Predicting Clinical Improvement in Early Psychosis Using Circuit-Based Resting-State Functional Magnetic Resonance Imaging.

BACKGROUND AND HYPOTHESIS: Identifying biomarkers that predict treatment response in early psychosis (EP) is a priority for psychiatry research. Previous work suggests that resting-state connectivity biomarkers may have promise as predictive measures, although prior results vary considerably in direction and magnitude. Here, we evaluated the relationship between intrinsic functional connectivity of the attention, default mode, and salience resting-state networks and 12-month clinical improvement in EP. STUDY DESIGN: Fifty-eight individuals with EP (less than 2 years from illness onset, 35 males, average age 20 years) had baseline and follow-up clinical data and were included in the final sample. Of these, 30 EPs showed greater than 20% improvement in Brief Psychiatric Rating Scale (BPRS) total score at follow-up and were classified as "Improvers." STUDY RESULTS: The overall logistic regression predicting Improver status was significant (χ2 = 23.66, Nagelkerke's R2 = 0.45, P < .001, with 85% concordance). Significant individual predictors of Improver status included higher default mode within-network connectivity, higher attention-default mode between-network connectivity, and higher attention-salience between-network connectivity. Including baseline BPRS as a predictor increased model significance and concordance to 92%, and the model was not significantly influenced by the dose of antipsychotic medication (chlorpromazine equivalents). Linear regression models predicting percent change in BPRS were also significant. CONCLUSIONS: Overall, these results suggest that resting-state functional magnetic resonance imaging connectivity may serve as a useful biomarker of clinical outcomes in recent-onset psychosis.

Are irrelevant items actively deleted from visual working memory?: No evidence from repulsion and attraction effects in dual-retrocue tasks.

Some theories propose that working memory (WM) involves the active deletion of irrelevant information, including items that were retained in WM, but are no longer relevant for ongoing cognition. Considerable evidence suggests that active-deletion occurs for categorical representations, but whether it also occurs for recall of features that are typically bound together in an object, such as line orientations, is unclear. In two experiments, with or without binding instructions, healthy young adults maintained two orientations, focused attention to recall the orientation cued first, and then switched attention to recall the orientation cued second, at which point the uncued orientation was no longer relevant on the trial. In contrast to the active-deletion hypothesis, the results showed that the no-longer-relevant items exerted the strongest bias on participants' recall, which was either repulsive or attractive depending on both the degree of difference between the target and nontarget orientations and the proximity to cardinal axes. We suggest that visual WM can bind features like line orientations into chunked representations, and an irrelevant feature of a chunked object cannot be actively deleted - it biases recall of the target feature. Models of WM need to be updated to explain this and related dynamic phenomena.