Schizophrenia (Heidelberg, Germany)最新文献

{"title":"Cell-type specific reductions in interneuron gene expression within the cingulate gyrus of schizophrenia and bipolar disorder subjects.","authors":"David M Krolewski, Huzefa Khalil, Maria Waselus, Marquis P Vawter, Blynn G Bunney, Richard M Myers, Francis S Y Lee, Alan F Schatzberg, William E Bunney, Huda Akil, Stanley J Watson","doi":"10.1038/s41537-025-00638-6","DOIUrl":"https://doi.org/10.1038/s41537-025-00638-6","url":null,"abstract":"<p><p>Schizophrenia (SZ) and bipolar disorder (BP) patients share overlapping neurocognitive deficits of varied magnitude. Neuroimaging in patients and postmortem gene expression analyses suggest that compromised cingulate gyrus GABA-ergic interneurons may contribute to cognitive impairments in SZ and BP. To address this, we used radioactive in situ hybridization to investigate potential gene expression signatures for SZ and BP using interneuron cell-type specific markers including glutamic acid decarboxylase (GAD67), parvalbumin (PV), somatostatin (SST), and vasoactive intestinal peptide (VIP) within specific Brodmann's areas (BA) of the cingulate gyrus. We report reduced GAD67 mRNA in anterior midcingulate cortex (aMCC) of BP subjects within BA24c', the most dysregulated subregion across disorders that also demonstrated reduced PV and VIP mRNA in the SZ group. In the retrosplenial (RSC) and ectosplenial (ESC) cortices, decreases in PV expression were shared by both SZ and BP subjects. Our results show unique and shared transcription signatures of two disorders in specific cingulate gyrus regions and cell types. SZ and BP displayed divergent aMCC gene expression reductions suggesting transcriptional changes are associated with disease-specific gene/subregion signatures, potentially underlying differential subregional dysregulation within areas associated with error detection/action monitoring and the salience network. In RSC/ESC, transcriptional changes are associated with more common expression patterns, possibly related to overlapping effects on visuospatial memory processing and allocation of attentional resources involving the default mode network.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"91"},"PeriodicalIF":3.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vivo assessment of GABAergic inhibition and glutamate facilitation in treatment-resistant schizophrenia: a TMS study integrating clinical, cognitive, and neurophysiological evaluations.","authors":"Annarita Barone, Gianmaria Senerchia, Giuseppe De Simone, Marco Manzo, Mariateresa Ciccarelli, Stefano Tozza, Valentina Virginia Iuzzolino, Myriam Spisto, Raffaele Dubbioso, Felice Iasevoli, Rosa Iodice, Andrea de Bartolomeis","doi":"10.1038/s41537-025-00634-w","DOIUrl":"10.1038/s41537-025-00634-w","url":null,"abstract":"<p><p>Treatment-resistant schizophrenia (TRS) affects approximately one-third of individuals with schizophrenia, posing significant challenges for clinical management. Clozapine treatment is often delayed, underscoring the urgent need for an early potential signature of TRS. To date, specific alterations in cortical excitability and plasticity underlying TRS remain unexplored. We evaluated cortical excitability and plasticity in 30 patients with schizophrenia (15 TRS, 15 non-TRS) and 21 controls using transcranial magnetic stimulation (TMS). Measures included motor thresholds and protocols probing GABAergic inhibition and glutamatergic facilitatory activity, the excitation index (EI) in the primary motor cortex (M1), and long-term potentiation (LTP)-like plasticity using intermittent theta burst stimulation (iTBS). Clinical severity and cognitive performance were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Brief Assessment of Cognition in Schizophrenia (BACS). TRS patients exhibited significantly higher active motor thresholds (p = 0.015) and impaired short-interval intracortical inhibition (SICI) (p = 0.001) vs healthy controls, reflecting GABAergic dysfunction. EI was elevated in TRS vs non-TRS patients (p = 0.034) and controls (p = 0.002), indicating pronounced cortical hyperexcitability. Both TRS (p = 0.008) and non-TRS patients (p = 0.033) showed reduced plasticity following iTBS compared to controls, with no TRS vs non-TRS difference. SICI deficits significantly correlated with negative (r = 0.524, p_adj = 0.03) and autistic (r = 0.517, p_adj = 0.03) symptom severity as assessed by the PANSS negative score and Positive and Negative Syndrome Scale Autism Severity Score (PAUSS). Our findings point to a neurophysiological continuum in schizophrenia, with TRS patients demonstrating the most pronounced cortical hyperexcitability and impaired plasticity, and non-TRS patients showing intermediate deficits.