RT distributional analysis of cognitive-control-related brain activity in first-episode schizophrenia

Abnormal theta and alpha oscillations in children and adolescents with first-episode psychosis and clinical high-risk psychosis

BACKGROUND

Cognitive control deficits are one of the main symptoms of psychosis. The basic neural oscillation patterns associated with cognitive control are already present in early adolescence. However, as previous studies have focused on adults with psychosis, it is unclear whether neurobiological impairments in cognitive control are present in children and adolescents with first-episode psychosis (FEP) or clinical high-risk (CHR) state for psychosis.

AIMS

To explore the deficits of electroencephalogram related to cognitive control tasks in children and adolescents with FEP and CHR.

METHOD

Electroencephalogram was recorded in untreated 48 patients with FEP, 24 patients with CHR and 42 healthy controls aged 10-17 years, while performing the visual oddball task. The N2 amplitude, theta and alpha oscillations were then analysed and compared between groups.

RESULTS

There was no significant group difference in N2 amplitude (P = 0.099). All groups showed increased theta and alpha oscillations relative to baseline before the stimulus in the frontal, central, left fronto-central and right fronto-central areas. These changes differed significantly between groups, with the FEP group showing significantly smaller theta (P < 0.001) and alpha (P < 0.01) oscillation than healthy controls. Theta and alpha oscillations in the CHR group did not differ significantly from the FEP group and healthy controls.

CONCLUSIONS

These results suggest that neural damage has already occurred in the early stage of psychosis, and that abnormal rhythmic activity of neurons may constitute the pathophysiological mechanism of cognitive dysfunction related to early-onset psychosis.

Concurrent expectation and experience-based metacontrol: EEG insights and the role of working memory capacity

We investigated the simultaneous influence of expectation and experience on metacontrol, which we define as the instantiation of context-specific control states. These states could entail heightened control states in preparation for frequent task switching or lowered control states for task repetition. Specifically, we examined whether "expectations" regarding future control demands prompt proactive metacontrol, while "experiences" with items associated with specific control demands facilitate reactive metacontrol. In Experiment 1, we utilized EEG with a high temporal resolution to differentiate between brain activities associated with proactive and reactive metacontrol. We successfully observed cue-locked and image-locked ERP patterns associated with proactive and reactive metacontrol, respectively, supporting concurrent instantiation of two metacontrol modes. In Experiment 2, we focused on individual differences to investigate the modulatory role of working memory capacity (WMC) in the concurrent instantiation of two metacontrol modes. Our findings revealed that individuals with higher WMC exhibited enhanced proactive metacontrol, indicated by smaller response time variability (RTV). Additionally, individuals with higher WMC showed a lower tendency to rely on reactive metacontrol, indicated by a smaller item-specific switch probability (ISSP) effect. In conclusion, our results suggest that proactive and reactive metacontrol can coexist, but their interplay is influenced by individuals' WMC. Higher WMC promotes the use of proactive metacontrol while attenuating reliance on reactive metacontrol. This study provides insights into the interplay between proactive and reactive metacontrol and highlights the impact of WMC on their concurrent instantiation.

Genome-wide association study in 404,302 individuals identifies 7 significant loci for reaction time variability

Reaction time variability (RTV), reflecting fluctuations in response time on cognitive tasks, has been proposed as an endophenotype for many neuropsychiatric disorders. There have been no large-scale genome-wide association studies (GWAS) of RTV and little is known about its genetic underpinnings. Here, we used data from the UK Biobank to conduct a GWAS of RTV in participants of white British ancestry (n = 404,302) as well as a trans-ancestry GWAS meta-analysis (n = 44,873) to assess replication. We found 161 genome-wide significant single nucleotide polymorphisms (SNPs) distributed across 7 genomic loci in our discovery GWAS. Functional annotation of the variants implicated genes involved in synaptic function and neural development. The SNP-based heritability (h2SNP) estimate for RTV was 3%. We investigated genetic correlations between RTV and selected neuropsychological traits using linkage disequilibrium score regression, and found significant correlations with several traits, including a positive correlation with mean reaction time and schizophrenia. Despite the high genetic correlation between RTV and mean reaction time, we demonstrate distinctions in the genetic underpinnings of these traits. Lastly, we assessed the predictive ability of a polygenic score (PGS) for RTV, calculated using PRSice and PRS-CS, and found that the RTV-PGS significantly predicted RTV in independent cohorts, but that the generalisability to other ancestry groups was poor. These results identify genetic underpinnings of RTV, and support the use of RTV as an endophenotype for neurological and psychiatric disorders.

Predictors of within-individual variability in cognitive performance in schizophrenia in a South African case-control study

INTRODUCTION

Cognitive dysfunction in schizophrenia may be assessed by measuring within-individual variability (WIV) in performance across a range of cognitive tests. Previous studies have found increased WIV in people with schizophrenia, but no studies have been conducted in low- to middle-income countries where the different sociocultural context may affect WIV. We sought to address this gap by exploring the relationship between WIV and a range of clinical and demographic variables in a large study of people with schizophrenia and matched controls in South Africa.

METHODS

544 people with schizophrenia and 861 matched controls completed an adapted version of The University of Pennsylvania Computerized Neurocognitive Battery (PennCNB). Demographic and clinical information was collected using the Structured Clinical Interview for DSM-IV Diagnoses. Across-task WIV for performance speed and accuracy on the PennCNB was calculated. Multivariate linear regression was used to assess the relationship between WIV and a diagnosis of schizophrenia in the whole sample, and WIV and selected demographic and clinical variables in people with schizophrenia.

RESULTS

Increased WIV of performance speed across cognitive tests was significantly associated with a diagnosis of schizophrenia. In people with schizophrenia, increased speed WIV was associated with older age, a lower level of education and a lower score on the Global Assessment of Functioning scale. Increased accuracy WIV was significantly associated with a younger age in people with schizophrenia.

