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Neurocognition and adaptive functioning in a genetic high risk model of schizophrenia

Published online by Cambridge University Press:  01 August 2018

A. M. Fiksinski Open the ORCID record for A. M. Fiksinski [Opens in a new window] ,
E. J. Breetvelt ,
Y. J. Lee ,
E. Boot ,
N. Butcher ,
L. Palmer ,
E. W. C. Chow ,
R. S. Kahn ,
J. A. S. Vorstman  and
A. S. Bassett
A. M. Fiksinski
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
E. J. Breetvelt
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
Y. J. Lee
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
E. Boot
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
N. Butcher
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
L. Palmer
Affiliation:
The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
E. W. C. Chow
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
R. S. Kahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
J. A. S. Vorstman
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Program in Genetics and Genome Biology, Research Institute, Toronto, Ontario, Canada Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
A. S. Bassett*
Affiliation:
Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada The Dalglish Family 22q Clinic for 22q11.2 Deletion Syndrome, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada Department of Mental Health, Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
*
Author for correspondence: A. S. Bassett, E-mail: anne.bassett@utoronto.ca
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Abstract

Background

Identifying factors that influence the functional outcome is an important goal in schizophrenia research. The 22q11.2 deletion syndrome (22q11DS) is a unique genetic model with high risk (20–25%) for schizophrenia. This study aimed to identify potentially targetable domains of neurocognitive functioning associated with functional outcome in adults with 22q11DS.

Methods

We used comprehensive neurocognitive test data available for 99 adults with 22q11DS (n = 43 with schizophrenia) and principal component analysis to derive four domains of neurocognition (Verbal Memory, Visual and Logical Memory, Motor Performance, and Executive Performance). We then investigated the association of these neurocognitive domains with adaptive functioning using Vineland Adaptive Behavior Scales data and a linear regression model that accounted for the effects of schizophrenia status and overall intellectual level.

Results

The regression model explained 46.8% of the variance in functional outcome (p < 0.0001). Executive Performance was significantly associated with functional outcome (p = 0.048). Age and schizophrenia were also significant factors. The effects of Executive Performance on functioning did not significantly differ between those with and without psychotic illness.

Conclusion

The findings provide the impetus for further studies to examine the potential of directed (early) interventions targeting Executive Performance to improve long-term adaptive functional outcome in individuals with, or at high risk for, schizophrenia. Moreover, the neurocognitive test profiles may benefit caregivers and clinicians by providing insight into the relative strengths and weaknesses of individuals with 22q11DS, with and without psychotic illness.

Keywords

Adaptive functioninghigh-riskneurocognitionschizophrenia22q11DS
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 6 , April 2019 , pp. 1047 - 1054
Copyright
Copyright © Cambridge University Press 2018 

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