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Erschienen in: European Archives of Psychiatry and Clinical Neuroscience 8/2009

01.12.2009 | Original Paper

Heritability of Trail Making Test performance in multiplex schizophrenia families: implications for the search for an endophenotype

verfasst von: Raúl Mendoza Quiñones, Yuranny Cabral Calderín, Mayelin Domínguez, Tania M. Bravo, Adnelys Reyes Berazaín, Alexander García, Antonio Caballero, Migdyrai Martín Reyes

Erschienen in: European Archives of Psychiatry and Clinical Neuroscience | Ausgabe 8/2009

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Abstract

The impairment of the Trail Making Test (TMT) performance as a measure of executive function deficits has been found both in patients with schizophrenia and in their unaffected first-degree relatives, suggesting that it might be considered as a familial vulnerability marker, but its heritability estimates are not well known. This study investigated the genetic heritability of impairments in TMT performance using a sample of 80 schizophrenia patients, 145 unaffected first-degree relatives and 127 healthy controls from families with multiple members with schizophrenia. Consistent with previous reports in the literature, relatives performed in between healthy controls and schizophrenia patients. Based on these results, a variance component-analysis provided small, but significant additive heritability estimates for performance indices relating performance in TMT-version A to TMT-version B. These results showed that this significant but small evidence of heritability on the one hand suggests an association with genetic predisposition to schizophrenia, but that TMT performance is also associated with epigenetic or environmental factors.
Literatur
1.
Zurück zum Zitat Aleman A, Hijman R, de Haan EH, Kahn RS (1999) Memory impairment in schizophrenia: a meta-analysis. Am J Psychiatry 156(9):1358–1366PubMed Aleman A, Hijman R, de Haan EH, Kahn RS (1999) Memory impairment in schizophrenia: a meta-analysis. Am J Psychiatry 156(9):1358–1366PubMed
2.
Zurück zum Zitat Almasy L, Blangero J (1998) Multipoint quantitative-trait linkage analysis in general pedigrees. Am J Hum Genet 62:1198–1211CrossRefPubMed Almasy L, Blangero J (1998) Multipoint quantitative-trait linkage analysis in general pedigrees. Am J Hum Genet 62:1198–1211CrossRefPubMed
3.
Zurück zum Zitat American Psychiatric Association (1984) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatry Association, Washington American Psychiatric Association (1984) Diagnostic and statistical manual of mental disorder, 4th edn. American Psychiatry Association, Washington
4.
Zurück zum Zitat Anokhin AP, Heath A, Ralano A (2003) Genetic influences on frontal brain function: WCST performance in twins. Neuroreport 14(15):1975–1978CrossRefPubMed Anokhin AP, Heath A, Ralano A (2003) Genetic influences on frontal brain function: WCST performance in twins. Neuroreport 14(15):1975–1978CrossRefPubMed
5.
Zurück zum Zitat Arbuthnott K, Frank J (2000) Trail Making Test, part B as a measure of executive control: validation using a set-switching paradigm. J Clin Exp Neuropsychol 22(4):518–528CrossRefPubMed Arbuthnott K, Frank J (2000) Trail Making Test, part B as a measure of executive control: validation using a set-switching paradigm. J Clin Exp Neuropsychol 22(4):518–528CrossRefPubMed
6.
Zurück zum Zitat Asarnow RF, Nuechterlein KH, Subotnik KL, Fogelson DL, Torquato RD, Payne DL, Asamen J, Mintz J, Guthrie D (2002) Neurocognitive impairments in nonpsychotic parents of children with schizophrenia and attention-deficit/hyperactivity disorder: the University of California, Los Angeles Family Study. Arch Gen Psychiatry 59:1053–1060CrossRefPubMed Asarnow RF, Nuechterlein KH, Subotnik KL, Fogelson DL, Torquato RD, Payne DL, Asamen J, Mintz J, Guthrie D (2002) Neurocognitive impairments in nonpsychotic parents of children with schizophrenia and attention-deficit/hyperactivity disorder: the University of California, Los Angeles Family Study. Arch Gen Psychiatry 59:1053–1060CrossRefPubMed
7.
