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Understanding Lifespan Trajectories of Social Cognition, Brain Microstructure and Iron Dysregulation in Schizophrenia

23. september 2026 oppdatert av: Beatrice Frajo-Apor, Medical University Innsbruck

SilverMinds - Lifespan Trajectories of Social Cognition and Iron Dysregulation in Schizophrenia

This study aims to better understand how schizophrenia may affect social thinking, emotion regulation, brain function, and biological processes over time.

Two groups will take part in the study:

  1. people diagnosed with schizophrenia
  2. healthy adults without schizophrenia

Participants in both groups will complete a series of behavioral tasks and questionnaires. These will assess abilities such as understanding other people, processing social information, and regulating emotions. For participants with schizophrenia, we will also assess clinical symptoms and their severity.

The study includes three assessment visits:

  1. Baseline: at the beginning of the study
  2. 12-month follow-up: approximately one year later
  3. 24-month follow-up: approximately two years later

At all three visits, participants will complete behavioral tests and questionnaires, and blood and hair samples will be collected. These samples may help researchers investigate biological factors that are related to mental health, stress, and changes over time.

Participants will also undergo an MRI brain scan at the baseline visit and again at the 12-month follow-up.

People with schizophrenia may experience changes in thinking, emotions, social functioning, physical health, and brain function across adulthood. However, we still do not fully understand how these changes develop over time or how they differ from normal aging.

By comparing people with schizophrenia with healthy adults of different ages and following them over time, we can study possible differences in aging trajectories. This means examining whether certain abilities, symptoms, biological markers, or brain characteristics change differently with age in people with schizophrenia.

The study uses an accelerated longitudinal design. Instead of following one group of people for many decades, researchers recruit participants from different age groups and follow them for a shorter period. Combining information across these age groups can help researchers estimate longer-term patterns of change.

Studieoversikt

Status

Rekruttering

Forhold

Studietype

Observasjonsmessig

Registrering (Antatt)

180

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

    • Tyrol
      • Innsbruck, Tyrol, Østerrike, 6020
        • Rekruttering
        • Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology; Medical University of Innsbruck
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 70 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Ja

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Participants with SZ will be recruited through multiple clinical pathways to ensure adequate sample size and representativeness across the adult lifespan. The primary recruitment source is the specialized outpatient clinic for SZ spectrum disorders at the Department of Psychiatry, MUI, which serves a large catchment area and maintains detailed diagnostic records. Additional participants will be recruited through a collaborating psychiatric hospital and office-based psychiatrists and psychosocial service providers in the region, with whom the Dep. of Psychiatry maintains established referral networks. Patients in the SZ group must have a DSM-5 diagnosis of schizophrenia confirmed by their treating psychiatrist. HC participants will be recruited through advertisements in online platforms, social media, and community outreach.

Beskrivelse

Inclusion criteria (all participants):

age 18-70 years at baseline; normal or corrected-to-normal vision; sufficient hearing; fluency in German; willingness and ability to understand and comply with study procedures. Participants must either be healthy adults without any mental health disorder (HC) or have a confirmed DSM-5 diagnosis of SZ.

Inclusion criteria (SZ only):

clinical stability at assessment, defined as no clinically significant change in psychopathological symptoms and no modification of pharmacotherapy for at least three months prior to study entry, as confirmed by the treating psychiatrist; full remission is not required.

Exclusion criteria (all participants):

incapacity to consent; current or lifetime history of brain surgery or epilepsy; MRI contraindications (unremovable metal parts in the upper body, active implants, claustrophobia); current or past substance abuse disorder (excluding caffeine and nicotine); pregnancy.

Exclusion criteria (HC only):

any current or lifetime Axis I psychiatric disorder; first-degree relative with an Axis I disorder; any neurological disorder or other mental health condition; current or past use of psychotropic medication.

Additional Eligibility Criteria for Cycle-Timed Neuroimaging:

To minimize hormonal confounding of emotion-regulation-related neural measures, menstruating female participants will be scanned in the early follicular phase (cycle days 1-6), requiring regular menstrual cycles (21-35 days) and a negative pregnancy test at relevant visits.

Use of hormonal contraception will be recorded.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Observasjonsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og intervensjoner

Gruppe / Kohort
Schizophrenia Group

Group of people with a diagnosis of schizophrenia confirmed by their treating psychiatrist.

Healthy control group

Group absent of any Axis-I Diagnosis

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Theory of Mind performance
Tidsramme: Baseline, 12 months, and 24 months

Theory of Mind will be assessed using the EmpaToM task. The outcome will include performance-based indices of cognitive and affective Theory of Mind. Higher scores indicate better ability to infer and understand the mental states of others.

Baseline, 12 months, and 24 months
Change in attributional style
Tidsramme: Baseline, 12 months, and 24 months

Attributional style will be assessed using the Internal, Personal and Situational Attributions Questionnaire-Revised. The outcome will measure tendencies to attribute positive and negative social events to internal, personal-external, or situational-external causes; aswell as monocausal-inference-style.

