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Brain abnormalities associated with psychosis present at a young age

Recent findings suggest that brain abnormalities associated with psychosis are present at a young age before clinical high-risk symptoms are typically identified.

“Based on the early age at onset and convergent evidence from animal models, psychosis is increasingly conceptualized as a downstream product of abnormal neurodevelopment. A better understanding of the developmental antecedents of psychosis may lead to both early identification and novel targeted interventions,” Theodore D. Satterthwaite, MD, MA, of the Perelman School of Medicine, University of Pennsylvania, and colleagues wrote.

To determine the presence of structural brain abnormalities in youth with psychosis spectrum symptoms, researchers assessed data from the Philadelphia Neurodevelopmental Cohort for 791 youth who completed a structured psychiatric evaluation and underwent neuroimaging. Participants, aged 8 to 22 years, were identified as having psychosis spectrum features (n = 391) or typically developing comparison individuals without significant psychopathology (n = 400).

Youth with psychosis spectrum symptoms exhibited decreased whole-brain gray matter volume and expanded white matter volume compared with typically developing youth.

Voxelwise analysis indicated significantly lower gray matter volume in the medial temporal lobe and in the frontal, temporal and parietal cortex.

Reduced volume in the medial temporal lobe was associated with psychosis spectrum symptom severity, according to researchers.

“These results establish that community youth with [psychosis spectrum] symptoms have patterns of structural brain abnormalities similar to those seen in clinically ascertained samples. Together with recent reports from this sample regarding cognitive deficits, reduced executive activation, exaggerated amygdala threat responsivity, and functional network disconnectivity in youth with [psychosis spectrum] symptoms, these findings suggest that brain abnormalities are associated with [psychosis spectrum] symptoms at a young age before clinical high-risk symptoms are typically identified. Such deficits are not dependent on disease chronicity or the confounding influence of psychotropic medication,” the researchers wrote. “Moving forward, development of data-driven analytic techniques to parse heterogeneity within the psychosis spectrum will accelerate translation to clinical practice.” – by Amanda Oldt

Disclosure: Satterthwaite reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.