title: Different duration of at-risk mental state associated with neurofunctional abnormalities. A multimodal imaging study.
abstract: OBJECTIVE
  Neurofunctional alterations are correlates of vulnerability to psychosis, as well as of the disorder itself. How these abnormalities relate to different probabilities for later transition to psychosis is unclear. We investigated vulnerability- versus disease-related versus resilience biomarkers of psychosis during working memory (WM) processing in individuals with an at-risk mental state (ARMS).
  
  
  METHODS
  Patients with "first-episode psychosis" (FEP, n = 21), short-term ARMS (ARMS-ST, n = 17), long-term ARMS (ARMS-LT, n = 16), and healthy controls (HC, n = 20) were investigated with an n-back WM task. We examined functional magnetic resonance imaging (fMRI) and structural magnetic resonance imaging (sMRI) data in conjunction using biological parametric mapping (BPM) toolbox.
  
  
  RESULTS
  There were no differences in accuracy, but the FEP and the ARMS-ST group had longer reaction times compared with the HC and the ARMS-LT group. With the 2-back > 0-back contrast, we found reduced functional activation in ARMS-ST and FEP compared with the HC group in parietal and middle frontal regions. Relative to ARMS-LT individuals, FEP patients showed decreased activation in the bilateral inferior frontal gyrus and insula, and in the left prefrontal cortex. Compared with the ARMS-LT, the ARMS-ST subjects showed reduced activation in the right inferior frontal gyrus and insula. Reduced insular and prefrontal activation was associated with gray matter volume reduction in the same area in the ARMS-LT group.
  
  
  CONCLUSIONS
  These findings suggest that vulnerability to psychosis was associated with neurofunctional alterations in fronto-temporo-parietal networks in a WM task. Neurofunctional differences within the ARMS were related to different duration of the prodromal state and resilience factors.
authors.affiliation: Department of Psychiatry, University of Basel, c/o University Hospital Basel, Petersgraben 4, Basel 4031, Switzerland.
authors.forename: Renata
authors.initials: R
authors.lastname: Smieskova
authors.forename: Paul
authors.initials: P
authors.lastname: Allen
authors.forename: Andor
authors.initials: A
authors.lastname: Simon
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Aston
authors.forename: Kerstin
authors.initials: K
authors.lastname: Bendfeldt
authors.forename: Jürgen
authors.initials: J
authors.lastname: Drewe
authors.forename: Kerstin
authors.initials: K
authors.lastname: Gruber
authors.forename: Ute
authors.initials: U
authors.lastname: Gschwandtner
authors.forename: Markus
authors.initials: M
authors.lastname: Klarhoefer
authors.forename: Claudia
authors.initials: C
authors.lastname: Lenz
authors.forename: Klaus
authors.initials: K
authors.lastname: Scheffler
authors.forename: Rolf-Dieter
authors.initials: RD
authors.lastname: Stieglitz
authors.forename: Ernst-Wilhelm
authors.initials: EW
authors.lastname: Radue
authors.forename: Philip
authors.initials: P
authors.lastname: McGuire
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rössler
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Borgwardt
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000503:physiopathology*; D012307:Risk Factors