Predictive Role of Fixation Stability for Clinical Stages and Conversion in Schizophrenia and Its Correlation with Cognitive Function.

IF 4.8 1区 医学 Q1 PSYCHIATRY
Yuqing Gu, Yu Li, Lihua Xu, Tianhong Zhang, Huiru Cui, Yanyan Wei, Mengqing Xia, Wenjun Su, Yingying Tang, Xiaochen Tang, Dan Zhang, Xu Liu, Jijun Wang
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Abstract

Background and hypothesis: Given that fixation stability is closely linked to cognition, we investigated fixation stability in patients at different stages of schizophrenia, its relationship with cognitive impairments, and its predictive role for conversion to psychosis.

Study design: Fixation stability was measured by bivariate contour ellipse area (BCEA), and cognition was assessed by the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery for 75 patients with first-episode schizophrenia (FES), 75 patients with clinical high-risk (CHR) syndrome, and 75 healthy controls (HCs). After a 1-year longitudinal study, CHR follow-up outcomes were classified as CHR-converters and CHR-nonconverters. Diagnostic model for clinical stages and prediction model for conversion were constructed using logistic regression and Cox regression, respectively.

Study results: Patients exhibited fixation instability and cognition impairments compared to HC, with impairments increasing from CHR to FES. In CHR, BCEA negatively correlated with Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery scores, but this correlation was absent in FES. Diagnostic model effectively discriminated HC and FES, with an area under the receiver-operating characteristic curve of 0.914. Among 66 CHR followed up for 1 year, 13 have converted to schizophrenia, with a conversion rate of 19.70%. When divided into large and small BCEA groups (33 each), the conversion rate was 27.27% and 12.12%. Conversion prediction model achieved an area under the receiver-operating characteristic curve of 0.708.

Conclusions: Our results indicate that fixation instability worsens with schizophrenia progression, which is associated with cognitive impairments. Additionally, BCEA may serve as a biomarker for predicting conversion to psychosis.

固定稳定性对精神分裂症临床分期和转归的预测作用及其与认知功能的相关性。
背景与假设:鉴于固定稳定性与认知密切相关,我们研究了精神分裂症不同阶段患者的固定稳定性,其与认知障碍的关系,以及其对精神病转化的预测作用。研究设计:对75例首发精神分裂症(FES)患者、75例临床高危综合征(CHR)患者和75例健康对照(hc)患者采用双变量轮廓椭圆面积(BCEA)测量固定稳定性,认知能力采用改善精神分裂症共识认知电池的测量与治疗研究进行评估。经过1年的纵向研究,将CHR随访结果分为chrr转化者和chrr非转化者。采用logistic回归和Cox回归分别建立临床分期诊断模型和转归预测模型。研究结果:与HC相比,患者表现出固定不稳定和认知障碍,从CHR到FES,损伤增加。在CHR中,BCEA与改善精神分裂症共识认知电池评分的测量和治疗研究负相关,但在FES中不存在这种相关性。诊断模型能有效区分HC和FES,受者-工作特征曲线下面积为0.914。66例随访1年的CHR中,13例转化为精神分裂症,转复率为19.70%。将其分成大、小两组(各33个),转化率分别为27.27%和12.12%。转换预测模型实现了接收机-工作特性曲线下面积为0.708。结论:我们的研究结果表明,固定不稳定性随着精神分裂症的进展而恶化,这与认知障碍有关。此外,BCEA可以作为预测转化为精神病的生物标志物。
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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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