Summary: New research reveals that cognitive impairments in psychotic disorders, like schizophrenia and bipolar disorder, are connected to brain network organization. This connection is evident even before the first psychotic break in at-risk individuals, offering potential for early diagnosis and intervention.
The study highlights a novel brain network-cognition relationship that could lead to targeted treatments for these often treatment-resistant symptoms.
Key Facts
- Cognitive impairments in psychotic disorders are tied to brain network organization.
- This brain-cognition link is observable in individuals before their first psychotic break.
- Early detection and intervention opportunities may arise from these findings.
Source: Elsevier
According to new research, cognitive impairments in psychotic disorders, such as schizophrenia and bipolar disorder, are linked to brain network organization. This link between cognition and brain networks is present in individuals considered at-risk for psychotic disorders even prior to their first psychotic break.
This groundbreaking study in Biological Psychiatry, published by Elsevier, suggests an opportunity for early diagnosis and intervention for these treatment-resistant symptoms.
Lead author Heather Burrell Ward, MD, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, explains, “Cognitive impairment is highly prevalent in schizophrenia and other psychotic disorders. There are currently no medications to treat cognitive impairment, resulting in significant disability.
“This impairment is frequently present by the time an individual has their first psychotic break, making early detection and intervention critical. Our current study is part of our work to understand and treat the medication-resistant symptoms of psychotic disorders.”
Several cognitive domains found to be reliably impaired in psychotic disorders have received intensive study, such as overall cognitive ability. To measure cognitive impairment in psychosis, most studies have utilized cognitive tasks originally designed and validated in control populations.
However, these studies do not address the question of whether cognitive constructs map onto quantifiable brain substrates.
The current research used a cutting-edge MRI analysis approach and a cognitive test designed for people with psychosis to analyze data collected by two consortia of researchers: the Human Connectome Project for Early Psychosis (HCP-EP) and the North American Prodrome Longitudinal Study (NAPLS).
Co-senior author Roscoe O. Brady, Jr., MD, PhD, Harvard Medical School; Department of Psychiatry, Beth Israel Deaconess Medical Center, and McLean Hospital and Harvard Medical School, notes, “We observed that in individuals with psychotic disorders, cognitive impairment is linked to brain network organization.
“We then attempted something that has not been previously demonstrated: We asked if we can observe this same brain signature of cognitive impairment in individuals prior to their psychotic break.
“We analyzed data from individuals considered at-risk for psychotic disorders, but who had not yet had their first psychotic episode. We identified this same brain network-cognition relationship only in individuals who would eventually develop psychosis in the future.”
Commenting on the implications of the study, John Krystal, MD, Editor of Biological Psychiatry, says, “Researchers of this novel study used the combination of a data-driven connectome-wide multivariate pattern analysis and a disease-informed cognitive assessment to identify a novel and reproducible relationship between brain connectivity and cognitive performance in psychotic disorders, offering important insights for the early detection and intervention of psychotic disorders.”
Co-senior author Kathryn E. Lewandowski, PhD, McLean Hospital and Harvard Medical School, concludes, “There is an ongoing international effort to identify biomarkers and targets for intervention in individuals at-risk for psychotic disorders through the Accelerating Medicines Partnership® Schizophrenia (AMP SCZ).
“Our discovery of a link between cognition and brain networks, observed even prior to the first psychotic break, suggests an opportunity for early diagnosis and intervention, such as via noninvasive neuromodulation.”
About this psychosis and neuroscience research news
Author: Eileen Leahy
Source: Elsevier
Contact: Eileen Leahy – Elsevier
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Robust Brain Correlates of Cognitive Performance in Psychosis and Its Prodrome” by Heather Burrell Ward et al. Biological Psychiatry
Abstract
Robust Brain Correlates of Cognitive Performance in Psychosis and Its Prodrome
Background
Neurocognitive impairment is a well-known phenomenon in schizophrenia that begins prior to psychosis onset. Connectome-wide association studies have inconsistently linked cognitive performance to resting-state fMRI. We hypothesized a carefully selected cognitive instrument and refined population would allow identification of reliable brain-behavior associations with connectome-wide association studies. To test this hypothesis, we first identified brain-cognition correlations via a connectome-wide association study in early psychosis. We then asked, in an independent dataset, if these brain-cognition relationships would generalize to individuals who develop psychosis in the future.
Methods
The Seidman Auditory Continuous Performance Task (ACPT) effectively differentiates healthy participants from those with psychosis. Our connectome-wide association study used the Human Connectome Project for Early Psychosis (n=183) to identify links between connectivity and ACPT performance. We then analyzed the North American Prodrome Longitudinal Study 2 (n=345), a multi-site prospective study of individuals at risk for psychosis. We tested the connectome-wide association study-identified cognition-connectivity relationship in both individuals at risk for psychosis and controls.
Results
Our connectome-wide association study in early-course psychosis identified robust associations between better ACPT performance and higher prefrontal-somatomotor connectivity (p<.005). Prefrontal-somatomotor connectivity was also related to ACPT performance in at-risk individuals who would develop psychosis (n=17). This finding was not observed in nonconverters (n=196) or controls (n=132).
Conclusions
This connectome-wide association study identified reproducible links between connectivity and cognition in separate samples of psychosis and at-risk individuals who would later develop psychosis. A carefully selected task and population improves the ability of connectome-wide association studies to identify reliable brain-phenotype relationships.
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