Cingulo-opercular network efficiency mediates the association between psychotic-like experiences and cognitive ability in the general population.

BACKGROUND: Psychosis is hypothesized to occur on a spectrum between psychotic disorders and healthy individuals. In the middle of the spectrum are individuals who endorse psychotic-like experiences (PLEs) that may not impact daily functioning or cause distress. Individuals with PLEs show alterations in both cognitive ability and functional connectivity of several brain networks, but the relationship between PLEs, cognition, and functional networks remains poorly understood.

METHODS: We analyzed resting-state fMRI data, a range of neuropsychological tasks, and questions from the Achenbach Adult Self Report (ASR) in 468 individuals from the Human Connectome Project. We aimed to determine whether global efficiency of specific functional brain networks supporting higher-order cognition (the fronto-parietal network (FPN), cingulo-opercular network (CON), and default mode network (DMN)) was associated with PLEs and cognitive ability in a non-psychiatric sample.

RESULTS: 21.6% of individuals in our sample endorsed at least one PLE. PLEs were significantly negatively associated with higher-order cognitive ability, CON global efficiency, and DMN global efficiency, but not crystallized knowledge. Higher-order cognition was significantly positively associated with CON and DMN global efficiency. Interestingly, the association between PLEs and cognitive ability was partially mediated by CON global efficiency and, in a subset of individuals who tested negative for drugs (N=405), the participation coefficient of the right anterior insula (a hub within the CON).

CONCLUSIONS: These findings suggest that CON integrity may represent a shared mechanism that confers risk for psychotic experiences and the cognitive deficits observed across the psychosis spectrum.