CONCLUSIONS

Measurements of WIV of performance speed can add to the knowledge gained from studies of cognitive dysfunction in schizophrenia in resource-limited settings.

Genome-wide association study in 404,302 individuals identifies 7 significant loci for reaction time variability

Reaction time variability (RTV), reflecting fluctuations in response time on cognitive tasks, has been proposed as an endophenotype for many neuropsychiatric disorders. There have been no large-scale genome wide association studies (GWAS) of RTV and little is known about its genetic underpinnings. Here, we used data from the UK Biobank to conduct a GWAS of RTV in participants of white British ancestry (n = 404,302) as well as a trans-ancestry GWAS meta-analysis (n = 44,873) to assess replication. We found 161 genome-wide significant single nucleotide polymorphisms (SNPs) distributed across 7 genomic loci in our discovery GWAS. Functional annotation of the variants implicated genes involved in synaptic function and neural development. The SNP-based heritability (h2SNP) estimate for RTV was 3%. We investigated genetic correlations between RTV and selected neuropsychological traits using linkage disequilibrium score regression, and found significant correlations with several traits, including a positive correlation with schizophrenia. We assessed the predictive ability of a polygenic score (PGS) for RTV, calculated using PRSice and PRS-CS, and found that the RTV-PGS significantly predicted RTV in independent cohorts, but that the generalizability to other ancestry groups was poor. These results identify genetic underpinnings of RTV, and support the use of RTV as an endophenotype for neurological and psychiatric disorders.

Contributions of Parasympathetic Arousal-Related Activity to Cognitive Performance in Patients With First-Episode Psychosis and Control Subjects

BACKGROUND

Cognitive impairment is integral to the pathophysiology of psychosis. Recent findings implicate autonomic arousal-related activity in both momentary fluctuations and individual differences in cognitive performance. Although altered autonomic arousal is common in patients with first-episode psychosis (FEP), its contribution to cognitive performance is unknown.

METHODS

A total of 24 patients with FEP (46% male, age = 24.31 [SD 4.27] years) and 24 control subjects (42% male, age = 27.06 [3.44] years) performed the Multi-Source Interference Task in-scanner with simultaneous pulse oximetry. First-level models included the cardiac-blood oxygen level-dependent regressor, in addition to task (congruent, interference, and error) and nuisance (motion and CompCor physiology) regressors. The cardiac-blood oxygen level-dependent regressor reflected parasympathetic arousal-related activity and was created by convolving the interbeat interval at each heartbeat with the hemodynamic response function. Group models examined the effect of group or cognitive performance (reaction times × error rate) on arousal-related and task activity, while controlling for sex, age, and framewise displacement.

RESULTS

Parasympathetic arousal-related activity was robust in both groups but localized to different regions for patients with FEP and healthy control subjects. Within both groups, arousal-related activity was significantly associated with cognitive performance across occipital and temporal cortical regions. Greater arousal-related activity in the bilateral prefrontal cortex (Brodmann area 9) was related to better performance in healthy control subjects but not patients with FEP.

CONCLUSIONS

Autonomic arousal circuits contribute to cognitive performance and the pathophysiology of FEP. Arousal-related functional activity is a novel indicator of cognitive ability and should be incorporated into neurobiological models of cognition in psychosis.

Within-individual variability in cognitive performance in schizophrenia: A narrative review of the key literature and proposed research agenda

Schizophrenia is a neurodevelopmental disorder and a leading cause of disability worldwide. Deficits in cognitive function are characteristic of schizophrenia and are predictors of functional outcomes in the disorder. Within-individual variability (WIV) in cognitive performance is elevated in schizophrenia and has been suggested to provide additional insight into cognitive function over and above mean performance measures. Despite growing interest in WIV in schizophrenia, research on the clinical significance and neural correlates of WIV in the disorder remains sparse. The present narrative review summarizes the key literature linking WIV in schizophrenia to clinical, neural, and genetic correlates. Here, we aim to highlight key knowledge gaps and provide directions for future research into WIV in schizophrenia.

Decreased preparatory activation and inattention to cues suggest lower activation of proactive cognitive control among high procrastinating students

Procrastination is a voluntary delay in completing an important task while being aware that this behavior may lead to negative outcomes. It has been shown that an increased tendency to procrastinate is associated with deficits in some aspects of cognitive control. However, none of the previous studies investigated these dysfunctions through the lenses of the Dual Mechanisms Framework, which differentiates proactive and reactive modes of control. The present study was designed to fill this gap, using behavioral and neurophysiological assessment during the completion of the AX-Continuous Performance Task (AX-CPT) by high (HP) and low (LP) procrastinating students (N = 139). Behavioral results indicated that HP (vs. LP) were characterized by increased attentional fluctuations (higher reaction time variability) and reduction in some indices of proactive cognitive control (lower d'-context and A-cue bias, but similar PBIs). Furthermore, the neurophysiological data showed that HP, compared with LP, allocated less attentional resources (lower P3b) to cues that help to predict the correct responses to upcoming probes. They also responded with reduced preparatory activity (smaller CNV) after cues presentation. The two groups did not differ in neural responses linked to conflict detection and inhibition (similar N2 and P3a). Obtained findings indicate that HP might present deficits in some cognitive functions that are essential for effective proactive control engagement, along with preserved levels of reactive cognitive control. In the present paper, we discuss the potential neural and cognitive mechanisms responsible for the observed effects.

Delta plots for conflict tasks: An activation-suppression race model

We describe a mathematically simple yet precise model of activation suppression that can explain the negative-going delta plots often observed in standard Simon tasks. The model postulates a race between the identification of the relevant stimulus attribute and the suppression of irrelevant location-based activation, with the irrelevant activation only having an effect if the irrelevant activation is still present at the moment when central processing of the relevant attribute starts. The model can be fitted by maximum likelihood to observed distributions of RTs in congruent and incongruent trials, and it provides good fits to two previously-reported data sets with plausible parameter values. R and MATLAB software for use with the model is provided.

