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Associating Psychotic Symptoms with Altered Brain Anatomy in Psychotic Disorders Using Multidimensional Item Response Theory Models.

ABSTRACT: Reduced cortical thickness has been demonstrated in psychotic disorders, but its relationship to clinical symptoms has not been established. We aimed to identify the regions throughout neocortex where clinical psychosis manifestations correlate with cortical thickness. Rather than perform a traditional correlation analysis using total scores on psychiatric rating scales, we applied multidimensional item response theory to identify a profile of psychotic symptoms that was related to a region where cortical thickness was reduced. This analysis was performed using a large population of probands with psychotic disorders (N = 865), their family members (N = 678) and healthy volunteers (N = 347), from the 5-site Bipolar-Schizophrenia Network for Intermediate Phenotypes. Regional cortical thickness from structural magnetic resonance scans was measured using FreeSurfer; individual symptoms were rated using the Positive and Negative Syndrome Scale, Montgomery-Asberg Depression Rating Scale, and Young Mania Rating Scale. A cluster of cortical regions whose thickness was inversely related to severity of psychosis symptoms was identified. The regions turned out to be located contiguously in a large region of heteromodal association cortex including temporal, parietal and frontal lobe regions, suggesting a cluster of contiguous neocortical regions important to psychosis expression. When we tested the relationship between reduced cortical surface area and high psychotic symptoms we found no linked regions describing a related cortical set.

SUBMITTER: Stan AD

PROVIDER: S-EPMC7197072 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Associating Psychotic Symptoms with Altered Brain Anatomy in Psychotic Disorders Using Multidimensional Item Response Theory Models.

Stan Ana D AD Tamminga Carol A CA Han Kihwan K Kim Jong Bae JB Padmanabhan Jaya J Tandon Neeraj N Hudgens-Haney Matthew E ME Keshavan Matcheri S MS Clementz Brett A BA Pearlson Godfrey D GD Sweeney John A JA Gibbons Robert D RD

Cerebral cortex (New York, N.Y. : 1991) 20200501 5

Reduced cortical thickness has been demonstrated in psychotic disorders, but its relationship to clinical symptoms has not been established. We aimed to identify the regions throughout neocortex where clinical psychosis manifestations correlate with cortical thickness. Rather than perform a traditional correlation analysis using total scores on psychiatric rating scales, we applied multidimensional item response theory to identify a profile of psychotic symptoms that was related to a region wher ...[more]

PMID: 31813988

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Project description:IntroductionUp to 20% of older adults in the United States have mild cognitive impairment (MCI), and about one-third of people with MCI are predicted to transition to Alzheimer's disease (AD) within 5 years. Standard cognitive assessments are long and require a trained technician to administer. We developed the first computerized adaptive test (CAT) based on multidimensional item response theory (MIRT) to more precisely, rapidly, and repeatedly assesses cognitive abilities across the adult lifespan. We present results for a prototype CAT (pCAT-COG) for assessment of global cognitive function.MethodsWe sampled items across five cognitive domains central to neuropsychological testing (episodic memory [EM], semantic memory/language [SM], working memory [WM], executive function/flexible thinking, and processing speed [PS]). The item bank consists of 54 items, with 9 items of varying difficulty drawn from six different cognitive tasks. Each of the 54 items has 3 response trials, yielding an ordinal score (0-3 trials correct). We also include three long-term memory items not designed for adaptive administration, for a total bank of 57 items. Calibration data were collected in-person and online, calibrated using a bifactor MIRT model, and pCAT-COG scores validated against a technician-administered neuropsychological battery.ResultsThe bifactor MIRT model improved fit over a unidimensional IRT model (p < 0.0001). The global pCAT-COG scores were inversely correlated with age (r = -0.44, p < 0.0001). Simulated adaptive administration of 11 items maintained a correlation of r = 0.94 with the total item bank scores. Significant differences between mild and no cognitive impairment (NCI) were found (effect size of 1.08 SD units). The pCAT-COG correlated with clinician-based global measure (r = 0.64).DiscussionMIRT-based CAT is feasible and valid for the assessment of global cognitive impairment, laying the foundation for the development of a full CAT-COG that will draw from a much larger item bank with both global and domain specific measures of cognitive impairment.HighlightsAs Americans age, numbers at risk for developing cognitive impairment are increasing.Aging-related declines in cognition begins decades prior to the onset of obvious cognitive impairment.Traditional assessment is burdensome and requires trained clinicians.We developed an adaptive testing framework using multidimensional item response theory.It is comparable to lengthier in-person assessments that require trained psychometrists.

Dataset Information

Associating Psychotic Symptoms with Altered Brain Anatomy in Psychotic Disorders Using Multidimensional Item Response Theory Models.

Publications

Associating Psychotic Symptoms with Altered Brain Anatomy in Psychotic Disorders Using Multidimensional Item Response Theory Models.

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