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"90"},"PeriodicalIF":3.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White matter abnormalities of the frontal-striatal-thalamic circuit in individuals with attenuated positive symptom syndromes: a probabilistic tractography study.","authors":"Zhenzhu Chen, Qijing Bo, Lei Zhao, Yushen Ding, Yimeng Wang, Qitong Jiang, Feng Li, Yuan Zhou, Chuanyue Wang","doi":"10.1038/s41537-025-00635-9","DOIUrl":"10.1038/s41537-025-00635-9","url":null,"abstract":"<p><p>Attenuated positive symptoms syndrome (APSS) is a risk state preceding psychosis, and its early identification is key to early intervention. Previous studies have suggested that disturbances in the frontal-striatal-thalamic (FST) circuit may play a role in the neuropathology of APSS. However, the evidence regarding white matter structure remains fragmented. This study aimed to systematically investigate white matter (WM) alterations within the FST circuits in individuals with APSS. Diffusion magnetic resonance imaging (dMRI) and T1-weighted images were acquired from 43 individuals with APSS and 50 healthy controls (HCs). The dMRI data were preprocessed using FMRIB Software Library software. The Brainnetome Atlas was utilized to extract regions of interest (ROIs) in the frontal lobe, striatum, and thalamus. Bidirectional probabilistic tractography was performed to construct the FST circuit. The connection probability (CP) and diffusion index values were compared between the APSS and HC groups using the two-sample t test. Compared to HCs, individuals with APSS exhibited significantly lower CP values in right orbital gyrus_area 13- right nucleus accumbens (OrG_A13-NAC) fiber tract; higher mean diffusivity values in the left OrG_A13-NAC and left ventral caudate-left caudal temporal thalamus (vCa-cTtha) fiber tracts; higher radial diffusivity values in the right OrG_A13-NAC fiber tract; and higher axial diffusivity values in multiple frontal lobe ROI-striatum ROI and striatum ROI-thalamus ROI fiber tracts. Overall, individuals with APSS demonstrated white matter microstructural abnormalities, especially in the OrG_A13-NAC fiber tracts. These alterations may contribute to our understanding on the neuropathology of APSS.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"89"},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular protein profiling in patients with first-episode psychosis.","authors":"Anna Malmqvist, Feride Eren, Lilly Schwieler, Funda Orhan, Helena Fatouros-Bergman, Lena Flyckt, Fredrik Piehl, Simon Cervenka, Magnus Bäck, Carl M Sellgren, Göran Engberg, Sophie Erhardt","doi":"10.1038/s41537-025-00633-x","DOIUrl":"10.1038/s41537-025-00633-x","url":null,"abstract":"<p><p>Patients with schizophrenia have a threefold higher mortality from cardiovascular disease than people in the general population. Atherosclerosis is linked to immune activation, a process tentatively entwined with the underlying pathophysiological mechanisms of schizophrenia. The aim of the present study was to investigate an extensive array of cardiovascular biomarkers in individuals experiencing their first episode of psychosis (FEP), either drug-naïve or exposed to short-term antipsychotic treatment, alongside a group of healthy controls (HC). Using the OLINK Proximity Extension Assay, Cardiovascular II Panel, we analyzed plasma from 72 FEP patients, including 42 later diagnosed with schizophrenia and 54 HCs. Biomarker levels, that significantly differed between patients and controls, were correlated with symptom severity, cognitive performance and cardiovascular risk factors. Fifteen out of 92 cardiovascular biomarkers were higher in individuals with FEP compared to HC, and one biomarker was lower in FEP patients compared to HC. BMI, waist size, blood pressure, fp-glucose, HbA1c and serum lipid levels were similar between the groups. No correlations that held for multiple comparisons were seen between biomarker concentrations and symptom severity, cognitive performance or cardiovascular risk factors in FEP patients. Higher concentrations of several cardiovascular biomarkers were observed in individuals with FEP compared to in HC. This suggests that patients with FEP are at an increased risk of developing cardiovascular disease from the onset of psychosis, even before changes in traditional biomarkers are detectable. It underscores the need for innovative approaches to detect and monitor this risk early.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"88"},"PeriodicalIF":3.