The impact of inflammation on neurocognition and risk for psychosis: a critical review
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INVITED REVIEW
The impact of inflammation on neurocognition and risk for psychosis: a critical review Sophia Kogan1 · Luz H. Ospina1 · Vijay A. Mittal2 · David Kimhy1,3 Received: 16 May 2019 / Accepted: 24 September 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Neurocognitive difficulties are highly prevalent among people with schizophrenia and have been linked to increased inflammation, as well as dysfunction and disability. Poor neurocognitive functioning has also been documented in individuals at clinical high risk for psychosis (CHR) and a burgeoning literature point to alterations in inflammation markers in this population. However, there is limited information regarding the putative link between inflammation and neurocognition in CHR individuals, and the potential role of inflammation in the development of cognitive difficulties and psychosis. As previous reports indicate that early treatment in schizophrenia is associated with better outcomes, there is an urgent need to identify neurobiological mechanisms underlying cognitive deterioration and psychosis in CHR individuals to provide them with care prior to significant cognitive and functional declines. To address this gap in the literature, we review and summarize the relevant literatures on inflammation and neurocognitive dysfunction in schizophrenia and CHR individuals, point to remaining gaps, and suggest directions for future research. Keywords Clinical high risk · Prodrome · Inflammation · Neurocognition · Psychosis · Schizophrenia
Introduction The psychosis prodrome of schizophrenia is characterized by attenuated psychotic, negative, and neurocognitive symptoms that typically result in decreased social, academic, and occupational functioning prior to the onset of frank psychosis [1]. While historically the clinical management of schizophrenia often began at the first psychotic episode, such interventions were typically preceded by months or years of functional decline [1]. However, a growing literature indicates that early interventions are associated with a better response to treatment and improved functional outcomes [2]. Consequently, efforts have been made to identify * David Kimhy [email protected] 1
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, 1230, New York, NY 10029, USA
2
Department of Psychology, Northwestern University, Evanston, IL, USA
3
Mental Illness Research Education and Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA
individuals at clinical high risk (CHR) for psychosis to better understand the pathophysiology underlying the onset of psychosis and to develop early interventions to delay or prevent onset of full psychotic symptoms. The CHR label describes individuals who meet criteria for a psychosis risk syndrome and are at risk for converting to a schizophrenia spectrum disorder. Because schizophrenia severely limits the most productive years of an individual’s life, the promise of early detection and inter
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