This K23 application proposes a training and mentored research plan that will provide the applicant with new skills related to cognitive neuroscience and functional neuroimaging that will support the development of an independent research career investigating the cognitive and neural mechanisms underlying clinical and functional outcome in individuals at ultra-high-risk (UHR) for psychosis. The proposed training plan incorporates rigorous training in fMRI methodology, and relevant coursework in statistical analysis, programming, and the responsible conduct of human research. The academic and professional environment at UC Davis provides rich resources for the implementation of this proposal, including consistent access to an experienced mentorship team, a distinguished research and clinical faculty, two on-site magnetic resonance imaging (MRI) scanners and support staff dedicated to research purposes. In addition to this outstanding research training environment, the applicant will have ongoing access to established clinical populations for subject recruitment, and a strong departmental commitment to the development of the applicant's research career. The proposed mentored research study seeks to elucidate cognitive markers of risk for clinical and functional deterioration in individuals at ultra-high-risk for psychosis using fMRI. This investigation will extend previous findings established in individuals with schizophrenia by exploring prefrontally-mediated cognitive control and the integrity of underlying neurobiological circuitry in UHR individuals and healthy matched controls. Cognitive control, which is subserved by a distributed network of brain regions, coordinates thoughts and actions in order to generate goal-directed behavior. Cognitive control impairments have been consistently demonstrated in individuals with schizophrenia and, more recently, linked to clinical and functional impairment. While impairments on behavioral measures of cognition have been observed in UHR populations, the neural mechanisms underlying such impairments have not been established. Further, the link between such cognitive impairments and deterioration in clinical and psychosocial domains has not been systematically explored. This investigation utilizes an event-related functional magnetic resonance imaging (fMRI) paradigm to examine the role of the dorsolateral prefrontal cortex (DLPFC), which serves as an integral part of the distributed cognitive control network, during a task requiring high levels of cognitive control. It is hypothesized that UHR individuals will demonstrate reduced cognitive control with concurrent reductions in DLPFC activation when compared to normal controls. Furthermore, it is predicted that connectivity between the DLPFC and the distributed neural network that supports cognitive control will also be reduced in the UHR group. Finally, relationships between cortical activation and measures of clinical symptomatology and psychosocial functioning will be examined in order to determine if dysfunction in the DLPFC circuit underlying cognitive control contributes to clinical and functional outcome in these at-risk individuals. In concordance with the goals of the current NIMH Strategic Plan, results of this investigation will provide novel information on the role of prefrontal connectivity during the period preceding psychosis onset, offering insight into potential neurobiological markers as well as the possible developmental trajectory of illness progression for those individuals who are at highest risk for developing psychosis. Further, this study will broaden our understanding of the impact of prefrontal functioning on clinical and psychosocial functioning for at-risk adolescents, enhancing early identification algorithms and contributing to the development of more effective early intervention efforts.

Public Health Relevance

The identification of putative markers of risk for psychosis is an essential step toward enhancing early detection and intervention efforts. This research proposes to use an fMRI paradigm to investigate cognitive control processes in the prefrontal cortex to identify markers of risk for clinical and functional deterioration in youth at ultra-high risk for psychosis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH087708-03
Application #
8258354
Study Section
Special Emphasis Panel (ZRG1-BDCN-T (03))
Program Officer
Wynne, Debra K
Project Start
2010-07-01
Project End
2015-01-31
Budget Start
2012-02-01
Budget End
2013-01-31
Support Year
3
Fiscal Year
2012
Total Cost
$158,586
Indirect Cost
$11,747
Name
University of California Davis
Department
Psychiatry
Type
Schools of Medicine
DUNS #
047120084
City
Davis
State
CA
Country
United States
Zip Code
95618
Carrión, Ricardo E; Cornblatt, Barbara A; Burton, Cynthia Z et al. (2016) Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the EDIPPP Project. Am J Psychiatry 173:989-996
Solomon, Marjorie; Ragland, J Daniel; Niendam, Tara A et al. (2015) Atypical Learning in Autism Spectrum Disorders: A Functional Magnetic Resonance Imaging Study of Transitive Inference. J Am Acad Child Adolesc Psychiatry 54:947-55
Niendam, Tara A; Lesh, Tyler A; Yoon, Jong et al. (2014) Impaired context processing as a potential marker of psychosis risk state. Psychiatry Res 221:13-20
Solomon, Marjorie; Yoon, Jong H; Ragland, J Daniel et al. (2014) The development of the neural substrates of cognitive control in adolescents with autism spectrum disorders. Biol Psychiatry 76:412-21
Swaab, Tamara Y; Boudewyn, Megan A; Long, Debra L et al. (2013) Spared and impaired spoken discourse processing in schizophrenia: effects of local and global language context. J Neurosci 33:15578-87
Lesh, Tyler A; Westphal, Andrew J; Niendam, Tara A et al. (2013) Proactive and reactive cognitive control and dorsolateral prefrontal cortex dysfunction in first episode schizophrenia. Neuroimage Clin 2:590-9
Fulford, Daniel; Niendam, Tara A; Floyd, Erin G et al. (2013) Symptom dimensions and functional impairment in early psychosis: more to the story than just negative symptoms. Schizophr Res 147:125-31
Schlosser, Danielle A; Jacobson, Sarah; Chen, Qiaolin et al. (2012) Recovery from an at-risk state: clinical and functional outcomes of putatively prodromal youth who do not develop psychosis. Schizophr Bull 38:1225-33
Bachman, Peter; Niendam, Tara A; Jalbrzikowski, Maria et al. (2012) Processing speed and neurodevelopment in adolescent-onset psychosis: cognitive slowing predicts social function. J Abnorm Child Psychol 40:645-54
Yoon, Jong H; Nguyen, Danh V; McVay, Lindsey M et al. (2012) Automated classification of fMRI during cognitive control identifies more severely disorganized subjects with schizophrenia. Schizophr Res 135:28-33

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