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Understanding the mechanisms underlying cognitive control in psychosis
R Maitra1,2, I L J Lemmers-Jansen1,3,4, M Vooren5,6,7
1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Psychological Medicine
|May 23, 2024
Summary
Cognitive control (CC) is impaired in schizophrenia patients, especially with increasing task complexity. Early intervention may improve CC flexibility and learning in psychosis.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Cognitive control (CC) is a crucial top-down mechanism for flexible stimulus response.
- CC deficits are a significant feature of schizophrenia.
- Understanding CC impairments is vital for schizophrenia treatment.
Purpose of the Study:
- To investigate how increasing cognitive control processing complexity affects individuals with psychosis.
- To examine behavioral performance, neural activity, and symptom severity in relation to CC.
- To identify potential therapeutic intervention windows for improving CC in schizophrenia.
Main Methods:
- Studied 140 subjects with psychosis and 39 healthy adults.
- Assessed behavioral performance across varying CC task complexities (Stroop, Faces, Trust Game).
- Analyzed neural regions of interest and schizophrenia symptom severity.
Main Results:
- All psychosis patients showed impaired basic CC (Stroop task).
- Emotional CC (Faces task) was most impaired in first-episode psychosis.
- Iterative learning in higher-order CC (Trust Game) was most impaired in chronic schizophrenia.
- CC network flexibility for learning was compromised in later stages of schizophrenia.
Conclusions:
- Cognitive control deficits vary with task complexity and illness chronicity in schizophrenia.
- First-episode psychosis patients with lower symptom load show more CC network flexibility.
- These findings highlight optimal timing for therapeutic interventions targeting CC.
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