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Validation of the cognitively normal range and below normal range subtypes in chronically hospitalized patients with schizophrenia.

ABSTRACT: Many studies have found a substantial minority of patients whose performance puts them within the normal range of neuropsychological functioning. Recently, a study has seen the delineation of two neurocognitive subtypes of schizophrenia -'cognitively normal range' (CNR) and 'below normal range' (BNR) - based on neurocognitive performance across multiple domains.The participants were from two studies that collected neurocognitive, psychopathology and social function data between 2008 and 2015. In total the complete data from one hundred and thirty one patients of Han Chinese ethnicity with schizophrenia were collected on 21 neurocognitive indexes (assessing the domains of processing speed, attention, working memory, verbal memory, visual memory, reasoning and problem solving and IQ). Fifty-five patients of the one hundred and thirty one participants received additional ratings on their psychopathology and social functions. An exploratory graphic analysis was conducted on the neurocognitive measures for the entire sample. Difference analyses were also performed according to the aims of the study using the Independent t test, Chi-square test, and Cohen's d effect size.Analyses revealed the existence of two patients subtypes. The post hoc tests showed that there were significant differences on all of their neurocognitive measures and on most of the psychopathology and social functions between the two subtypes. These two subtypes could be referred to as the CNR subtype and the BNR subtype respectively.There are neurocognitive subtypes of schizophrenia with differential illness characteristics comparable with the CNR and the BNR in patients of Han Chinese ethnicity with schizophrenia.

SUBMITTER: Chiang SK

PROVIDER: S-EPMC5514302 | biostudies-other | 2016 Sep

REPOSITORIES: biostudies-other

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Project description:In a large multicentre sample of cognitively normal subjects, as a function of age, gender and APOE genotype, we studied the frequency of abnormal cerebrospinal fluid levels of Alzheimer's disease biomarkers including: total tau, phosphorylated tau and amyloid-?1-42. Fifteen cohorts from 12 different centres with either enzyme-linked immunosorbent assays or Luminex® measurements were selected for this study. Each centre sent nine new cerebrospinal fluid aliquots that were used to measure total tau, phosphorylated tau and amyloid-?1-42 in the Gothenburg laboratory. Seven centres showed a high correlation with the new Gothenburg measurements; therefore, 10 cohorts from these centres are included in the analyses here (1233 healthy control subjects, 40-84 years old). Amyloid-? amyloid status (negative or positive) and neurodegeneration status (negative or positive) was established based on the pathological cerebrospinal fluid Alzheimer's disease cut-off values for cerebrospinal fluid amyloid-?1-42 and total tau, respectively. While gender did not affect these biomarker values, APOE genotype modified the age-associated changes in cerebrospinal fluid biomarkers such that APOE ?4 carriers showed stronger age-related changes in cerebrospinal fluid phosphorylated tau, total tau and amyloid-?1-42 values and APOE ?2 carriers showed the opposite effect. At 40 years of age, 76% of the subjects were classified as amyloid negative, neurodegeneration negative and their frequency decreased to 32% at 85 years. The amyloid-positive neurodegeneration-negative group remained stable. The amyloid-negative neurodegeneration-positive group frequency increased slowly from 1% at 44 years to 16% at 85 years, but its frequency was not affected by APOE genotype. The amyloid-positive neurodegeneration-positive frequency increased from 1% at 53 years to 28% at 85 years. Abnormally low cerebrospinal fluid amyloid-?1-42 levels were already frequent in midlife and APOE genotype strongly affects the levels of cerebrospinal fluid amyloid-?1-42, phosphorylated tau and total tau across the lifespan without influencing the frequency of subjects with suspected non-amyloid pathology.

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Validation of the cognitively normal range and below normal range subtypes in chronically hospitalized patients with schizophrenia.

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