[Article Review] Early SSRI Treatment in 22q11.2 Deletion Syndrome: A Promising Path for Cognition and Brain Development?

Reference

Mancini, V., Maeder, J., Bortolin, K., Schneider, M., Schaer, M., & Eliez, S. (2021). Long-term effects of early treatment with SSRIs on cognition and brain development in individuals with 22q11.2 deletion syndrome. Translational Psychiatry, 11, 336. https://doi.org/10.1038/s41398-021-01480-3

Review

The present study by Mancini et al. (2021) investigates the long-term effects of early treatment with selective serotonin reuptake inhibitors (SSRIs) on cognition and brain development in individuals with 22q11.2 deletion syndrome (22q11DS). This genetic disorder has the highest risk for schizophrenia, making it an ideal population for studying the development of individuals at risk for psychosis. The authors conducted a retrospective cohort study with 98 participants, aged 10 to 32, diagnosed with 22q11DS, and followed up 2–4 times.

The participants were divided into three groups: those without psychiatric disorders and no psychotropic medications (n = 30), those with psychotic symptoms but not treated with SSRIs (n = 30), and those receiving SSRI treatment (n = 38). The authors observed increased IQ scores and developmental trajectories in participants treated with SSRIs, including those with psychotic symptoms. Additionally, the thickness of frontal regions and hippocampal volume were relatively increased in the treated group. The magnitude of the outcomes was inversely correlated to the age at the onset of the treatment.

This study provides preliminary evidence that early long-term treatment with SSRIs may attenuate the cognitive decline associated with psychosis in 22q11DS and developmental brain abnormalities. The findings hold promise for identifying novel strategies to improve cognitive and brain development in individuals with 22q11DS, as well as other populations at risk for psychosis. However, more research is needed to confirm and expand these findings and to explore the potential benefits and risks of early SSRI treatment in this population.

[Article Review] White Matter Microstructure and Cognitive Performance: Insights from a Meta-Analysis in Schizophrenia

Reference

Holleran, L., Kelly, S., Alloza, C., Agartz, I., Andreassen, O. A., Arango, C., ... & Donohoe, G. (2020). The Relationship Between White Matter Microstructure and General Cognitive Ability in Patients With Schizophrenia and Healthy Participants in the ENIGMA Consortium. American Journal of Psychiatry, 177(6), 537-547. https://doi.org/10.1176/appi.ajp.2019.19030225

Review

Holleran et al. (2020) conducted a meta-analysis to explore the relationship between white matter microstructure and cognitive performance in patients with schizophrenia and healthy participants using data from the ENIGMA Consortium. The study included 760 patients with schizophrenia and 957 healthy participants from 11 sites. The authors used principal component analysis to calculate a global fractional anisotropy component and a fractional anisotropy component for six long association tracts. The results showed that higher fractional anisotropy was associated with higher cognitive ability. The study provides robust evidence that cognitive ability is associated with global structural connectivity, independent of diagnosis.

The authors noted that schizophrenia is associated with widespread white matter microstructural abnormalities, but the functional effects of these abnormalities remain unclear. This study contributes to the current understanding of the relationship between white matter microstructure and cognitive performance in patients with schizophrenia and healthy participants. The meta-analysis included a large sample size from multiple sites, and a common analysis pipeline was used, which enhances the validity of the results. The findings suggest that there is a more general, rather than disease-specific, pattern of association between fractional anisotropy and cognitive ability.

Overall, the study by Holleran et al. (2020) provides valuable insights into the relationship between white matter microstructure and cognitive performance in patients with schizophrenia and healthy participants. The findings suggest that cognitive ability is associated with global structural connectivity, and the association is independent of diagnosis. The study highlights the importance of investigating the functional effects of white matter microstructural abnormalities in schizophrenia to improve social and functional outcomes in patients.