Lateralized evoked responses in parietal cortex demonstrate visual short-term memory deficits in first-episode schizophrenia

Acceptability, engagement, and efficacy of cognitive remediation for cognitive outcomes in young adults with first-episode psychosis and social anxiety: A randomized-controlled trial

Social anxiety disorder (SAD) is a frequent comorbidity in first-episode psychosis (FEP) and may increase cognitive impairments. Cognitive remediation (CR) is an effective treatment for cognition, particularly in a group format. This study aims to assess the efficacy, acceptability and engagement of group CR on cognitive outcomes in FEP+SAD compared to group cognitive-behavioral therapy (CBT). Participants with FEP+SAD were randomized to group CR (n = 45) or CBT-SAD (n = 51). They were assessed for cognition at baseline, post-therapy and 3- and 6-month follow-up. The CR group additionally completed scale to assess perceived competency and enjoyment in CR. Linear mixed models for repeated measures were used for cognitive scores. Descriptive statistics and t-tests were used to summarize acceptability, perceived competency, and enjoyment, for CR completers and non-completers. The CR group performed significantly better than CBT on executive functions and visual memory at post-therapy compared to baseline. Twenty participants completed CR (44 %; mean 5.5 sessions). At week 1, CR non-completers presented higher levels of perceived competency. Completers reported higher enjoyment scores at the last session compared to the first session. Group CR is effective for cognitive outcomes in FEP+SAD, but acceptability and engagement present a challenge. Future studies are necessary to explore approaches promoting engagement.

Microstate D as a Biomarker in Schizophrenia: Insights from Brain State Transitions

Objectives. There is a significant correlation between EEG microstate and the neurophysiological basis of mental illness, brain state, and cognitive function. Given that the unclear relationship between network dynamics and different microstates, this paper utilized microstate, brain network, and control theories to understand the microstate characteristics of short-term memory task, aiming to mechanistically explain the most influential microstates and brain regions driving the abnormal changes in brain state transitions in patients with schizophrenia. Methods. We identified each microstate and analyzed the microstate abnormalities in schizophrenia patients during short-term memory tasks. Subsequently, the network dynamics underlying the primary microstates were studied to reveal the relationships between network dynamics and microstates. Finally, using control theory, we confirmed that the abnormal changes in brain state transitions in schizophrenia patients are driven by specific microstates and brain regions. Results. The frontal-occipital lobes activity of microstate D decreased significantly, but the left frontal lobe of microstate B increased significantly in schizophrenia, when the brain was moving toward the easy-to-reach states. However, the frontal-occipital lobes activity of microstate D decreased significantly in schizophrenia, when the brain was moving toward the hard-to-reach states. Microstate D showed that the right-frontal activity had a higher priority than the left-frontal, but microstate B showed that the left-frontal priority decreased significantly in schizophrenia, when changes occur in the synchronization state of the brain. Conclusions. In conclusion, microstate D may be a biomarker candidate of brain abnormal activity during the states transitions in schizophrenia, and microstate B may represent a compensatory mechanism that maintains brain function and exchanges information with other brain regions. Microstate and brain network provide complementary perspectives on the neurodynamics, offering potential insights into brain function in health and disease.

Five-week music therapy improves overall symptoms in schizophrenia by modulating theta and gamma oscillations

Introduction

Some clinical studies have shown that music therapy as an adjunctive therapy can improve overall symptoms in patients with schizophrenia. However, the neural mechanisms of this improvement remain unclear due to insufficient neuroimaging evidence.

Methods

In this work, 17 patients with schizophrenia accepted a five-week music therapy (music group) that integrated listening, singing, and composing, and required patients to cooperate in a group to complete music therapy tasks. Meanwhile, 15 patients with schizophrenia received a five-week visual art intervention as the control group including handicraft and painting activities. We collected the Manchester Scale (MS) and Positive and Negative Symptom Scale (PANSS) scores and electroencephalography (EEG) data before and after intervention in two groups.

Results

Behavioral results showed that both interventions mentioned above can effectively help patients with schizophrenia relieve their overall symptoms, while a trend-level effect was observed in favor of music therapy. The EEG results indicated that music therapy can improve abnormal neural oscillations in schizophrenia which is reflected by a decrease in theta oscillation in the parietal lobe and an increase in gamma oscillation in the prefrontal lobe. In addition, correlation analysis showed that in the music group, both reductions in theta oscillations in the parietal lobe and increases in gamma oscillations in the prefrontal lobe were positively correlated with the improvement of overall symptoms.

Discussion

These findings help us to better understand the neural mechanisms by which music therapy improves overall symptoms in schizophrenia and provide more evidence for the application of music therapy in other psychiatric disorders.

