# The Contribution of Parasympathetic Arousal-Related Thalamocortical Activity to Attention and Cognition in First Episode Psychosis

> **NIH NIH R21** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $460,625

## Abstract

ABSTRACT
Recent research suggests that the Autonomic Nervous System (ANS), which plays a role in arousal and
wakefulness, is likewise important for attention and cognitive functions. While key circuits involved in these
functions have long been implicated in the pathophysiology of psychosis, the mechanism linking the ANS to
cognitive impairment in psychosis is lacking. Stress triggers a shift in the balance between the
parasympathetic and sympathetic nervous systems. We propose that stress-induced ANS imbalance alters
arousal-related brain circuitry and constitutes a key component of the pathophysiology underlying cognitive
impairment in psychosis. In the current proposal, we combine functional Magnetic Resonance Imaging (fMRI)
with peripheral physiological recordings to examine on-going fluctuations in arousal-related cortical activity
associated with trial-to-trial fluctuations in cognitive task performance in patients with First Episode Psychosis
(FEP).
ANS arousal-related brain circuitry will be interrogated in a well-characterized cohort of 40 medication naïve
patients with FEP and 40 matched controls. Biological samples and questionnaires assessing current and
chronic stress levels will be collected to test whether ANS arousal-related cortical activity mediates the
relationship between stress and cognitive impairment in FEP. ANS function will be well-characterized both in-
scanner and out-of-scanner (biological samples, electrocardiogram, pulse-oximetry). Resting-state fMRI and
two well-validated fMRI tasks will be employed to probe key cognitive circuitry that is aberrant in FEP in order
to assess how ANS arousal-related activity impacts different cognitive abilities. Psychotic symptomatology
(hallucinations, delusions, and thought disorder) and cognitive abilities will be measured using comprehensive
batteries. Potentially confounding factors (e.g. diurnal rhythms, caffeine use, drug use, medication status) will
be controlled for. We aim to establish a novel pathway in the neurobiology of cognitive impairment associated
with psychosis, which will provide important insight into the pathophysiology of psychosis and potentially yield
novel therapeutic targets.

## Key facts

- **NIH application ID:** 9957865
- **Project number:** 1R21MH122886-01
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Anita Dyan Barber
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $460,625
- **Award type:** 1
- **Project period:** 2020-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9957865

## Citation

> US National Institutes of Health, RePORTER application 9957865, The Contribution of Parasympathetic Arousal-Related Thalamocortical Activity to Attention and Cognition in First Episode Psychosis (1R21MH122886-01). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9957865. Licensed CC0.

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