Zurück zum Zitat Aukes MF, Alizadeh BZ, Sistkoorn MM, Selten J, Sinke RJ, Kemmer C, Ophoff RA, Kahn RS (2008) Finding suitable phenotypes for genetic studies of schizophrenia: heritability and segregation analysis. Biol Psychiatry 64(2):128–136CrossRefPubMed Aukes MF, Alizadeh BZ, Sistkoorn MM, Selten J, Sinke RJ, Kemmer C, Ophoff RA, Kahn RS (2008) Finding suitable phenotypes for genetic studies of schizophrenia: heritability and segregation analysis. Biol Psychiatry 64(2):128–136CrossRefPubMed
8.
Zurück zum Zitat Bonilha L, Molnar C, Horner MD, Anderson B, Forster L, George MS, Nahas Z (2008) Neurocognitive deficits and prefrontal cortical atrophy in patients with schizophrenia. Schizophr Res 101:142–151CrossRefPubMed Bonilha L, Molnar C, Horner MD, Anderson B, Forster L, George MS, Nahas Z (2008) Neurocognitive deficits and prefrontal cortical atrophy in patients with schizophrenia. Schizophr Res 101:142–151CrossRefPubMed
9.
Zurück zum Zitat Brazo P, Delamillieure P, Morello R, Halbecq I, Marie RM, Dollfus S (2005) Impairments of executive/attentional functions in schizophrenia with primary and secondary negative symptoms. Psychiatry Res 133:45–55CrossRefPubMed Brazo P, Delamillieure P, Morello R, Halbecq I, Marie RM, Dollfus S (2005) Impairments of executive/attentional functions in schizophrenia with primary and secondary negative symptoms. Psychiatry Res 133:45–55CrossRefPubMed
10.
Zurück zum Zitat Cornblatt BA, Malhotra AK (2001) Impaired attention as an endophenotype for molecular genetic studies of schizophrenia. Am J Med Genet 105(1):11–15CrossRefPubMed Cornblatt BA, Malhotra AK (2001) Impaired attention as an endophenotype for molecular genetic studies of schizophrenia. Am J Med Genet 105(1):11–15CrossRefPubMed
11.
Zurück zum Zitat Dollfus S, Lombardo C, Benali K, Halbecq I, Abadie P, Marie RM, Brazo P (2002) Executive/attentional cognitive functions in schizophrenic patients and their parents: a preliminary study. Schizophr Res 1(53):93–99CrossRef Dollfus S, Lombardo C, Benali K, Halbecq I, Abadie P, Marie RM, Brazo P (2002) Executive/attentional cognitive functions in schizophrenic patients and their parents: a preliminary study. Schizophr Res 1(53):93–99CrossRef
12.
Zurück zum Zitat Egan MF, Goldberg TE, Gscheidle T, Weirich M, Rawlings R, Hyde TM, Bigelow L, Weinberger DR (2001) Relative risk for cognitive impairments in siblings of patients with schizophrenia. Biol Psychiatry 50:98–107CrossRefPubMed Egan MF, Goldberg TE, Gscheidle T, Weirich M, Rawlings R, Hyde TM, Bigelow L, Weinberger DR (2001) Relative risk for cognitive impairments in siblings of patients with schizophrenia. Biol Psychiatry 50:98–107CrossRefPubMed
13.
Zurück zum Zitat Franke P, Maier W, Hardt J, Hain C (1993) Cognitive functioning and anhedonia in subjects at risk for schizophrenia. Schizophr Res 10:77–84CrossRefPubMed Franke P, Maier W, Hardt J, Hain C (1993) Cognitive functioning and anhedonia in subjects at risk for schizophrenia. Schizophr Res 10:77–84CrossRefPubMed
14.
