Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness.
Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness.
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早期情感性和精神性疾病中认知障碍的跨诊断亚群。
DOI：
10.1038/s41386-023-01729-7
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发表时间：
2024-02
影响因子：
7.6
通讯作者：
Kambeitz-Ilankovic, Lana
中科院分区：
文献类型：
--
作者：
Wenzel, Julian;Badde, Luzie;Haas, Shalaila S.;Bonivento, Carolina;Van Rheenen, Tamsyn E.;Antonucci, Linda A.;Ruef, Anne;Penzel, Nora;Rosen, Marlene;Lichtenstein, Theresa;Lalousis, Paris Alexandros;Paolini, Marco;Stainton, Alexandra;Dannlowski, Udo;Romer, Georg;Brambilla, Paolo;Wood, Stephen J.;Upthegrove, Rachel;Borgwardt, Stefan;Meisenzahl, Eva;Salokangas, Raimo K. R.;Pantelis, Christos;Lencer, Rebekka;Bertolino, Alessandro;Kambeitz, Joseph;Koutsouleris, Nikolaos;Dwyer, Dominic B.;Kambeitz-Ilankovic, Lana
在精神病和抑郁症以及临床精神病高危人群（CHR）中确定认知障碍患者亚组和幸免患者亚组。研究表明，潜在的大脑结构和功能特征存在差异。目前尚不清楚认知亚群在精神病和情感障碍的早期阶段是否是一种可在神经水平上验证的跨诊断现象。通过多中心研究PRONIA招募了新发精神病患者（ROP, N = 140，女性= 54）、新发抑郁症患者（ROD, N = 130，女性= 73）、CHR患者（N = 128，女性= 61）和健康对照（HC, N = 270，女性= 165）。通过支持向量机（SVM）分类，以脑灰质体积（sMRI）和静息状态功能连接（rsFC）为特征，将跨诊断样本和个体研究组根据其在8个认知领域的表现聚为亚组。我们发现一个受损亚组（NROP = 79, NROD = 30, NCHR = 37）在执行功能、工作记忆、处理速度和语言学习方面表现出认知障碍（均p < 0.001）。一个幸免亚组（NROP = 61, NROD = 100, NCHR = 91）的表现与HC相当。单一疾病亚组表明，与ROD和CHR受损相比，ROP受损的认知障碍更为明显。ROP和ROD的亚组表现出特定的症状和功能模式。与sMRI相比，rsFC在区分跨诊断亚组和HC方面显示出更高的准确性（bac受损= 58.5%；bac未受损= 61.7%，均p < 0.01）。认知结果在PRONIA复制样本中得到验证（N = 409）。ROP、ROD和CHR的个体认知亚组比跨诊断亚组更具信息性，因为它们映射到个体认知障碍和特定功能和症状模式，而在sMRI和rsFC中显示有限的重叠。德国临床试验注册（DRKS）。临床试验注册网址：https://www.drks.de/drks_web/。临床试验注册号：DRKS00005042。
Cognitively impaired and spared patient subgroups were identified in psychosis and depression, and in clinical high-risk for psychosis (CHR). Studies suggest differences in underlying brain structural and functional characteristics. It is unclear whether cognitive subgroups are transdiagnostic phenomena in early stages of psychotic and affective disorder which can be validated on the neural level. Patients with recent-onset psychosis (ROP; N = 140; female = 54), recent-onset depression (ROD; N = 130; female = 73), CHR (N = 128; female = 61) and healthy controls (HC; N = 270; female = 165) were recruited through the multi-site study PRONIA. The transdiagnostic sample and individual study groups were clustered into subgroups based on their performance in eight cognitive domains and characterized by gray matter volume (sMRI) and resting-state functional connectivity (rsFC) using support vector machine (SVM) classification. We identified an impaired subgroup (NROP = 79, NROD = 30, NCHR = 37) showing cognitive impairment in executive functioning, working memory, processing speed and verbal learning (all p < 0.001). A spared subgroup (NROP = 61, NROD = 100, NCHR = 91) performed comparable to HC. Single-disease subgroups indicated that cognitive impairment is stronger pronounced in impaired ROP compared to impaired ROD and CHR. Subgroups in ROP and ROD showed specific symptom- and functioning-patterns. rsFC showed superior accuracy compared to sMRI in differentiating transdiagnostic subgroups from HC (BACimpaired = 58.5%; BACspared = 61.7%, both: p < 0.01). Cognitive findings were validated in the PRONIA replication sample (N = 409). Individual cognitive subgroups in ROP, ROD and CHR are more informative than transdiagnostic subgroups as they map onto individual cognitive impairment and specific functioning- and symptom-patterns which show limited overlap in sMRI and rsFC. German Clinical Trials Register (DRKS). Clinical trial registry URL: https://www.drks.de/drks_web/. Clinical trial registry number: DRKS00005042.
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影响因子：
6.9
作者：
Burdick KE;Russo M;Frangou S;Mahon K;Braga RJ;Shanahan M;Malhotra AK
通讯作者：
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精神病高风险状态：全面的最新评论。
影响因子：
25.8
作者：
Fusar-Poli, Paolo;Borgwardt, Stefan;Bechdolf, Andreas;Addington, Jean;Riecher-Rossler, Anita;Schultze-Lutter, Frauke;Keshavan, Matcheri;Wood, Stephen;Ruhrmann, Stephan;Seidman, Larry J.;Valmaggia, Lucia;Cannon, Tyrone;Velthorst, Eva;De Haan, Lieuwe;Cornblatt, Barbara;Bonoldi, Ilaria;Birchwood, Max;McGlashan, Thomas;Carpenter, William;McGorry, Patrick;Klosterkotter, Joachim;McGuire, Philip;Yung, Alison
通讯作者：
Yung, Alison