The British Journal of Psychiatry (2009) 194: 25-33. doi: 10.1192/bjp.bp.107.046789
© 2009 The Royal College of Psychiatrists
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Neural correlates of executive function and working memory in the ‘at-risk mental state’

Matthew R. Broome, BSc, PhD, MBChB, MRCPsych

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, and Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, UK

Pall Matthiasson, MD, MRCPsych, PhD

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London

Paolo Fusar-Poli, MD

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, UK, and Department of Applied and Psychobehavioural Health Sciences, University of Pavia, Italy

James B. Woolley, BSc, MBBS, MRCP, MRCPsych, Louise C. Johns, DPhil, DClinPsy, Paul Tabraham, BSc, DClinPsy and Elvira Bramon, MD, PhD

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, UK

Lucia Valmaggia, PhD, DClinPsy

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, UK, and Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands

Steven C. R. Williams, PhD

Neuroimaging Research Group, Department of Neurology, Institute of Psychiatry, King’s College London, UK

Michael J. Brammer, PhD and Xavier Chitnis, MSc

Brain Image Analysis Unit, Department of Biostatistics and Computing, Institute of Psychiatry, King’s College London, UK

Philip K. McGuire, MD, PhD, FRCPsych

Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, UK

Correspondence: Matthew R. Broome, Warwick Medical School, University of Warwick, Gibbet Hill, Coventry CV4 7AL, UK. Email: m.r.broome{at}warwick.ac.uk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

People with prodromal symptoms have a very high risk of developing psychosis.

Aims

To use functional magnetic resonance imaging to examine the neurocognitive basis of this vulnerability.

Method

Cross-sectional comparison of regional activation in individuals with an’at-risk mental state’ (at-risk group: n=17), patients with first-episode schizophreniform psychosis (psychosis group: n=10) and healthy volunteers (controls: n=15) during an overt verbal fluency task and an N-back working memory task.

Results

A similar pattern of between-group differences in activation was evident across both tasks. Activation in the at-risk group was intermediate relative to that in controls and the psychosis group in the inferior frontal and anterior cingulate cortex during the verbal fluency task and in the inferior frontal, dorsolateral prefrontal and parietal cortex during the N-back task.

Conclusions

The at-risk mental state is associated with abnormalities of regional brain function that are qualitatively similar to, but less severe than, those in patients who have recently presented with psychosis.


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