Zurück zum Zitat Gilvarry CM, Rusell A, Hemsley D, Murray RM (2000) Trail Making Test performance in the first degree relatives of schizophrenic and affected psychotic patients. Cogn Neuropsychiatry 5:219–234CrossRef Gilvarry CM, Rusell A, Hemsley D, Murray RM (2000) Trail Making Test performance in the first degree relatives of schizophrenic and affected psychotic patients. Cogn Neuropsychiatry 5:219–234CrossRef
15.
Zurück zum Zitat González-Blanch C, Álvarez-Jiménez M, Rodríguez-Sánchez JM, Pérez-Iglesias R, Vázquez-Barquero JL, Crespo-Facorro B (2006) Cognitive functioning in the early course of first-episode schizophrenia spectrum disorders. Eur Arch Psychiatry Clin Neurosci 256:364–371CrossRefPubMed González-Blanch C, Álvarez-Jiménez M, Rodríguez-Sánchez JM, Pérez-Iglesias R, Vázquez-Barquero JL, Crespo-Facorro B (2006) Cognitive functioning in the early course of first-episode schizophrenia spectrum disorders. Eur Arch Psychiatry Clin Neurosci 256:364–371CrossRefPubMed
16.
Zurück zum Zitat Gottesman II, Gould TD (2003) The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 160:636–645CrossRefPubMed Gottesman II, Gould TD (2003) The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 160:636–645CrossRefPubMed
17.
Zurück zum Zitat Heinrich RW, Zakzanis KK (1998) Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12:426–445CrossRef Heinrich RW, Zakzanis KK (1998) Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology 12:426–445CrossRef
18.
Zurück zum Zitat Keefe RS, Silverman JM, Roitman SE, Harvey PD, Duncan MA, Alroy D, Siever LJ, Davis KL, Mohs RC (1994) Performance of nonpsychotic relatives of schizophrenic patients on cognitive tests. Psychiatry Res 53:1–12CrossRefPubMed Keefe RS, Silverman JM, Roitman SE, Harvey PD, Duncan MA, Alroy D, Siever LJ, Davis KL, Mohs RC (1994) Performance of nonpsychotic relatives of schizophrenic patients on cognitive tests. Psychiatry Res 53:1–12CrossRefPubMed
19.
Zurück zum Zitat Kremen WS, Seidman LJ, Pepple JR, Lyons MJ, Tsuang MT, Faraone SV (1994) Neuropsychological risk indicators for schizophrenia: a review of family studies. Schizophr Bull 20(1):103–119PubMed Kremen WS, Seidman LJ, Pepple JR, Lyons MJ, Tsuang MT, Faraone SV (1994) Neuropsychological risk indicators for schizophrenia: a review of family studies. Schizophr Bull 20(1):103–119PubMed
20.
Zurück zum Zitat Ma X, Wang Q, Sham PC, Liu X, Rabe-Hesketh S, Sun X, Hu J, Meng H, Chen W, Chen EYH, Deng W, Chan RCK, Murray R, Collier D, Li T (2007) Neurocognitive deficits in first-episode schizophrenic patients and their first-degree relatives. Am J of Med Genet B Neuropsychiatr Genet 144B:407–416CrossRef Ma X, Wang Q, Sham PC, Liu X, Rabe-Hesketh S, Sun X, Hu J, Meng H, Chen W, Chen EYH, Deng W, Chan RCK, Murray R, Collier D, Li T (2007) Neurocognitive deficits in first-episode schizophrenic patients and their first-degree relatives. Am J of Med Genet B Neuropsychiatr Genet 144B:407–416CrossRef
21.
Zurück zum Zitat Maxwell ME (1992) Family interview for genetic studies. Clinical Neurogenetic Branch, Intramural Research Program, NIMH Maxwell ME (1992) Family interview for genetic studies. Clinical Neurogenetic Branch, Intramural Research Program, NIMH
22.
