Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.

BACKGROUND: Neurocognitive impairments in executive and mnemonic domains are already evident in the pre-psychotic phases. The longitudinal dynamic course of the neurofunctional abnormalities underlying liability to psychosis and their relation to clinical outcomes is unknown. METHODS: In this study...

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Main Authors: Fusar-Poli, P, Broome, MR, Matthiasson, P, Woolley, J, Johns, L, Tabraham, P, Bramon, E, Valmaggia, L, Williams, S, McGuire, P
Format: Journal article
Language:English
Published: 2010
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author Fusar-Poli, P
Broome, MR
Matthiasson, P
Woolley, J
Johns, L
Tabraham, P
Bramon, E
Valmaggia, L
Williams, S
McGuire, P
author_facet Fusar-Poli, P
Broome, MR
Matthiasson, P
Woolley, J
Johns, L
Tabraham, P
Bramon, E
Valmaggia, L
Williams, S
McGuire, P
author_sort Fusar-Poli, P
collection OXFORD
description BACKGROUND: Neurocognitive impairments in executive and mnemonic domains are already evident in the pre-psychotic phases. The longitudinal dynamic course of the neurofunctional abnormalities underlying liability to psychosis and their relation to clinical outcomes is unknown. METHODS: In this study we used functional magnetic resonance imaging (fMRI) in a cohort of subjects at ultra high clinical risk for psychosis (with an "At Risk Mental State", ARMS) and in healthy controls. Images were acquired at baseline and again after one year on a 1.5 Tesla Signa, while patients were performing a visuospatial working memory task. Psychopathological assessment of the prodromal symptoms was conducted at the same time points by using the CAARMS and the PANSS instruments. RESULTS: There were no significant differences between the ARMS and control groups with respect to age or IQ. Although both groups performed the PAL task with a high degree of accuracy, the ARMS showed an increased latency in answers during the most demanding level of the task. At baseline, such cognitive impairment was associated with reduced activation in the left precuneus, left superior parietal lobule, right middle temporal gyrus in the ARMS as compared to controls. In addition, the ARMS failed to activate parietal areas with increasing difficulty of the task. Between presentation and follow-up the overall clinical status of the ARMS sample improved, despite 2 out of the 15 subjects having developed a full-blown psychosis: the CAARMS (perceptual disorder and thought disorder subscales) and the PANNS general scores decreased, while the GAF score increased. Such clinical amelioration was associated with a longitudinal compensatory increase in occipitoparietal regions. CONCLUSIONS: The prodromal phase of psychosis is associated with functional alterations in parietal and temporal networks subserving visuospatial working memory which are more evident under high cognitive loads. The clinical improvement at one year is associated with a compensatory increase in occipitoparietal regions.
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spelling oxford-uuid:1adb966d-995a-41f5-adfb-57d3bcdea2882022-03-26T10:57:10ZSpatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1adb966d-995a-41f5-adfb-57d3bcdea288EnglishSymplectic Elements at Oxford2010Fusar-Poli, PBroome, MRMatthiasson, PWoolley, JJohns, LTabraham, PBramon, EValmaggia, LWilliams, SMcGuire, PBACKGROUND: Neurocognitive impairments in executive and mnemonic domains are already evident in the pre-psychotic phases. The longitudinal dynamic course of the neurofunctional abnormalities underlying liability to psychosis and their relation to clinical outcomes is unknown. METHODS: In this study we used functional magnetic resonance imaging (fMRI) in a cohort of subjects at ultra high clinical risk for psychosis (with an "At Risk Mental State", ARMS) and in healthy controls. Images were acquired at baseline and again after one year on a 1.5 Tesla Signa, while patients were performing a visuospatial working memory task. Psychopathological assessment of the prodromal symptoms was conducted at the same time points by using the CAARMS and the PANSS instruments. RESULTS: There were no significant differences between the ARMS and control groups with respect to age or IQ. Although both groups performed the PAL task with a high degree of accuracy, the ARMS showed an increased latency in answers during the most demanding level of the task. At baseline, such cognitive impairment was associated with reduced activation in the left precuneus, left superior parietal lobule, right middle temporal gyrus in the ARMS as compared to controls. In addition, the ARMS failed to activate parietal areas with increasing difficulty of the task. Between presentation and follow-up the overall clinical status of the ARMS sample improved, despite 2 out of the 15 subjects having developed a full-blown psychosis: the CAARMS (perceptual disorder and thought disorder subscales) and the PANNS general scores decreased, while the GAF score increased. Such clinical amelioration was associated with a longitudinal compensatory increase in occipitoparietal regions. CONCLUSIONS: The prodromal phase of psychosis is associated with functional alterations in parietal and temporal networks subserving visuospatial working memory which are more evident under high cognitive loads. The clinical improvement at one year is associated with a compensatory increase in occipitoparietal regions.
spellingShingle Fusar-Poli, P
Broome, MR
Matthiasson, P
Woolley, J
Johns, L
Tabraham, P
Bramon, E
Valmaggia, L
Williams, S
McGuire, P
Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title_full Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title_fullStr Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title_full_unstemmed Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title_short Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study.
title_sort spatial working memory in individuals at high risk for psychosis longitudinal fmri study
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