Contributions of parasympathetic arousal-related activity to cognitive performance in First Episode Psychosis patients and controls.

Abstract Background Cognitive impairment is integral to the pathophysiology of psychosis. Recent findings implicate autonomic arousal-related activity in both momentary fluctuations and individual differences in cognitive performance. Although altered autonomic arousal is common in First Episode Psychosis (FEP) patients, its contribution to cognitive performance is unknown. Methods 24 FEP patients (46% male, age = 24.31 (4.27) years) and 24 healthy controls (42% male, age = 27.06 (3.44) years) performed the Multi-Source Interference Task in-scanner with simultaneous pulse oximetry. First-level models included the cardiac-BOLD regressor, which reflected parasympathetic arousal-related activity and was created by convolving the inter-beat interval at each heartbeat with the hemodynamic response function, in addition to task (congruent, interference, and error) and nuisance (motion and aCompCor physiology) regressors. Group models examined the effect of group or cognitive performance (reaction times * error rate) on arousal-related and task activity, while controlling for sex, age, and Framewise Displacement. Results Parasympathetic arousal-related activity was robust in both groups, but localized to different regions for FEP patients and healthy control subjects. Within both groups, arousal-related activity was significantly associated with cognitive performance across occipital and temporal cortical regions. Greater arousal-related activity in the bilateral prefrontal cortex (BA 9) was related to better performance in healthy controls, but not FEP patients. Conclusions Autonomic arousal circuits contribute to cognitive performance and the pathophysiology of FEP. Arousal-related functional activity is a novel indicator of cognitive ability and should be incorporated into neurobiological models of cognition in psychosis.