Pharmacological Treatment of Cognitive Impairment Associated With Schizophrenia: State of the Art and Future Perspectives

Schizophrenia Bulletin Open, Год журнала: 2024, Номер 5(1)

Опубликована: Янв. 1, 2024

Abstract Cognitive Impairment Associated with Schizophrenia (CIAS) represents one of the core dimensions Spectrum Disorders (SSD), an important negative impact on real-world functional outcomes people living SSD. Treatment CIAS a therapeutic goal considerable importance, and while cognition-oriented evidence-based psychosocial interventions are available, effective pharmacological treatment could represent game-changer in lives The present critical review reports discusses evidence regarding effects several agents that available clinical practice or under study, commenting both current future perspectives treatment. In particular, antipsychotic medications, anticholinergic benzodiazepines, which currently commonly used SSD, iclepertin, d-serine, luvadaxistat, xanomeline-trospium, ulotaront, anti-inflammatory molecules, oxytocin, undergoing regulatory trials can be considered as experimental agents, will reported discussed. Currently, do not appear to provide substantial benefits CIAS, but accurate management medications avoiding treatments further exacerbate strategies. Some molecules being investigated Phase 2 3 have provided very promising preliminary results, more information is required assess their effectiveness contexts clear recommendations use practice. results ongoing studies reveal whether any these awaited CIAS.

Язык: Английский

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Attenuated Psychosis Syndrome: Keeping up with Advances in the Field

Asian Journal of Psychiatry, Год журнала: 2024, Номер 100, С. 104223 - 104223

Опубликована: Сен. 4, 2024

Язык: Английский

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Acceptance and Commitment Therapy for Psychosis

Опубликована: Дек. 13, 2024

Acceptance and Commitment Therapy (ACT) is a third-wave cognitive-behavioral therapy which focuses on acceptance, mindfulness values-based actions to support living rich meaningful life. ACT has been successfully applied recovery from psychosis across multiple contexts. This paper provides an overview of for psychosis, followed by outline how effectively adapt individuals experiencing including various practical clinical tips practitioners. Finally, the research literature supporting efficacy presented, consideration next steps in innovations.

Язык: Английский

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The Balance in the Head: How Developmental Factors Explain Relationships Between Brain Asymmetries and Mental Diseases

Brain Sciences, Год журнала: 2025, Номер 15(2), С. 169 - 169

Опубликована: Фев. 9, 2025

Cerebral lateralisation is a core organising principle of the brain that characterised by complex pattern hemispheric specialisations and interhemispheric interactions. In various mental disorders, functional and/or structural asymmetries are changed compared to healthy controls, these alterations may contribute primary symptoms cognitive impairments specific disorder. Since multiple genetic epigenetic factors influence both pathogenesis illness development asymmetries, it likely neural developmental pathways overlap or even causally intertwined, although timing, magnitude, direction interactions vary depending on However, underlying steps neuronal mechanisms still unclear. this review article, we briefly summarise what know about structural, functional, relationships outline hypothetical connections, which could be investigated in appropriate animal models. Altered cerebral features disorder, as trigger neuropathogenesis embedded asymmetrical organisation developing brain. Therefore, occurrence severity processing cognition probably cannot understood independently lateralised intra- networks. Conversely, impaired cellular processes can also hinder favourable asymmetry lead deficits particular.

Язык: Английский

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The New Horizon of Antipsychotics beyond the Classic Dopaminergic Hypothesis—The Case of the Xanomeline–Trospium Combination: A Systematic Review

Pharmaceuticals, Год журнала: 2024, Номер 17(5), С. 610 - 610

Опубликована: Май 9, 2024

Although the dopamine hypothesis of schizophrenia explains effects all available antipsychotics in clinical use, there is an increasing need for developing new drugs treatment positive, negative, and cognitive symptoms chronic psychoses. Xanomeline–trospium (KarXT) a drug combination that based on essential role played by acetylcholine regulation processes interactions between this neurotransmitter other signaling pathways central nervous system, with potential onset schizophrenia, Alzheimer’s disease, substance use disorders. A systematic literature review included four electronic databases (PubMed, Cochrane, Clarivate/Web Science, Google Scholar) US National Library Medicine database trials detected twenty-one sources referring to fourteen studies focused KarXT, out which only have results. Based results these trials, short-term efficacy tolerability xanomeline–trospium are good, but more data needed before may be recommended use. However, theoretical level, exploration KarXT useful interest researchers finding new, non-dopaminergic, could used either as monotherapy or add-on drugs.

Язык: Английский

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Developmental perspectives on the origins of psychotic disorders: The need for a transdiagnostic approach

Development and Psychopathology, Год журнала: 2024, Номер unknown, С. 1 - 11

Опубликована: Фев. 26, 2024

Research on serious mental disorders, particularly psychosis, has revealed highly variable symptom profiles and developmental trajectories prior to illness-onset. As Dante Cicchetti pointed out decades before the term "transdiagnostic" was widely used, pathways psychopathology emerge in a system involving equifinality multifinality. Like most other psychological psychosis is associated with multiple domains of risk factors, both genetic environmental, there are many transdiagnostic that can lead psychotic syndromes. In this article, we discuss our current understanding heterogeneity etiology its implications for approaches conceptualizing research. We highlight need examining factors at levels increase emphasis as key etiologic subtypes. This will be increasingly feasible now large, longitudinal datasets becoming available researchers have access more sophisticated analytic tools, such machine learning, which identify homogenous subtypes ultimate goal enhancing options treatment preventive intervention.

