Real-time cognitive performance and positive symptom expression in schizophrenia

Area of Science:

• Neuroscience
• Psychiatry
• Cognitive Psychology

Background:

• Cognitive deficits are common in schizophrenia, often viewed as stable traits.
• Daily fluctuations in cognitive function and their link to dynamic psychotic symptom expression remain unclear.

Purpose of the Study:

• To investigate the real-time relationship between cognitive performance and positive symptom occurrence in individuals with schizophrenia using Ecological Momentary Assessment (EMA).
• To explore potential neural correlates of these dynamic associations using functional MRI and graph theory.

Main Methods:

• Thirty-three individuals with schizophrenia underwent a one-week EMA study with five daily assessments of cognition and positive symptoms.
• A subsample also completed functional MRI scans analyzed with graph theory indices.
• Statistical models examined prospective associations between cognitive performance and subsequent symptom expression.

Main Results:

• Moments of worsened cognitive performance were prospectively associated with an increased likelihood of positive symptom occurrence in subsequent hours.
• These associations varied based on graph theory indices from functional MRI, implicating the Executive Control Network.
• The findings demonstrate a link between daily cognitive fluctuations and psychotic symptom expression.

Conclusions:

• Cognitive performance is prospectively linked to psychotic symptom expression in the daily lives of individuals with schizophrenia.
• Underlying neural markers in the Executive Control Network may be associated with these dynamic symptom fluctuations.
• Further research is needed to investigate the causal nature of this cognitive-psychosis relationship.