Baseline, 12 months, and 24 months
Change in emotion recognition performance
Tidsramme: Baseline, 12 months, and 24 months

Emotion recognition will be assessed using the DiagnosIS Emotion Recognition Task. The outcome will measure accuracy in identifying facial emotional expressions. Higher scores indicate better emotion recognition performance.

Baseline, 12 months, and 24 months
Change in Emotion Regulation Choice
Tidsramme: Baseline, 12 months, 24 months

The Emotion Regulation Choice Task is a behavioral paradigm used to examines whether individuals adapt their choice of emotion regulation strategy according to the intensity of negative emotional stimuli.

It will be used to assess the change in the degree to which strategy choice changes as a function of emotional intensity.

Baseline, 12 months, 24 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in reflective functioning
Tidsramme: Baseline, 12 months, and 24 months

Reflective functioning will be assessed using the Reflective Functioning Questionnaire. The outcome will measure certainty and uncertainty about mental states. Scores will be analyzed according to the scoring rules of the instrument.

Baseline, 12 months, and 24 months
Change in self reported Emotion Regulation
Tidsramme: Baseline, 12 months, 24 months

Self reported emotion regulation will be assessed using the Emotion Regulation Questionnaire (ERQ). The ERQ is a 10-item self-report measure assessing the habitual use of two emotion-regulation strategies: cognitive reappraisal and expressive suppression.

Baseline, 12 months, 24 months
Change in global cognitive functioning
Tidsramme: Baseline, 12 months, and 24 months

Global cognition will be assessed using the Screen for Cognitive Impairment in Psychiatry. The outcome will provide a standardized measure of cognitive functioning across domains including verbal learning, working memory, verbal fluency, and processing speed. Higher scores indicate better cognitive performance.

Baseline, 12 months, and 24 months
Change in daily functioning and disability
Tidsramme: Baseline, 12 months, and 24 months

Daily functioning and disability will be assessed using the World Health Organization Disability Assessment Schedule 2.0. The outcome will measure functioning across cognition, mobility, self-care, interpersonal relationships, life activities, and participation in society. Higher scores indicate greater disability.

Baseline, 12 months, and 24 months
Change in brain iron distribution measured by quantitative susceptibility mapping
Tidsramme: Baseline and 12 months

Brain iron distribution will be assessed using quantitative susceptibility mapping (QSM) derived from multi-echo gradient echo MRI.

Baseline and 12 months
Change in R2* relaxometry measures of brain iron-sensitive signal
Tidsramme: Baseline and 12 months

R2* values will be derived from multi-echo gradient echo MRI as an iron-sensitive neuroimaging measure.

Baseline and 12 months
Change in white matter microstructure
Tidsramme: Baseline and 12 months

White matter microstructure will be assessed using diffusion-weighted MRI. Outcomes will include fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity.

Baseline and 12 months
Change in resting-state functional connectivity
Tidsramme: Baseline and 12 months

Resting-state functional connectivity will be assessed using resting-state functional MRI.

Baseline and 12 months
Change in extracellular vesicle-derived redox markers
Tidsramme: Baseline, 12 months, and 24 months

Neuronally derived extracellular vesicles will be isolated from plasma samples.

Baseline, 12 months, and 24 months
Change in hair proteomic signatures
Tidsramme: Baseline, 12 months, and 24 months

Hair samples will be analyzed using untargeted proteomic profiling. Outcomes will include proteomic signature related to oxidative stress, antioxidant defense, inflammation, mitochondrial bioenergetics, systemic stress, and biological aging.

Baseline, 12 months, and 24 months
Change in hair cortisol concentration
Tidsramme: Baseline, 12 months, and 24 months

Hair cortisol concentration will be measured from scalp hair samples as an index of cumulative hypothalamic-pituitary-adrenal axis activity over the preceding months. Higher values indicate higher cumulative cortisol exposure.

Baseline, 12 months, and 24 months
Change in psychopathological symptom severity
Tidsramme: Baseline, 12 months, and 24 months

Psychopathological symptoms in participants with schizophrenia will be assessed using the Positive and Negative Syndrome Scale. The outcome will include total and subscale scores for positive symptoms, negative symptoms, and general psychopathology. Higher scores indicate greater symptom severity.

Baseline, 12 months, and 24 months
Change in negative symptom severity
Tidsramme: Baseline, 12 months, and 24 months

Negative symptoms will be assessed using the Brief Negative Symptom Scale. The outcome will measure negative symptom domains including anhedonia, asociality, avolition, blunted affect, and alogia. Higher scores indicate greater negative symptom severity.

Baseline, 12 months, and 24 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Samarbeidspartnere

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. september 2026

Primær fullføring (Antatt)

1. september 2030

Studiet fullført (Antatt)

30. september 2030

Datoer for studieregistrering

Først innsendt

23. september 2026

Først innsendt som oppfylte QC-kriteriene

23. september 2026

Først lagt ut (Faktiske)

2. oktober 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

2. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

23. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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