Zhang TianHong, Tang XiaoChen, Wei YanYan, Xu LiHua, Cui HuiRu, Liu HaiChun, Wang ZiXuan, Chen Tao, Zeng LingYun, Tang YingYing, Yi ZhengHui, Li ChunBo, Wang JiJun
Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, 200030, China.
Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, China.
BMC Med. 2025 Apr 24;23(1):240. doi: 10.1186/s12916-025-04059-1.
Neurocognitive resilience (NCR) refers to the ability of individuals to maintain cognitive function despite the presence of risk factors for psychosis. Investigating NCR is important as it may help predict the onset of psychosis and functional outcomes in individuals at clinical high risk (CHR) for psychosis.
This study employed a multi-group prospective design with a 3-year follow-up as part of the ShangHai At Risk for Psychosis-Extended project. Neurocognitive performance was assessed using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. The study focused on two primary outcomes: conversion/non-conversion to psychosis (CHR-C/CHR-NC) and non-remission/remission (CHR-NR/CHR-R). NCR was defined based on the adjusted cognitive variable relative to the healthy control(HC) group's mean, with three categories: NCR (NCR = 0) for scores within one standard deviation, NCR + (NCR = 1) for scores more than one standard deviation above, and NCR - (NCR = - 1) for scores more than one standard deviation below.
The study included 771 individuals at CHR (346 males, mean age 18.8 years) and 764 HCs (359 males, mean age 22.5 years). Among the CHR participants, 540 (70.0%) completed the 3-year follow-up, with 106 (19.6%) converting to psychosis (CHR-C) and 277 (51.3%) classified as non-remission (CHR-NR). Significant negative correlations were found between the total NCR score and various clinical symptoms. Comparing CHR-C and non-converters (CHR-NC), there were notable differences in NCR distributions across four cognitive measures, with a higher proportion of CHR-C individuals categorized as NCR - . For CHR-NR versus remission (CHR-R), CHR-NR individuals were more likely to be classified as NCR - across nearly all cognitive domains. The receiver operating characteristic (ROC) curve for predicting conversion to psychosis yielded an area under the curve (AUC) of 0.621 (95% CI (0.561-0.681), p = 0.0001), while the ROC for predicting non-remission demonstrated a higher AUC of 0.826 (95% CI (0.790-0.861), p < 0.0001).
NCR was associated with both conversion to psychosis and non-remission outcomes in CHR individuals, showing notable predictive accuracy, particularly for non-remission.
神经认知恢复力（NCR）是指个体尽管存在精神病风险因素但仍能维持认知功能的能力。研究NCR很重要，因为它可能有助于预测临床高危（CHR）个体中精神病的发作及功能转归。
本研究采用多组前瞻性设计，并进行了3年随访，是上海精神病高危扩展项目的一部分。使用中文版的精神分裂症认知改善测量与治疗研究共识认知成套测验评估神经认知表现。该研究聚焦于两个主要结局：是否转化为精神病（CHR-C/CHR-NC）以及是否缓解（CHR-NR/CHR-R）。NCR是基于相对于健康对照组（HC）均值调整后的认知变量来定义的，分为三类：得分在一个标准差范围内为NCR（NCR = 0），得分高于一个标准差以上为NCR +（NCR = 1），得分低于一个标准差以下为NCR -（NCR = -1）。
该研究纳入了771名CHR个体（346名男性，平均年龄18.8岁）和764名HC个体（359名男性，平均年龄22.5岁）。在CHR参与者中，540名（70.0%）完成了3年随访，其中106名（19.6%）转化为精神病（CHR-C），277名（51.3%）被归类为未缓解（CHR-NR）。NCR总分与各种临床症状之间存在显著负相关。比较CHR-C组和未转化组（CHR-NC），在四项认知测量的NCR分布上存在显著差异，CHR-C个体中被归类为NCR -的比例更高。对于CHR-NR组与缓解组（CHR-R），几乎在所有认知领域，CHR-NR个体更有可能被归类为NCR -。预测转化为精神病的受试者工作特征（ROC）曲线下面积（AUC）为0.621（95%CI（0.561 - 0.681），p = 0.0001），而预测未缓解的ROC曲线下面积更高，为0.826（95%CI（0.790 - 0.861），p < 0.0001）。
NCR与CHR个体转化为精神病及未缓解结局均相关，显示出显著的预测准确性，尤其是对于未缓解情况。
Zotero 插件
