Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study

Abstract Background The heterogeneity of cognitive impairments in schizophrenia has been widely observed. However, reliable cognitive boundaries to differentiate the subgroups remain elusive. The key challenge for cognitive subtyping is applying an integrated and standardized cognitive assessment an...

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Main Authors: Yuyan Huang, Weiyan Wang, Gangrui Hei, Tiannan Shao, Li Li, Ye Yang, Xiaoyi Wang, Yujun Long, Jingmei Xiao, Xingjie Peng, Chuhan Song, Jingda Cai, Xueqin Song, Xijia Xu, Shuzhan Gao, Jing Huang, Dongyu Kang, Ying Wang, Jingping Zhao, Yunzhi Pan, Renrong Wu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-024-03835-9
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author Yuyan Huang
Weiyan Wang
Gangrui Hei
Tiannan Shao
Li Li
Ye Yang
Xiaoyi Wang
Yujun Long
Jingmei Xiao
Xingjie Peng
Chuhan Song
Jingda Cai
Xueqin Song
Xijia Xu
Shuzhan Gao
Jing Huang
Dongyu Kang
Ying Wang
Jingping Zhao
Yunzhi Pan
Renrong Wu
author_facet Yuyan Huang
Weiyan Wang
Gangrui Hei
Tiannan Shao
Li Li
Ye Yang
Xiaoyi Wang
Yujun Long
Jingmei Xiao
Xingjie Peng
Chuhan Song
Jingda Cai
Xueqin Song
Xijia Xu
Shuzhan Gao
Jing Huang
Dongyu Kang
Ying Wang
Jingping Zhao
Yunzhi Pan
Renrong Wu
author_sort Yuyan Huang
collection DOAJ
description Abstract Background The heterogeneity of cognitive impairments in schizophrenia has been widely observed. However, reliable cognitive boundaries to differentiate the subgroups remain elusive. The key challenge for cognitive subtyping is applying an integrated and standardized cognitive assessment and understanding the subgroup-specific neurobiological mechanisms. The present study endeavors to explore cognitive subgroups and identify their morphological features. Methods A total of 920 schizophrenia patients and 169 healthy controls were recruited. MATRICS Consensus Cognitive Battery was applied to assess cognitive performance and recognize cognitive subgroups through latent profile and latent transition analysis. Cortical thickness and gray matter volume were employed for the morphological features across subgroups. Results Four reproducible cognitive subgroups were identified, including multidomain-intact, executive-preserved, executive-deteriorated, and multidomain-deteriorated subgroup. After 12 weeks of follow-up, the cognitive characteristics of three out of the four subgroups kept stability, except for multidomain-deteriorated subgroup in which 48.8% of patients with improved cognition transited into the executive-deteriorated subgroup. Across subgroups, significant gradient features of brain structure were exhibited in fronto-temporal regions, hippocampus, and insula. Compared to healthy controls, multidomain-intact subgroup showed the most intact cognition and morphology, and multidomain-deteriorated subgroup with youngest age showed morphological decline in extensive regions. The remaining two subgroups showed intermediate cognitive performance, but could be distinguished by executive function and morphological differences in posterior cingulate cortex. Conclusions Our study provides novel insights into the heterogeneity of cognitive impairments in schizophrenia and the morphological features from cross-sectional and longitudinal levels, which could advance our understanding of complex cognition-morphology relationships and guide personalized interventions.
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spelling doaj-art-0dfe16de51864d139090496118b6adcd2025-01-12T12:26:50ZengBMCBMC Medicine1741-70152025-01-0123111710.1186/s12916-024-03835-9Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis studyYuyan Huang0Weiyan Wang1Gangrui Hei2Tiannan Shao3Li Li4Ye Yang5Xiaoyi Wang6Yujun Long7Jingmei Xiao8Xingjie Peng9Chuhan Song10Jingda Cai11Xueqin Song12Xijia Xu13Shuzhan Gao14Jing Huang15Dongyu Kang16Ying Wang17Jingping Zhao18Yunzhi Pan19Renrong Wu20Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityThe First Affiliated Hospital of Zhengzhou UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityThe First Affiliated Hospital of Zhengzhou UniversityDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing Brain HospitalDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityMental Health Center of Xiangya Hospital, Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityDepartment of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South UniversityAbstract Background The heterogeneity of cognitive impairments in schizophrenia has been widely observed. However, reliable cognitive boundaries to differentiate the subgroups remain elusive. The key challenge for cognitive subtyping is applying an integrated and standardized cognitive assessment and understanding the subgroup-specific neurobiological mechanisms. The present study endeavors to explore cognitive subgroups and identify their morphological features. Methods A total of 920 schizophrenia patients and 169 healthy controls were recruited. MATRICS Consensus Cognitive Battery was applied to assess cognitive performance and recognize cognitive subgroups through latent profile and latent transition analysis. Cortical thickness and gray matter volume were employed for the morphological features across subgroups. Results Four reproducible cognitive subgroups were identified, including multidomain-intact, executive-preserved, executive-deteriorated, and multidomain-deteriorated subgroup. After 12 weeks of follow-up, the cognitive characteristics of three out of the four subgroups kept stability, except for multidomain-deteriorated subgroup in which 48.8% of patients with improved cognition transited into the executive-deteriorated subgroup. Across subgroups, significant gradient features of brain structure were exhibited in fronto-temporal regions, hippocampus, and insula. Compared to healthy controls, multidomain-intact subgroup showed the most intact cognition and morphology, and multidomain-deteriorated subgroup with youngest age showed morphological decline in extensive regions. The remaining two subgroups showed intermediate cognitive performance, but could be distinguished by executive function and morphological differences in posterior cingulate cortex. Conclusions Our study provides novel insights into the heterogeneity of cognitive impairments in schizophrenia and the morphological features from cross-sectional and longitudinal levels, which could advance our understanding of complex cognition-morphology relationships and guide personalized interventions.https://doi.org/10.1186/s12916-024-03835-9SchizophreniaHeterogeneityCognitive subgroupLatent profile analysisCortical thicknessGray matter volume
spellingShingle Yuyan Huang
Weiyan Wang
Gangrui Hei
Tiannan Shao
Li Li
Ye Yang
Xiaoyi Wang
Yujun Long
Jingmei Xiao
Xingjie Peng
Chuhan Song
Jingda Cai
Xueqin Song
Xijia Xu
Shuzhan Gao
Jing Huang
Dongyu Kang
Ying Wang
Jingping Zhao
Yunzhi Pan
Renrong Wu
Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
BMC Medicine
Schizophrenia
Heterogeneity
Cognitive subgroup
Latent profile analysis
Cortical thickness
Gray matter volume
title Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
title_full Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
title_fullStr Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
title_full_unstemmed Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
title_short Subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features: a latent profile analysis study
title_sort subgroups of cognitive impairments in schizophrenia characterized by executive function and their morphological features a latent profile analysis study
topic Schizophrenia
Heterogeneity
Cognitive subgroup
Latent profile analysis
Cortical thickness
Gray matter volume
url https://doi.org/10.1186/s12916-024-03835-9
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