Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: A meta-analytic review of putative endophenotypes
Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: A meta-analytic review of putative endophenotypes
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DOI：
10.1093/schbul/sbi048
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发表时间：
2006-01-01
影响因子：
6.6
通讯作者：
Carter, CS
中科院分区：
文献类型：
--
作者：
Snitz, BE;MacDonald, AW;Carter, CS
认知缺陷可能是精神分裂症遗传易感性的指标，也是这种疾病的候选内表型。为了比较认知任务对健康亲属和对照组之间群体差异的敏感程度以及调节变量的影响，本综述报告了来自58项关于精神分裂症患者未受影响的成年亲属的认知表现的43个认知测试分数的平均效应大小。结果表明，可靠的相对控制差异，在中小效应范围内，在不同的任务阵列上，最大的效应大小出现在连续操作任务、听觉言语学习、设计临摹测试和类别流利性的复杂版本中。研究发现，三个研究设计特征对总体效应大小有显著影响：教育上不匹配的组，年龄上不匹配的组，以及不对称的精神疾病排除标准。在排除了后两种设计特征的研究后，在认知测试变量的较小子集上仍然观察到了可靠的绩效差异，其中在路径B(d=0.50)以及连续操作任务的简单(d=0.56)和复杂(d=0.60-0.66)版本的绩效测量中的效果最大。6个最大效应大小中的4个反映了执行控制要求较高的共同任务，如工作记忆需求、定势转移和优先反应抑制。认知缺陷，特别是那些利用执行控制功能的缺陷，应该继续被证明是寻找与精神分裂症相关的特定遗传因素的有价值的内在表型。
Cognitive deficits may index genetic liability for schizophrenia and are candidate endophenotypes for the illness. In order to compare the degree of sensitivity among cognitive tasks to group differences between healthy relatives and controls and the influence of moderator variables, this review reports mean effect sizes for 43 cognitive test scores from 58 studies of cognitive performance in the unaffected adult relatives of schizophrenia patients. Results indicate reliable relative-control differences, in the small to medium effect size range, over a diverse array of tasks, with the largest effect sizes seen in complex versions of continuous performance tasks, auditory verbal learning, design copy tests, and category fluency. Three study design features were found to have significant effects on overall effect size magnitude: groups unmatched on education, groups unmatched on age, and asymmetric psychiatric exclusion criteria. After excluding studies with the latter 2 design features, reliable performance differences were still observed over a smaller subset of cognitive test variables, with the largest effect sizes seen in Trails B (d = 0.50) and performance measures from both simple (d = 0.56) and complex (d = 0.60-0.66) versions of continuous performance tasks. Four of the 6 largest effect sizes reflect tasks with high executive control demands in common, such as working memory demands, set shifting, and inhibition of prepotent responses. Cognitive deficits, particularly those tapping such executive control functions, should continue to prove valuable as endophenotypes of interest in the search for specific genetic factors related to schizophrenia.