School of Psychological Sciences, College of Engineering, Science, and the Environment, The University of Newcastle, Newcastle, NSW, Australia.
Hunter Medical Research Institute, Newcastle, NSW, Australia.
Schizophr Bull. 2023 Jul 4;49(4):987-996. doi: 10.1093/schbul/sbad010.
Impairments in the expression, experience, and recognition of emotion are common in early psychosis (EP). Computational accounts of psychosis suggest disrupted top-down modulation by the cognitive control system (CCS) on perceptual circuits underlies psychotic experiences, but their role in emotional deficits in EP is unknown.
The affective go/no-go task was used to probe inhibitory control during the presentation of calm or fearful faces in young persons with EP and matched controls. Computational modeling of functional magnetic resonance imaging (fMRI) data were performed using dynamic causal modeling (DCM). The influence of the CCS on perceptual and emotional systems was examined using parametric empirical bayes.
When inhibiting motor response to fearful faces, EP participants showed higher brain activity in the right posterior insula (PI). To explain this, we used DCM to model effective connectivity between the PI, regions from the CCS activated during inhibition (dorsolateral prefrontal cortex [DLPFC] and anterior insula [AI]), and a visual input region, the lateral occipital cortex (LOC). EP participants exerted a stronger top-down inhibition from the DLPFC to the LOC than controls. Within the EP cohort, increased top-down connectivity between the LOC and AI was associated with a higher burden of negative symptoms.
Young persons with a recent onset of psychosis show a disturbance in the cognitive control of emotionally salient stimuli and the suppression of irrelevant distractors. These changes are associated with negative symptoms, suggesting new targets for the remediation of emotional deficits in young persons with EP.
在早期精神病（EP）中，情绪的表达、体验和识别受损很常见。精神病的计算模型表明，认知控制系统（CCS）对感知回路的自上而下的调节中断是产生精神病体验的基础，但它们在 EP 中情绪缺陷中的作用尚不清楚。
使用情感 Go/No-Go 任务来探测 EP 患者和匹配对照组在呈现平静或恐惧面孔时的抑制控制。使用动态因果建模（DCM）对功能磁共振成像（fMRI）数据进行计算模型分析。使用参数经验贝叶斯检验来检查 CCS 对感知和情感系统的影响。
当抑制对恐惧面孔的运动反应时，EP 参与者在右侧后岛（PI）显示出更高的大脑活动。为了解释这一点，我们使用 DCM 来模拟 PI 与抑制期间激活的 CCS 区域（背外侧前额叶皮层[DLPFC]和前岛[AI]）之间以及视觉输入区域（外侧枕叶皮层[LOC]）之间的有效连接。与对照组相比，EP 参与者从 DLPFC 到 LOC 的自上而下抑制更强。在 EP 队列中，LOC 和 AI 之间的自上而下连接增加与更高的阴性症状负担相关。
新近发病的精神病患者表现出对情绪相关刺激的认知控制和对无关干扰的抑制的紊乱。这些变化与阴性症状相关，表明针对 EP 年轻患者情绪缺陷的新治疗靶点。
