Auditory attention in first episode psychosis

选择性注意力，即集中在一个被感知者身上的能力，是最先受到影响的执行功能之一 精神病神经科学的基础工作已经开始阐明选择性神经元的潜在机制， 注意力产生于前额叶皮层，通过与后顶叶的联系调节感觉皮层的活动。 皮层在生理学方面，α波（~10 Hz）和γ波（~40 Hz）似乎起着核心作用 在注意力的影响，其中感官活动要参加的事件增加，而感官活动 被忽略的事件减少了。在人类认知神经科学研究中， 基于特定振荡（而不是头皮）的大脑不同区域之间的连接是 相对较少。拟议中的研究将扩大我们对注意力如何增加大脑中感觉活动的认识。 以及这些过程在新出现的精神病中是如何出错的。在人类精神病理学中 研究，几个新兴的线程已经改变了精神病的理解方式。首先，证据表明 进行性认知和皮质灰质下降，在早期疾病过程中，甚至之前， 精神病的出现。其次，越来越多的证据表明，精神病不仅影响最高水平的 但是感觉过程也会受到影响。目前尚不清楚的是，这些感官在多大程度上 缺陷是由于皮质感觉区的进行性病理或执行控制的进行性病理所致 前额叶皮层和后顶叶皮层的中枢，这样， 中心通过减少功能连接而受损。精神分裂症和情感性精神病 是晚期神经发育障碍并伴有进行性恶化我们假设高阶运算 其需要在多个远端皮层区域之间进行长距离通信和同步， 复杂的综合处理将首先受到影响。因此，我们建议选择性注意调制 感觉活动在病程的早期就会受损。我们的主要目标是研究注意力如何影响 听觉系统中的感觉活动，当受试者注意或忽略一个音调，两个音调或四个音调时， 增加每项任务的注意力需求。我们将使用组合EEG和MEG重建成个体 结构MRI的脑形态，这将允许高度精确地测量神经活动内 大脑作为参与者执行任务。受试者将在首次精神病发作时和6个月后接受测试， 随访任何进展性病理，并在12个月时指定明确的诊断。第二个目标是 确定是否缺陷的能力，调节感官活动的注意，在我们的初步数据表明，可能 作为精神病的生物标志物。如果是这样的话，我们的下一步将是检查注意力调节， 高风险可能是前驱求助者的感觉信号。因此，我们的战略是验证潜在的预- 在已知病例中，精神病生物标志物在精神病出现时，然后可以用于检测 相对较少的高风险求助者实际上是精神病的前驱。

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 goal is to examine how attention affects sensory activity in the auditory system as subjects attend or ignore one tone, two tones, or four tones, thereby increasing the attentional demand for each task. 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 as participants perform the tasks. Subjects will be tested at first psychotic episode and 6 months later to follow any progressive pathology, and at 12 months to assign definitive diagnoses. A secondary goal is to determine if deficits in the ability to modulate sensory activity by attention, as indicated in our preliminary data, may serve as biomarkers for emerging psychosis. If so, our next step would be to examine attentional modulation of sensory signals in high-risk possibly prodromal help seekers. Thus our strategy is to validate potential pre- psychosis biomarkers right at the emergence of psychosis in known cases, which may then be used to detect the relatively few high-risk help seekers that are actually prodromal for psychosis.