Is Cognitive Training Neuroprotective in Early Psychosis?

The current protocol seeks to examine whether cognitive training can prevent accelerated gray matter loss and promote changes in the functional connectome in first-episode psychosis patients. Specifically, we aim to use Prisma 3T and 7T imaging to examine functional, structural, and diffusion weighted images to determine whether these treatments can influence neural plasticity. Scanning will be done at the Center for Magnetic Resonance Research (CMRR) at the University of Minnesota. Participants will complete three approximately one-hour scanning sessions on the 3T Siemens Prisma scanner and three approximately one-hour scanning sessions on the 7T-AS scanner. We aim to use scan sequences compatible with the Human Connectome Project both for purposes of cross collaboration and data sharing.

This study will seek to enroll 80 participants. 60 participants will be considered First Episode Psychosis (FEP) patients, meaning that they have been diagnosed with a psychotic illness and have started receiving treatment at a First Episode Psychosis clinic (following the NAVIGATE model) within the last two years prior to enrollment. These participants will be recruited from a separate study protocol conducted by Dr. Sophia Vinogradov which examines remote cognitive training in FEP subjects (Minnesota Community-Based Cognitive Training in Early Psychosis, NCT03079024). 20 of these participants will receive treatment as usual (TAU), 20 will be assigned to Targeted Cognitive Training (TCT), and 20 will be assigned to Generalized Cognitive Exercises (GCE). Additionally, the investigators will enroll 20 healthy, age and gender matched controls (HC). All participants will undergo one 7T MRI and one Prisma scan at three time points: Baseline; Post-Intervention/12-weeks; and 6 month follow up.

The three 3T scan sessions will be matched as closely as possible, given hardware limitations, to the HCP 3T imaging protocol described here: http://protocols.humanconnectome.org/HCP/3T/imaging-protocols.html. This will include ~16 minutes of 3D structural imaging using MP-RAGE and T2-weighted scans, ~14 minutes of resting state fMRI relying on a gradient-echo EPI sequence, and 18 minutes of diffusion weighted MRI relying on a spin-echo EPI sequence. Scan parameters for acquisitions will seek to match the HCP Lifespan data acquired to date on the CMRR Prisma 3T.

For 7T scans, we will collect a standard T1-weighted MP2-RAGE structural scan, 12 minutes of resting fMRI using standard gradient-echo EPI sequences, and a diffusion-weighted DTI sequence compatible both with HCP and 7T-AS hardware. To maximize use of high-resolution imaging techniques while balancing ease of access and use, we aim to use the Siemens 7T-AS scanner with the NOVA 32-Channel head coil optimized for both structural and functional imaging.

Specific Aims