Zurück zum Zitat Meyer-Lindenberg A, Poline JB, Kohn PD, Holt JL, Egan MF, Weinberger DR, Berman KF (2001) Evidence for abnormal cortical functional connectivity during working memory in schizophrenia. Am J Psychiatry 158:1809–1817CrossRefPubMed Meyer-Lindenberg A, Poline JB, Kohn PD, Holt JL, Egan MF, Weinberger DR, Berman KF (2001) Evidence for abnormal cortical functional connectivity during working memory in schizophrenia. Am J Psychiatry 158:1809–1817CrossRefPubMed
23.
Zurück zum Zitat Pantelis C, Barber FZ, Barnes TRE, Nelson HE, Owen SM, Robbins TW (1999) Comparison of set-shifting ability in patients with chronic schizophrenia and frontal lobe damage. Schizophr Res 37(3):251–270CrossRefPubMed Pantelis C, Barber FZ, Barnes TRE, Nelson HE, Owen SM, Robbins TW (1999) Comparison of set-shifting ability in patients with chronic schizophrenia and frontal lobe damage. Schizophr Res 37(3):251–270CrossRefPubMed
24.
Zurück zum Zitat Periáñez JA, Ríos-Lago M, Rodríguez-Sánchez JM, Adrover-Roig D, Sánchez-Cubillo I, Cresco-Facorro B, Quemada JL, Barceló F (2007) Trail Making in traumatic brain injury, schizophrenia, and normal ageing: sample comparisons and normative data. Arch Clin Neuropsychol 22:433–447CrossRefPubMed Periáñez JA, Ríos-Lago M, Rodríguez-Sánchez JM, Adrover-Roig D, Sánchez-Cubillo I, Cresco-Facorro B, Quemada JL, Barceló F (2007) Trail Making in traumatic brain injury, schizophrenia, and normal ageing: sample comparisons and normative data. Arch Clin Neuropsychol 22:433–447CrossRefPubMed
25.
Zurück zum Zitat Pogue-Geile MF, Garrett AH, Brunke JJ, Hall JK (1991) Neuropsychological impairments are increased in siblings of schizophrenic patients. Schizophr Res 4:390CrossRef Pogue-Geile MF, Garrett AH, Brunke JJ, Hall JK (1991) Neuropsychological impairments are increased in siblings of schizophrenic patients. Schizophr Res 4:390CrossRef
26.
Zurück zum Zitat Reitan RM (1958) Validity of Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 8:271–276CrossRef Reitan RM (1958) Validity of Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 8:271–276CrossRef
27.
Zurück zum Zitat Riedel M, Spellmann I, Strassnig M, Douhet A, Dehning S, Opgen-Rhein M, Valdevit R, Engel R, Kleindienst N, Müller N, Möller H (2007) Effects of risperidone and quetiapine on cognition in patients with schizophrenia and predominantly negative symptoms. Eur Arch Psychiatry Clin Neurosci 257:360–370CrossRefPubMed Riedel M, Spellmann I, Strassnig M, Douhet A, Dehning S, Opgen-Rhein M, Valdevit R, Engel R, Kleindienst N, Müller N, Möller H (2007) Effects of risperidone and quetiapine on cognition in patients with schizophrenia and predominantly negative symptoms. Eur Arch Psychiatry Clin Neurosci 257:360–370CrossRefPubMed
28.
Zurück zum Zitat Ritter LM, Meador-Woodruff JH, Dalack GW (2004) Neurocognitive measures of prefrontal cortical dysfunction in schizophrenia. Schizophr Res 68:65–73CrossRefPubMed Ritter LM, Meador-Woodruff JH, Dalack GW (2004) Neurocognitive measures of prefrontal cortical dysfunction in schizophrenia. Schizophr Res 68:65–73CrossRefPubMed
29.