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromodulation in the treatment of social cognition dysfunction in Schizophrenia: a systematic review.","authors":"Marta Moura Neves, Fabiana Ventura, Nuno Madeira","doi":"10.1038/s41537-025-00629-7","DOIUrl":"10.1038/s41537-025-00629-7","url":null,"abstract":"<p><strong>Background: </strong>Deficits in social cognition are significant barriers to functional living for individuals with schizophrenia. Although these symptoms have garnered increasing research attention, an effective treatment remains elusive. This systematic review evaluates the use of neuromodulation techniques in treating social cognition deficits in schizophrenia.</p><p><strong>Methods: </strong>We conducted a literature search in MEDLINE/PubMed, Web of Science, The Cochrane Library, and Embase databases, adhering to PRISMA guidelines. We included randomized, sham-controlled trials, non-controlled and/or open-label trials that assessed the efficacy of neuromodulation in patients diagnosed with schizophrenia (as per the DSM-III or later editions, or ICD equivalents), aged over 18 years.</p><p><strong>Results: </strong>Thirteen papers (1 on ECT, 4 on rTMS, and 8 on tES), including 11 RCTs, met the inclusion criteria. Seven of the thirteen analyzed studies indicated improvements in certain domains of social cognition associated with neuromodulation treatments.</p><p><strong>Conclusions: </strong>Neuromodulation techniques improved some domains of social cognition in individuals with schizophrenia. Further research is required to develop robust treatment protocols with proven efficacy in improving social cognition.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"87"},"PeriodicalIF":3.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional mimicry and smiling behaviors in schizophrenia: An ecological approach.","authors":"Mathilde Parisi, Stéphane Raffard, Tifenn Fauviaux, Victor Vattier, Dorra Mrabet, Delphine Capdevielle, Ludovic Marin","doi":"10.1038/s41537-025-00632-y","DOIUrl":"10.1038/s41537-025-00632-y","url":null,"abstract":"<p><p>Individuals with schizophrenia often experience social skill deficits, leading to reduced social interaction quality. Emotional mimicry, the automatic imitation of a counterpart's expression, plays a crucial role in social interactions. This study introduces a novel methodology for assessing positive emotional mimicry during a naturalistic conversation. We recruited interacting partners (n = 20), each engaging in two interactions: one with an individual diagnosed with schizophrenia (n = 20) and one with a matched healthy control (n = 20). Participants were video recorded while taking turns sharing happy personal memories during six minutes. Using OpenFace, we detected participants' emotional expressions and computed mimicry scores based on their temporal alignment. Consistent with our hypotheses, individuals with schizophrenia exhibited reduced smiling and positive emotion mimicry. Furthermore, interacting partners reported lower willingness to continue interacting with individuals with schizophrenia compared to healthy controls. This study stands out for its innovative methodology, assessing a key social skill in an ecological setting. Our findings highlight the potential of emotional mimicry training as an important intervention to improve social interaction in schizophrenia.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"86"},"PeriodicalIF":3.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The electroencephalography protocol for the Accelerating Medicines Partnership® Schizophrenia Program: Reliability and stability of measures.","authors":"Daniel H Mathalon, Spero Nicholas, Brian J Roach, Tashrif Billah, Suzie Lavoie, Thomas Whitford, Holly K Hamilton, Lauren Addamo, Andrey Anohkin, Tristan Bekinschtein, Aysenil Belger, Kate Buccilli, John Cahill, Ricardo E Carrión, Stefano Damiani, Ilvana Dzafic, Bjørn H Ebdrup, Igor Izyurov, Johanna Jarcho, Raoul Jenni, Anna Jo, Sarah Kerins, Clarice Lee, Elizabeth A Martin, Rocio Mayol-Troncoso, Margaret A Niznikiewicz, Muhammad Parvaz, Oliver Pogarell, Julio Prieto-Montalvo, Rachel Rabin, David R Roalf, Jack Rogers, Dean F Salisbury, Riaz Shaik, Stewart Shankman, Michael C Stevens, Yi Nam Suen, Nicole C Swann, Xiaochen Tang, Judy L Thompson, Ivy Tso, Julian Wenzel, Juan Helen Zhou, Jean Addington, Luis Alameda, Celso Arango, Nicholas J K Breitborde, Matthew R Broome, Kristin S Cadenhead, Monica E Calkins, Rolando I Castillo-Passi, Eric Yu Hai Chen, Jimmy Choi, Philippe Conus, Cheryl M Corcoran, Barbara A Cornblatt, Covadonga M Diaz-Caneja, Lauren M Ellman, Paolo Fusar-Poli, Pablo A Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E Horton, Christy Lai Ming Hui, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Matcheri S Keshavan, Minah Kim, Sung-Wan Kim, Nikolaos Koutsouleris, Jun Soo Kwon, Kerstin Langbein, Daniel Mamah, Vijay A Mittal, Merete Nordentoft, Godfrey D Pearlson, Jesus Perez, Diana