Auditory Attention in First Episode Psychosis

选择性注意力，即集中在一种感知和其他感知上的能力，是最初的执行功能之一 受精神病影响。神经科学的基础工作已经开始阐明 选择性注意产生于前额叶皮质，通过与后叶的联系调节感觉皮质的活动 顶叶皮质。在生理方面，阿尔法波(~10赫兹)和伽马波(~40赫兹)似乎起到了 在注意力的影响中发挥核心作用，通过这种作用，对要参加的事件的感觉活动增加，而 对不被忽视的事件的感觉活动减少。在人类认知神经科学研究中，研究表明 在特定振荡的基础上检查大脑不同区域之间的功能连接(而不是 比在头皮上)相对较少。拟议中的研究将扩大我们对注意力如何增加的了解 人类大脑中的感觉活动，以及这些过程在新出现的精神病中是如何出错的。在人类中 在精神病理学研究中，几个新出现的线索改变了人们对精神病的理解。第一, 有证据表明，在早期病程中，认知和皮质灰质的进行性下降，甚至 在精神病出现之前。第二，越来越多的证据表明，精神病不仅影响 最高水平的认知，但感觉过程也会受到影响。目前尚不清楚的是在多大程度上 这些感觉缺陷是由于皮质感觉区的进行性病理或 执行控制中枢位于前额叶皮质和后顶叶皮质，从而调节感觉 执行中心的活动因功能连接减少而受到影响。精神分裂症和情感性精神分裂症 精神病被认为是一种进行性恶化的晚期神经发育障碍。我们假设 需要在多个远端之间进行远程通信和同步的更高级别的操作 皮质区域和高度复杂的综合处理将首先受到影响。因此，我们建议有选择地 以注意力为基础的感觉活动调节在病程的早期就会受损。我们的主要目标 是研究当受试者注意或忽略声音时，注意力如何影响听觉系统中的感觉活动， 目的是为了在早期精神病中理清感觉和执行对知觉缺陷的贡献， 确定大脑功能和大脑结构的关系，并跟踪进展的功能和结构 在发病临近时会发生变化。我们将使用脑电和脑磁图相结合的方法重建个体大脑 结构核磁共振的形态，将允许高精度测量神经活动在 大脑。受试者将在第一次精神病发作时接受测试，并在6个月后接受任何进行性病理学检查。 本附录的目的是对参与者进行纵向重测，增加人数 的基线参与者，以取代研究中失去的参与者，从COVID19关闭，并实现 可靠的分析和较大的首发精神病的充分表现所需的样本量 用于泛化的人口。

Selective attention, the ability to focus on one percept among others, is one of the first executive functions affected by psychosis. Basic neuroscience work has begun to elucidate the underlying mechanisms of how selective attention, arising in prefrontal cortex, modulates sensory cortex activity via connections with posterior parietal cortex. In terms of physiology, alpha waves (~10 Hz) and gamma waves (~40 Hz) appear to play a central role in the effects of attention, by which sensory activity to to-be-attended events is increased, while sensory activity to to-be-ignored events is decreased. In human cognitive neuroscience research, studies that examine functional connectivity between different areas of the brain on the basis of specific oscillations (rather than at the scalp) are relatively few. The proposed studies will expand our knowledge of how attention increases sensory activity in the human brain, and how these processes go awry in newly emerging psychosis. In human psychopathology research, several emerging threads have changed the way psychosis is understood. First, evidence indicates progressive cognitive and cortical gray matter decline during the early disease course, even prior to the emergence of psychosis. Second, increasing evidence suggests that psychosis not only affects the highest levels of cognition, but that sensory processes are affected as well. What is not known is to what degree these sensory deficits are due to progressive pathology of cortical sensory areas or to progressive pathology of executive control centers in prefrontal cortex and posterior parietal cortex, such that modulation of sensory activity by executive centers is impaired via reduced functional connectivity. Both schizophrenia and affective psychosis are thought to be late neurodevelopmental disorders with progressive worsening. We hypothesize that higher-order operations that require long range communication and synchronization between multiple distal cortical areas and highly complex integrated processing will be affected first. Hence, we suggest selective attention-based modulation of sensory activity will be impaired quite early in disease course. Our primary goals is to examine how attention affects sensory activity in the auditory system as subjects attend or ignore sounds, with an aim towards disentangling sensory and executive contributions to perceptual deficits in early psychosis, determine brain function and brain structure relationships, and to track progressive functional and structural changes proximal to illness onset. We will use combined EEG & MEG reconstructed into individual brain morphology from structural MRI which will allow for highly precise measurement of neural activity within the brain. Subjects will be tested at first psychotic episode and 6 months later to follow any progressive pathology. The purpose of this Supplement is to perform longitudinal retesting on participants and to increase the number of baseline participants to replace the participants lost to the study from the COVID19 shutdown, and to achieve the necessary sample sizes for reliable analyses and sufficient representation of the larger first psychosis population for generalizability.