Abstract
Cognitive maturation during adolescence is modulated by brain maturation. However, it is unknown how these processes intertwine in early onset psychosis (EOP). Studies examining longitudinal brain changes and cognitive performance in psychosis lend support for an altered development of high-order cognitive functions, which parallels progressive gray matter (GM) loss over time, particularly in fronto-parietal brain regions. We aimed to assess this relationship in a subsample of 33 adolescents with first-episode EOP and 47 matched controls over 2 years. Backwards stepwise regression analyses were conducted to determine the association and predictive value of longitudinal brain changes over cognitive performance within each group. Fronto-parietal GM volume loss was positively associated with decreased working memory in adolescents with psychosis (frontal left (B = 0.096, p = 0.008); right (B = 0.089, p = 0.015); parietal left (B = 0.119, p = 0.007), right (B = 0.125, p = 0.015)) as a function of age. A particular decrease in frontal left GM volume best predicted a significant amount (22.28%) of the variance of decreased working memory performance over time, accounting for variance in age (14.9%). No such association was found in controls. Our results suggest that during adolescence, EOP individuals seem to follow an abnormal neurodevelopmental trajectory, in which fronto-parietal GM volume reduction is associated with the differential age-related working memory dysfunction in this group.
Highlights
The development of cognitive function plays a vital role in the ability of an individual to relate to the world
The aim of this study is to explore the relationship between brain changes in frontal and parietal gray matter (GM) volume, and changes in high-order cognitive functions in adolescents with a first episode of early onset psychosis (EOP) and controls over a 2 year period, using data from the longitudinal child and adolescent first-episode psychosis study (CAFEPS) [56]
We found that longitudinal change in frontal GM volume was positively associated with decreased working memory performance in individuals with EOP (left (B = 0.096, p = 0.008); and right (B = 0.089, p = 0.015)) as a function of age
Summary
The development of cognitive function plays a vital role in the ability of an individual to relate to the world. In high-order cognitive processes (i.e., sustained attention, working memory and executive function) has consistently been shown in early psychosis [1,2], leading to significant social, functional and vocational impairments and poor quality of life [3,4,5,6]. High-order cognitive processes have generally been associated with fronto-parietal brain regions, which appear to be the last regions to mature. Of particular importance is the prefrontal cortex, in which the connections with the parietal lobes are involved with cognitive abilities required for planning, decision making and complex problem solving, such as set-shifting, selective and sustained attention and working memory [7,8,9,10,11]. Our own clinical studies lend support for an altered development of higher brain cognitive functions [14], which parallels progressive
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