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Schizophrenia (SZ) is associated with thalamic dysconnectivity. Compared to healthy controls (HCs), individuals with SZ have hyperconnectivity with sensory regions, and hypoconnectivity with cerebellar, thalamic, and prefrontal regions. Despite replication of this pattern in chronically ill individuals, less is known about when these abnormalities emerge in the illness course and if they are present prior to illness onset.
Resting-state functional magnetic resonance imaging data were collected from psychosis risk syndrome (PRS) youth (n = 45), early illness SZ (ESZ) (n = 74) patients, and HCs (n = 85). Age-adjusted functional connectivity, seeded from the thalamus, was compared among the groups.
Significant effects of group were observed in left and right middle temporal regions, left and right superior temporal regions, left cerebellum, and bilateral thalamus. Compared to HCs, ESZ demonstrated hyperconnectivity to all temporal lobe regions and reduced connectivity with cerebellar, anterior cingulate, and thalamic regions. Compared to HCs, PRS demonstrated hyperconnectivity with the left and right middle temporal regions, and hypoconnectivity with the cerebellar and other thalamic regions. Compared to PRS participants, ESZ participants were hyperconnected to temporal regions, but did not differ from PRS in hypoconnectivity with cerebellar and thalamic regions. Thalamic dysconnectivity was unrelated to positive symptom severity in ESZ or PRS groups.
PRS individuals demonstrated an intermediate level of thalamic dysconnectivity, whereas ESZ showed a pattern consistent with prior observations in chronic samples. These cross-sectional findings suggest that thalamic dysconnectivity may occur prior to illness onset and become more pronounced in early illness stages.
This chapter discusses associations between neurocognition and functional outcome that are typically stronger than those found between psychotic symptoms and functional outcome, and sometimes even stronger than those between negative symptoms and outcome. Research in social cognition in schizophrenia has tended to cluster around four types of social cognitive processes: emotion processing, social perception, attributional style, and mental state attribution. Neurocognitive and social cognitive tasks often share cognitive demands, such as working memory and perception. Negative symptoms reflect a decrease or absence of normal functions within two broad domains: internal experience-related impairments, including diminished emotional experience, motivation to engage in productive activities, and desire for social affiliation; expressive or communicative impairments, including diminished facial expressivity, gestures, prosody, and speech production. It has been known for a long time that, neurocognition, negative symptoms are consistent predictors of daily functioning.
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