Zurück zum Zitat Sitskoorn MM, Aleman A, Ebisch SJH, Apples MCM, Kahn RS (2004) Cognitive deficits in relatives of patients with schizophrenia: a meta-analysis. Schizophr Res 71:285–295CrossRefPubMed Sitskoorn MM, Aleman A, Ebisch SJH, Apples MCM, Kahn RS (2004) Cognitive deficits in relatives of patients with schizophrenia: a meta-analysis. Schizophr Res 71:285–295CrossRefPubMed
30.
Zurück zum Zitat Snitz BE, Macdonald AW, Carter CS (2006) Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophr Bull 32:179–194CrossRefPubMed Snitz BE, Macdonald AW, Carter CS (2006) Cognitive deficits in unaffected first-degree relatives of schizophrenia patients: a meta-analytic review of putative endophenotypes. Schizophr Bull 32:179–194CrossRefPubMed
31.
Zurück zum Zitat Spellmann I, Müller N, Musil R, Zill P, Douhet A, Dehning S, Cerovecki A, Bondy B, Möller H, Riedel M (2008) Associations of SNAP-25 polymorphisms with cognitive dysfunctions in Caucasian patients with schizophrenia during a brief trail of treatment with atypical antipsychotics. Eur Arch Psychiatry Clin Neurosci 258:335–344CrossRefPubMed Spellmann I, Müller N, Musil R, Zill P, Douhet A, Dehning S, Cerovecki A, Bondy B, Möller H, Riedel M (2008) Associations of SNAP-25 polymorphisms with cognitive dysfunctions in Caucasian patients with schizophrenia during a brief trail of treatment with atypical antipsychotics. Eur Arch Psychiatry Clin Neurosci 258:335–344CrossRefPubMed
32.
Zurück zum Zitat Swan GE, Carmelli D (2002) Evidence for genetic mediation of executive control: a study of aging male twins. J Gerontol B Psychol Sci Soc Sci 57:133–143 Swan GE, Carmelli D (2002) Evidence for genetic mediation of executive control: a study of aging male twins. J Gerontol B Psychol Sci Soc Sci 57:133–143
33.
Zurück zum Zitat Szöke A, Schurhoff F, Mathieu F, Meary A, Ionescu S, Leboyer M (2005) Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis. Psychol Med 35:771–782CrossRefPubMed Szöke A, Schurhoff F, Mathieu F, Meary A, Ionescu S, Leboyer M (2005) Tests of executive functions in first-degree relatives of schizophrenic patients: a meta-analysis. Psychol Med 35:771–782CrossRefPubMed
34.
Zurück zum Zitat Taylor J (2007) Heritability of Wisconsin Card Sorting Test (WCST) and Stroop Color-Word Test performance in normal individuals: implications for the search for endophenotypes. Twin Res Hum Genet 10(6):829–834CrossRefPubMed Taylor J (2007) Heritability of Wisconsin Card Sorting Test (WCST) and Stroop Color-Word Test performance in normal individuals: implications for the search for endophenotypes. Twin Res Hum Genet 10(6):829–834CrossRefPubMed
35.
Zurück zum Zitat Thompson JL, Watson JR, Steinhauer SR, Goldstein G, Pogue-Geile MF (2005) Indicators of genetic liability to schizophrenia: a sibling study of neuropsychological performance. Schizophr Bull 31(1):85–96CrossRefPubMed Thompson JL, Watson JR, Steinhauer SR, Goldstein G, Pogue-Geile MF (2005) Indicators of genetic liability to schizophrenia: a sibling study of neuropsychological performance. Schizophr Bull 31(1):85–96CrossRefPubMed
36.
