Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness
© 2023. The Author(s)..
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. CLINICAL TRIAL REGISTRY NAME: German Clinical Trials Register (DRKS). Clinical trial registry URL: https://www.drks.de/drks_web/ . Clinical trial registry number: DRKS00005042.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology - 49(2024), 3 vom: 15. Feb., Seite 573-583 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wenzel, Julian [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 26.01.2024 Date Revised 17.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1038/s41386-023-01729-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362338574 |
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| 100 | 1 | |a Wenzel, Julian |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 17.03.2024 | ||
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a 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. CLINICAL TRIAL REGISTRY NAME: German Clinical Trials Register (DRKS). Clinical trial registry URL: https://www.drks.de/drks_web/ . Clinical trial registry number: DRKS00005042 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Badde, Luzie |e verfasserin |4 aut | |
| 700 | 1 | |a Haas, Shalaila S |e verfasserin |4 aut | |
| 700 | 1 | |a Bonivento, Carolina |e verfasserin |4 aut | |
| 700 | 1 | |a Van Rheenen, Tamsyn E |e verfasserin |4 aut | |
| 700 | 1 | |a Antonucci, Linda A |e verfasserin |4 aut | |
| 700 | 1 | |a Ruef, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Penzel, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Rosen, Marlene |e verfasserin |4 aut | |
| 700 | 1 | |a Lichtenstein, Theresa |e verfasserin |4 aut | |
| 700 | 1 | |a Lalousis, Paris Alexandros |e verfasserin |4 aut | |
| 700 | 1 | |a Paolini, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Stainton, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Dannlowski, Udo |e verfasserin |4 aut | |
| 700 | 1 | |a Romer, Georg |e verfasserin |4 aut | |
| 700 | 1 | |a Brambilla, Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Wood, Stephen J |e verfasserin |4 aut | |
| 700 | 1 | |a Upthegrove, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Borgwardt, Stefan |e verfasserin |4 aut | |
| 700 | 1 | |a Meisenzahl, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Salokangas, Raimo K R |e verfasserin |4 aut | |
| 700 | 1 | |a Pantelis, Christos |e verfasserin |4 aut | |
| 700 | 1 | |a Lencer, Rebekka |e verfasserin |4 aut | |
| 700 | 1 | |a Bertolino, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Kambeitz, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Koutsouleris, Nikolaos |e verfasserin |4 aut | |
| 700 | 1 | |a Dwyer, Dominic B |e verfasserin |4 aut | |
| 700 | 1 | |a Kambeitz-Ilankovic, Lana |e verfasserin |4 aut | |
| 700 | 0 | |a PRONIA consortium |e verfasserin |4 aut | |
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