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Functional connectivity associated with improvement in emotion management after cognitive enhancement therapy in early-course schizophrenia

Published online by Cambridge University Press:  13 November 2020

Synthia Guimond Open the ORCID record for Synthia Guimond [Opens in a new window] ,
George Ling ,
Jessica Drodge ,
Hannah Matheson ,
Jessica A. Wojtalik ,
Betzamel Lopez ,
Guusje Collin ,
Roscoe Brady ,
Raquelle I. Mesholam-Gately  and
Heidi Thermenos
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Synthia Guimond*
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, K1Z 7K4, Canada Department of Psychoeducation and Psychology, University of Québec in Outaouais, Gatineau, QC, J8X 3X7, Canada Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8L1, Canada
George Ling
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA University of Miami Miller School of Medicine, Miami, FL, 33136, USA
Jessica Drodge
Affiliation:
Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, K1Z 7K4, Canada Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, K1H 8L1, Canada
Hannah Matheson
Affiliation:
Department of Psychiatry, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, K1Z 7K4, Canada
Jessica A. Wojtalik
Affiliation:
Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, 44106, USA
Betzamel Lopez
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA
Guusje Collin
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA University Medical Center Utrecht Brain Center, 3584 XC Utrecht, The Netherlands
Roscoe Brady
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
Raquelle I. Mesholam-Gately
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
Heidi Thermenos
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
Shaun M. Eack
Affiliation:
School of Social Work and Department of Psychiatry, University of Pittsburgh, 4200 Fifth Ave, Pittsburgh, PA 15260, USA
Matcheri S. Keshavan
Affiliation:
Department of Psychiatry, Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center Division of Public Psychiatry, MA, 02115, USA Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
*
Author for correspondence: Synthia Guimond, E-mail: synthia.guimond@theroyal.ca, sguimond@uottawa.ca
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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.

Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 12 , September 2022 , pp. 2245 - 2254
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally

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