Fusar-Poli, Paolo, Broome, Matthew R., Matthiasson, P., Woolley, J. B., Johns, L. C., Tabraham, P., Bramon, E., Valmaggia, L., Williams, S. C. and McGuire, Philip. (2010) Spatial working memory in individuals at high risk for psychosis: longitudinal fMRI study. Schizophrenia Research, Vol.123 (No.1). pp. 45-52. ISSN 0920-9964

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Abstract

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. (C) 2010 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Schizophrenia Research
Publisher:	Elsevier BV
ISSN:	0920-9964
Official Date:	October 2010
Dates:	Date Event October 2010 Published
Volume:	Vol.123
Number:	No.1
Number of Pages:	8
Page Range:	pp. 45-52
Identification Number:	10.1016/j.schres.2010.06.008
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
URI:	http://wrap.warwick.ac.uk/id/eprint/4955

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