QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
Transl Psychiatry. 2023 Mar 3;13(1):77. doi: 10.1038/s41398-023-02381-x.
The mixed cognitive outcomes in early psychosis (EP) have important implications for recovery. In this longitudinal study, we asked whether baseline differences in the cognitive control system (CCS) in EP participants would revert toward a normative trajectory seen in healthy controls (HC). Thirty EP and 30 HC undertook functional MRI at baseline using the multi-source interference task-a paradigm that selectively introduces stimulus conflict-and 19 in each group repeated the task at 12 months. Activation of the left superior parietal cortex normalized over time for the EP group, relative to HC, coincident with improvements in reaction time and social-occupational functioning. To examine these group and timepoint differences, we used dynamic causal modeling to infer changes in effective connectivity between regions underlying the MSIT task execution, namely visual, anterior insula, anterior cingulate, and superior parietal cortical regions. To resolve stimulus conflict, EP participants transitioned from an indirect to a direct neuromodulation of sensory input to the anterior insula over timepoints, though not as strongly as HC participants. Stronger direct nonlinear modulation of the anterior insula by the superior parietal cortex at follow-up was associated with improved task performance. Overall, normalization of the CCS through adoption of more direct processing of complex sensory input to the anterior insula, was observed in EP after 12 months of treatment. Such processing of complex sensory input reflects a computational principle called gain control, which appears to track changes in cognitive trajectory within the EP group.
早期精神病（EP）的混合认知结果对康复有重要影响。在这项纵向研究中，我们询问了 EP 参与者的认知控制系统（CCS）在基线时的差异是否会恢复到健康对照组（HC）中看到的正常轨迹。30 名 EP 和 30 名 HC 在基线时使用多源干扰任务进行了功能磁共振成像（fMRI），这是一种选择性引入刺激冲突的范式，并且每组中有 19 人在 12 个月时重复了该任务。与 HC 相比，EP 组的左顶叶上回的激活随着时间的推移趋于正常，这与反应时间和社交职业功能的改善相一致。为了检查这些组间和时间点的差异，我们使用动态因果建模来推断 MSIT 任务执行下的区域之间的有效连接变化，即视觉、前岛叶、前扣带和顶叶皮层区域。为了解决刺激冲突，EP 参与者随着时间的推移从间接到直接神经调节前岛叶的感觉输入，尽管不如 HC 参与者强烈。在前扣带皮层对前岛叶的直接非线性调制越强，任务表现越好。总的来说，在 12 个月的治疗后，EP 患者的 CCS 通过采用更直接的处理前岛叶的复杂感觉输入来实现正常化。这种对复杂感觉输入的处理反映了一种称为增益控制的计算原则，该原则似乎反映了 EP 组内认知轨迹的变化。
