Transdiagnostic associations between functional brain network integrity and cognition

Julia M. Sheffield, Sridhar Kandala, Carol A. Tamminga, Godfrey D. Pearlson, Matcheri S. Keshavan, John A. Sweeney, Brett A. Clementz, Dov B. Lerman-Sinkoff, S. Kristian Hill, Deanna M. Barch

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

IMPORTANCE Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. OBJECTIVE To examine whether the general cognitive deficit observed across psychotic disorders is similarly associated with functional integrity of 2 brain networks widely implicated in supporting many cognitive domains. DESIGN, SETTING, AND PARTICIPANTS A total of 201 healthy control participants and 375 patients with psychotic disorders from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were studied from September 29, 2007, to May 31, 2011. The B-SNIP recruited healthy controls and stable outpatients from 6 sites: Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan; and Hartford, Connecticut. All participants underwent cognitive testing and resting-state functional magnetic resonance imaging. Data analysis was performed from April 28, 2015, to February 21, 2017. MAIN OUTCOMES AND MEASURES The Brief Assessment of Cognition in Schizophreniawas used to measure cognitive ability. A principal axis factor analysis on the Brief Assessment of Cognition in Schizophrenia battery yielded a single factor (54%variance explained) that served as the measure of general cognitive ability. Functional network integrity measures included global and local efficiency of the whole brain, cingulo-opercular network (CON), frontoparietal network, and auditory network and exploratory analyses of all networks from the Power atlas. Group differences in network measures, associations between cognition and network measures, and mediation models were tested. RESULTS The final sample for the current study included 201 healthy controls, 143 patients with schizophrenia, 103 patients with schizoaffective disorder, and 129 patients with psychotic bipolar disorder (mean [SD] age, 35.1 [12.0] years; 281 male [48.8%] and 295 female [51.2%]; 181 white [31.4%], 348 black [60.4%], and 47 other [8.2%]). Patients with schizophrenia (Cohen d = 0.36, P < .001) and psychotic bipolar disorder (Cohen d = 0.33, P = .002) had significantly reduced CON global efficiency compared with healthy controls. All patients with psychotic disorders had significantly reduced CON local efficiency, but the clinical groups did not differ from one another. The CON global efficiency was significantly associated with general cognitive ability across all groups (β = 0.099, P = .009) and significantly mediated the association between psychotic disorder status and general cognition (β =-0.037; 95%CI, .0.076 to .0.014). Subcortical network global efficiency was also significantly reduced in psychotic disorders (F3,587 = 4.01, P = .008) and positively predicted cognitive ability (β = 0.094, P = .009). CONCLUSIONS AND RELEVANCE These findings provide evidence that reduced CON and subcortical network efficiency play a role in the general cognitive deficit observed across the psychosis spectrum. They provide new support for the dimensional hypothesis that a shared neurobiological mechanism underlies cognitive impairment in psychotic disorders.

Original languageEnglish (US)
Pages (from-to)605-613
Number of pages9
JournalJAMA Psychiatry
Volume74
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

Psychotic Disorders
Cognition
Brain
Aptitude
Schizophrenia
Efficiency
Bipolar Disorder
Phenotype
Baltimore
Atlases
Statistical Factor Analysis
Healthy Volunteers
Outpatients
Magnetic Resonance Imaging
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Transdiagnostic associations between functional brain network integrity and cognition. / Sheffield, Julia M.; Kandala, Sridhar; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.; Clementz, Brett A.; Lerman-Sinkoff, Dov B.; Hill, S. Kristian; Barch, Deanna M.

In: JAMA Psychiatry, Vol. 74, No. 6, 01.06.2017, p. 605-613.

