Functional connectivity and gray matter deficits within the auditory attention circuit in first-episode psychosis

BackgroundSelective attention deficits in first episode of psychosis (FEP) can be indexed by impaired attentional modulation of auditory M100. It is unknown if the pathophysiology underlying this deficit is restricted to auditory cortex or involves a distributed attention network. We examined the auditory attention network in FEP. MethodsMEG was recorded from 27 FEP and 31 matched healthy controls (HC) while alternately ignoring or attending tones. A whole-brain analysis of MEG source activity during auditory M100 identified non-auditory areas with increased activity. Time-frequency activity and phase-amplitude coupling were examined in auditory cortex to identify the attentional executive carrier frequency. Attention networks were defined by phase-locking at the carrier frequency. Spectral and gray matter deficits in the identified circuits were examined in FEP. ResultsAttention-related activity was identified in prefrontal and parietal regions, markedly in precuneus. Theta power and phase coupling to gamma amplitude increased with attention in left primary auditory cortex. Two unilateral attention networks were identified with precuneus seeds in HC. Network synchrony was impaired in FEP. Gray matter thickness was reduced within the left hemisphere network in FEP but did not correlate with synchrony. ConclusionSeveral extra-auditory attention areas with attention-related activity were identified. Theta was the carrier frequency for attentional modulation in auditory cortex. Left and right hemisphere attention networks were identified, with bilateral functional deficits and left hemisphere structural deficits, though FEP showed intact auditory cortex theta phase-gamma amplitude coupling. These novel findings indicate attention-related circuitopathy early in psychosis potentially amenable to future non-invasive interventions.

Automated summary

This study found that first episode of psychosis (FEP) patients have deficits in selective attention, and the underlying pathophysiology may involve a distributed attention network beyond the auditory cortex. The study also identified attention-related activity in prefrontal and parietal regions, notably in the precuneus. Compared to the healthy controls, FEP patients showed impaired network synchrony and reduced gray matter thickness in the left hemisphere network. These novel findings suggest the presence of attention-related circuitopathy in early psychosis, which may be amenable to non-invasive interventions in the future.