Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-28T05:55:18.880Z Has data issue: false hasContentIssue false
  • English
  • Français

The use and meaning of the continuous performance test in schizophrenia

Published online by Cambridge University Press:  11 April 2011

Marcella Bellani  and
Paolo Brambilla
Marcella Bellani*
Affiliation:
Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona (Italy) Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona and University of Udine
Paolo Brambilla
Affiliation:
Section of Psychiatry, Department of Pathology and Experimental & Clinical Medicine, University of Udine, Udine (Italy) Inter-University Centre for Behavioural Neurosciences (ICBN), University of Verona and University of Udine
*
Dr. M. Bellani, Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona (Italy). Fax: +39-045-585.871 E-mail: marcella.bellani@univr.it
Get access Rights & Permissions [Opens in a new window]

Abstract

The continuous performance test (CPT) is a behavioural assessment of attentional modulation of the motor system (Rosvold et al., 1956). It has firstly been used in patients with brain injuries and then applied to assess sustained attention and vigilance in epilepsy, brain tumor, dementia, schizophrenia and other psychiatric diseases, such as attention-deficit hyperactivity disorder (ADHD) and anxiety disorders (Rosvold et al., 1956; Honey et al., 2005; Kanaka et al., 2008). There are several versions of the test. For instance, the X-CPT version presents randomly different stimuli and subjects are asked to push a button only on presentation of the target stimuli (X). In the AX-CPT version, the subjects are required to push the button only when a cue stimulus is presented before the target one (A before X). The following items are measured for the X and AX tasks: omission errors (number of times subjects fail to respond to target stimulation), commission errors (number of times subjects respond to non target stimulation), average reaction time and coefficient of variance for both correct reactions and commission errors (Suwa et al., 2004). There are other versions, such as the CPT-not X version where the subjects are asked not to push a button when the target stimulus (X) is presented; the Degraded Stimuli (DS)-CPT (Nuechterlein, 1983); the CPT playing card version (Rutschmann et al., 1977); and the CPT Identical Pairs version (Cornblatt et al., 1988), which is a more difficult task prepared to assess high risk population. Interestingly, the Identical Pairs version has been included in the Matrics neurocognitive assessment, a consensus cognitive battery for clinical trials of cognition in schizophrenia (Nuechterlein et al., 2008).

