Brain Network Resilience and Cognitive Function in Patients With First-Episode Schizophrenia Spectrum Disorders

Background First-episode schizophrenia spectrum disorders (FESSDs) are associated with significant cognitive impairment that affects daily functioning. While these deficits are well documented, the neural mechanisms underlying the cognitive impairment in FESSDs remain limited. Because the structure robustness and resilience of the brain network in healthy populations are reported to be associated with cognitive function, we examined these associations in patients with FESSDs. Methods In this study, we investigated the relationships of the structure robustness and resilience of the core brain network with cognitive function and psychopathology in patients with FESSDs ( n = 340) using data from 2 independent cohorts in South Korea and China. Age- and sex-matched healthy control (HC) participants ( n = 420) were also recruited. We applied advanced k-shell decomposition techniques to functional brain networks and estimated various measures of structure robustness and resilience. Results Patients with FESSDs had brain networks with a less robust structure and resilience than those of HC participants. Resilience measures were positively correlated with executive function in patients. Core brain network structure and k-core resilience were negatively correlated with Positive and Negative Syndrome Scale scores. Subgroup analysis showed that structure robustness and resilience at each site matched the main analysis, but correlations with cognitive function and psychopathology were observed only in the South Korea cohort. Conclusions Better preservation of brain network structure and resilience is associated with higher cognitive function and milder clinical symptoms in patients with FESSDs. This highlights potential targets for therapeutic interventions aimed at enhancing cognitive function and improving the symptoms of patients with FESSDs.