Zurück zum Zitat Tuulio-Henriksson A, Haukka J, Partonen T, Varilo T, Paunio T, Ekelund J, Cannon TD, Lönnqvist J (2002) Heritability of neurocognitive functions and number of quantitative trait loci contributing to them in families with schizophrenia. Am J Med Genet B Neuropsychiatr Genet 114:483–490CrossRef Tuulio-Henriksson A, Haukka J, Partonen T, Varilo T, Paunio T, Ekelund J, Cannon TD, Lönnqvist J (2002) Heritability of neurocognitive functions and number of quantitative trait loci contributing to them in families with schizophrenia. Am J Med Genet B Neuropsychiatr Genet 114:483–490CrossRef
37.
Zurück zum Zitat Vázquez-Barquero JL (1992) Report on the Spanish Translation of the SCAN, Schedules and Glossary. Informe a la Organización Mundial de la Salud. Unidad de Investigación en Psiquiatría Social de Cantabria, Santander Vázquez-Barquero JL (1992) Report on the Spanish Translation of the SCAN, Schedules and Glossary. Informe a la Organización Mundial de la Salud. Unidad de Investigación en Psiquiatría Social de Cantabria, Santander
38.
Zurück zum Zitat Velligan DI, DiCocco M, Bow-Thomas CC, Cadle C, Glahn DC, Miller AL, Bigg MM, Shores-Wilson K, McKenzie CA, Crismon ML (2004) A brief cognitive assessment for use with schizophrenia patients in community clinics. Schizophr Res 71:273–283CrossRefPubMed Velligan DI, DiCocco M, Bow-Thomas CC, Cadle C, Glahn DC, Miller AL, Bigg MM, Shores-Wilson K, McKenzie CA, Crismon ML (2004) A brief cognitive assessment for use with schizophrenia patients in community clinics. Schizophr Res 71:273–283CrossRefPubMed
39.
Zurück zum Zitat Waldman ID (2005) Statistical approaches to complex phenotypes: evaluating neuropsychological endophenotypes for attention-deficit/hyperactivity disorder. Biol Psychiatry 57:1347–1356CrossRefPubMed Waldman ID (2005) Statistical approaches to complex phenotypes: evaluating neuropsychological endophenotypes for attention-deficit/hyperactivity disorder. Biol Psychiatry 57:1347–1356CrossRefPubMed
40.
Zurück zum Zitat Yurgelun-Todd DA, Kinney DK (1993) Patterns of neuropsychological deficits that discriminate schizophrenic individuals from siblings and control subjects. J Neuropsychiatry 5:294–300 Yurgelun-Todd DA, Kinney DK (1993) Patterns of neuropsychological deficits that discriminate schizophrenic individuals from siblings and control subjects. J Neuropsychiatry 5:294–300
41.
Zurück zum Zitat Zalla T, Joyce C, Szoke A, Schurhoff F, Pillon B, Komano O, Perez-Diaz F, Bellivier F, Alter C, Duboise B, Rouillon F, Houde O, Leboyer M (2004) Executive dysfunctions as potential markers of familial vulnerability to bipolar disorder and schizophrenia. Psychiatry Res 121:207–217CrossRefPubMed Zalla T, Joyce C, Szoke A, Schurhoff F, Pillon B, Komano O, Perez-Diaz F, Bellivier F, Alter C, Duboise B, Rouillon F, Houde O, Leboyer M (2004) Executive dysfunctions as potential markers of familial vulnerability to bipolar disorder and schizophrenia. Psychiatry Res 121:207–217CrossRefPubMed
Metadaten
Titel
Heritability of Trail Making Test performance in multiplex schizophrenia families: implications for the search for an endophenotype
verfasst von
Raúl Mendoza Quiñones
Yuranny Cabral Calderín
Mayelin Domínguez
Tania M. Bravo
Adnelys Reyes Berazaín
Alexander García
Antonio Caballero
Migdyrai Martín Reyes
Publikationsdatum
01.12.2009
Verlag
D. Steinkopff-Verlag
Erschienen in
European Archives of Psychiatry and Clinical Neuroscience / Ausgabe 8/2009
Print ISSN: 0940-1334
Elektronische ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-009-0012-6

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