Keywords

prefrontal cortexpsychosismagnetic resonancecognition
Type
Neurobiology of Psychosis. Clinical and Psychosocial Implications
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 3 , September 2008 , pp. 188 - 191
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asarnow, R.F. & MacCrimmon, D.J. (1978). Residual performance deficit in clinically remitted schizophrenics: a marker for schizophrenia? Journal of Abnormal Psychology 87, 597–608.CrossRefGoogle ScholarPubMed
Barch, D.M., Carter, C.S.Braver, T.S., Sabb, F.W., MacDonald, A.W. III, Noll, D.C. & Cohen, J.D. (2001). Selective deficits in prefrontal cortex function in medication-naive patients with schizophrenia. Archives of General Psychiatry 58, 280–288.CrossRefGoogle ScholarPubMed
Barch, D., Carter, C., MacDonald, A., Braver, T. & Cohen, J. (2003). Context processing deficits in schizophrenia: diagnostic specificity, four week course, and relationships to clinical symptoms. Journal of Abnormal Psychology 112, 132–143.CrossRefGoogle Scholar
Birkett, P., Sigmundsson, T., Sharma, T., Toulopoulou, T., Griffiths, T.D., Reveley, A. & Murray, R. (2007). Reaction time and sustained attention in schizophrenia and its genetic predisposition. Schizophrenia Research 95, 76–85.CrossRefGoogle ScholarPubMed
Brambilla, P., MacDonald, A.W. III, Sassi, R.B., Johnson, M.K., Mallinger, A.G., Carter, C.S. & Soares, J.C. (2007). Context processing performance in bipolar disorder patients. Bipolar Disorders 9, 230–237.CrossRefGoogle ScholarPubMed
Buchsbaum, M.S., Haier, R.J., Potkin, S.G., Nuechterlein, K., Bracha, H.S., Katz, M. et al. (1992). Frontostriatal disorder of cerebral metabolism in never-medicated schizophrenics. Archives of General Psychiatry 49, 935–942.CrossRefGoogle ScholarPubMed
Chen, W.J., Lui, S.K., Chang, C., Lien, Y., Chang, Y. & Hwu, H. (1998). Sustained attention deficit and schizotypal personality features in the non psychotic relatives of schizophrenic patients. American Journal of Psychiatry 155, 1214–1220.CrossRefGoogle Scholar
Cohen, J.D., Barch, D.M., Carter, C. & Servan-Schreiber, D. (1999). Context-processing deficits in schizophrenia: converging evidence from three theoretically motivated cognitive tasks. Journal of Abnomal Psychology 108, 120–133.CrossRefGoogle ScholarPubMed
Cornblatt, B.A., Risch, N.J., Faris, G., Friedman, D. & Erlenmeyer-Kimling, L. (1988). The continuous performance test, identical pairs version (CPT-IP): New findings about sustained attention in normal families. Psychiatry Research 26, 223–238.CrossRefGoogle ScholarPubMed
Cornblatt, B.A. & Kielp, J.G. (1994). Impaired attention, genetics, and the pathophysiology of schizophrenia. Schizophrenia Bulletin 20, 31–46.CrossRefGoogle ScholarPubMed
Cornblatt, B.A. & Malhotra, A.K. (2001). Impaired attention as an endophenotype for molecular genetic studies of schizophrenia. American Journal of Medical Genetics 105, 11–15.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Cremasco, L. & Cappa, S.F. (2002). Attentional dysfunction of chronic schizophrenia: no association with long-term institutionalization. Psychiatry and Clinical Neurosciences 56, 419–423.CrossRefGoogle ScholarPubMed
Danese, A. (2006). A public health genetic approach for schizophrenia. Epidemiologia e Psichiatria Sociale 15, 185–193.CrossRefGoogle ScholarPubMed
Erickson, W.D., Yellin, A.M., Hopwood, J.H., Realmuto, G.M. & Greenberg, L.M. (1984). The effects of neuroleptics on attention in adolescents schizophrenics. Biological Psychiatry 19, 745–753.Google ScholarPubMed
Erlenmeyer, Kimling L. & Cornblatt, B. (1978). Attentional measures in a study of children at high-risk for schizophrenia. Journal of Psychiatry Research 14, 93–98.CrossRefGoogle Scholar