O Perkins, Albert R Powers, Fred W Sabb, Jason Schiffman, Jai L Shah, Steven M Silverstein, Stefan Smesny, William S Stone, Gregory P Strauss, Rachel Upthegrove, Swapna K Verma, Jijun Wang, Daniel H Wolf, Tianhong Zhang, Sylvain Bouix, Ofer Pasternak, Kang-Ik K Cho, Michael J Coleman, Dominic Dwyer, Angela Nunez, Zailyn Tamayo, Stephen J Wood, Rene S Kahn, John M Kane, Patrick D McGorry, Carrie E Bearden, Barnaby Nelson, Scott W Woods, Martha E Shenton, Gregory A Light","doi":"10.1038/s41537-025-00622-0","DOIUrl":"10.1038/s41537-025-00622-0","url":null,"abstract":"<p><p>Individuals at clinical high risk for psychosis (CHR) have variable clinical outcomes and low conversion rates, limiting development of novel and personalized treatments. Moreover, given risks of antipsychotic drugs, safer effective medications for CHR individuals are needed. The Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) Program was launched to address this need. Based on past CHR and schizophrenia studies, AMP SCZ assessed electroencephalography (EEG)-based event-related potential (ERP), event-related oscillation (ERO), and resting EEG power spectral density (PSD) measures, including mismatch negativity (MMN), auditory and visual P300 to target (P3b) and novel (P3a) stimuli, 40-Hz auditory steady state response, and resting EEG PSD for traditional frequency bands (eyes open/closed). Here, in an interim analysis of AMP SCZ EEG measures, we assess test-retest reliability and stability over sessions (baseline, month-2 follow-up) in CHR (n = 654) and community control (CON; n = 87) participants. Reliability was calculated as Generalizability (G)-coefficients, and changes over session were assessed with paired t-tests. G-coefficients were generally good to excellent in both groups (CHR: mean = 0.72, range = 0.49-0.85; CON: mean = 0.71, range = 0.44-0.89). Measure magnitudes significantly (p < 0.001) decreased over session (MMN, auditory and visual target P3b, visual novel P3a, 40-Hz ASSR) and/or over runs within sessions (MMN, auditory/visual novel P3a and target P3b), consistent with habituation effects. Despite these small systematic habituation effects, test-retest reliabilities of the AMP SCZ EEG-based measures are sufficiently strong to support their use in CHR studies as potential predictors of clinical outcomes, markers of illness progression, and/or target engagement or secondary outcome measures in controlled clinical trials.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"85"},"PeriodicalIF":3.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing social cognition in psychosis - the potential role of open dialogue.","authors":"Maria Gariup, Tomi Bergström, Katharina Saliger, Justin M Palanci, Robert O Cotes, Joseph B Stoklosa, Jaakko Seikkula","doi":"10.1038/s41537-025-00608-y","DOIUrl":"10.1038/s41537-025-00608-y","url":null,"abstract":"","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"84"},"PeriodicalIF":3.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health technologies in the accelerating medicines Partnership® Schizophrenia Program.","authors":"Johanna T W Wigman, Ann Ee Ching, Yoonho Chung, Habiballah Rahimi Eichi, Erlend Lane, Carsten Langholm, Aditya Vaidyam, Andrew Jin Soo Byun, Anastasia Haidar, Jessica Hartmann, Angela Nunez, Dominic Dwyer, Adibah Amani Nasarudin, Owen Borders, Isabelle Scott, Zailyn Tamayo, Priya Matneja, Kang-Ik Cho, Jean Addington, Luis K Alameda, Celso Arango, Nicholas J K Breitborde, Matthew R Broome, Kristin S Cadenhead, Monica E Calkins, Eric Yu Hai Chen, Jimmy Choi, Philippe Conus, Cheryl M Corcoran, Barbara A Cornblatt, Covadonga M Diaz-Caneja, Lauren M Ellman, Paolo Fusar-Poli, Pablo A Gaspar, Carla Gerber, Louise Birkedal Glenthøj, Leslie E Horton, Christy Lai Ming Hui, Joseph Kambeitz, Lana Kambeitz-Ilankovic, Matcheri S Keshavan, Sung-Wan Kim, Nikolaos Koutsouleris, Kerstin Langbein, Daniel Mamah, Daniel H Mathalon, Vijay A Mittal, Merete Nordentoft, Godfrey D Pearlson, Jesus Perez, Diana O Perkins, Albert R Powers, Jack Rogers, Fred W Sabb, Jason Schiffman, Jai L Shah, Steven M Silverstein, Stefan Smesny, Walid Yassin, William S Stone, Gregory P Strauss, Judy L Thompson, Rachel Upthegrove, Swapna Verma, Jijun Wang, Daniel H Wolf, Phillip Wolff, Laura M Rowland, Simon D'Alfonso, Ofer Pasternak, Sylvain Bouix, Patrick D McGorry, Rene S Kahn, John M Kane, Carrie E Bearden, Scott W Woods, Martha E Shenton, Barnaby Nelson, Justin T Baker, John Torous","doi":"10.1038/s41537-025-00599-w","DOIUrl":"10.1038/s41537-025-00599-w","url":null,"abstract":"<p><p>Although meta-analytic studies have shown that 25-33% of those at Clinical High Risk (CHR) for psychosis transition to a first episode of psychosis within three years, less is known about