J Korean Neuropsychiatr Assoc.  2017 May;56(2):61-67. 10.4306/jknpa.2017.56.2.61.

Comparison of Cognitive Control Deficits in Patients with Schizophrenia and Their Unaffected First-Degree Relatives

• Yun H
• Woo S
• Lee SW
• Won S

• KMID: 2379387
• DOI: http://doi.org/10.4306/jknpa.2017.56.2.61

Abstract

OBJECTIVES
This study aimed to identify the differences in the profiles of cognitive control deficits among schizophrenic patients and endophenotypes.
METHODS
The study examined three groups: remitted patients with schizophrenia (n=54), unaffected first-degree relatives of the probands with schizophrenia (n=36), and a healthy control group (n=51), which were all matched for age, sex, and years of education. The AX version of the continuous performance test was used to examine cognitive control. The error rate, correct response times of each subset (AX, BX, AY, BY), and d"² as an indication of the accuracy sensitivity index were calculated. The psychopathology, intelligence, and psychomotor speed were also assessed.
RESULTS
Patients with schizophrenia showed significantly poorer error rates and d"² in the AX and BX subsets than the others. They showed more delayed correct response times than the healthy control group in all subsets. The first-degree relatives also showed more delayed correct response times in the BX and AY subsets than the healthy control group, but were similar to the patients.
CONCLUSION
These findings suggest that cognitive control is impaired in schizophrenia and endophynotypes possibly share this delayed information processing from the higher loading states of cognitive control.

Keyword

Schizophrenia; Cognitive control; AX-CPT; First-degree relatives; Endophenotype

MeSH Terms

Automatic Data Processing
Education
Endophenotypes
Humans
Intelligence
Psychopathology
Reaction Time
Schizophrenia*

Reference

1. Green MF, Kern RS, Heaton RK. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res. 2004; 72:41–51.

2. Egan MF, Goldberg TE, Gscheidle T, Weirich M, Rawlings R, Hyde TM, et al. Relative risk for cognitive impairments in siblings of patients with schizophrenia. Biol Psychiatry. 2001; 50:98–107.

3. Cannon TD, Zorrilla LE, Shtasel D, Gur RE, Gur RC, Marco EJ, et al. Neuropsychological functioning in siblings discordant for schizophrenia and healthy volunteers. Arch Gen Psychiatry. 1994; 51:651–661.

4. Kim DH, Kim J, Hwang S, Kim B, Won S. Neurocognitive deficits in patients with schizophrenia and unaffected first-degree relatives. Korean J Biol Psychiatry. 2014; 21:65–73.

5. Miller EK. The prefrontal cortex and cognitive control. Nat Rev Neurosci. 2000; 1:59–65.

6. Buschman TJ, Miller EK. Top-down versus bottom-up control of attention in the prefrontal and posterior parietal cortices. Science. 2007; 315:1860–1862.

7. Cohen JD, Braver TS, O'Reilly RC. A computational approach to prefrontal cortex, cognitive control and schizophrenia: recent developments and current challenges. Philos Trans R Soc Lond B Biol Sci. 1996; 351:1515–1527.

8. Cohen JD, Barch DM, Carter C, Servan-Schreiber D. Context-processing deficits in schizophrenia: converging evidence from three theoretically motivated cognitive tasks. J Abnorm Psychol. 1999; 108:120–133.

9. Minzenberg MJ, Laird AR, Thelen S, Carter CS, Glahn DC. Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia. Arch Gen Psychiatry. 2009; 66:811–822.

10. Richard AE, Carter CS, Cohen JD, Cho RY. Persistence, diagnostic specificity and genetic liability for context-processing deficits in schizophrenia. Schizophr Res. 2013; 147:75–80.

11. Rotaru DC, Lewis DA, Gonzalez-Burgos G. The role of glutamatergic inputs onto parvalbumin-positive interneurons: relevance for schizophrenia. Rev Neurosci. 2012; 23:97–109.

