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Neural correlates of executive function and working memory in the ‘at-risk mental state’

  • Matthew R. Broome (a1), Pall Matthiasson (a2), Paolo Fusar-Poli (a3), James B. Woolley (a4), Louise C. Johns (a4), Paul Tabraham (a4), Elvira Bramon (a4), Lucia Valmaggia (a5), Steven C. R. Williams (a6), Michael J. Brammer (a7), Xavier Chitnis (a7) and Philip K. McGuire (a4)...
Extract
Background

People with prodromal symptoms have a very high risk of developing psychosis.

Aims

To use functional magnetic resonance imaging to examine the neurocognitive basis of this vulnerability.

Method

Cross-sectional comparison of regional activation in individuals with an ‘at-risk mental state’ (at-risk group: n=17), patients with first-episode schizophreniform psychosis (psychosis group: n=10) and healthy volunteers (controls: n=15) during an overt verbal fluency task and an N-back working memory task.

Results

A similar pattern of between-group differences in activation was evident across both tasks. Activation in the at-risk group was intermediate relative to that in controls and the psychosis group in the inferior frontal and anterior cingulate cortex during the verbal fluency task and in the inferior frontal, dorsolateral prefrontal and parietal cortex during the N-back task.

Conclusions

The at-risk mental state is associated with abnormalities of regional brain function that are qualitatively similar to, but less severe than, those in patients who have recently presented with psychosis.

