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Neuroimaging may indicate risk for worsening mood, psychosis in adolescence

Abnormal neural responses at age 14 years may predict mood fluctuations and psychotic experiences at age 16 years among youth who report psychotic-like experiences.

“Studying young adolescents prone to [psychotic-like experiences] will help to identify etiologic processes implicated in psychosis proneness, without the confounds of diverse risk factors and iatrogenic effects, such as substance misuse, medication, and social impairment,” Josiane Bourque, MSc, of Université de Montréal, and colleagues wrote. “Investigating the neural correlates of this preclinical psychosis proneness during cognitive functioning can shed light on early altered neural processes prior to significant cognitive impairments.”

To assess functional neuroimaging predictors of psychotic symptoms reported among adolescents, researchers measured functional imaging responses to stop-signal, monetary incentive delay and face tasks among individuals at age 14 years. Participants reported psychotic-like experiences at baseline and were matched with controls. Brain activity differences were used to predict psychotic symptoms at age 16 years. The full sample included 1,196 youths and the subsample included 246 youths.

Participants who reported psychotic-like experiences exhibited increased activity in the hippocampus/amygdala during processing of neutral faces and decreased activity in the dorsolateral prefrontal cortex during failed inhibition.

When controlling for baseline psychotic-like experiences and cannabis use, hyperactivation in the hippocampus/amygdala was the most significant difference between participants with mood fluctuation and psychotic symptoms and controls with and without mood fluctuations and no psychotic symptoms.

“The results of the present study suggest that an aberrant neural response to nonsalient stimuli may be an important early vulnerability marker for psychosis, at least in the context of mood fluctuations,” the researchers wrote. “These findings might help to guide early intervention strategies for at-risk youth. It has yet to be determined whether individual differences in emotional reactivity to nonsalient stimuli can be modified in young adolescents and whether such modifications have any clinical significance for high-risk youth.” – by Amanda Oldt

Disclosure: Bourque reports receiving support from a doctoral fellowship from the Canadian Institutes of Health Research. Please see the study for a full list of all relevant financial disclosures.