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Deconstructing psychosis with human brain imaging.

Raquel E Gur1, Matcheri S Keshavan, Stephen M Lawrie

  • 1Department of Psychiatry, University of Pennsylvania 10 Gates, 3400 Spruce Philadelphia, PA 19104, USA. raquel@bbl.med.upenn.edu

Schizophrenia Bulletin
|June 6, 2007
PubMed
Summary
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Neuroimaging reveals brain differences in psychosis, including reduced volumes and altered neurotransmitter levels in schizophrenia. More research is needed to compare disorders and make brain imaging clinically relevant.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Current knowledge on the neurobiology of psychosis is synthesized from in vivo brain-imaging studies.
  • Evidence primarily includes studies on schizophrenia, with fewer on bipolar disorder, lacking direct comparisons and cross-method integration.

Purpose of the Study:

  • To review and synthesize current neuroimaging findings on psychosis.
  • To identify replicated findings and areas needing further investigation for clinical relevance.

Main Methods:

  • Systematic review of hundreds of in vivo brain-imaging studies.
  • Analysis of structural and functional imaging data in patients with schizophrenia and bipolar disorder.

Main Results:

Related Experiment Videos

  • Replicated findings in schizophrenia include reduced brain and hippocampal volume, reduced N-acetyl aspartate, dopamine D(2) receptor upregulation, and altered frontal-temporal activation.
  • These neurobiological alterations are not medication-related but their specificity across the psychosis spectrum is unclear.
  • Associations between psychotic symptoms, cognitive impairment, and imaging findings are replicated in schizophrenia but not yet in bipolar disorder.

    • Conclusions:

    • Current diagnostic categories for psychosis should be maintained due to limited direct comparisons between disorders.
    • Further research requires standardized approaches, sufficient statistical power, and longitudinal studies to make neuroimaging clinically relevant for deconstructing psychosis.