Gooding, D.C., Matts, C.W. & Rollmann, E.A. (2006). Sustained attention deficits in relation to psychometrically identified schizotypy: evaluating a potential endophenotypic marker. Schizophrenia Research 82, 27–37.CrossRefGoogle ScholarPubMed
Gottesman, I.I. & Gould, T.D. (2003). The endophenotype concept in psychiatry: Etymology and strategic intentions. American Journal of Psychiatry 160, 636–645.CrossRefGoogle ScholarPubMed
Grunebaum, H., Weiss, J.L., Gallant, D. & Cohler, B.J. (1974). Attention in young children of psychotic mothers. American Journal of Psychiatry 131, 887–891.CrossRefGoogle ScholarPubMed
Heinrichs, R.W. & Zakzanis, K.K. (1998). Neurocognitive deficit in schizophrenia: A quantitative review of the evidence. Neuropsychology 12, 426–445.CrossRefGoogle ScholarPubMed
Honey, G.D., Pomarol-Clotet, E., Corlett, P.R., Honey, R.A.E., Mckenna, P.J., Bullmore, E.T. & Fletcher, P.C. (2005). Functional dysconnectivity in schizophrenia associated with attentional modulation of motor function. Brain 128, 2597–2611.CrossRefGoogle ScholarPubMed
Jablensky, A. (2005). The long and winding road of schizophrenia research. Epidemiologia e Psichiatria Sociale 14, 179–183.CrossRefGoogle Scholar
Javitt, D.C., Shelley, A.M., Silipo, G. & Lieberman, J.A. (2000). Deficits in auditory and visual context-dependent processing in schizophrenia. Archives of General Psychiatry 57, 1131–1137.CrossRefGoogle ScholarPubMed
Kanaka, N., Matsuda, T., Tomimoto, Y., Noda, Y., Matsushima, E., Matsuura, M. & Kojima, T. (2008). Measurement of development of cognitive and attention functions in children using continuous performance test. Psychiatry and Clinical Neurosciences 62, 135–141.CrossRefGoogle ScholarPubMed
Keshavan, M.S., Diwadkar, V. & Rosenberg, D.R. (2005). Developmental biomarkers in schizophrenia and other psychiatric disorders: common origins, different trajectories? Epidemiologia e Psichiatria Sociale 14, 188–193.CrossRefGoogle ScholarPubMed
Killackey, E., Young, A.R. & McGorry, P. D. (2007). Early psychosis: where we've been, where we still have to go. Epidemiologia e Psichiatria Sociale 16, 102–108.CrossRefGoogle ScholarPubMed
Liu, S.K., Chiu, C.H., Chang, C.J., Hwang, T.J., Hwu, H.G & Chen, W.J. (2002). Deficits in sustained attention in schizophrenia and affective disorders: stable versus state-dependent markers. American Journal of Psychiatry 159, 975–982.CrossRefGoogle ScholarPubMed
MacDonald, A.W. III & Carter, C.S. (2003). Event-related FMRI study of context processing in dorsolateral prefrontal cortex of patients with schizophrenia. Journal of Abnormal Psychology 112, 689–697.CrossRefGoogle ScholarPubMed
MacDonald, A.W. III, Cohen, J.D., Stenger, V.A. & Carter, C.S. (2000). Dissociating the role of dorsolateral prefrontal and anterior cingulate cortex in cognitive control. Science 288, 1835–1838.CrossRefGoogle ScholarPubMed
MacDonald, A.W. III, Pogue-Geile, M.F., Johnson, M.K. & Carter, C.S. (2003). A specific deficit in context processing in the unaffected siblings of patients with schizophrenia. Archives of General Psychiatry 60, 57–65.CrossRefGoogle ScholarPubMed
MacDonald, A.W. III, Carter, C.S., Kerns, J.G., Ursu, S., Barch, D.M., Holmes, A.J., Stenger, V.A. & Cohen, J.D. (2005). Specificity of prefrontal dysfunction and context processing deficits to schizophrenia in never-medicated patients with first-episode psychosis. American Journal of Psychiatry 16, 475–484.CrossRefGoogle Scholar
Miller, E.K. (2000). The prefrontal cortex and cognitive control. Nature Reviews Neuroscience 1, 59–65.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H. (1983). Signal detection in vigilance tasks and behavioral attributes among offspring of schizophrenic mothers and among hyperactive children. Journal of Abnormal Psychology 92, 4–28.CrossRefGoogle ScholarPubMed
