title: Neuroanatomical correlates of executive dysfunction in the at-risk mental state for psychosis.
abstract: Deficits in executive functioning have been described as a core feature of schizophrenia and have been linked to patterns of fronto-temporo-limbic brain alterations. To date, such structure-cognition relationships have not been explored in a clinically defined at-risk mental state (ARMS) for psychosis using whole-brain neuroimaging techniques. Therefore, we used voxel-based morphometry in 40 ARMS and 30 matched healthy control (HC) individuals to investigate whether gray and white matter volumes (1) correlated with the performance in the Trail-Making Test B (TMT-B), an established measure of executive functioning, and (2) were volumetrically linked to the ventromedial prefrontal cortex (VMPFC), found to be associated with TMT-B in the ARMS during the first analysis step. We found the ARMS subjects to be specifically impaired in their TMT-B performance versus HC. Brain-cognition associations involving the insular cortices were observed in the HC, but not in the ARMS individuals. Conversely, TMT-B correlations in the VMPFC, the cerebellum, the fronto-callosal white matter were detected in the ARMS, but not the HC group. The VMPFC was linked to the temporo-limbic cortices in HC, whereas the connectivity pattern in the ARMS involved the left temporal and dorsolateral prefrontal cortex, the cerebellum, the right SMA and extended portions of the fronto-callosal white matter. These findings suggest that executive deficits are already present in the ARMS for psychosis and may be subserved by structurally altered networks of interconnected cortical and subcortical brain regions in line with the disconnectivity hypothesis of schizophrenia.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany. Nikolaos.Koutsouleris@med.uni-muenchen.de
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Koutsouleris
authors.forename: Katja
authors.initials: K
authors.lastname: Patschurek-Kliche
authors.forename: Johanna
authors.initials: J
authors.lastname: Scheuerecker
authors.forename: Petra
authors.initials: P
authors.lastname: Decker
authors.forename: Ronald
authors.initials: R
authors.lastname: Bottlender
authors.forename: Gisela
authors.initials: G
authors.lastname: Schmitt
authors.forename: Dan
authors.initials: D
authors.lastname: Rujescu
authors.forename: Ina
authors.initials: I
authors.lastname: Giegling
authors.forename: Christian
authors.initials: C
authors.lastname: Gaser
authors.forename: Maximilian
authors.initials: M
authors.lastname: Reiser
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Eva M
authors.initials: EM
authors.lastname: Meisenzahl
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D003071:Cognition; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008032:Limbic System / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009445:Neuroanatomy; D009483:Neuropsychological Tests; D017397:Prefrontal Cortex / Q000473:pathology; D011618:Psychotic Disorders / Q000473:pathology* / Q000523:psychology*; D012307:Risk Factors; D013702:Temporal Lobe / Q000473:pathology; D055815:Young Adult