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Longitudinal alterations of executive function in non-psychotic adolescents at familial risk for schizophrenia
Authors:Tejas S. Bhojraj  Vaibhav A. Diwadkar  John A. Sweeney  Konasale M. Prasad  Shaun M. Eack  Debra M. Montrose  Matcheri S. Keshavan
Affiliation:1. Department of Psychiatry, Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Harvard Medical School, Boston, Massachusetts, USA;2. Wayne State University, Detroit, Michigan, USA;3. University of Illinois Medical Center at Chicago, Chicago, Illinois, USA;4. Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, USA
Abstract:
Genetic diathesis to schizophrenia may involve alterations of adolescent neurodevelopment manifesting as cognitive deficits. Brain regions mediating executive function (fronto-striatal circuits) develop during adolescence while those supporting elementary aspects of attention (e.g. sustained focused attention) have a more protracted maturation beginning in childhood. We hence predicted that adolescents at risk for schizophrenia would show a failure of normal maturation of executive function. We prospectively assessed 18 offspring and 6 siblings of schizophrenia patients (HR) and 28 healthy controls at baseline, year-1 and year-2 follow-up using the Continuous Performance Test [visual-d′] and Wisconsin Card Sort Test (WCST). Perseverative errors on the WCST in HR remained stable but decreased in controls over the follow-up (study-group by assessment–time interaction, p = 0.01, controlling for IQ). No significant study-group by assessment-time interactions were seen for sustained attentional performance. HR may not improve while healthy subjects progressively improve on executive function during adolescence and early adulthood. Our results suggest an altered maturational trajectory of executive function during adolescence in individuals at familial risk for schizophrenia.
Keywords:WCST, Wisconsin Card Sorting test   CPT-IP, Continuous Performance Test-Identical Pairs version   IQ, Intelligence Quotient   HC, Healthy control subjects   HR, Subjects at high risk for schizophrenia   SD, Standard Deviation   ANCOVA, Analysis of covariance   ANOVA, Analysis of variance   DSM, Diagnostic and Statistical Manual of Mental Disorders   SCID, Structured Clinical Interview for DSM Disorders
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