Cognitive subtypes in recent onset psychosis: distinct neurobiological fingerprints?
Koutsouleris Nikolaos; Salokangas Raimo KR; Paolini Marco; Antonucci Linda A; Wenzel Julian; Bonivento Carolina; Ruef Anne; Dwyer Dominic B; Kambeitz-Ilankovic Lana; and the PRONIA consortium; Oeztuerk Oemer Faruk; Upthegrove Rachel; Ferro Adele; Meisenzahl Eva; Brambilla Paolo; Wood Stephen J; Garzitto Marco; von Saldern Sebastian; Kambeitz Joseph; Borgwardt Stefan; Blautzik Janusch; Haas Shalaila S
Cognitive subtypes in recent onset psychosis: distinct neurobiological fingerprints?
Koutsouleris Nikolaos
Salokangas Raimo KR
Paolini Marco
Antonucci Linda A
Wenzel Julian
Bonivento Carolina
Ruef Anne
Dwyer Dominic B
Kambeitz-Ilankovic Lana; and the PRONIA consortium
Oeztuerk Oemer Faruk
Upthegrove Rachel
Ferro Adele
Meisenzahl Eva
Brambilla Paolo
Wood Stephen J
Garzitto Marco
von Saldern Sebastian
Kambeitz Joseph
Borgwardt Stefan
Blautzik Janusch
Haas Shalaila S
SPRINGERNATURE
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042826907
https://urn.fi/URN:NBN:fi-fe2021042826907
Tiivistelmä
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.
Kokoelmat
- Rinnakkaistallenteet [19207]