Approaches to evaluation of neurocognitive profile in patients with residual schizophrenia depending on a history of cerebral stroke
DOI:
https://doi.org/10.14739/2310-1210.2024.5.305172Keywords:
schizophrenia, cerebral stroke, cognitive functions, neurocognitive functions, neuropsychological testingAbstract
Cerebral stroke consequence assessment in patients with residual schizophrenia is a complex clinical scenario questioning both diagnostic and therapeutic strategies.
Aim. To assess the structure of neurocognitive dysfunctions in patients with residual schizophrenia with pronounced negative symptoms depending on a history of cerebral stroke.
Materials and methods. In the period of 2020–2023, a clinical examination of 47 patients of Zaporizhzhia Regional Clinical Psychiatric Hospital and Veselovsky Psychoneurological Boarding School with a diagnosis of residual schizophrenia (ICD-10: F20.5) was carried out. Study groups were formed: G1 – 9 patients with residual schizophrenia and the history of cerebral stroke; G2 – 36 patients with residual schizophrenia without the history of cerebral stroke.
Results. The DSM-5 neurocognitive functioning assessment system was used in the study, based on which a protocol for rapid testing of neurocognitive functions adapted for patients with residual schizophrenia was developed. The group of patients with the history of cerebral stroke has demonstrated lower results in attention allocation (p ≤ 0.05). This group has also shown relatively poor results in planning (p ≤ 0.05), error correction (p ≤ 0.05), inhibition (p ≤ 0.05) and flexibility (p ≤ 0.05). As concerning verbal ability, worse results of expressive speech (p ≤ 0.05), grammar and syntax (p ≤ 0.05) have been revealed in the group of patients with the history of cerebral stroke. In terms of perceptual-motor functions, the gnosis task has been performed worse (p ≤ 0.05) by the group of patients with the history of cerebral stroke. Differences in emotion recognition and theory of mind were insignificant between groups.
Conclusions. An original neurocognitive function assessment protocol adapted for the Ukrainian-speaking patient population with residual schizophrenia has been developed. The patient population with residual schizophrenia and the history of cerebral stroke or without it has been examined with the use of the developed protocol for the assessment of neurocognitive functions. According to the obtained results, patients with residual schizophrenia and the history of cerebral stroke have demonstrated worse cognitive performance compared to those without the history of stroke.
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. 2013. doi: https://doi.org/10.1176/appi.books.9780890425596
Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia?. Am J Psychiatry. 1996;153(3):321-30. doi: https://doi.org/10.1176/ajp.153.3.321
Gupta M, Bassett E, Iftene F, Bowie CR. Functional outcomes in schizophrenia: understanding the competence-performance discrepancy. J Psychiatr Res. 2012;46(2):205-11. doi: https://doi.org/10.1016/j.jpsychires.2011.09.002
Yun DY, Hwang SS, Kim Y, Lee YH, Kim YS, Jung HY. Impairments in executive functioning in patients with remitted and non-remitted schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35(4):1148-54. doi: https://doi.org/10.1016/j.pnpbp.2011.03.018
Safonov DM. Cognitive symptomes associated with antipsychotic course experience in residual schizophrenia. J Educ Health Sport. 2021;11(06):268-74. doi: https://doi.org/10.12775/JEHS.2021.11.06.030
Costa LG, Massuda R, Pedrini M, Passos IC, Czepielewski LS, Brietzke E, et al. Functioning in early and late stages of schizophrenia. Trends Psychiatry Psychother. 2014;36(4):209-13. doi: https://doi.org/10.1590/2237-6089-2014-0028
Hofer A, Bodner T, Kaufmann A, Kemmler G, Mattarei U, Pfaffenberger NM, et al. Symptomatic remission and neurocognitive functioning in patients with schizophrenia. Psychol Med. 2011;41(10):2131-9. doi: https://doi.org/10.1017/S0033291711000353
Darii VI, Safonov DM. Comparison of basic neurocognitive violations in patients with residual schizophrenia with and without history of ischemic stroke. J Educ Health Sport. 2023;47(1):84-94. doi: https://doi.org/10.12775/JEHS.2023.47.01.008
Chuhunov VV, Darii VI, Safonov DM, Horodokin AD. Pharmacogenic and neurologic components of residual condition in schizophrenia. Zaporozhye medical journal. 2022;24(6):710-3. doi: https://doi.org/10.14739/2310-1210.2022.6.259924
Safonov DN. Retrospective analysis of antipsychotic prescription models in correlation with symptoms of residual schizophrenia. Part 1. J Educ Health Sport. 2020;10(8):534-41. doi: https://doi.org/10.12775/JEHS.2020.10.08.065
Buckner RL. Memory and executive function in aging and AD: multiple factors that cause decline and reserve factors that compensate. Neuron. 2004;44(1):195-208. doi: https://doi.org/10.1016/j.neuron.2004.09.006
Folstein MF, Folstein SE, McHugh PR. Mini-Mental State Examination (MMS, MMSE) [Database record]. APA PsycTests. 1975. doi: https://doi.org/10.1037/t07757-000
Jacova C, Kertesz A, Blair M, Fisk JD, Feldman HH. Neuropsychological testing and assessment for dementia. Alzheimers Dement. 2007;3(4):299-317. doi: https://doi.org/10.1016/j.jalz.2007.07.011
Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. Montreal Cognitive Assessment (MoCA) [Database record]. APA PsycTests. 2005. doi: https://doi.org/10.1037/t27279-000
Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, et al. Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004;256(3):240-6. doi: https://doi.org/10.1111/j.1365-2796.2004.01380.x
Planton M, Peiffer S, Albucher JF, Barbeau EJ, Tardy J, Pastor J, et al. Neuropsychological outcome after a first symptomatic ischaemic stroke with ‘good recovery’. Eur J Neurol. 2012;19(2):212-9. doi: https://doi.org/10.1111/j.1468-1331.2011.03450.x
Bagnoli S, Failli Y, Piaceri I, Rinnoci V, Bessi V, Tedde A, et al. Suitability of neuropsychological tests in patients with vascular dementia (VaD). J Neurol Sci. 2012;322(1-2):41-5. doi: https://doi.org/10.1016/j.jns.2012.05.045
Sheng B, Cheng LF, Law CB, Li HL, Yeung KM, Lau KK. Coexisting cerebral infarction in Alzheimer’s disease is associated with fast dementia progression: applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l’Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer’s Disease with Concomitant Cerebral Infarction. J Am Geriatr Soc. 2007;55(6):918-22. doi: https://doi.org/10.1111/j.1532-5415.2007.01171.x
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