Conjoint fluctuations of PFC-mediated processes and behavior: An investigation of error-related neural mechanisms in relation to sustained attention

The ability to detect errors, which derives from the medial prefrontal cortex (mPFC), is crucial to maintain attention over a long period of time. While impairment of this ability has been reported in patients with sustained attention disruption, the role mPFC-mediated processes play in the intra-individual fluctuation of sustained attention remains an open question. In this context, we computed the variance time course of reaction time (RT) of 42 healthy individuals to distinguish intra-individual periods of low and high performance instability, assumed to represent optimal and suboptimal attentional states, when performing a sustained Go/NoGo task. Analysis of the neurophysiological mechanisms of response monitoring revealed a specific reduction in the error-related negativity (ERN) amplitude and frontal midline theta power during periods of high compared to low RT variability, but only in individuals with a higher standard deviation of reaction time (SD-RT). Concerning post-error adaptation, an increase in the correct-related negativity (CRN) amplitude as well as the frontal lateral theta power on trials following errors was observed in individuals with lower SD-RT but not in those with higher SD-RT. Our results thus show that individuals with poor sustained attention ability exhibit altered post-error adaptation and attentional state-dependent efficiency of error monitoring. Conversely, individuals with good sustained attention performances retained their post-error adaptation and response monitoring regardless of the attentional periods. These findings reveal the critical role of the action-monitoring system in intra-individual behavioral stability and highlight the importance of considering attentional states when studying mPFC-mediated processes, especially in subjects with low sustained attention ability.

Manipulations of the Response-Stimulus Intervals as a Factor Inducing Controlled Amount of Reaction Time Intra-Individual Variability

Aggrandized fluctuations in the series of reaction times (RTs) are a very sensitive marker of neurocognitive disorders present in neuropsychiatric populations, pathological ageing and in patients with acquired brain injury. Even though it was documented that processing inconsistency founds a background of higher-order cognitive functions disturbances, there is a vast heterogeneity regarding types of task used to compute RT-related variability, which impedes determining the relationship between elementary and more complex cognitive processes. Considering the above, our goal was to develop a relatively new assessment method based on a simple reaction time paradigm, conducive to eliciting a controlled range of intra-individual variability. It was hypothesized that performance variability might be induced by manipulation of response-stimulus interval’s length and regularity. In order to verify this hypothesis, a group of 107 healthy students was tested using a series of digitalized tasks and their results were analyzed using parametric and ex-Gaussian statistics of RTs distributional markers. In general, these analyses proved that intra-individual variability might be evoked by a given type of response-stimulus interval manipulation even when it is applied to the simple reaction time task. Collected outcomes were discussed with reference to neuroscientific concepts of attentional resources and functional neural networks.

Schizophrenia and bipolar disorder are associated with opposite brain reward anticipation-associated response

Blunted and exaggerated neuronal response to rewards are hypothesized to be core features of schizophrenia spectrum disorders (SZ) and bipolar disorder (BD), respectively. Nonetheless, direct tests of this hypothesis, in which response between SZ and BD is compared in the same study, are lacking. Here we examined the functional correlates of reward processing during the Incentivized Control Engagement Task (ICE-T) using 3T fMRI. Reward-associated activation was examined in 49 healthy controls (HCs), 52 recent-onset individuals with SZ, and 22 recent-onset individuals with Type I BD using anterior cingulate (ACC), anterior insula, and ventral striatal regions of interest. Significant group X reward condition (neutral vs. reward) interactions were observed during reward anticipation in the dorsal ACC (F(2,120) = 4.21, P = 0.017) and right insula (F(2,120) = 4.77, P = 0.010). The ACC interaction was driven by relatively higher activation in the BD group vs. HCs (P = 0.007) and vs. individuals with SZ (P = 0.010). The insula interaction was driven by reduced activation in the SZ group relative to HCs (P = 0.018) and vs. people with BD (P = 0.008). A composite of reward anticipation-associated response across all associated ROIs also differed significantly by diagnosis (F(1,120) = 5.59, P = 0.02), BD > HC > SZ. No effects of group or group X reward interactions were observed during reward feedback. These results suggest that people with SZ and BD have opposite patterns of activation associated with reward anticipation but not reward receipt. Implications of these findings in regard to Research Domain Criteria-based classification of illness and the neurobiology of reward in psychosis are discussed.

Hyperfocus: the forgotten frontier of attention

'Hyperfocus' is a phenomenon that reflects one's complete absorption in a task, to a point where a person appears to completely ignore or 'tune out' everything else. Hyperfocus is most often mentioned in the context of autism, schizophrenia, and attention deficit hyperactivity disorder, but research into its effect on cognitive and neural functioning is limited. We propose that hyperfocus is a critically important aspect of cognition, particularly with regard to clinical populations, and that it warrants significant investigation. Hyperfocus, though ostensibly self-explanatory, is poorly defined within the literature. In many cases, hyperfocus goes undefined, relying on the assumption that the reader inherently knows what it entails. Thus, there is no single consensus to what constitutes hyperfocus. Moreover, some studies do not refer to hyperfocus by name, but describe processes that may be related. In this paper, we review how hyperfocus (as well as possibly related phenomena) has been defined and measured, the challenges associated with hyperfocus research, and assess how hyperfocus affects both neurotypical and clinical populations. Using this foundation, we provide constructive criticism about previously used methods and analyses. We also propose an operational definition of hyperfocus for researchers to use moving forward.

Brain potentials reveal reduced attention and error-processing during a monetary Go/No-Go task in procrastination

Procrastination is a self-regulatory problem of voluntarily and destructively delaying intended and necessary or personally important tasks. Previous studies showed that procrastination is associated with executive dysfunctions that seem to be particularly strong in punishing contexts. In the present event-related potential (ERP) study a monetary version of the parametric Go/No-Go task was performed by high and low academic procrastinators to verify the influence of motivational context (reward vs. punishment expectation) and task difficulty (easy vs. hard) on procrastination-related executive dysfunctions. The results revealed increased post-error slowing along with reduced P300 and error-related negativity (ERN) amplitudes in high (vs. low) procrastination participants—effects that indicate impaired attention and error-related processing in this group. This pattern of results did not differ as a function of task difficulty and motivation condition. However, when the task got more difficult executive attention deficits became even more apparent at the behavioral level in high procrastinators, as indexed by increased reaction time variability. The findings substantiate prior preliminary evidence that procrastinators show difficulties in certain aspects of executive functioning (in attention and error processing) during execution of task-relevant behavior, which may be more apparent in highly demanding situations.

