Cingulo-opercular Network Efficiency Mediates the Association Between Psychotic-like Experiences and Cognitive Ability in the General Population

Abstract

Background Psychosis is hypothesized to occur on a spectrum between psychotic disorders and healthy individuals. In the middle of the spectrum are individuals who endorse psychotic-like experiences (PLEs) that may not impact daily functioning or cause distress. Individuals with PLEs show alterations in both cognitive ability and functional connectivity of several brain networks, but the relationship between PLEs, cognition, and functional networks remains poorly understood. Methods We analyzed resting-state fMRI data, a range of neuropsychological tasks, and questions from the Achenbach Adult Self Report (ASR) in 468 individuals from the Human Connectome Project. We aimed to determine whether global efficiency of specific functional brain networks supporting higher-order cognition (the fronto-parietal network (FPN), cingulo-opercular network (CON), and default mode network (DMN)) was associated with PLEs and cognitive ability in a non-psychiatric sample. Results 21.6% of individuals in our sample endorsed at least one PLE. PLEs were significantly negatively associated with higher-order cognitive ability, CON global efficiency, and DMN global efficiency, but not crystallized knowledge. Higher-order cognition was significantly positively associated with CON and DMN global efficiency. Interestingly, the association between PLEs and cognitive ability was partially mediated by CON global efficiency and, in a subset of individuals who tested negative for drugs (N=405), the participation coefficient of the right anterior insula (a hub within the CON). Conclusions These findings suggest that CON integrity may represent a shared mechanism that confers risk for psychotic experiences and the cognitive deficits observed across the psychosis spectrum.

Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective

“…Presence of sub-clinical psychosis has been associated with processing speed deficits as measured by the digit symbol task (Rossler et al 2015). In data from the Human Connectome Project, 21.6% of individuals endorsed at least one psychotic-like experience, and psychotic-like experiences were significantly negatively associated with general cognitive ability, replicating previous findings (Sheffield et al 2016). Further, individuals who endorse symptoms of schizotypy in the general population have below average cognitive performance (Dinn et al 2002) (Park et al 1995).…”

Neuroimaging tests for clinical psychiatry: Are we there yet?

“…20 Individual differences in network efficiency covaried with cognitive function, with the cortical and the subcortical networks making statistically independent contributions. These findings replicate observations made in 2 separate smaller samples 21,22 and were presaged by similar findings from independent researchers.…”

“…1,32 For example, Drysdale and colleagues 10 replicated the anxietyinsomnia-related depression biotype in patients with diagnoses of generalized anxiety disorder. The studies by Sheffield and colleagues [20][21][22] found the same psychosis-related connectivity patterns, irrespective of whether the patient's formal diagnosis was schizophrenia, schizoaffective disorder, or a bipolar mood disorder. Mary Phillips' research group reports that, in patients with bipolar depression, emotional dysregulation is associated with disturbed connectivity in the limbic circuitry implicated in negative mood states; 9 high sensation-seeking youth exhibit frontostriatal connectivity alterations across diagnoses.…”

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): I. Psychosis superspectrum

“…Connectivity patterns differ across conditions, but show substantial overlap, especially hypoconnectivity within the default mode network and cingulo‐opercular network. This hypoconnectivity was found across psychotic disorders and in people with psychotic experiences 216‐218 . Similarly, poor efficiency in the connectivity of the cingulo‐opercular network was observed across psychotic disorders 219 and was associated with psychoticism in the general population 218 .…”