verbal learning and memory in at-risk mental state and first episode psychosis patients and their...

*04.04.2017University of Basel Psychiatric Hospital | www.upkbs.ch |

Verbal Learning and Memory in At-risk Mental State and First Episode Psychosis Patients and their Brain Structural Correlates

Laura Egloff, MScDepartment of Psychiatry

Faculty Disclosure

Company Name Honoraria/Expenses

Consulting/ Advisory Board

Funded Research

Royalties/ Patent

Stock Options

Ownership/ Equity

PositionEmployee Other

(please specify)

X No, nothing to disclose Yes, please specify:


BRAIN VOLUMETRIC ALTERATIONS

› Patients with a first episode psychosis (FEP) have repeatedly been shown to have brain structural alterations such as in

whole brain volume white matter (WM) and gray matter (GM) volume

› including a large number of regions such as anterior cingulate superior temporal gyrus cerebellum insula and hippocampus

› Some of these neuroanatomical abnormalities are already evident in the ARMS for psychosis, including GM volume reductions of

prefrontal temporal and cingulate cortices parahippocampal gyrus and hippocampus insula and caudate

INTRODUCTION


DATA COLLECTION

› Data were collected within the prospective Früherkennung von Psychosen (FePsy) study, which aims to improve the early detection of psychosis.

› VLM were assessed using the California Verbal Learning Test 2 word lists each containing 16 words List A is orally presented over five immediate-recall trials An interference list (List B) is then presented for one immediate recall trial

followed by short- and long-delay free- and cued-recall and recognition test of List A

› Structural images were acquired using a 3 Tesla magnetic resonance imaging scanner (Magnetom Verio, Siemens Healthcare, Erlangen, Germany)

12-channel phased-array radio frequency head coil 3D T1-weighted magnetisation prepared rapid gradient echo (MPRAGE) All scans were screened for gross radiological abnormalities by resident

neuroradiologists

METHODS


STATISTICAL ANALYSES

› In order to test CVLT performance as well as their correlations with brain structural alterations between ARMS and FEP patients directly within the structural equation modelling framework, we extended the measurement model of Donders (2008) by regressing the four latent factors Attention Span (AS), Learning Efficiency (LE), Delayed Memory (DM) and Inaccurate Memory (IM) on group, brain structural volume and the interaction between group x brain structural volume.

› The variable group was represented in the model as a dummy-coded contrast variable using the FEP group as the reference group.

› This resulted in a so-called multiple-indicator multiple-causes (MIMIC) model, which not only takes measurement error into account when testing group differences, but can also accommodate factorial non-invariance between groups or so-called differential item functioning.

› To account for multiple testing corrected p-values were calculated separately for the correlational and interaction analyses using the false discovery rate.

METHODS

**Universitäre Psychiatrische Kliniken Basel | www.upkbs.ch |

Not only GM alterations but also neurocognitive impairments predate the onset of frank psychosis

Verbal learning and memory (VLM) are among the most impaired cognitive domains in ARMS and FEP patients and may potentially be useful for the early detection and intervention of the disorder

Although several different brain regions have been found to be associated with VLM performance in ARMS, FEP and schizophrenia patients, results are largely inconclusive

Only few studies have investigated the associations of VLM with subcortical volumes so far, presenting mixed results

Furthermore, a direct comparison of these associations between ARMS and FEP patients is lacking to date

NEUROCOGNITIVE IMPAIRMENTSINTRODUCTION


STATISTICAL ANALYSESMETHODS


› Data from 59 ARMS and 47 FEP patients were analysed

› Structural equation models revealed significant associations between amygdala and AS, LE and IM thalamus and LE and IM caudate, hippocampus and putamen with IM

› However, none of these significant results withstood correction for multiple testing

RESULTS


› Although VLM is among the most impaired cognitive domains in emerging psychosis, we could not demonstrate an association between low performance in this domain and reductions in subcortical GM volumes.

› Our results suggest that deficits in this domain need not necessarily stem from alterations in subcortical structures.

CONCLUSIONS


Laura Egloff, MScPsychologistDepartment of PsychiatryUniversity of Basel Psychiatric Hospital

[email protected]

THANK YOU FOR YOUR ATTENTION

• http://www.upkbs.ch

mailto:[email protected]





verbal learning and memory in at-risk mental state and first episode psychosis patients and their...

Health & Medicine