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Copyright
Corresponding author
Matthew R. Broome, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, UK. Email: m.r.broome@warwick.ac.uk
Footnotes
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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes
References
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1 Miller, TJ, McGlashan, TH, Rosen, JL, Somjee, L, Markovich, PJ, Stein, K, et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002; 159: 863–5.
2 Yung, AR, Phillips, LJ, Yuen, HP, Francey, SM, McFarlane, CA, Hallgren, M, et al. Psychosis prediction: 12-month follow up of a high-risk (‘prodromal’) group. Schizophr Res 2003; 60: 2132.
3 Wagner, M, Frommann, I, Jessen, F, Pukrop, R, Bechdolf, A, Ruhrmann, S, et al. Cognitive and neurobiological risk indicators in early and late prodromal stages. Schizophr Res 2006; 86 (suppl): s356.
4 Pukrop, R, Ruhrmann, S, Schultze-Lutter, F, Bechdolf, A, Brockhaus-Dumke, A, Klosterkotter, J. Neurocognitive indicators for a conversion to psychosis: Comparison of patients in a potentially initial prodromal state who did or did not convert to a psychosis. Schizophr Res 2007; 92: 116–25.
5 Pantelis, C, Velakoulis, D, McGorry, PD, Wood, SJ, Suckling, J, Phillips, LJ, et al. Neuroanatomical abnormalities before and after onset of psychosis: a cross-sectional and longitudinal MRI comparison. Lancet 2003; 361: 281–8.
6 Morey, RA, Inan, S, Mitchell, TV, Perkins, DO, Lieberman, JA, Belger, A. Imaging frontostriatal function in ultra-high-risk, early, and chronic schizophrenia during executive processing. Arch Gen Psychiatry 2005; 62: 254–62.
7 Yung, AR, Phillips, LJ, McGorry, PD, McFarlane, CA, Francey, S, Harrigan, S, et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry 1998; 172 (suppl 33): s1420.
8 Broome, MR, Woolley, JB, Johns, LC, Valmaggia, LR, Tabraham, P, Gafoor, R, et al. Outreach and Support in South London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state. Eur Psychiatry 2005; 20: 372–8.
9 World Health Organization. ICD–10: The ICD–10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.
10 McGuffin, P, Farmer, A, Harvey, I. A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Arch Gen Psychiatry 1991; 48: 764–70.
11 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). APA, 1994.
12 Nelson, HE. National Adult Reading Test (NART) Manual. nferNelson, 1982.
13 Kay, S, Fiszbein, A, Opler, L. The positive and negative symptom scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261–76.
14 Fu, CH, Morgan, K, Suckling, J, Williams, SC, Andrew, C, Vythelingum, GN, et al. A functional magnetic resonance imaging study of overt letter verbal fluency using a clustered acquisition sequence: greater anterior cingulate activation with increased task demand. Neuroimage 2002; 17: 871–9.
15 Bullmore, ET, Brammer, MJ, Rabe-Hesketh, S, Curtis, VA, Morris, RG, Williams, SC, et al. Methods for diagnosis and treatment of stimulus-correlated motion in generic brain activation studies using fMRI. Hum Brain Mapp 1999; 7: 3848.
16 Friman, O, Borga, P, Lundberg, P, Knutsson, H. Adaptive analysis of fMRI data. Neuroimage 2003; 19: 837–45.
17 Bullmore, ET, Long, C, Suckling, J, Fadili, J, Calvert, G, Zelaya, F, et al. Coloured noise and computational inference in neurophysiological (fMRI) time series analysis. Resampling methods in time and wavelet domains. Hum Brain Mapp 2001; 12: 6178.
18 Bullmore, ET, Suckling, J, Overmayer, S, Rabe-Hesketh, S, Taylor, E, Brammer, MJ. Global, voxel and cluster tests, by theory and permutation, for a difference between two groups of structural MR images of the brain. IEEE Trans Med Imaging 1999; 18: 3242.
19 Talairach, J, Tournoux, P. Co-Planar Stereotaxic Atlas of the Human Brain 3-Dimensional Proportional System: An Approach to Cerebral Imaging. Thieme Publishing Group, 1988.
20 Brammer, MJ, Bullmore, ET, Simmons, A, Williams, SCR, Grasby, PM, Howard, RJ, et al. Generic brain activation mapping in fMRI: a nonparametric approach. Magn Reson Imaging 1997; 15: 763–70.
21 Thirion, B, Pinel, P, Meriaux, S, Roche, A, Dehaene, S, Poline, J-B. Analysis of a large fMRI cohort: statistical and methodological issues for group analysis. Neuroimage 2007; 35: 105–20.
22 Callicott, JH, Egan, MF, Mattay, VS, Bertolino, A, Bone, AD, Verchinksi, B, et al. Abnormal fMRI response of the dorsolateral prefrontal cortex in cognitively intact siblings of patients with schizophrenia. Am J Psychiatry 2003; 160: 709–19.
23 Callicott, JH, Mattay, VS, Verchinski, BA, Marenco, S, Egan, MF, Weinberger, DR. Complexity of prefrontal cortical dysfunction in schizophrenia: more than up or down. Am J Psychiatry 2003; 160: 2209–15.
24 Honey, R, Honey, G, O'Loughlin, C, Sharar, SR, Kumaran, D, Bullmore, ET, et al. Acute ketamine administration alters the brain responses to executive demands in a verbal working memory task: an fMRI study. Neuropsychopharmacology 2004; 29: 1203–14.
25 Crespo-Facorro, B, Paradiso, S, Andreasen, N, O'Leary, DS, Watkins, GL, Boles Ponto, LL, et al. Recalling word lists reveals ‘cognitive dysmetria’ in schizophrenia: a positron emission tomography study. Am J Psychiatry 1999; 156: 386–92.
26 Curtis, V, Dixon, T, Morris, R, Bullmore, ET, Brammer, MJ, Williams, SC, et al. Differential frontal activation in schizophrenia and bipolar illness during verbal fluency. J Affect Disord 2001; 66: 111–21.
27 Fu, CH, Suckling, J, Williams, SC, Andrew, CM, Vythelingum, GN, McGuire, PK. Effects of psychotic state and task demand on prefrontal function in schizophrenia: an fMRI study of overt verbal fluency. Am J Psychiatry 2005; 162: 485–94.
28 Yurgelun-Todd, D, Waternaux, C, Cohen, B, Gruber, S, English, C, Renshaw, P. Functional magnetic resonance imaging of schizophrenic patients during word production. Am J Psychiatry 1996; 153: 200–5.
29 Spence, SA, Brooks, DJ, Hirsch, SR, Liddle, PF, Meehan, J, Grasby, PM. A PET study of voluntary movement in schizophrenic patients experiencing passivity phenomena (delusions of alien control). Brain 1997; 120 (Pt 11): 19972011.
30 Curtis, V, Bullmore, ET, Brammer, MJ, Wright, IC, Williams, SC, Morris, RG, et al. Attenuated frontal activation during a verbal fluency task in patients with schizophrenia. Am J Psychiatry 1998; 155: 1056–63.
31 Wagner, AD, Pare-Blagoev, EJ, Clark, J, Poldrack, RA. Recovering meaning: left prefrontal cortex guides controlled semantic retrieval. Neuron 2001; 31: 329–38.
32 Moss, HE, Abdallah, S, Fletcher, P, Bright, P, Pilgrim, L, Acres, K, et al. Selecting among competing alternatives: selection and retrieval in the left inferior frontal gyrus. Cereb Cortex 2005; 15: 1723–35.
33 Brewer, WJ, Francey, SM, Wood, SJ, Jackson, HJ, Pantelis, C, Phillips, LJ, et al. Memory impairments identified in people at ultra-high risk for psychosis who later develop first-episode psychosis. Am J Psychiatry 2005; 162: 71–8.
34 Hawkins, KA, Addington, J, Keefe, RS, Christensen, B, Perkins, DO, Zipurksy, R, et al. Neuropsychological status of subjects at high risk for a first episode of psychosis. Schizophr Res 2004; 67: 115–22.
35 Gschwandtner, U, Aston, J, Borgwardt, S, Drewe, M, Feinendegen, C, Lacher, D, et al. Neuropsychological and neurophysiological findings in individuals suspected to be at risk for schizophrenia: preliminary results from the Basel early detection of psychosis study – Fruherkennung von Psychosen (FEPSY). Acta Psychiatr Scand 2003; 108: 152–5.
36 Pflueger, MO, Gschwandtner, U, Aston, J, Berger, G, Borgwardt, S, Drewe, M, et al. Cognitive capability of individuals at risk with and without transition to psychosis. Eur Psychiatry 2007; 22: s30.
37 Broome, MR, Johns, LC, Valli, I, Woolley, JB, Tabraham, P, Brett, C, et al. Delusion formation and reasoning biases in those at clinical high risk for psychosis. Br J Psychiatry 2007; 51: s3842.
38 Broome, MR, Woolley, JB, Tabraham, P, Johns, LC, Bramon, E, Murray, GK, et al. What causes the onset of psychosis? Schizophr Res 2005; 79: 2334.
39 Borgwardt, S, Riecher-Rössler, A, Dazzan, P, Chitnis, X, Aston, J, Drewe, M, et al. Regional gray matter volume abnormalities in the at risk mental state. Biol Psychiatry 2007; 61: 1148–56.
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Neural correlates of executive function and working memory in the ‘at-risk mental state’

  • Matthew R. Broome (a1), Pall Matthiasson (a2), Paolo Fusar-Poli (a3), James B. Woolley (a4), Louise C. Johns (a4), Paul Tabraham (a4), Elvira Bramon (a4), Lucia Valmaggia (a5), Steven C. R. Williams (a6), Michael J. Brammer (a7), Xavier Chitnis (a7) and Philip K. McGuire (a4)...
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