Synthia Guimond1,2, George Ling2, Betzamel Lopez2, Rachel Templeton2, Roscoe Brady1,2, Heidi Thermenos1,2, Shaun Eack3, Matcheri Keshavan1,2; 1Harvard Medical School, 2Beth Israel Deaconess Medical Center, Massachusetts Mental Health Center, 3University of Pittsburgh
Social cognition is a key determinant of functional outcomes in early course schizophrenia. The goal of our study was to examine the impact of cognitive enhancement therapy (CET) on social cognition and on functional connectivity in early course schizophrenia. Eighty-four participants were randomly assigned to either treatment groups (CET, n=49; Enriched Supportive Therapy (EST), n=35). Resting state scans and social cognition performance, as measured by the MATRICS battery, were collected at baseline, 9, 18 and 30 months. We conducted mixed linear model analyses to investigate the impact of treatment (CET vs. EST) on social cognition and on the dorsolateral prefrontal cortex (DLPFC) functional connectivity to the right and left amygdala. CET group showed significant improvement over time in social cognition in comparison to the EST group (p<.05). Change in functional connectivity over time did not significantly differ between treatments. However, we observed a significant positive correlation between increased right DLPFC functional connectivity to the right amygdala and social cognition performance in the CET group (p<.05). Our results replicate previous work demonstrating that CET is effective at improving social cognition in schizophrenia. In addition, we found evidence that this improvement could be reflected in the DLPFC-amygdala circuit connectivity. This neural circuit potentially provides a mechanistic link between the biology of emotion regulation and more complex social cognition processes that can be improved in early stage of the illness.
