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Progressive brain structural changes mapped as psychosis develops in 'at risk' individuals.

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Brain volume loss in the prefrontal cortex occurs as individuals transition to psychosis. This finding highlights ongoing pathological brain changes during the onset of psychosis.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Brain Imaging

Background:

  • Schizophrenia and related psychoses are linked to brain structural abnormalities.
  • Progressive brain changes precede psychosis onset in at-risk populations.
  • Cortical changes in prefrontal and temporal regions are seen in first-episode schizophrenia.

Purpose of the Study:

  • To investigate if structural changes in the cerebral cortex occur with psychosis onset.
  • To determine the timing and extent of cortical changes relative to psychosis emergence.
  • To test the hypothesis of progressive prefrontal volume loss during the transition to psychosis.

Main Methods:

  • Longitudinal structural MRI study of 35 individuals at ultra-high risk (UHR) for psychosis.
  • 12 of the 35 UHR individuals experienced psychotic onset within 1 year (converters).
  • Cortical Pattern Matching used to assess longitudinal brain surface contractions from T1-weighted MR images.

Main Results:

  • Significantly greater brain contraction observed in the right prefrontal region of converters.
  • Comparison made between converters and UHR non-converters.

Conclusions:

  • Cortical volume loss is associated with the onset of psychosis.
  • Ongoing pathological processes occur during the transition to psychosis.
  • Prefrontal volume loss aligns with known schizophrenia abnormalities, suggesting a key role in psychosis development.