estimating the risk of transition at an individual level. Digital phenotyping offers a novel approach to explore the nature of CHR and may help to improve personalized risk prediction. Specifically, digital data enable detailed mapping of experiences, moods and behaviors during longer periods of time (e.g., weeks, months) and offer more insight into patterns over time at the individual level across their routine daily life. However, while novel digital health technologies open up many new avenues of research, they also come with specific challenges, including replicability of results and the adherence of participants. This paper outlines the design of the digital component of the Accelerating Medicines Partnership® Schizophrenia Program (AMP SCZ) project, a large international collaborative project that follows individuals at CHR for psychosis over a period of two years. The digital component comprises one-year smartphone-based digital phenotyping and actigraphy. Smartphone-based digital phenotyping includes 30-item short daily self-report surveys and voice diaries as well as passive data capture (geolocation, on/off screen state, and accelerometer). Actigraphy data are collected via an Axivity wristwatch. The aim of this paper is to describe the design and the three goals of the digital measures used in AMP SCZ to: (i) better understand the symptoms, real-life experiences, and behaviors of those at CHR for psychosis, (ii) improve the prediction of transition to psychosis and other health outcomes in this population based on digital phenotyping and, (iii) serve as an example for replicable and ethical research across geographically diverse regions and cultures. Accordingly, we describe the rationale, protocol and implementation of these digital components of the AMP SCZ project. **Link to video interview: https://vimeo.com/1060935583 *.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"83"},"PeriodicalIF":3.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12134270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare resource utilization burden associated with cognitive impairments identified through natural language processing among patients with schizophrenia in the United States.","authors":"Jerome Vaccaro, Mona Nili, Pin Xiang, James K Nelson, Cory Pack, Randall Thompson, Joe Vasey, Joseph Parks","doi":"10.1038/s41537-025-00628-8","DOIUrl":"10.1038/s41537-025-00628-8","url":null,"abstract":"<p><p>While cognitive impairments in schizophrenia are well documented in research, their identification and impact in clinical practice remain less well understood, despite their association with high patient burden and impact on long-term functional outcomes. In this study we aimed to identify documented cognitive impairments using natural language processing (NLP) and to characterize treatment patterns and healthcare resource utilization (HCRU) among patients with schizophrenia. This US retrospective cohort study used electronic health records (EHR) linked to administrative claims data from January 2016 through February 2023. Adult patients (≥18 years) with at least two schizophrenia diagnosis codes were included. Cognitive impairments were identified by NLP. Patient characteristics were assessed in the 12 months preceding the index date (first documented schizophrenia diagnosis). Treatment patterns and HCRU were measured over the 12 months after index date. A total of 79,326 patients were enrolled in the EHR cohort and 19,974 (25.2%) had documented cognitive impairments. Impairments in \"Reasoning and Problem Solving\" were identified most often (70.4%) followed by \"Working Memory\" (27.1%) and \"Attention and Vigilance\" (19.2%). In the EHR cohort, 11,293 patients (14.2%) had linked claims. Patients with documented cognitive impairments had more HCRU including outpatient visits, psychosocial interventions, and all-cause healthcare claims than patients without documented cognitive impairments (all p < 0.001). Patients with cognitive impairments had greater psychiatric pharmacy utilization than those without cognitive impairments. These observational data add to the limited published literature on cognitive impairments in patients with schizophrenia in the US. The low documented identification of cognitive impairments in this study underscores the importance of improving recognition and documentation of this important domain of schizophrenia. The association of cognitive impairments with high healthcare utilization further emphasizes the need for better treatment options for patients with schizophrenia.</p>","PeriodicalId":74758,"journal":{"name":"Schizophrenia (Heidelberg, Germany)","volume":"11 1","pages":"82"},"PeriodicalIF":3.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}