Abstract
Background
Cognitive impairment is integral to the pathophysiology of psychosis. Recent findings
implicate autonomic arousal–related activity in both momentary fluctuations and individual
differences in cognitive performance. Although altered autonomic arousal is common
in patients with first-episode psychosis (FEP), its contribution to cognitive performance
is unknown.
Methods
A total of 24 patients with FEP (46% male, age = 24.31 [SD 4.27] years) and 24 control
subjects (42% male, age = 27.06 [3.44] years) performed the Multi-Source Interference
Task in-scanner with simultaneous pulse oximetry. First-level models included the
cardiac-blood oxygen level–dependent regressor, in addition to task (congruent, interference,
and error) and nuisance (motion and CompCor physiology) regressors. The cardiac-blood
oxygen level–dependent regressor reflected parasympathetic arousal–related activity
and was created by convolving the interbeat interval at each heartbeat with the hemodynamic
response function. Group models examined the effect of group or cognitive performance
(reaction times × error rate) on arousal-related and task activity, while controlling
for sex, age, and framewise displacement.
Results
Parasympathetic arousal–related activity was robust in both groups but localized to
different regions for patients with FEP and healthy control subjects. Within both
groups, arousal-related activity was significantly associated with cognitive performance
across occipital and temporal cortical regions. Greater arousal-related activity in
the bilateral prefrontal cortex (Brodmann area 9) was related to better performance
in healthy control subjects but not patients with FEP.
Conclusions
Autonomic arousal circuits contribute to cognitive performance and the pathophysiology
of FEP. Arousal-related functional activity is a novel indicator of cognitive ability
and should be incorporated into neurobiological models of cognition in psychosis.
Keywords
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Article info
Publication history
Published online: October 29, 2021
Accepted:
October 15,
2021
Received in revised form:
October 14,
2021
Received:
June 21,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