12. MacDonald AW 3rd, Pogue-Geile MF, Johnson MK, Carter CS. A specific deficit in context processing in the unaffected siblings of patients with schizophrenia. Arch Gen Psychiatry. 2003; 60:57–65.

13. Docherty NM, Gordinier SW. Immediate memory, attention and communication disturbances in schizophrenia patients and their relatives. Psychol Med. 1999; 29:189–197.

14. Chkonia E, Roinishvili M, Herzog MH, Brand A. First-order relatives of schizophrenic patients are not impaired in the Continuous Performance Test. J Clin Exp Neuropsychol. 2010; 32:481–486.

15. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;1994.

16. Leucht S, Kane JM, Kissling W, Hamann J, Etschel E, Engel R. Clinical implications of Brief Psychiatric Rating Scale scores. Br J Psychiatry. 2005; 187:366–371.

17. Ahn YM, Lee KY, Yi JS, Kang MH, Kim DH, Kim JL, et al. A validation study of the Korean-version of the Montgomery-Asberg Depression Rating Scale. J Korean Neuropsychiatr Assoc. 2005; 44:466–476.

18. Hahn OS, Ahn JH, Song SH, Cho MJ, Kim JK, Bae JN, et al. Development of Korean version of Structured Clinical Interview Schedule for DSM-IV Axis I Disorder: interrater reliability. J Korean Neuropsychiatr Assoc. 2000; 39:362–372.

19. Lee YS, Kim ZS. Validity of short forms of the Korean-Wechsler Adult Intelligence Scale. Korean J Clin Psychol. 1995; 14:111–116.

20. Morrison MW, Gregory RJ, Paul JJ. Reliability of the Finger Tapping Test and a note on sex differences. Percept Mot Skills. 1979; 48:139–142.

21. Servan-Schreiber D, Cohen JD, Steingard S. Schizophrenic deficits in the processing of context. A test of a theoretical model. Arch Gen Psychiatry. 1996; 53:1105–1112.

22. Braver TS, Barch DM. A theory of cognitive control, aging cognition, and neuromodulation. Neurosci Biobehav Rev. 2002; 26:809–817.

23. Ophir E, Nass C, Wagner AD. Cognitive control in media multitaskers. Proc Natl Acad Sci U S A. 2009; 106:15583–15587.

24. Cohen RM, Semple WE, Gross M, Nordahl TE, DeLisi LE, Holcomb HH, et al. Dysfunction in a prefrontal substrate of sustained attention in schizophrenia. Life Sci. 1987; 40:2031–2039.

25. Barch DM, Braver TS, Nystrom LE, Forman SD, Noll DC, Cohen JD. Dissociating working memory from task difficulty in human prefrontal cortex. Neuropsychologia. 1997; 35:1373–1380.

26. Wang Q, Chan R, Sun J, Yao J, Deng W, Sun X, et al. Reaction time of the Continuous Performance Test is an endophenotypic marker for schizophrenia: a study of first-episode neuroleptic-naive schizophrenia, their non-psychotic first-degree relatives and healthy population controls. Schizophr Res. 2007; 89:293–298.

27. Martínez-Arán A, Vieta E, Colom F, Reinares M, Benabarre A, Gastó C, et al. Cognitive dysfunctions in bipolar disorder: evidence of neuropsychological disturbances. Psychother Psychosom. 2000; 69:2–18.

28. Sitskoorn MM, Aleman A, Ebisch SJ, Appels MC, Kahn RS. Cognitive deficits in relatives of patients with schizophrenia: a meta-analysis. Schizophr Res. 2004; 71:285–295.

29. Snitz BE, Macdonald AW 3rd, Carter CS. Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophr Bull. 2006; 32:179–194.

30. Kim D, Kim JW, Koo TH, Yun HR, Won SH. Shared and distinct neurocognitive endophenotypes of schizophrenia and psychotic bipolar disorder. Clin Psychopharmacol Neurosci. 2015; 13:94–102.

31. Barker MJ, Greenwood KM, Jackson M, Crowe SF. Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis. Arch Clin Neuropsychol. 2004; 19:437–454.