Cognitive control network dysconnectivity and response to antipsychotic treatment in schizophrenia

Abstract

To better understand cognitive control impairment in schizophrenia, it is vital to determine the extent of dysfunctional connectivity in the associated fronto-striatal brain network, with a focus on the connections with the anterior cingulate cortex (ACC), prior to the potential confounding effect of medication. It is also essential to determine the effects following antipsychotic medication and the relationship of those effects on psychosis improvement. Twenty-two patients with schizophrenia, initially unmedicated and after a 6-week course of risperidone, and 20 matched healthy controls (HC) performed a fMRI task twice, six weeks apart. We investigated group and longitudinal differences in ACC-related functional connectivity during performance of a Stroop color task as well as connectivity patterns associated with improvement in psychosis symptoms. Unmedicated patients with schizophrenia showed greater functional connectivity between ACC and bilateral caudate and midbrain and lower connectivity with left putamen compared to healthy controls. At baseline, greater functional connectivity between ACC and bilateral putamen predicted subsequent better treatment response. Change in functional connectivity between ACC and left putamen positively correlated with better treatment response. These results suggest that patterns of functional connectivity in fronto-striatal networks can be utilized to predict potential response to antipsychotic medication. Prior to treatment, brain function may be structured with a predisposition that favors or not treatment response.

Symptom Remission and Brain Cortical Networks at First Clinical Presentation of Psychosis: The OPTiMiSE Study

“…Moreover, the regions involved in the respective networks appear to overlap, with connections to the anterior cingulate and frontal cortex altered in both. 27,28 Overall, our data suggest that poor treatment response in schizophrenia is related to altered connectivity across a distributed set of brain regions, rather than focal morphological alterations in a specific area. This is coherent with both the inconsistency and the large variability of findings reported in previous studies of focal neuromorphological correlates of psychosis outcomes.…”

Magnetic Resonance Imaging-Based Connectomics in First-Episode Schizophrenia: From Preclinical Study to Clinical Translation

“…Connectomics provides a reference for evaluating the efficacy of antipsychotics in schizophrenia. By analyzing MRI data of 22 patients and 20 healthy controls, Cadena et al found that greater functional connectivity between anterior cingulate cortex and bilateral putamen at baseline predicted subsequent better treatment response (32). To investigate whether resting-state functional connectivity is associated with long-term clinical outcomes of patients with schizophrenia, Lee et al found that poorer clinical outcomes in patients with schizophrenia were associated with decreased DMN connectivity (33).…”

“…By analyzing MRI data of 22 patients and 20 healthy controls, Cadena et al. found that greater functional connectivity between anterior cingulate cortex and bilateral putamen at baseline predicted subsequent better treatment response ( 32 ). To investigate whether resting-state functional connectivity is associated with long-term clinical outcomes of patients with schizophrenia, Lee et al.…”

Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial

“…Researchers have used the Stroop effect as one way to study the IC deficit in schizophrenia and other psychotic disorders ( Laurenson et al, 2015 ). Prior studies have shown that people experiencing psychosis are slower and less accurate in the interference condition of Stroop test than healthy controls ( Cadena et al, 2019 ; Popov, Kustermann, Popova, Miller, & Rockstroh, 2019 ) and this difference in performance is not related with premorbid IQ ( Martin, Mowry, Reutens, & Robinson, 2015 ), or affective symptoms ( Tyburski et al, 2017 ), or other cognitive processes ( Ettinger et al, 2018 ). Also, the negative effect of ageing in Stroop performance is more pronounced in psychosis, which suggests that IC decline associated to aging starts earlier in psychosis ( Thuaire et al, 2020 ).…”