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Perinatal complications and executive dysfunction in early-onset schizophrenia
Charlotte M Teigset1, Christine Mohn2,3, Bjørn Rishovd Rund2,4
1Vestre Viken Hospital Trust, Research Department, Wergelands gate 10, 3004, Drammen, Norway. charlotte.teigset@psykologi.uio.no.
Insights
Perinatal complications, especially shorter gestational length, are linked to executive dysfunction in early-onset schizophrenia (EOS). These issues were not seen in healthy controls, highlighting EOS vulnerability to perinatal insults.
Area of Science:
- Neuroscience
- Psychiatry
- Developmental Psychology
Background:
- Early-onset schizophrenia (EOS) is characterized by higher rates of obstetric complications and executive dysfunction.
- Newborns' developing brains are vulnerable to perinatal insults, potentially impacting prefrontal cortex maturation and executive functions.
- Perinatal complications may play a role in the development of executive dysfunction observed in EOS.
Purpose of the Study:
- To investigate the association between perinatal obstetric complications and executive dysfunction in individuals with EOS.
- To compare these associations in EOS patients versus healthy controls.
- To explore the specific impact of gestational length and Apgar scores on executive function.
Main Methods:
- Study included 19 EOS patients and 54 healthy controls.
- Executive function assessed using the D-KEFS Color Word Interference Test and Wisconsin Card Sorting Test.
- Perinatal data, including obstetric complications and Apgar 5-min scores, obtained from the Norwegian Medical Birth Registry.
- Stepwise regression analyses used to examine associations between perinatal factors and executive function.
Main Results:
- Shorter gestational length and other perinatal complications were significantly associated with executive dysfunction in EOS patients.
- Perinatal complications did not significantly affect executive function in healthy controls.
- Lower Apgar 5-min scores were associated with executive dysfunction in both EOS patients and healthy controls.
Conclusions:
- Exposure to perinatal complications, particularly shorter gestational length, increases executive dysfunction risk in EOS.
- EOS patients show heightened vulnerability to perinatal insults leading to executive deficits.
- Low Apgar 5-min scores may serve as an early indicator of executive difficulties in adolescents, irrespective of diagnosis.
Background:
The present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS.
Methods:
The participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses.
Results:
Perinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls.
Conclusions:
Exposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.
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