Research output: Contribution to journalArticle

Sheffield, JM, Kandala, S, Tamminga, CA, Pearlson, GD, Keshavan, MS, Sweeney, JA, Clementz, BA, Lerman-Sinkoff, DB, Hill, SK & Barch, DM 2017, 'Transdiagnostic associations between functional brain network integrity and cognition', JAMA Psychiatry, vol. 74, no. 6, pp. 605-613. https://doi.org/10.1001/jamapsychiatry.2017.0669
Sheffield, Julia M. ; Kandala, Sridhar ; Tamminga, Carol A. ; Pearlson, Godfrey D. ; Keshavan, Matcheri S. ; Sweeney, John A. ; Clementz, Brett A. ; Lerman-Sinkoff, Dov B. ; Hill, S. Kristian ; Barch, Deanna M. / Transdiagnostic associations between functional brain network integrity and cognition. In: JAMA Psychiatry. 2017 ; Vol. 74, No. 6. pp. 605-613.
@article{ea66a2f234254a6cb79942089419caf5,
title = "Transdiagnostic associations between functional brain network integrity and cognition",
abstract = "IMPORTANCE Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. OBJECTIVE To examine whether the general cognitive deficit observed across psychotic disorders is similarly associated with functional integrity of 2 brain networks widely implicated in supporting many cognitive domains. DESIGN, SETTING, AND PARTICIPANTS A total of 201 healthy control participants and 375 patients with psychotic disorders from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were studied from September 29, 2007, to May 31, 2011. The B-SNIP recruited healthy controls and stable outpatients from 6 sites: Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan; and Hartford, Connecticut. All participants underwent cognitive testing and resting-state functional magnetic resonance imaging. Data analysis was performed from April 28, 2015, to February 21, 2017. MAIN OUTCOMES AND MEASURES The Brief Assessment of Cognition in Schizophreniawas used to measure cognitive ability. A principal axis factor analysis on the Brief Assessment of Cognition in Schizophrenia battery yielded a single factor (54{\%}variance explained) that served as the measure of general cognitive ability. Functional network integrity measures included global and local efficiency of the whole brain, cingulo-opercular network (CON), frontoparietal network, and auditory network and exploratory analyses of all networks from the Power atlas. Group differences in network measures, associations between cognition and network measures, and mediation models were tested. RESULTS The final sample for the current study included 201 healthy controls, 143 patients with schizophrenia, 103 patients with schizoaffective disorder, and 129 patients with psychotic bipolar disorder (mean [SD] age, 35.1 [12.0] years; 281 male [48.8{\%}] and 295 female [51.2{\%}]; 181 white [31.4{\%}], 348 black [60.4{\%}], and 47 other [8.2{\%}]). Patients with schizophrenia (Cohen d = 0.36, P < .001) and psychotic bipolar disorder (Cohen d = 0.33, P = .002) had significantly reduced CON global efficiency compared with healthy controls. All patients with psychotic disorders had significantly reduced CON local efficiency, but the clinical groups did not differ from one another. The CON global efficiency was significantly associated with general cognitive ability across all groups (β = 0.099, P = .009) and significantly mediated the association between psychotic disorder status and general cognition (β =-0.037; 95{\%}CI, .0.076 to .0.014). Subcortical network global efficiency was also significantly reduced in psychotic disorders (F3,587 = 4.01, P = .008) and positively predicted cognitive ability (β = 0.094, P = .009). CONCLUSIONS AND RELEVANCE These findings provide evidence that reduced CON and subcortical network efficiency play a role in the general cognitive deficit observed across the psychosis spectrum. They provide new support for the dimensional hypothesis that a shared neurobiological mechanism underlies cognitive impairment in psychotic disorders.",
author = "Sheffield, {Julia M.} and Sridhar Kandala and Tamminga, {Carol A.} and Pearlson, {Godfrey D.} and Keshavan, {Matcheri S.} and Sweeney, {John A.} and Clementz, {Brett A.} and Lerman-Sinkoff, {Dov B.} and Hill, {S. Kristian} and Barch, {Deanna M.}",
year = "2017",
month = "6",
day = "1",
doi = "10.1001/jamapsychiatry.2017.0669",
language = "English (US)",
volume = "74",
pages = "605--613",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - Transdiagnostic associations between functional brain network integrity and cognition

AU - Sheffield, Julia M.

AU - Kandala, Sridhar

AU - Tamminga, Carol A.

AU - Pearlson, Godfrey D.

AU - Keshavan, Matcheri S.

AU - Sweeney, John A.

AU - Clementz, Brett A.

AU - Lerman-Sinkoff, Dov B.