Differing functional mechanisms underlie cognitive control deficits in psychotic spectrum disorders

BACKGROUND

Functional underpinnings of cognitive control deficits in unbiased samples (i.e., all comers) of patients with psychotic spectrum disorders (PSD) remain actively debated. While many studies suggest hypofrontality in the lateral prefrontal cortex (PFC) and greater deficits during proactive relative to reactive control, few have examined the full hemodynamic response.

METHODS

Patients with PSD (n = 154) and healthy controls (n = 65) performed the AX continuous performance task (AX-CPT) during rapid (460 ms) functional neuroimaging and underwent full clinical characterization.

RESULTS

Behavioural results indicated generalized cognitive deficits (slower and less accurate) across proactive and reactive control conditions in patients with PSD relative to healthy controls. We observed a delayed/prolonged neural response in the left dorsolateral PFC, the sensorimotor cortex and the superior parietal lobe during proactive control for patients with PSD. These proactive hemodynamic abnormalities were better explained by negative rather than by positive symptoms or by traditional diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR), with subsequent simulations unequivocally demonstrating how these abnormalities could be erroneously interpreted as hypoactivation. Conversely, true hypoactivity, unassociated with clinical symptoms or DSM-IV-TR diagnoses, was observed within the ventrolateral PFC during reactive control.

LIMITATIONS

In spite of guidance for AX-CPT use in neuroimaging studies, one-third of patients with PSD could not perform the task above chance and were more clinically impaired.

CONCLUSION

Current findings question the utility of the AX-CPT for neuroimaging-based appraisal of cognitive control across the full spectrum of patients with PSD. Previously reported lateral PFC "hypoactivity" during proactive control may be more indicative of a delayed/prolonged neural response, important for rehabilitative purposes. Negative symptoms may better explain certain behavioural and hemodynamic abnormalities in patients with PSD relative to DSM-IV-TR diagnoses.

Impaired Frontal Midline Theta During Periods of High Reaction Time Variability in Schizophrenia

BACKGROUND

Impairment in cognitive control is one of the most significant cognitive deficits in schizophrenia. Although it has generally been associated with altered engagement of lateral and medial prefrontal cortices, how attention fluctuations affect this engagement is still not known. In this context, we explored sustained (or proactive) and transient (or reactive) control engagement by investigating frontal theta-band oscillations during periods of low- and high-performance instability, assumed to represent intraindividual attentional fluctuations.

METHODS

A total of 25 patients with schizophrenia (16 males) and 25 healthy matched control subjects (18 males) performed a long-sustained Go/NoGo task coupled with electroencephalographic recording. Proactive control was explored through frontal lateral theta during trial-by-trial conflict (Go N-1/Go N+1), whereas reactive control was explored through frontal midline theta and the N2 component during current-trial conflict (Go/NoGo). Variance in the time course of reaction time (RT) was computed to identify periods of low and high RT variability in each subject.

RESULTS

Patients with schizophrenia exhibited no frontal lateral theta activity regardless of the RT variability periods, whereas in control subjects, this activity was preserved only during periods of low RT variability (less error prone). During these periods, patients exhibited preserved midline frontal theta activity and N2. However, during high RT variability periods (more error prone), the midline theta activity was impaired in patients but preserved in control subjects.

CONCLUSIONS

Our results reveal that the efficient engagement of reactive control in patients with schizophrenia and of proactive control in control subjects was state dependent. The findings highlight the importance of accounting for attentional fluctuations when investigating cognitive control impairment in schizophrenia.

Intraindividual reaction time variability as an index of attentional control acts as a moderator of the longitudinal relationships between marital quality and children's externalizing problems

The current study investigated whether trial-to-trial intraindividual reaction time variability (IIRTV), which serves as an index of attentional control fluctuations, moderates the effect of marital quality at 7 years of age on the development of children's externalizing problems from 7 to 9 years of age (N = 197). At the first assessment (T1), a flanker task was administered to children for assessing their IIRTV. The Chinese version of a marital quality questionnaire (Evaluating and Nurturing Relationship Issues, Communication, and Happiness [ENRICH]) and the Chinese version of the Child Behavior Checklist (CBCL) were completed by children's mothers to assess marital quality and children's externalizing problems. At the second and third assessments (T2 and T3), children's externalizing problems were reassessed by their mothers. Growth curve analyses showed that boys' externalizing problems were relatively high and significantly decreased over time, whereas girls' externalizing problems were relatively low and stable. Importantly, the results indicated that boys' IIRTV (but not girls' IIRTV) and parental marital quality interactively predict the concurrent and developmental trajectories of externalizing problems. Specifically, boys with greater IIRTV were found to exhibit a relatively persistent high level of externalizing problems in the context of poor parental marital quality, whereas boys with lower IIRTV were found to exhibit a relatively low level of externalizing problems over time regardless of their parental marital quality. The findings suggest that poorer attentional control indexed by greater IIRTV is a robust predictor of boys' externalizing problems and that better attentional control indexed by lower IIRTV may buffer the negative impact of adverse family environment on the development of boys' externalizing problems.

Adolescents at clinical high risk for psychosis show qualitatively altered patterns of activation during rule learning

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Novel investigation of novel rule learning in psychosis risk.

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Failed to replicate previous study comparing novel and practiced rule learning.

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No significant group differences, but effect size comparison revealed differences.

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Results suggest that psychosis risk group may rely on different rule retrieval strategies.

