Synthia Guimond1,2,3,4,5, George Ling1,6, Jessica Drodge3,5, Hannah Matheson3, Jessica A Wojtalik7, Betzamel Lopez1, Guusje Collin1,8,9, Roscoe Brady1,2, Raquelle I Mesholam-Gately1,2, Heidi Thermenos1,2, Shaun M Eack10, Matcheri S Keshavan1,2. 1. Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA. 3. Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, K1Z 7K4, Canada. 4. Department of Psychoeducation and Psychology, University of Québec in Outaouais, Gatineau, QC, J8X 3X7, Canada. 5. Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8L1, Canada. 6. University of Miami Miller School of Medicine, Miami, FL, 33136, USA. 7. Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA. 8. Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA. 9. University Medical Center Utrecht Brain Center, 3584 XC Utrecht, The Netherlands. 10. School of Social Work and Department of Psychiatry, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA.
Abstract
BACKGROUND: The ability to manage emotions is an important social-cognitive domain impaired in schizophrenia and linked to functional outcome. The goal of our study was to examine the impact of cognitive enhancement therapy (CET) on the ability to manage emotions and brain functional connectivity in early-course schizophrenia. METHODS: Participants were randomly assigned to CET (n = 55) or an enriched supportive therapy (EST) control group (n = 45). The resting-state functional magnetic resonance imaging scans and measures of emotion management performances were collected at baseline, 9, and 18 months follow-up. The final sample consisted of 37 CET and 25 EST participants, including 19 CET and 12 EST participants with imaging data. Linear mixed-effects models investigated the impact of treatment on emotion management and functional connectivity from the amygdala to ventrolateral and dorsolateral prefrontal cortex (dlPFC). RESULTS: The CET group showed significant improvement over time in emotion management compared to EST. Neither functional connectivity changes nor main group differences were observed following treatment. However, a significant between-group interaction showed that improved emotion management ability was associated with increased functional connectivity between the left amygdala and the left dlPFC in the CET group exclusively. CONCLUSION: Our results replicate the previous work demonstrating that CET is effective at improving some aspects of social cognition in schizophrenia. We found evidence that improvement in emotion management may be associated with a change in amygdala-dlPFC connectivity. This fronto-limbic circuit may provide a mechanistic link between the biology of emotion management processes that can be enhanced in individuals with schizophrenia.
BACKGROUND: The ability to manage emotions is an important social-cognitive domain impaired in schizophrenia and linked to functional outcome. The goal of our study was to examine the impact of cognitive enhancement therapy (CET) on the ability to manage emotions and brain functional connectivity in early-course schizophrenia. METHODS: Participants were randomly assigned to CET (n = 55) or an enriched supportive therapy (EST) control group (n = 45). The resting-state functional magnetic resonance imaging scans and measures of emotion management performances were collected at baseline, 9, and 18 months follow-up. The final sample consisted of 37 CET and 25 EST participants, including 19 CET and 12 EST participants with imaging data. Linear mixed-effects models investigated the impact of treatment on emotion management and functional connectivity from the amygdala to ventrolateral and dorsolateral prefrontal cortex (dlPFC). RESULTS: The CET group showed significant improvement over time in emotion management compared to EST. Neither functional connectivity changes nor main group differences were observed following treatment. However, a significant between-group interaction showed that improved emotion management ability was associated with increased functional connectivity between the left amygdala and the left dlPFC in the CET group exclusively. CONCLUSION: Our results replicate the previous work demonstrating that CET is effective at improving some aspects of social cognition in schizophrenia. We found evidence that improvement in emotion management may be associated with a change in amygdala-dlPFC connectivity. This fronto-limbic circuit may provide a mechanistic link between the biology of emotion management processes that can be enhanced in individuals with schizophrenia.
Authors: Kyung-Hwan Park; Eun-Sook Park; Sung-Mi Jo; Mi-Hui Seo; Young-Ok Song; Sun-Joo Jang Journal: Int J Environ Res Public Health Date: 2021-05-20 Impact factor: 3.390