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Neuroimaging defines patterns of dysfunction in youth psychosis symptoms

Symptoms of psychosis spectrum in youths are associated with executive circuit hypoactivation during working memory and with amygdala hyperactivation when patients process threatening emotional expressions, according to data.

“Evaluation of these two categorical effects revealed significant within-group heterogeneity,” Daniel H. Wolf, MD, of the department of psychiatry in the Perelman School of Medicine at the University of Pennsylvania, and colleagues wrote. “Executive hypofunction was related to cognitive deficits but not to symptom severity, while amygdala hyperfunction showed the reverse pattern.”

Wolf and colleagues included 1,445 patients (aged 11 to 22 years) from the Philadelphia Neurodevelopmental Cohort – a genotyped sample of nearly 10,000 youths who underwent psychiatric evaluation and a computerized neurocognitive test, between November 2009 and November 2011. They were categorized as having features of psychosis spectrum (n = 260) or youth without significant psychopathology (n = 220), according to data.

Results showed that working memory led to less activation in the psychosis group compared with the control group throughout the executive control circuitry, including dorsolateral prefrontal cortex (P < .05), the researchers wrote.

The activation of the dorsolateral prefrontal cortex in the psychosis group also correlated with cognitive deficits (P < .001), they added. However, they found no link to positive symptom severity.

Those in the psychosis group also demonstrated greater responses to threatening facial expressions in amygdala and left fusiform cortex and right middle frontal gyrus (P < .05), when researchers identified patients’ emotions.

Interestingly, this response in the amygdala was linked to positive symptom severity (P = .01), but not cognitive deficits, they wrote.

“Therefore, our findings help define patterns of neural dysfunction associated with [psychosis spectrum] at an earlier age, a critical step toward developing interventions that might bend the curve of disease trajectory and permit primary prevention of schizophrenia and other adverse long-term outcomes associated with [psychosis spectrum],” they wrote. – by Samantha Costa

Disclosure: The researchers report no relevant financial disclosures.