Background

The ability to flexibly apply rules to novel situations is a critical aspect of adaptive human behavior. While executive function deficits are known to appear early in the course of psychosis, it is unclear which specific facets are affected. Identifying whether rule learning is impacted at the early stages of psychosis is necessary for truly understanding the etiology of psychosis and may be critical for designing novel treatments. Therefore, we examined rule learning in healthy adolescents and those meeting criteria for clinical high risk (CHR) for psychosis.

Methods

24 control and 22 CHR adolescents underwent rapid, high-resolution fMRI while performing a paradigm which required them to apply novel or practiced task rules.

Results

Previous work has suggested that practiced rules rely on rostrolateral prefrontal cortex (RLPFC) during rule encoding and dorsolateral prefrontal cortex (DLPFC) during task performance, while novel rules show the opposite pattern. We failed to replicate this finding, with greater activity for novel rules during performance. Comparing the HC and CHR group, there were no statistically significant effects, but an effect size analysis found that the CHR group showed less activation during encoding and greater activation during performance. This suggests the CHR group may use less efficient reactive control to retrieve task rules at the time of task performance, rather than proactively during rule encoding.

Conclusions

These findings suggest that flexibility is qualitatively altered in the clinical high risk state, however, more data is needed to determine whether these deficits predict disease progression.

Traces of culture: The feedback loop between behavior, brain, and disorder

Culture is part of an extensive series of feedback loops, which involve multiple organismic levels including social contexts, cognitive mediations, neural processes, and behavior. Recent studies in neuroscience show that culturally contingent social processes shape some neural pathways. Studying the influence of cultural context on neural processes may yield new insights into psychiatric disorders. New methodologies in the neurosciences offer innovative ways to assess the impact of culture on mental health and illness. However, implementing these methodologies raises important theoretical and ethical concerns, which must be resolved to address patient individuality and the complexity of cultural diversity. This article discusses cultural context as a major influence on (and consequence of) human neural plasticity and advocates a culture-brain-behavior (CBB) interaction model for conceptualizing the relationship between culture, brain, and psychiatric disorders. Recommendations are made for integrating neuroscientific techniques into transcultural psychiatric research by taking a systems approach to evaluating disorders.

Psychomotor Slowing in Schizophrenia: Implications for Endophenotype and Biomarker Development

Motor abnormalities (e.g., dyskinesia, psychomotor slowing, neurological soft signs) are core features of schizophrenia that occur independent of drug treatment and are associated with the genetic vulnerability and pathophysiology for the illness. Among this list, psychomotor slowing in particular is one of the most consistently observed and robust findings in the field. Critically, psychomotor slowing may serve as a uniquely promising endophenotype and/or biomarker for schizophrenia considering it is frequently observed in those with genetic vulnerability for the illness, predicts transition in subjects at high-risk for the disorder, and is associated with symptoms and recovery in patients. The purpose of the present review is to provide an overview of the history of psychomotor slowing in psychosis, discuss its possible neural underpinnings, and review the current literature supporting slowing as a putative endophenotype and/or biomarker for the illness. This review summarizes substantial evidence from a diverse array of methodologies and research designs that supports the notion that psychomotor slowing not only reflects genetic vulnerability, but is also sensitive to disease processes and the pathophysiology of the illness. Furthermore, there are unique deficits across the cognitive (prefix "psycho") and motor execution (root word "motor") aspects of slowing, with cognitive processes such as planning and response selection being particularly affected. These findings suggest that psychomotor slowing may serve as a promising endophenotype and biomarker for schizophrenia that may prove useful for identifying individuals at greatest risk and tracking the course of the illness and recovery.

Aberrant functional connectivity of resting state networks related to misperceptions and intra-individual variability in Parkinson's disease

Patients with Parkinson's disease (PD) frequently suffer from visual misperceptions and hallucinations, which are difficult to objectify and quantify. We aimed to develop an image recognition task to objectify misperceptions and to assess performance fluctuations in PD patients with and without self-reported hallucinations. Thirty-two non-demented patients with Parkinson's disease (16 with and 16 without self-reported visual hallucinations) and 25 age-matched healthy controls (HC) were tested. Participants performed a dynamic image recognition task with real and scrambled images. We assessed misperception scores and intra-individual variability in recognition times. To gain insight into possible neural mechanisms related to misperceptions and performance fluctuations we correlated resting state network connectivity to the behavioral outcomes in a subsample of Parkinson's disease patients (N = 16). We found that PD patients with self-reported hallucinations (PD-VH) exhibited higher perceptual error rates, due to decreased perceptual sensitivity and not due to changed decision criteria. In addition, PD-VH patients exhibited higher intra-individual variability in recognition times than HC or PD-nonVH patients. Both, misperceptions and intra-individual variability were negatively correlated with resting state functional connectivity involving frontal and parietal brain regions, albeit in partly different subregions. Consistent with previous research suggesting that hallucinations arise from dysfunction in attentional networks, misperception scores correlated with reduced functional connectivity between the dorsal attention and salience network. Intra-individual variability correlated with decreased connectivity between somatomotor and right fronto-parietal networks. We conclude that our task can detect visual misperceptions that are more prevalent in PD-VH patients. In addition, fluctuating visual performance appear to be a signature of PD-VH patients, which might assist further studies of the underlying pathophysiological mechanisms and cognitive processes.