Язык: Английский

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Cognitive presentation at psychosis onset through premorbid deterioration and exposure to environmental risk factors

Psychological Medicine, Год журнала: 2025, Номер 55

Опубликована: Янв. 1, 2025

Abstract Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range socio-environmental risk factors associated with FEP, aiming a) to compare FEP community controls using the Maudsley Environmental Risk Score for (ERS), weighted sum following risks: paternal age, childhood adversities, cannabis use, ethnic minority membership; b) explore putative differences in specific environmental distinguishing within patient from controls. Methods A univariable general linear model (GLS) compared ERS between 1,263 derived 802 patients, namely, low (n = 223) high-cognitive-functioning 205), intermediate 224) deteriorating 150), EU-GEI study. multivariable GLS by different exposures included ERS. Results The was higher all controls, mostly ( β =2.8, 95% CI 2.3 3.4 , η 2 0.049) low-cognitive-functioning cluster =2.4, 1.9 2.8, distinguished them high-cognitive-functioning. had exposure (mean difference 0.48, 0.49 0.91) than having identical IQ, more people an 0.77, 0.24 1.29) cluster. Conclusions High might result cognitive impairment lower-than-expected functioning individuals at onset psychosis. Some patients’ trajectories involved that could be modified tailored interventions.

Язык: Английский

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Exposotypes in Psychotic Disorders

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Фев. 18, 2025

Abstract Psychiatry lags in adopting etiological approaches to diagnosis, prognosis, and outcome prediction compared the rest of medicine. Etiological factors such as childhood trauma (CHT), substance use (SU), socioeconomic status (SES) significantly affect psychotic disorder symptoms. This study applied an agnostic clustering approach identify exposome clusters “Exposotypes (ETs)” examine their relationship with clinical, cognitive, functional outcomes. Using data from individuals disorders (n=1,350), controls (n=623), we assessed between exposotypes Four were identified: ET1 characterized by high CHT SU; ET2, CHT; ET3, ET4, low exposure. Compared demonstrated higher positive general symptoms, anxiety, depression, impulsivity, mania; ET2 had impulsivity; ET3 better cognitive outcomes lower negative Intracranial volume was largest smallest ET2. No group differences schizophrenia polygenic risk scores found. The age onset 5 years earlier than ET4. These findings provide insight into complex interplay trauma, SU, well unique effects on clinical cognition, neurobiology, genetic risk, functioning.

Язык: Английский

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Impact of Relapse in BDNF Receptors Expression in Patients With a First Episode of Schizophrenia

Schizophrenia Bulletin, Год журнала: 2025, Номер unknown

Опубликована: Фев. 20, 2025

Relapsing after a first episode of schizophrenia (FES) is main predictor clinical and functional prognosis. Brain-derived neurotrophic factor (BDNF) plays critical role in neuronal development plasticity, its signaling may be altered by successive relapses. We assessed the impact relapse expression 2 isoforms BDNF tropomyosin-related kinase B (TrkB) receptor (active full-length TrkB-F inactive truncated TrkB-T) peripheral blood mononuclear cells from 53 FES patients remission followed up for 3 years. The group participants that relapsed (n = 24) during follow-up presented significant decrease active compared to baseline (M 100 ± 28.13 vs. M 83.42 33.84, t 2.5, P .02), with no changes TrkB-T nor plasma levels. This also led decline F/T ratio 1.13 0.38 0.94 0.36, 2.17, .041). No differences were found receptors' levels cases remained 29). These results not associated between groups terms pathway biomarkers, or treatment variables. findings highlight biological produces over systemic BDNF-TrkB pathway, potentially undermining crucial functions. Identifying actors involved can help design specific interventions prevention improve prognosis people early stages schizophrenia.

Язык: Английский

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Proposal for a Novel Classification of Patients With Enlarged Ventricles and Cognitive Impairment Based on Data‐Driven Analysis of Neuroimaging Results in Patients With Psychiatric Disorders

Neuropsychopharmacology Reports, Год журнала: 2025, Номер 45(1)

Опубликована: Фев. 26, 2025

ABSTRACT One of the challenges in diagnosing psychiatric disorders is that results biological and neuroscience research are not reflected diagnostic criteria. Thus, data‐driven analyses incorporating cross‐disease perspectives, regardless category, have recently been proposed. A clustering study based on subcortical volumes 5604 subjects classified into four brain biotypes associated with cognitive/social functioning. Among identified controls patients schizophrenia, bipolar disorder, major depressive autism spectrum other disorders, we further analyzed biotype 1 subjects, those an extremely small limbic region, for clinical utility. We found representative feature enlarged lateral ventricles. An ventricle, defined by average z ‐score left right ventricle > 3, had a sensitivity 99.1% specificity 98.1% discriminating 1. However, presence was sufficient to classify patient subgroups, as 1% also Reclassification ventricles according cognitive impairment resulted stratified subgroup included high proportion schizophrenia diagnoses, electroencephalography abnormalities, rare pathological genetic copy number variations. Data‐driven analysis neuroimaging data revealed subgroups impairment. This could be new candidate disorders. concept strategy may useful identifying biologically future.

Язык: Английский

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