The BAsic NeuroCognitive Continuum (BANCC): Delineation of dimensional and categorical features for etiological and treatment investigations of idiopathic psychosis.

AIM: Cognition varies across people with psychosis, including within a specific diagnosis. An important issue is identifying psychosis-specific neuro-cognitive dysfunctions. We addressed this issue by studying patterns of relationships between cognition and multiple other measures in persons with psychosis, their first-degree biological relatives, and healthy individuals (largest possible n = 2826).

METHODS

Brief Assessment of Cognition and Wide Range Achievement Test estimated cognitive performance. Neuroanatomical measures were FreeSurfer parcellations of 3T MRI structural brain scans. Brain functioning measures included saccades, smooth pursuit eye movements, stop signal, EEG, ERPs, resting state fMRI, plus clinical characteristics. Overall associations between 452 measures of brain structure-function and clinical characteristics (predictors) with cognitive performance (criterion) were estimated using the High Dimensional Empirical Bayes Screening algorithm.

RESULTS

The model yielded a common slope of predictors on cognitive performance (slope = 0.18, r = 0.33, P < 0.001). The majority (85%) of predictors fit this function, called the BAsic NeuroCognitive Continuum (BANCC). This relationship was stronger for psychosis probands (slope = 0.20, r = 0.38) than for relatives (slope = 0.09, r = 0.17) and healthy persons (slope = 0.11, r = 0.22). There were predictor-specific deviations from the common slope. Variables more strongly associated with cognitive performance (frontal-temporal-parietal lobe volumes, hippocampal regions, antisaccade performance) may tap neural architecture common to primary psychosis pathology. Variables unrelated to cognitive performance (intrinsic neural activity, volumes of lateral thalamic nuclei) distinguish specific neurophysiologically defined B-SNIP psychosis Biotypes and may capture signatures of psychosis pathophysiology.

DISCUSSION: BANCC is identifiable across humans, but deviations from that common attribute identify features of brain structure-function perhaps most central and specific to psychosis-related pathophysiology.