Abnormalities in hubs location and nodes centrality predict cognitive slowing and increased performance variability in first-episode schizophrenia patients

Introducing the Minimum Spanning Tree (MST) algorithms to neural networks science eliminated the problem of arbitrary setting of the threshold for connectivity strength. Despite these advantages, MST has been rarely used to study network abnormalities in schizophrenia. An MST graph mapping a network structure is its simplification, therefore, it is important to verify whether the reconfigured network is significantly related to the behavioural dimensions of the clinical picture of schizophrenia. 35 first-episode schizophrenia patients and 35 matched healthy controls underwent an assessment of information processing speed, cognitive inter-trial variability modelled with ex-Gaussian distributional analysis of reaction times and resting-state EEG recordings to obtain frequency-specific functional connectivity matrices from which MST graphs were computed. The patients’ network had a more random structure and star-like arrangement with overloaded hubs positioned more posteriorly than it was in the case of the control group. Deficient processing speed in the group of patients was predicted by increased maximal betweenness centrality in beta and gamma bands, while decreased consistency in cognitive processing was predicted by the betweenness centrality of posterior nodes in the gamma band, together with duration of illness. The betweenness centrality of posterior nodes in the gamma band was also significantly correlated with positive psychotic symptoms in the clinical group.

Hypo-activity of the dorsolateral prefrontal cortex relates to increased reaction time variability in patients with schizophrenia

Increased reaction time intra-subject variability (RT-ISV) in fast decision tasks has been confirmed in patients with schizophrenia and has been hypothesized to result from a deficit in the control of attention. Here, an attentional task and functional brain imaging were used to probe the neural correlates of increased RT-ISV in schizophrenia.

Thirty patients and 30 age and sex matched controls performed the Eriksen flanker spatial attention task with concurrent measurement of brain activity using functional magnetic resonance imaging (fMRI). The behavioral measures included accuracy, mean, standard deviation of RT (RTSD), coefficient of variation of RT (RTCV) and ex-Gaussian model of RT distribution parameters (mu, sigma and tau).

Larger mean RT and Ex-Gaussian mu was observed for patients compared to controls. The group difference was larger for incongruent (attentionally demanding) versus congruent trials confirming a deficit in the control of spatial attention for patients. Significant increase in RT-ISV measures (RTSD, sigma and tau) for patients compared to controls was observed and was not modulated by trial congruency. Attention modulation (congruency effect) resulted in activation of bilateral frontal and parietal areas that was not different between patients and controls. Right middle frontal, right superior temporal and bilateral cingulate areas were more active in controls compared to patients independent of congruency. Activation in ROIs extracted from attention (congruency) and group related areas correlated with RT-ISV measures (especially RTCV and tau). Hypo-activation of the right middle frontal area correlated with increased tau specifically in patients.

Hypo-activity of the right prefrontal cortex predicted increased RT-ISV in schizophrenia. This effect was unrelated to the effects of spatial attention and might be linked to a deficit in the inhibitory control of action for these patients.

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Schizophrenia patients show increased reaction time intra-subject variability (RT-ISV).

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fMRI of patients and aged matched controls while performing a spatial attention task.

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RT-ISV measures were increased in patients independent of spatial attention load.

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Activity of the right middle frontal cortex predicted RT-ISV increase in patients.

Dysfunctional Neural Processes Underlying Context Processing Deficits in Schizophrenia

BACKGROUND

People with schizophrenia (PSZ) have profound deficits in context processing, an executive process that guides adaptive behaviors according to goals and stored contextual information. Although various neural processes are involved in context processing and are affected in PSZ, the core underlying neural dysfunction is unclear.

METHODS

To determine the relative importance of neural dysfunctions within prefrontal cognitive control, sensory activity, and motor activity to context processing deficits in PSZ, we examined event-related potentials (ERPs) in 60 PSZ and 51 healthy control subjects during an optimal context processing task. We also analyzed the Ex-Gaussian reaction time distribution to examine abnormalities in motor control variability in PSZ.

RESULTS

Compared with healthy control subjects, PSZ had lower response accuracy and greater variability in their normal reaction times during high context processing demands. Latencies of normal and slow responses were generally increased in PSZ. High context processing-related reductions in frontal ERPs were indicative of specific deficits in proactive and reactive cognitive controls in PSZ, while ERPs associated with visual and motor processes were reduced regardless of context processing demands, indicating generalized visuomotor deficits. In contrast to previous studies, we found that diminished frontal responses reflective of proactive control of the contextual cue, rather than visual responses of cue encoding, predicted response accuracy deficits in PSZ. In addition, probe-related ERP components of motor preparation, prefrontal reactive control, and frontomotor interaction predicted Ex-Gaussian indices of reaction time instability in PSZ.

CONCLUSIONS

Prefrontal proactive and reactive control deficits associated with failures in using mental representation likely underlie context processing deficits in PSZ.

Oscillatory brain dynamics supporting impaired Stroop task performance in schizophrenia-spectrum disorder

The Stroop color-word interference task, prompting slower response to color-incongruent than to congruent items, is often used to study neural mechanisms of inhibitory control and dysfunction in schizophrenia-spectrum disorders. Inconsistent findings of an augmented Stroop effect limit identification of relevant dysfunctional mechanism(s) in schizophrenia. The present study sought to advance understanding of normal and impaired neural oscillatory dynamics by distinguishing interference detection and response preparation during the Stroop task in schizophrenia-spectrum disorders via analysis of behavioral performance and 4-7 Hz (theta) and 10-30 Hz (alpha/beta) EEG oscillations in 40 patients (SZ) and 27 healthy comparison participants (HC). SZ responded more slowly and showed less dorsal anterior cingulate (dACC) theta enhancement during INC trials, less enhancement of dACC-sensorimotor cortex connectivity (theta phase synchrony) during INC trials, more alpha/beta suppression though less enhancement of that suppression during INC trials, and slower post-response alpha/beta rebound than did HC. Reaction time distributions showed larger group and Stroop effects during the 25% of trials with the slowest responses. Poorer theta phase coherence in patients indicates impaired communication between regions associated with interference processing (dACC) and response preparation (sensorimotor cortex). Results suggest a failure cascade in which compromised behavioral Stroop effects are driven at least in part by dysfunctional interference processing (less theta power increase) prompting dysfunctional motor response preparation (less alpha/beta power suppression). Inconsistent Stroop effects in past studies of schizophrenia may result from differing task parameters sampling different degrees of Stroop task difficulty.

