Proactive and reactive cognitive control and dorsolateral prefrontal cortex dysfunction in first episode
Tyler A Lesh1, Andrew J Westphal, Tara A Niendam
1Department of Psychiatry, University of California, Davis, USA.
Neuroimage. Clinical
|November 2, 2013
Summary
Patients with schizophrenia show deficits in proactive cognitive control, evidenced by a lack of prefrontal cortex activity during demanding tasks. This dysfunction is linked to disorganization symptoms, unlike reactive control processes.
Area of Science:
- Cognitive Neuroscience
- Psychiatry
- Neuroimaging
Background:
- Cognitive control deficits are common in schizophrenia.
- A distinction exists between reactive and proactive cognitive control modes.
- Neural underpinnings of these control modes in schizophrenia are not fully understood.
Purpose of the Study:
- To investigate the neural recruitment differences between reactive and proactive cognitive control in first-episode schizophrenia patients.
- To examine the association between cognitive control processes and brain activity in schizophrenia.
- To correlate neural activity with clinical symptoms, specifically disorganization.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used to study 43 patients with first-episode schizophrenia and 54 healthy controls.
- The color word Stroop task and AX Continuous Performance Task (AX-CPT) were employed to assess reactive and proactive control, respectively.
- Analysis focused on brain activation patterns, particularly in the dorsolateral prefrontal cortex (DLPFC) and parietal cortex.
Main Results:
- Healthy controls showed significant activation in prefrontal and parietal regions for both tasks.
- Patients with schizophrenia exhibited no significant activation during proactive control but similar activation to controls during reactive control.
- Controls demonstrated increased DLPFC and parietal activity for proactive versus reactive control, a pattern absent in patients.
- Reduced DLPFC activity during proactive control in patients correlated with disorganization symptoms.
Conclusions:
- Proactive cognitive control and associated dysfunctional dorsolateral prefrontal cortex (DLPFC) recruitment are key features of schizophrenia.
- These deficits in proactive control are directly linked to disorganization symptoms in schizophrenia patients.
- The findings highlight a specific neural mechanism underlying cognitive control impairments in schizophrenia.
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