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Possible brain biomarker found in teens with psychotic-like experiences

Teenagers with elevated levels of psychotic-like experiences while engaging in a reward processing task showed differential activation in frontostriatal brain areas compared with control adolescents, data published in JAMA Psychiatry revealed.

“Late adolescence is a critical neurodevelopmental period in psychosis, with the classic age at onset being in early adulthood,” Evangelos Papanastasiou, MD, from the department of psychosis studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, and colleagues wrote. “Psychotic-like experiences offer a useful, nonclinical phenotype to study psychotic disorders with the advantages of a lack of exposure to the illness and antipsychotic medication, a critical phase of neurodevelopment for psychosis in drug-naive individuals.”

In this community-based cohort study, which utilized both a cross-sectional and longitudinal design, researchers assessed the neuroimaging profiles of more than 1,000 teens with psychotic-like experiences at age 14 years and 19 years as they performed a monetary incentive delay reward task. The investigators also included two subgroups of youth who scored as either high or low psychotic-like experiences on the Community Assessment of Psychic Experiences Questionnaire at age 19.

The first-level analysis focused on two predefined contrasts of anticipation and feedback of a win, and the second-level model examined activation within the reward network using an a priori–defined region of interest approach. They evaluated main effects of group, time and their interaction on brain activation.

The authors compared 1,434 teenagers and two subgroups of 149 youth who scored as high psychotic-like experiences and 149 who scored as low psychotic-like experiences at ages 14 years and 19 years. Analysis revealed a main effect of time on brain activation in two regions within the left and right middle frontal gyri (P = .02 and P = .03) from ages 14 years to 19 years. One brain region within the right middle frontal gyrus indicated a significant time/group interaction (P = .01).

“Our longitudinal studies confirmed the involvement of three frontal areas, showing hypoactivation in the high [psychotic-like experiences] group at age 14 years, which also manifested higher levels of activation at 19 years,” Papanastasiou and colleagues wrote. “This change might represent the outcome of a corrective mechanism, targeting brain areas with an activation deficit at an early phase.” – by Savannah Demko

Disclosures: Papanastasiou reports support from a National Institute for Health Research, Biomedical Research Council Clinical Disorder Pilot Funding Award (2012-2013) and an NIHR Collaboration for Leadership in Applied Health Research and Care South London fee support award (2015-2016). He is also employed by Lundbeck. Please see the study for all other authors’ relevant financial disclosures.