The Relationship between Cytokines and Verbal Memory in Individuals with Schizophrenia and Their Unaffected Siblings

BACKGROUND

Verbal memory impairment may be considered an endophenotype in schizophrenia (SZ), also affecting the siblings of SZ subjects. Furthermore, the immune-inflammatory system response has an important modulatory effect on brain processes, especially on memory circuits.

OBJECTIVE

Investigating the relationship between TNF-α and IL-6 and memory performance in patients with SZ, their unaffected siblings (SB) and healthy controls (HC).

METHODS

35 subjects with SZ, 36 SB, and 47 HC underwent a neurocognitive assessment for verbal memory by means of the revised Hopkins Verbal Learning Test (HVLT-R) in addition to serum cytokines analyses.

RESULTS

SZ patients performed worse in HVLT-R than SB and HC, but SB and HC were not different. Regarding the biomarker levels, we found significant results of TNF-α for both groups. However, we did not find differences between groups after multiple-comparisons analysis. There were no significant correlations between episodic verbal memory, TNF-α, and IL-6.

CONCLUSION

The results are compatible with the hypothesis that deficits in verbal memory of individuals with SZ could be secondary to inadequate functioning of cognitive processing areas, such as proactive cognitive control.

Impaired Antisaccades in Obsessive-Compulsive Disorder: Evidence From Meta-Analysis and a Large Empirical Study

Increasing evidence indicates that patients with obsessive-compulsive disorder (OCD) exhibit alterations in fronto-striatal circuitry. Performance deficits in the antisaccade task would support this model, but results from previous small-scale studies have been inconclusive as either increased error rates, prolonged antisaccade latencies, both or neither have been reported in OCD patients. In order to address this issue, we investigated antisaccade performance in a large sample of OCD patients (n = 169) and matched control subjects (n = 183). As impaired antisaccade performance constitutes a potential endophenotype of OCD, unaffected first-degree relatives of OCD patients (n = 100) were assessed, as well. Furthermore, we conducted a quantitative meta-analysis to integrate our data with previous findings. In the empirical study, OCD patients exhibited significantly increased antisaccade latencies, intra-subject variability (ISV) of antisaccade latencies, and antisaccade error rates. The latter effect was driven by errors with express latency (80-130 ms), as patients did not differ significantly from controls with regards to regular errors (>130 ms). Notably, unaffected relatives of OCD patients showed elevated antisaccade express error rates and increased ISV of antisaccade latencies, as well. Antisaccade performance was not associated with state anxiety within groups. Among relatives, however, we observed a significant correlation between antisaccade error rate and harm avoidance. Medication status of OCD patients, symptom severity, depressive comorbidity, comorbid anxiety disorders and OCD symptom dimensions did not significantly affect antisaccade performance. Meta-analysis of 10 previous and the present empirical study yielded a medium-sized effect (SMD = 0.48, p < 0.001) for higher error rates in OCD patients, while the effect for latencies did not reach significance owing to strong heterogeneity (SMD = 0.51, p = 0.069). Our results support the assumption of impaired antisaccade performance in OCD, although effects sizes were only moderately large. Furthermore, we provide the first evidence that increased antisaccade express error rates and ISV of antisaccade latencies may constitute endophenotypes of OCD. Findings regarding these more detailed antisaccade parameters point to potentially underlying mechanisms, such as early pre-stimulus inhibition of the superior colliculus.

Sustaining attention to simple visual tasks: a central deficit in schizophrenia? A systematic review

Impairments in sustained attention, that is, the ability to achieve and maintain the focus of cognitive activity on a given stimulation source or task, have been described as central to schizophrenia. Today, sustained attention deficit is still considered as a hallmark of schizophrenia. Nevertheless, current findings on this topic are not consistent. To clarify these findings, we attempt to put these results into perspective according to the type of assessment (i.e., overall and over time assessment), the participants' characteristics (i.e., clinical and demographic characteristics), and the paradigms (i.e., traditionally formatted tasks, go/no-go tasks, and the sustained attention task) and measures used. Two types of assessment lead to opposite findings; they do not evaluate sustained attention the same way. Studies using overall assessments of sustained attention ability tend to reveal a deficit, whereas studies using over time assessments do not. Therefore, further research is needed to investigate the underlying cognitive control mechanisms of changes in sustained attention in schizophrenia.

Meta-analysis of functional magnetic resonance imaging studies of timing and cognitive control in schizophrenia and bipolar disorder: Evidence of a primary time deficit

Schizophrenia (SZ) and Bipolar Disorder (BD) are associated with deficits in both timing and cognitive control functions. However, the underlying neurological dysfunctions remain poorly understood. The main goal of this study was to identify brain structures activated both by increases in cognitive activity and during timing tasks in patients with SZ and BD relative to controls. We conducted two signed differential mapping (SDM) meta-analyses of functional magnetic resonance imaging studies assessing the brain response to increasing levels of cognitive difficulty: one concerned SZ, and the other BD patients. We conducted a similar SDM meta-analysis on neuroimaging of timing in SZ (no studies in BD could be included). Finally, we carried out a multimodal meta-analysis to identify common brain regions in the findings of the two previous meta-analyses. We found that SZ patients showed hypoactivation in timing-related cortical-subcortical areas. The dysfunction observed during timing partially coincided with deficits for cognitive control functions. We hypothesize that a dysfunctional temporal/cognitive control network underlies the persistent cognitive impairment observed in SZ.

Trait impulsivity components correlate differently with proactive and reactive control

The relationship between impulsivity and cognitive control is still unknown. We hypothesized that trait impulsivity would differentially correlate with specific cognitive control processes. Trait impulsivity was measured by the Barratt Impulsiveness Scale, which assesses motor, attention, and non-planning impulsiveness components. Cognitive control was measured by a hybrid-designed Stroop task, which distinguishes proactive and reactive control. Thirty-three participants performed the Stroop task while they were scanned by functional magnetic resonance imaging. Proactive and reactive control involved increased activity in the fronto-parietal network, and brain activity was associated with impulsivity scores. Specifically, higher motor impulsiveness was associated with a larger proactive control effect in the inferior parietal lobule and a smaller reactive control effect in the right dorsolateral prefrontal cortex (DLPFC) and anterior cingulate contex. Higher attention impulsivity was associated with a smaller proactive control effect in the right DLPFC. Such a correlation pattern suggests that impulsivity trait components are attributable to different cognitive control subsystems.

