The neuropsychology and neurobiology of late-onset schizophrenia and very-late-onset schizophrenia-like psychosis: A critical review

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:83

Review

Van Assche, Lies¹  Morrens, Manuel^2,3  Luyten, Patrick^4,5  Van de Ven, Luc¹  Vandenbulcke, Mathieu¹ 

[1] Katholieke Univ Leuven, Univ Hosp Leuven, Sect Old Age Psychiat, Dept Psychiat, Leuven, Belgium

[2] Univ Antwerp, CAPRI, Antwerp, Belgium

[3] Univ Psychiat Hosp Antwerp, Campus Duffel, Edegem, Belgium

[4] Univ Leuven, Dept Psychol, Leuven, Belgium

[5] UCL, Res Dept Clin Educ & Hlth Psychol, London, England

关键词: Elderly;    Schizophrenia;    Neuropsychology;    Neurobiology;   

DOI  :  10.1016/j.neubiorev.2017.08.024

来源: Elsevier

【 摘 要 】

Objective: The current review discusses neuropsychological profiles and the longitudinal course of cognitive dysfunction in Late Onset Schizophrenia (LOS) and Very-late-onset schizophrenia-like psychosis (VLOSLP), and attempts to clarify its neurobiological underpinnings. Method: A systematic literature search resulted in 29 publications describing original research on the neu- ropsychology of LOS/VLOSLP and 46 studies focussing on neurobiology. Results: Although mildly progressive cognitive impairment is usually present, only a subgroup of LOS/VLOSLP develops dementia during a 10-year follow-up succeeding the onset of psychosis. This coincides with the absence of neuropathological evidence for neurodegeneration in many cases. Cognitive deterioration is characterized by deficits in (working) memory, language, psychomotor speed and executive functioning. Underlying neurobiological changes encompass white matter pathology, increased ventricle-to-brain ratio (VBR) with coinciding atrophy and hypo-metabolism of frontal, temporal and subcortical areas. Conclusions: Multiple changes in neurobiology and cognition contributing to LOS/VLOSLP may reflect stress related accelerated brain aging rather than neurodegenerative pathology. Their involvement in the onset of illness, however, might be inversely proportional to pre-existing (psychosocial and/or genetic) vulnerability to psychosis.

【 授权许可】

Free