociative Symptoms Scale and Psychotomimetic States Inventory, verbal learning and memory by Rey Auditory Verbal Learning Test (RAVLT), and physiological effects by heart rate. Outcomes were regularly measured on the test day, except for the RAVLT, which was assessed once. Peak differences from baseline were analyzed using a nonparametric method for repeated measures.
RESULTS
Oral THC (10 mg) demonstrated significant dose-related effects in psychotomimetic and physiological domains, but not in RAVLT outcomes. A notable interaction between THC dose and sex emerged concerning the subjective "high" scores, with women reporting heightened sensations (p = 0.05). No other significant effects of sex and THC dose interaction were observed.
CONCLUSION
Oral THC (10 mg) yields similar acute psychotomimetic and physiological effects across sexes, but women may experience a pronounced subjective psychoactive effect. Further research is needed to identify individual vulnerabilities and facilitate tailored interventions addressing CUD.
CLINICALTRIALS
GOV REGISTRATION: https://clinicaltrials.gov/study/NCT02781519?term=Ranganathan&intr=THC&rank=3 .
PubMed: 38832949
DOI: 10.1007/s00213-024-06625-6 -
Ear and Hearing May 2024Speech recognition in cochlear implant (CI) recipients is quite variable, particularly in challenging listening conditions. Demographic, audiological, and cognitive...
OBJECTIVES
Speech recognition in cochlear implant (CI) recipients is quite variable, particularly in challenging listening conditions. Demographic, audiological, and cognitive factors explain some, but not all, of this variance. The literature suggests that rapid auditory perceptual learning explains unique variance in speech recognition in listeners with normal hearing and those with hearing loss. The present study focuses on the early adaptation phase of task-specific rapid auditory perceptual learning. It investigates whether adult CI recipients exhibit this learning and, if so, whether it accounts for portions of the variance in their recognition of fast speech and speech in noise.
DESIGN
Thirty-six adult CI recipients (ages = 35 to 77, M = 55) completed a battery of general speech recognition tests (sentences in speech-shaped noise, four-talker babble noise, and natural-fast speech), cognitive measures (vocabulary, working memory, attention, and verbal processing speed), and a rapid auditory perceptual learning task with time-compressed speech. Accuracy in the general speech recognition tasks was modeled with a series of generalized mixed models that accounted for demographic, audiological, and cognitive factors before accounting for the contribution of task-specific rapid auditory perceptual learning of time-compressed speech.
RESULTS
Most CI recipients exhibited early task-specific rapid auditory perceptual learning of time-compressed speech within the course of the first 20 sentences. This early task-specific rapid auditory perceptual learning had unique contribution to the recognition of natural-fast speech in quiet and speech in noise, although the contribution to natural-fast speech may reflect the rapid learning that occurred in this task. When accounting for demographic and cognitive characteristics, an increase of 1 SD in the early task-specific rapid auditory perceptual learning rate was associated with ~52% increase in the odds of correctly recognizing natural-fast speech in quiet, and ~19% to 28% in the odds of correctly recognizing the different types of speech in noise. Age, vocabulary, attention, and verbal processing speed also had unique contributions to general speech recognition. However, their contribution varied between the different general speech recognition tests.
CONCLUSIONS
Consistent with previous findings in other populations, in CI recipients, early task-specific rapid auditory perceptual, learning also accounts for some of the individual differences in the recognition of speech in noise and natural-fast speech in quiet. Thus, across populations, the early rapid adaptation phase of task-specific rapid auditory perceptual learning might serve as a skill that supports speech recognition in various adverse conditions. In CI users, the ability to rapidly adapt to ongoing acoustical challenges may be one of the factors associated with good CI outcomes. Overall, CI recipients with higher cognitive resources and faster rapid learning rates had better speech recognition.
PubMed: 38829780
DOI: 10.1097/AUD.0000000000001523 -
The Journal of Pain May 2024Relatively recently, in 2009, experimental studies were undertaken to determine the role of social observational learning in forming hypoalgesic, analgesic and... (Review)
Review
Relatively recently, in 2009, experimental studies were undertaken to determine the role of social observational learning in forming hypoalgesic, analgesic and hyperalgesic responses to a placebo. The research findings obtained in studies published before 2018 were integrated and formed the basis of the theoretical model of social learning of placebo effects in pain proposed by Bajcar and Bąbel. This model considered the involvement of different types of modeling (ie, behavioral modeling, symbolic modeling, and verbal modeling) in shaping placebo hypoalgesia/analgesia and nocebo hyperalgesia. The model assumed that pain expectancies might be involved in observationally induced placebo effects in pain and that the effectiveness of observational learning in shaping placebo effects could be moderated by the observer's dispositions, especially empathy. Based on the latest research data, we propose a modified and significantly extended version of this model. The revised model includes the involvement of particular types of modeling in placebo effects and their role in shaping conscious pain-related expectancies. It explains the role of dispositional empathy in shaping observationally induced placebo effects. Notably, the extended version of the model considers the contribution of the characteristics of the observed person to the magnitude of placebo effects induced by social learning. PERSPECTIVE: The paper proposes a comprehensive theoretical approach to explaining the role of observational learning in shaping placebo effects in pain. The proposed model emphasizes the potential of this form of learning in shaping placebo responses and indicates factors that can modify the effectiveness of observational learning.
PubMed: 38825051
DOI: 10.1016/j.jpain.2024.104585 -
Translational Psychiatry Jun 2024People living with HIV and those diagnosed with alcohol use disorders (AUD) relative to healthy individuals commonly have low levels of serum albumin, substantiated as...
People living with HIV and those diagnosed with alcohol use disorders (AUD) relative to healthy individuals commonly have low levels of serum albumin, substantiated as an independent predictor of cardiovascular events. White matter hyperintensities (WMH)-a neuroimaging feature of cerebral small vessel disease-are also related to cardiovascular disease. Despite consensus regarding associations between high levels of urine albumin and WMH prevalence, and low serum albumin levels and impaired cognitive functioning, relations between serum albumin and WMH burdens have rarely been evaluated. Here, a sample including 160 individuals with AUD, 142 living with HIV, and 102 healthy controls was used to test the hypothesis that serum albumin would be inversely related to WMH volumes and directly related to cognitive performance in the two diagnostic groups. Although serum albumin and periventricular WMH volumes showed an inverse relationship in both AUD and HIV groups, this relationship persisted only in the HIV group after consideration of traditional cardiovascular (i.e., age, sex, body mass index (BMI), nicotine use, hypertension, diabetes), study-relevant (i.e., race, socioeconomic status, hepatitis C virus status), and disease-specific (i.e., CD4 nadir, HIV viral load, HIV duration) factors. Further, serum albumin contributed more significantly than periventricular WMH volume to variance in performance on a verbal learning and memory composite score in the HIV group only. Relations in both HIV and AUD groups between albumin and hematological red blood cell markers (e.g., hemoglobin, hematocrit) suggest that in this sample, serum albumin reflects hematological abnormalities. Albumin, a simple serum biomarker available in most clinical settings, may therefore help identify periventricular WMH burden and performance levels in specific cognitive domains in people living with HIV. Whether serum albumin contributes mechanistically to periventricular WMH in HIV will require additional investigation.
Topics: Humans; Female; Male; Middle Aged; White Matter; Magnetic Resonance Imaging; HIV Infections; Serum Albumin; Alcoholism; Adult; Cognitive Dysfunction
PubMed: 38824150
DOI: 10.1038/s41398-024-02953-5