Sleep deprivation as an experimental model system for psychosis: Effects on smooth pursuit, prosaccades, and antisaccades

Current antipsychotic medications fail to satisfactorily reduce negative and cognitive symptoms and produce many unwanted side effects, necessitating the development of new compounds. Cross-species, experimental behavioural model systems can be valuable to inform the development of such drugs. The aim of the current study was to further test the hypothesis that controlled sleep deprivation is a safe and effective model system for psychosis when combined with oculomotor biomarkers of schizophrenia. Using a randomized counterbalanced within-subjects design, we investigated the effects of 1 night of total sleep deprivation in 32 healthy participants on smooth pursuit eye movements (SPEM), prosaccades (PS), antisaccades (AS), and self-ratings of psychosis-like states. Compared with a normal sleep control night, sleep deprivation was associated with reduced SPEM velocity gain, higher saccadic frequency at 0.2 Hz, elevated PS spatial error, and an increase in AS direction errors. Sleep deprivation also increased intra-individual variability of SPEM, PS, and AS measures. In addition, sleep deprivation induced psychosis-like experiences mimicking hallucinations, cognitive disorganization, and negative symptoms, which in turn had moderate associations with AS direction errors. Taken together, sleep deprivation resulted in psychosis-like impairments in SPEM and AS performance. However, diverging somewhat from the schizophrenia literature, sleep deprivation additionally disrupted PS control. Sleep deprivation thus represents a promising but possibly unspecific experimental model that may be helpful to further improve our understanding of the underlying mechanisms in the pathophysiology of psychosis and aid the development of antipsychotic and pro-cognitive drugs.

Frontal Motor Cortex Activity During Reactive Control Is Associated With Past Suicidal Behavior in Recent-Onset Schizophrenia

BACKGROUND

Suicide is prevalent in schizophrenia (SZ), yet the neural system functions that confer suicide risk remain obscure. Circuits operated by the prefrontal cortex (PFC) are altered in SZ, including those that support reactive control, and PFC changes are observed in postmortem studies of heterogeneous suicide victims.

AIMS

We tested whether history of suicide attempt is associated with altered frontal motor cortex activity during reactive control processes.

METHOD

We evaluated 17 patients with recent onset of DSM-IV-TR-defined SZ using the Columbia Suicide Severity Rating Scale and functional magnetic resonance imaging during Stroop task performance. Group-level regression models relating past suicidal behavior to frontal activation controlled for depression, psychosis, and impulsivity.

RESULTS

Past suicidal behavior was associated with relatively higher activation in the left-hemisphere supplementary motor area (SMA), pre-SMA, premotor cortex, and dorsolateral PFC, all ipsilateral to the active primary motor cortex.

CONCLUSION

This study provides unique evidence that suicidal behavior in patients with recent-onset SZ directly relates to frontal motor cortex activity during reactive control, in a pattern reciprocal to the relationship with proactive control found previously. Further work should address how frontal-based control functions change with risk over time, and their potential utility as a biomarker for interventions to mitigate suicide risk in SZ.

The mindful eye: Smooth pursuit and saccadic eye movements in meditators and non-meditators

BACKGROUND

This study examined the effects of cultivated (i.e. developed through training) and dispositional (trait) mindfulness on smooth pursuit (SPEM) and antisaccade (AS) tasks known to engage the fronto-parietal network implicated in attentional and motion detection processes, and the fronto-striatal network implicated in cognitive control, respectively.

METHODS

Sixty healthy men (19-59years), of whom 30 were experienced mindfulness practitioners and 30 meditation-naïve, underwent infrared oculographic assessment of SPEM and AS performance. Trait mindfulness was assessed using the self-report Five Facet Mindfulness Questionnaire (FFMQ).

RESULTS

Meditators, relative to meditation-naïve individuals, made significantly fewer catch-up and anticipatory saccades during the SPEM task, and had significantly lower intra-individual variability in gain and spatial error during the AS task. No SPEM or AS measure correlated significantly with FFMQ scores in meditation-naïve individuals.

CONCLUSIONS

Cultivated, but not dispositional, mindfulness is associated with improved attention and sensorimotor control as indexed by SPEM and AS tasks.

Reaction time variability and related brain activity in methamphetamine psychosis

BACKGROUND

This study investigated the dynamics of cognitive control instability in methamphetamine (MA) abuse, as well its relationship to substance-induced psychiatric symptoms and drug use patterns.

METHODS

We used an ex-Gaussian reaction time (RT) distribution to examine intraindividual variability (IIV) and excessively long RTs (tau) in an individual's RT on a Stroop task in 30 currently drug-abstinent (3 months to 2 years) MA abusers compared with 27 nonsubstance-abusing control subjects. All subjects underwent functional magnetic resonance imaging while performing the Stroop task, which allowed us to measure the relationship between IIV and tau to functional brain activity.

RESULTS

Elevated IIV in the MA compared with the control group did not reach significance; however, when the MA group was divided into those subjects who had experienced MA-induced psychosis (MAP+) (n = 19) and those who had not (n = 11), the MAP+ group had higher average IIV compared with the other groups (p < .03). In addition, although control subjects displayed a relationship between IIV and conflict-related brain activity in bilateral prefrontal cortex such that increased IIV was associated with increased activity, the MAP+ group displayed this relationship in right prefrontal cortex only, perhaps reflecting elevated vigilance in the MAP+ group. Greater IIV did not correlate with severity of use or months MA abstinent. No group differences emerged in tau values.

CONCLUSIONS

These results suggest increased cognitive instability in those MA-dependent subjects who had experienced MA-induced psychosis.