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Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome

Cognitive impairment, typically more severe in treatment resistant patients, is considered a hallmark of schizophrenia and the prime driver of functional disability. Recent evidence suggests that metabolic syndrome may contribute to cognitive deficits in schizophrenia, possibly through shared underl...

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Autores principales: Bosia, Marta, Buonocore, Mariachiara, Bechi, Margherita, Santarelli, Laura, Spangaro, Marco, Cocchi, Federica, Guglielmino, Carmelo, Bianchi, Laura, Bringheli, Serena, Bosinelli, Francesca, Cavallaro, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293025/
https://www.ncbi.nlm.nih.gov/pubmed/30581395
http://dx.doi.org/10.3389/fpsyt.2018.00647
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author Bosia, Marta
Buonocore, Mariachiara
Bechi, Margherita
Santarelli, Laura
Spangaro, Marco
Cocchi, Federica
Guglielmino, Carmelo
Bianchi, Laura
Bringheli, Serena
Bosinelli, Francesca
Cavallaro, Roberto
author_facet Bosia, Marta
Buonocore, Mariachiara
Bechi, Margherita
Santarelli, Laura
Spangaro, Marco
Cocchi, Federica
Guglielmino, Carmelo
Bianchi, Laura
Bringheli, Serena
Bosinelli, Francesca
Cavallaro, Roberto
author_sort Bosia, Marta
collection PubMed
description Cognitive impairment, typically more severe in treatment resistant patients, is considered a hallmark of schizophrenia and the prime driver of functional disability. Recent evidence suggests that metabolic syndrome may contribute to cognitive deficits in schizophrenia, possibly through shared underlying mechanisms. However, results are still contradictory and no study has so far examined the influence of metabolic syndrome on cognitive outcome after cognitive remediation therapy (CRT). Based on these premises, this study aims to investigate the relationship between metabolic syndrome and cognition, specifically considering cognitive outcome after treatment. Secondary objectives include the analysis of the association between cognitive impairment and psychopathological status and, in a subgroup of patients, the evaluation of the effect of Sterol Regulatory Element Binding Transcription Factor 1 (SREBF-1) rs11868035 genetic polymorphism, previously associated with metabolic alterations, on both cognition and metabolic syndrome. One-hundred seventy-two outpatients with schizophrenia were assessed for metabolic parameters and neurocognitive measures and 138 patients, who completed CRT, were re-evaluated for cognition. A subsample of 51 patients was also genotyped for rs11868035 from peripheral blood sample. Results show a negative impact of metabolic syndrome on executive functions and global cognitive outcome after CRT. Data also revealed a significant effect of SREBF-1 polymorphism, with a higher prevalence of metabolic syndrome and worse processing speed performance among G/G homozygous subjects, compared the A allele carriers. Overall these findings support the hypothesis that metabolic alterations may hamper the capacity to restore cognitive deficits, as well as they highlight the need to further explore possible converging mechanisms underlying both cognitive and metabolic dysfunction. At the clinical level, results point to the importance of a comprehensive assessment including the metabolic status of patients and of individualized strategies addressing metabolic dysfunction in order to potentiate treatment outcome in schizophrenia.
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spelling pubmed-62930252018-12-21 Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome Bosia, Marta Buonocore, Mariachiara Bechi, Margherita Santarelli, Laura Spangaro, Marco Cocchi, Federica Guglielmino, Carmelo Bianchi, Laura Bringheli, Serena Bosinelli, Francesca Cavallaro, Roberto Front Psychiatry Psychiatry Cognitive impairment, typically more severe in treatment resistant patients, is considered a hallmark of schizophrenia and the prime driver of functional disability. Recent evidence suggests that metabolic syndrome may contribute to cognitive deficits in schizophrenia, possibly through shared underlying mechanisms. However, results are still contradictory and no study has so far examined the influence of metabolic syndrome on cognitive outcome after cognitive remediation therapy (CRT). Based on these premises, this study aims to investigate the relationship between metabolic syndrome and cognition, specifically considering cognitive outcome after treatment. Secondary objectives include the analysis of the association between cognitive impairment and psychopathological status and, in a subgroup of patients, the evaluation of the effect of Sterol Regulatory Element Binding Transcription Factor 1 (SREBF-1) rs11868035 genetic polymorphism, previously associated with metabolic alterations, on both cognition and metabolic syndrome. One-hundred seventy-two outpatients with schizophrenia were assessed for metabolic parameters and neurocognitive measures and 138 patients, who completed CRT, were re-evaluated for cognition. A subsample of 51 patients was also genotyped for rs11868035 from peripheral blood sample. Results show a negative impact of metabolic syndrome on executive functions and global cognitive outcome after CRT. Data also revealed a significant effect of SREBF-1 polymorphism, with a higher prevalence of metabolic syndrome and worse processing speed performance among G/G homozygous subjects, compared the A allele carriers. Overall these findings support the hypothesis that metabolic alterations may hamper the capacity to restore cognitive deficits, as well as they highlight the need to further explore possible converging mechanisms underlying both cognitive and metabolic dysfunction. At the clinical level, results point to the importance of a comprehensive assessment including the metabolic status of patients and of individualized strategies addressing metabolic dysfunction in order to potentiate treatment outcome in schizophrenia. Frontiers Media S.A. 2018-12-07 /pmc/articles/PMC6293025/ /pubmed/30581395 http://dx.doi.org/10.3389/fpsyt.2018.00647 Text en Copyright © 2018 Bosia, Buonocore, Bechi, Santarelli, Spangaro, Cocchi, Guglielmino, Bianchi, Bringheli, Bosinelli and Cavallaro. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Bosia, Marta
Buonocore, Mariachiara
Bechi, Margherita
Santarelli, Laura
Spangaro, Marco
Cocchi, Federica
Guglielmino, Carmelo
Bianchi, Laura
Bringheli, Serena
Bosinelli, Francesca
Cavallaro, Roberto
Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title_full Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title_fullStr Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title_full_unstemmed Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title_short Improving Cognition to Increase Treatment Efficacy in Schizophrenia: Effects of Metabolic Syndrome on Cognitive Remediation's Outcome
title_sort improving cognition to increase treatment efficacy in schizophrenia: effects of metabolic syndrome on cognitive remediation's outcome
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293025/
https://www.ncbi.nlm.nih.gov/pubmed/30581395
http://dx.doi.org/10.3389/fpsyt.2018.00647
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