Neuchterlein, K.H., Dawson, M.E., Ventura, J., Miklowitz, D. & Konishi, G. (1991). Information processing anomalies in the early course of schizophrenia and bipolar disorder. Schizophrenia Research 5, 195–196.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H., Green, M.F., Kern, R.S., Baade, L.E., Barch, D.M., Cohen, J.D., Essock, S., Fenton, W.S., Frese, F.J. III, Gold, J.M., Goldberg, T., Heaton, R.K., Keefe, R.S.E., Kraemer, H., Mesholam-Gately, R., Seidman, L.J., Stover, E., Weinberger, D.R., Young, A.S., Zalcman, S. & Marder, S.R. (2008). The MATRICS consensus cognitive battery, Part 1: test selection, reliability, and validity. American Journal of Psychiatry 165, 203–213.CrossRefGoogle ScholarPubMed
Orzack, M.H. & Kornetsky, C. (1966). Attention dysfunction in chronic schizophrenia. Archives of General Psychiatry 14, 323–326.CrossRefGoogle ScholarPubMed
Perlstein, W., Dixit, N., Carter, C., Noll, D. & Cohen, J. (2003). Prefrontal cortex dysfunction mediates deficits in working memory and prepotent responding in schizophrenia. Biological Psychiatry 53, 25–38.CrossRefGoogle ScholarPubMed
Purdon, S.E, Valiakalayil, A., Hanstock, C.C., Seres, P. & Tibbo, P. (2008). Elevated 3T proton MRS glutamate levels associated with poor Continuous Performance Test (CPT-0X) scores and genetic risk for schizophrenia. Schizophrenia Research 99, 218–224.CrossRefGoogle ScholarPubMed
Rosvold, H.E., Mirsky, A.F., Sarason, I., Bransome, E.D. Jr & Beck, L.H. (1956). A continuous performance test of brain damage. Journal of Consulting and Clinical Psychology 20, 343–350.CrossRefGoogle Scholar
Rund, B.R., Zeiner, P., Sundet, K., Oie, M. & Bryhn, G. (1998). No vigilance deficit found in either young schizophrenic or ADHD subjects. Scandinavian Journal of Psychology 39, 101–107.CrossRefGoogle ScholarPubMed
Rutschmann, J., Cornblatt, B. & Erlenmeyer-Kimling, L. (1977). Sustained attention in children at risk for schizophrenia. Archives of General Psychiatry 34, 571–575.CrossRefGoogle ScholarPubMed
Schroeder, J., Buchsbaum, M.S., Siegel, B.V., Geider, F.J., Haier, R.J., Lohr, J., Wu, J. & Potkin, S.G. (1994). Patterns of cortical activity in schizophrenia. Psychological Medicine 24, 947–55.CrossRefGoogle ScholarPubMed
Siegel, B.V. Jr, Buchsbaum, M.S., Bunney, W.E. Jr, Gottschalk, L.A., Haier, R.J., Lohr, J.B., Lottenberg, S., Najafi, A., Neuchterlein, K.N. & Potkin, S.G. (1993). Cortical-striatal-thalamic circuits and brain glucose metabolic activity in 70 unmedicated male schizophrenic patients. American Journal of Psychiatry 150, 1325–1336.Google ScholarPubMed
Sponheim, R., McGuire, K.A. & Stanwyck, J.J. (2006). Neural anomalies during sustained attention in first-degree biological relatives of schizophrenia patients. Biological Psychiatry 60, 242–252.CrossRefGoogle ScholarPubMed
Suwa, H.Matsushima, E., Ohta, K. & Mori, K. (2004). Attention disorders in schizophrenia. Psychiatry and Clinical Neurosciences 58, 249–256.CrossRefGoogle ScholarPubMed
Volz, H., Gaser, C., Hager, F., Rzanny, R., Ponisch, J., Mentzel, H., Kaiser, W.A & Sauer, H. (1999). Decreased frontal activation in schizophrenics during stimulation with the continuous performance test-a functional magnetic resonance imaging study. European Psychiatry 14, 17–24.CrossRefGoogle ScholarPubMed
Wohlberg, G.W. & Kornetsky, C. (1973). Sustained attention in remitted schizophrenics. Archives of General Psychiatry 28, 533–537.CrossRefGoogle ScholarPubMed
Wood, S.J., Yucel, M., Yung, A.R., Berger, G.E., Velakoulis, D. & Pantelis, C. (2004). The transition to psychosis: risk factors and brain changes. Epidemiologia e Psichiatria Sociale 13, 137–140.CrossRefGoogle ScholarPubMed