50 Therapy and Medication Use Moderating Neural Alterations Underlying Social Cognition Performance in Youth with Autism and Psychosis

Abstract

Objective:

Individuals with Autism Spectrum Disorder (ASD) or Early-Onset Psychosis (EOP) both experience substantial difficulties with social cognition (Spek et al. 2012; Lanillos et al. 2020); however, the impact of therapy and medication use on their social cognition has not yet been examined (Lai et al. 2014; Schiffman et al. 2018). This project will explore the effects of the history of therapy and medication use as moderating variables between neural architecture and social cognition performance.

Participants and Methods:

T1-weighted imaging data were acquired on a 3T Siemens scanner for 51 ASD and EOP participants (Mean Age = 16.33), with 41 individuals endorsing history of therapy and 23 endorsing history of medication use across groups. Cortical thickness was calculated using FreeSurfer imaging analysis software (v5.3; Fischel et al., 2002) for social brain regions including inferior parietal lobe (IPL), middle temporal lobe (MPL), caudal anterior cingulate cortex (cACC), rostral anterior cingulate cortex (rACC), fusiform gyrus, precuneus cortex, and insular cortex. The Awareness of Social Inference Test (TASIT; McDonald et al., 2006) was administered to assess social cognition performance. After controlling for individuals that had a history of both therapy and medication use, Pearson's correlations were utilized to examine the relationship between cortical thickness and social cognition performance in ASD and EOP patients. The PROCESS Procedure moderation analysis in SPSS was utilized to determine if history of therapy or medication use moderated the relationship between cortical thickness and social cognition performance (Hayes, 2018).

Results:

Across groups, there was a negative association between an individual's cACC thickness and TASIT Do score (r = -.415, p = .005) as well as the total TASIT score (r = -.325, p = .031). Additionally, there was a positive association between an individual's precuneus cortical thickness and their TASIT Say score (r = .440, p = .003). Results of the moderation analyses revealed that lack of medication use was associated with greater rACC thickness and higher TASIT Say score (R² Change = .1281 mm, p = .0191). Additionally, lack of past therapy experience was associated with greater insular thickness and higher TASIT Think scores (R² Change = .1957 mm, p = .0033). Conversely, past therapy history was associated with greater fusiform gyrus thickness and higher TASIT Say score (R² Change = .1115 mm, p =.0262).

Conclusions:

Our results suggest that for individuals without a history of therapy or medication use, higher cortical thickness of the rACC and insula support better social cognition performance; whereas for individuals with past therapy experience, higher cortical thickness of the fusiform cortex underlies better social cognition performance. Collectively, these findings suggest that an individual's history of therapy or medication use may be relevant variables to consider when examining the relationship between neural cortical thickness and social cognition performance in these neuropsychiatric conditions.