AU - Hill, S. Kristian

AU - Barch, Deanna M.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - IMPORTANCE Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. OBJECTIVE To examine whether the general cognitive deficit observed across psychotic disorders is similarly associated with functional integrity of 2 brain networks widely implicated in supporting many cognitive domains. DESIGN, SETTING, AND PARTICIPANTS A total of 201 healthy control participants and 375 patients with psychotic disorders from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were studied from September 29, 2007, to May 31, 2011. The B-SNIP recruited healthy controls and stable outpatients from 6 sites: Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan; and Hartford, Connecticut. All participants underwent cognitive testing and resting-state functional magnetic resonance imaging. Data analysis was performed from April 28, 2015, to February 21, 2017. MAIN OUTCOMES AND MEASURES The Brief Assessment of Cognition in Schizophreniawas used to measure cognitive ability. A principal axis factor analysis on the Brief Assessment of Cognition in Schizophrenia battery yielded a single factor (54%variance explained) that served as the measure of general cognitive ability. Functional network integrity measures included global and local efficiency of the whole brain, cingulo-opercular network (CON), frontoparietal network, and auditory network and exploratory analyses of all networks from the Power atlas. Group differences in network measures, associations between cognition and network measures, and mediation models were tested. RESULTS The final sample for the current study included 201 healthy controls, 143 patients with schizophrenia, 103 patients with schizoaffective disorder, and 129 patients with psychotic bipolar disorder (mean [SD] age, 35.1 [12.0] years; 281 male [48.8%] and 295 female [51.2%]; 181 white [31.4%], 348 black [60.4%], and 47 other [8.2%]). Patients with schizophrenia (Cohen d = 0.36, P < .001) and psychotic bipolar disorder (Cohen d = 0.33, P = .002) had significantly reduced CON global efficiency compared with healthy controls. All patients with psychotic disorders had significantly reduced CON local efficiency, but the clinical groups did not differ from one another. The CON global efficiency was significantly associated with general cognitive ability across all groups (β = 0.099, P = .009) and significantly mediated the association between psychotic disorder status and general cognition (β =-0.037; 95%CI, .0.076 to .0.014). Subcortical network global efficiency was also significantly reduced in psychotic disorders (F3,587 = 4.01, P = .008) and positively predicted cognitive ability (β = 0.094, P = .009). CONCLUSIONS AND RELEVANCE These findings provide evidence that reduced CON and subcortical network efficiency play a role in the general cognitive deficit observed across the psychosis spectrum. They provide new support for the dimensional hypothesis that a shared neurobiological mechanism underlies cognitive impairment in psychotic disorders.

AB - IMPORTANCE Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. OBJECTIVE To examine whether the general cognitive deficit observed across psychotic disorders is similarly associated with functional integrity of 2 brain networks widely implicated in supporting many cognitive domains. DESIGN, SETTING, AND PARTICIPANTS A total of 201 healthy control participants and 375 patients with psychotic disorders from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium were studied from September 29, 2007, to May 31, 2011. The B-SNIP recruited healthy controls and stable outpatients from 6 sites: Baltimore, Maryland; Boston, Massachusetts; Chicago, Illinois; Dallas, Texas; Detroit, Michigan; and Hartford, Connecticut. All participants underwent cognitive testing and resting-state functional magnetic resonance imaging. Data analysis was performed from April 28, 2015, to February 21, 2017. MAIN OUTCOMES AND MEASURES The Brief Assessment of Cognition in Schizophreniawas used to measure cognitive ability. A principal axis factor analysis on the Brief Assessment of Cognition in Schizophrenia battery yielded a single factor (54%variance explained) that served as the measure of general cognitive ability. Functional network integrity measures included global and local efficiency of the whole brain, cingulo-opercular network (CON), frontoparietal network, and auditory network and exploratory analyses of all networks from the Power atlas. Group differences in network measures, associations between cognition and network measures, and mediation models were tested. RESULTS The final sample for the current study included 201 healthy controls, 143 patients with schizophrenia, 103 patients with schizoaffective disorder, and 129 patients with psychotic bipolar disorder (mean [SD] age, 35.1 [12.0] years; 281 male [48.8%] and 295 female [51.2%]; 181 white [31.4%], 348 black [60.4%], and 47 other [8.2%]). Patients with schizophrenia (Cohen d = 0.36, P < .001) and psychotic bipolar disorder (Cohen d = 0.33, P = .002) had significantly reduced CON global efficiency compared with healthy controls. All patients with psychotic disorders had significantly reduced CON local efficiency, but the clinical groups did not differ from one another. The CON global efficiency was significantly associated with general cognitive ability across all groups (β = 0.099, P = .009) and significantly mediated the association between psychotic disorder status and general cognition (β =-0.037; 95%CI, .0.076 to .0.014). Subcortical network global efficiency was also significantly reduced in psychotic disorders (F3,587 = 4.01, P = .008) and positively predicted cognitive ability (β = 0.094, P = .009). CONCLUSIONS AND RELEVANCE These findings provide evidence that reduced CON and subcortical network efficiency play a role in the general cognitive deficit observed across the psychosis spectrum. They provide new support for the dimensional hypothesis that a shared neurobiological mechanism underlies cognitive impairment in psychotic disorders.

UR - http://www.scopus.com/inward/record.url?scp=85020727087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020727087&partnerID=8YFLogxK

U2 - 10.1001/jamapsychiatry.2017.0669

DO - 10.1001/jamapsychiatry.2017.0669

M3 - Article

VL - 74

SP - 605

EP - 613

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 6

ER -