The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
The National Clinical Research Center for Mental Disorders, China &Center of Depression, Beijing Institute for Brain Disorders & Mood Disorders Center, Beijing Anding Hospital, Capital Medical University, Beijing, China.
J Psychiatr Res. 2018 Aug;103:38-45. doi: 10.1016/j.jpsychires.2018.05.001. Epub 2018 May 5.
Findings of neurocognitive dysfunction in subjects at Clinical High Risk for Psychosis (CHR-P) have been controversial. This meta-analysis systematically examined studies of neurocognitive functions using the MATRICS Consensus Cognitive Battery (MCCB) in CHR-P. An independent literature search of both English and Chinese databases was conducted by two reviewers. Standardized mean difference (SMD) was calculated using a random effects model to evaluate the effect size of the meta-analytic results. Six case-control studies (n = 396) comparing neurocognitive functions between CHR-P subjects (n = 197) and healthy controls (n = 199) using the MCCB were identified; 4 (66.7%) studies were rated as "high quality". Compared to healthy controls, CHR-P subjects showed impairment with large effect size in overall cognition (n = 128, SMD = -1.00, 95%CI: -1.38, -0.63, P < 0.00001; I = 2%), processing speed (SMD = -1.21) and attention/vigilance (SMD = -0.83), and with medium effect size in working memory (SMD = -0.76), reasoning and problem solving (SMD = -0.71), visual (SMD = -0.68) and verbal learning (SMD = -0.67). No significant difference between CHR-P subjects and controls was found regarding social cognition (SMD = -0.33, 95%CI: -0.76, 0.10, P = 0.14; I = 70%) with small effect size. Apart from social cognition, CHR-P subjects performed worse than healthy control in all MCCB cognitive domains, particularly in processing speed, attention/vigilance and working memory.
临床精神病高危人群（CHR-P）的神经认知功能障碍的研究结果一直存在争议。本荟萃分析系统地研究了使用 MATRICS 共识认知电池（MCCB）的 CHR-P 中的神经认知功能。两位评审员独立地对中英文数据库进行了文献检索。使用随机效应模型计算标准化均数差（SMD），以评估荟萃分析结果的效应大小。共确定了 6 项病例对照研究（n=396），比较了使用 MCCB 的 CHR-P 受试者（n=197）和健康对照组（n=199）之间的神经认知功能；其中 4 项（66.7%）研究被评为“高质量”。与健康对照组相比，CHR-P 受试者在整体认知（n=128，SMD=-1.00，95%CI：-1.38，-0.63，P<0.00001；I²=2%）、加工速度（SMD=-1.21）和注意力/警觉性（SMD=-0.83）方面表现出明显的损害，并且在工作记忆（SMD=-0.76）、推理和解决问题（SMD=-0.71）、视空间（SMD=-0.68）和言语学习（SMD=-0.67）方面也表现出中等程度的损害。在社会认知（SMD=-0.33，95%CI：-0.76，0.10，P=0.14；I²=70%）方面，CHR-P 受试者与对照组之间无显著差异，效应大小较小。除了社会认知，CHR-P 受试者在所有 MCCB 认知领域的表现均差于健康对照组，特别是在加工速度、注意力/警觉性和工作记忆方面。
