According to an international team led by neuroscientists at the University of Pittsburgh Medical School and Maastricht University in the Netherlands, subtle differences in the shape of the brain that are present in adolescence are linked to the development of psychosis.
In the results published in the journal JAMA Psychiatry, the differences are too subtle to be seen in a person or used for diagnostic purposes.
However, the results could contribute to ongoing efforts to develop a cumulative risk score for psychosis that enables earlier detection and treatment, as well as targeted therapies. The discovery was made with the largest summary to date of brain scans in children and young adults who were psychiatric assessed to be at high risk of developing psychosis.
“These results were in some ways sobering,” said Dr. Maria Jalbrzikowski, Assistant Professor of Psychiatry at Pitt.
“On the one hand, our dataset includes 600 percent more high-risk adolescents who developed psychosis than any existing study, so we can see statistically significant results in brain structure. But the variance between developing a high-risk adolescent or not. The psychosis is so small that it is impossible to tell a difference on an individual level. More work is needed to translate our results into clinical care, “added Maria.
Psychosis is an umbrella term for a constellation of severe mental disorders that cause people to have difficulty determining what is real and what is not. Most of the time, people have hallucinations where they see or hear things that others don’t.
You may also have strong beliefs or delusions, even if most people don’t believe them. Schizophrenia is just a psychosis-related disorder, and psychotic symptoms can appear with other psychiatric disorders, such as bipolar disorder, depression, body dysmorphic disorder, or post-traumatic stress disorder.
There is great heterogeneity in outcomes over time in people diagnosed with psychosis.
Diagnosis is usually made in later adolescence and early adulthood. Most often, however, symptoms manifest in their teens, when doctors can use psychological assessments to determine a person’s risk of developing full blown psychosis.
Jalbrzikowsi and Dennis Hernaus, PhD, Assistant Professor at the Faculty of Mental Health and Neuroscience at Maastricht University, are co-chairs of the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA) group for clinically high risk of psychosis.
This group combined structural magnetic resonance imaging (MRI) scans from 3,169 volunteer participants with an average age of 21 years, who were recruited at 31 different institutions. About half – 1,792 of the participants – were at “clinically high risk of developing psychosis”.
Of these high-risk participants, 253 developed psychosis within two years. The Co-Chairs emphasized that this study would not be possible without the collaboration of over 100 researchers involved.
Looking at all of the scans together, the team found that those at high risk of psychosis had widespread lesser cortical thickness, a measure of the thickness of the brain’s gray matter. In high-risk children who later developed psychosis, a thinner cortex was most pronounced in several temporal and frontal regions.
Everyone goes through a cortical thinning process as they grow into an adult. However, the team found that younger participants between the ages of 12 and 16 who developed psychosis had the thinning already present. These high-risk children who developed psychosis also developed more slowly than the control group.
“We don’t know exactly what this means yet, but puberty is a critical time in a child’s life – it’s a time of opportunity to take risk and explore, but also a time of vulnerability,” said Jalbrzikowski.
“We could see the result of something that happened earlier in brain development, but only at this stage of development does it begin to affect behavior.”
Hernaus stressed that these results underscore the importance of early detection and intervention in people who have risk factors for developing psychosis, including whispering voices that are not there and a family history of psychosis.
“So far, researchers have primarily studied how the brain of people with a clinically high risk of psychosis differs at a particular point in time,” said Hernaus. “An important next step is to better understand brain changes over time, which could provide new clues about underlying mechanisms relevant to psychosis.”
This story was published by a wire agency feed with no changes to the text. Only the heading was changed.
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