Greater individual variability in functional brain activity during working memory performance in Schizophrenia Spectrum Disorders (SSD)

Heterogeneity has been a persistent challenge in understanding Schizophrenia Spectrum Disorders (SSD). Traditional case-control comparisons often show variable results, and may not map well onto individuals. To better understand heterogeneity and group differences in SSD compared to typically developing controls (TDC), we examined variability in functional brain activity during a working memory (WM) task with known deficits in SSD. Neuroimaging and behavioural data were extracted from two datasets collectively providing 34 TDC and 56 individuals with SSD (n = 90). Functional activity in response to an N-Back WM task (3-Back vs 1-Back) was examined between and within groups. Individual variability was calculated via the correlational distance of fMRI activity maps between participants; mean correlational distance from one participant to all others was defined as a 'variability score'. Greater individual variability in functional activity was found in SSD compared to TDC (p = 0.00090). At the group level, a case-control comparison suggested SSD had reduced activity in task positive and task negative networks. However, when SSD were divided into high and low variability subgroups, the low variability groups showed no differences relative to TDC while the high variability group showed little activity at the group level. Our results imply prior case-control differences may be driven by a subgroup of SSD who do not show specific impairments but instead show more 'idiosyncratic' activity patterns. In SSD but not TDC, variability was also related to cognitive performance and age. This novel approach focusing on individual variability has important implications for understanding the neurobiology of SSD.

Working Memory in People with Schizophrenia

Working memory (WM) refers to the ability to maintain a small number of representations in an activated, easily accessible state for a short period of time in the service of ongoing cognitive processing and behavior. Because WM is a resource critical for multiple forms of complex cognition and executive control of behavior, it is of central interest in the study of disorders such as schizophrenia that involve a broad compromise of cognitive function and in the regulation of goal-directed behavior. There is now robust evidence that WM impairment is characteristic of people with schizophrenia. The impairment includes both elementary storage capacity as well as more complex forms of WM that involve the manipulation and updating of WM representations. These impairments appear to underlie a substantial portion of the generalized cognitive deficit in schizophrenia. Neuroimaging studies have implicated widespread abnormalities in the broad neural system that subserves WM performance, consistent with the evidence of broad cognitive impairment seen in PSZ.

Multiscale Weighted Permutation Entropy Analysis of Schizophrenia Magnetoencephalograms

Schizophrenia is a neuropsychiatric disease that affects the nonlinear dynamics of brain activity. The primary objective of this study was to explore the complexity of magnetoencephalograms (MEG) in patients with schizophrenia. We combined a multiscale method and weighted permutation entropy to characterize MEG signals from 19 schizophrenia patients and 16 healthy controls. When the scale was larger than 42, the MEG signals of schizophrenia patients were significantly more complex than those of healthy controls (p<0.004). The difference in complexity between patients with schizophrenia and the controls was strongest in the frontal and occipital areas (p<0.001), and there was almost no difference in the central area. In addition, the results showed that the dynamic range of MEG complexity is wider in healthy individuals than in people with schizophrenia. Overall, the multiscale weighted permutation entropy method reliably quantified the complexity of MEG from schizophrenia patients, contributing to the development of potential magnetoencephalographic biomarkers for schizophrenia.

Fronto-parietal network function during cued visual search in the first-episode schizophrenia spectrum

Cognitive impairments account for significant morbidity in schizophrenia and are present at disease onset. Controlled processes are particularly susceptible and may contribute to pervasive selective attention deficits. The present study assessed fronto-parietal attention network (FPAN) functioning during cue presentation on a visual search task in first-episode schizophrenia spectrum patients (FE) and its relation to symptom burden and community functioning. Brain activity was recorded with magnetoencephalography from 38 FE and 38 healthy controls (HC) during blocks of pop-out and serial search target detection. Activity during cue presentation was compared between groups across bilateral FPAN regions (frontal eye fields (FEF), inferior frontal gyrus (IFG), midcingulate cortex (MCC), and intraparietal sulcus (IPS)). FE exhibited greater right hemisphere IFG activity despite worse performance relative to HC. Performance and FPAN activity were not correlated in HC. Among FE, however, stronger activity within right hemisphere FEF and IFG was associated with faster responses. Stronger right IPS and left IFG activity in patients was also associated with reduced negative symptoms and improved community functioning, respectively. Increased reliance on the FPAN for task completion suggests an inefficient cognitive control network and might reflect a compensation for impaired attentional deployment during target detection, a strategy employed by those with less severe illness. These findings represent a critical step towards identifying the neural substrates of negative symptoms and impaired neurocognition at disease onset.

Dynamic Changes of Brain Networks during Working Memory Tasks in Schizophrenia

Electroencephalograph (EEG) signals and graph theory measures have been widely used to characterize the brain functional networks of healthy individuals and patients by calculating the correlations between different electrodes over an entire time series. Although EEG signals have a high temporal resolution and can provide relatively stable results, the process of constructing and analyzing brain functional networks is inevitably complicated by high time complexity. Our goal in this research was to distinguish the brain function networks of schizophrenia patients from those of healthy participants during working memory tasks. Consequently, we utilized a method involving microstates, which are each characterized by a unique topography of electric potentials over an entire channel array, to reduce the dimension of the EEG signals during working memory tasks and then compared and analyzed the brain functional networks using the microstates time series (MTS) and original time series (OTS) of the schizophrenia patients and healthy individuals. We found that the right frontal and parietal-occipital regions neurons of the schizophrenia patients were less active than those of the healthy participants during working memory tasks. Notably, compared with OTS, the time needed to construct the brain functional networks was significantly reduced by using MTS. In conclusion, our results show that, like OTS, MTS can well distinguish the brain functional network of schizophrenia patients from those of healthy individuals during working memory tasks while greatly decreasing time complexity. MTS can thus provide a method for characterizing the original time series for the construction and analysis of EEG brain functional networks.